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Government ‘needs to listen’, doctors say, as satisfaction with GP services plummets

Government ‘needs to listen’, doctors say, as satisfaction with GP services plummets
By Anna Colivicchi
30 March 2023

The BMA has urged the Government to ‘listen’ as the public’s satisfaction with GP services has dropped to its lowest-ever level.

The British Social Attitudes Survey (BSA), published today by the Nuffield Trust and The King’s Fund, found that overall satisfaction with the NHS now stands at 29%, a fall of 7 percentage points from 2021 and the fourth largest year on year drop recorded.

Satisfaction with GP services fell to 35%, down from 38% in 2021, the lowest level recorded since the survey began in 1983 and a decline of more than 30 percentage points since 2019.

The 40th BSA survey was conducted by the National Centre for Social Research (NatCen) in September and October 2022 and is seen as a gold standard measure of public attitudes.

The main reasons people gave for being dissatisfied with the NHS were waiting times for hospital and GP appointments (69%), staff shortages (55%) and a view that the government does not spend enough money on the NHS (50%).

Over two-thirds of respondents (69%) chose long waiting times for GP and hospital appointments as one of the top reasons for dissatisfaction.

The researchers said that the British public now has ‘the lowest level of satisfaction with the NHS’ since the BSA survey began.

A record 40% of respondents also said they were dissatisfied with A&E services, an increase of 11 percentage points from the previous year and the largest increase in a single year since the question on A&E services was introduced in 1999. Only 30% of people said they were satisfied with A&E services.

There were also falls in public satisfaction across all other individual NHS services, including general practice, dentistry, and in-patient hospital services, with all services now reaching record levels of low satisfaction.

Nuffield Trust fellow Jessica Morris, one of the report authors, said: ‘Behind the political upheaval and turmoil playing out at the time of this survey, the British public was sending a message about the worsening situation for the NHS.

‘The fact we have now recorded the lowest level of satisfaction with the NHS in the 40-year history of this gold standard survey is a warning siren. The rate of decline has slowed from the previous year, but that is barely a silver lining given the challenges and impact of the pandemic.

‘The Prime Minister has made recovering the NHS one of his central promises going into the next general election. But these results show what an enormous task this will be.

‘It is clear that the level of unhappiness amongst the British public over the way the NHS is running is going to take many years to recover.’

King’s Fund senior fellow Dan Wellings, another author, said: ‘It is easy to become desensitised to the relentless flow of bad news about struggling health services, but we cannot underestimate the significance of today’s unprecedented results. These stark findings should act as a wake-up call to those in power.

‘In 2010, satisfaction with the NHS stood at a record high of 70%. Yet, satisfaction has now plummeted to its lowest ever level, at just 29%.

‘The public can see for themselves the results of more than a decade of underfunding and a lack of workforce planning.’

Professor Philip Banfield, BMA council chair, said: ‘We have record-low public satisfaction across all parts of the health service, with huge frustrations around long waits for GP and hospital appointments, staffing shortages and underfunding.

‘The public say they want services to be staffed properly, to be able to make a GP appointment more easily, and to see waiting times in A&E and for planned care slashed.

‘And even though staff are trying their absolute hardest – for example GP practices providing far more appointments than they were pre-pandemic despite plummeting GP numbers – improving patients’ experiences relies almost solely on boosting the workforce.

‘And looking at the system as a whole, you cannot reduce waits in secondary care without materially increasing resource in both the ‘front door’ that is general practice and the ‘back door’ that is social care, as well of course, as in hospitals themselves.

‘Yet this Government refuses to listen. It instead imposes a contract on GPs that offers no support to practices, it fails to value doctors with meaningful talks about pay, and a long-awaited and much-needed long-term workforce plan is still nowhere to be seen.

‘Like doctors, the public still strongly believes in and supports the principle of the NHS, but belief is not enough to keep services afloat.’

RCGP chair Professor Kamila Hawthorn said the college shared the patients’ frustrations highlighted in the report.

She said: ‘General practice is the bedrock of the NHS but there are simply not enough GPs or other members of practice staff to deliver the care and services we are trained for – and the impact of this on patients is reflected in today’s report.

‘GPs and our teams make the vast majority of NHS patient contacts and in doing so we reduce pressure across the NHS, including in A&E.

‘Without general practice, the rest of the NHS will collapse, yet the latest data for England shows that numbers of fully qualified, full time equivalent GPs continue to fall – by 852 since 2019, while our workload has risen by 9%. In some areas a qualified GP is now responsible for more than 2,500 patients.

‘The crisis in general practice is not the fault of dedicated GPs, it is a result of decades of underfunding and poor workforce planning.

‘But it is not too late to turn this dire situation around. The forthcoming primary care recovery plan and long-awaited NHS workforce plan will be key opportunities to do this, and we hope they will deliver what is needed to reverse public opinion.

‘The Government must also take steps to cut bureaucracy so that GPs have more time to deliver care to the growing numbers of patients who need it.’

The report’s main findings:

  • The fall in overall satisfaction with the NHS was seen across all ages, income groups, sexes and supporters of different political parties.
  • The main reasons people gave for being dissatisfied with the NHS were waiting times for hospital and GP appointments (69%), staff shortages (55%) and a view that the government does not spend enough money on the NHS (50%).
  • Of those who were satisfied with the NHS, the top reason was that NHS care is free at the point of use (74%), followed by the quality of care (55%) and the range of services and treatments available (49%).
  • There was a jump in the proportion of people who chose improving A&E waiting times as a priority for the NHS, from 38% in 2021 to 47% in 2022, taking improving A&E waits into the top three highest priorities.
  • Satisfaction with GP services fell to 35% in 2022, down from 38% in 2021. This is the lowest level of satisfaction recorded since the survey began. The fall was much less sharp than between 2019 and 2021 when satisfaction fell by 30 percentage points.

This article originally appeared on our sister title, Pulse.

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