The public and the NHS

Dan WellingsSenior Fellow@danwellings

2

Issues Facing Britain: Long Term Trends

Base: representative sample of c.1,000 British adults age 18+ each month, interviewed face-to-face in home

What do you see as the most/other important issues facing Britain today?

Source: Ipsos MORI Issues Index

0

10

20

30

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70

May1997

May1998

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May2009

May2010

May2011

May2012

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May2017

NHS UNEMPLOYMENTCRIME/LAW & ORDER ECONOMY IMMIGRATION EU/BREXIT

Where will this go next?

0

10

20

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80

1983

1984

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2016

Very and quite satisfied

Very and quite dissatisfied

Neither satisfied nor dissatisfied

63% in 2016

Q. All in all, how satisfied or dissatisfied would you say you are with the way in which the National Health Service runs nowadays?

Base: Between 1,096 and 3,358 British adults, aged 18+ Source: NatCen British Social Attitudes survey

34% in 1997

Whilst support to maintain the NHS has remained constant

Source: DH/Ipsos MORI polling2017: King’s Fund/Ipsos MORI polling

Q. Which of the following statements best reflects your thinking about the NHS?

Base: c. 1,000 English adults, 15+, August 2017 polling conducted face-to-face

7975 77 78

73 75 77 78 77 76 74 7773 74 77

1923 20 20

25 22 21 20 21 21 23 2125 23 23

2 1 2 2 2 3 3 2 1 2 2 2 3 3 0

The NHS is crucial to Britishsociety and we must doeverything to maintain it

The NHS was a great project but we probably can’t maintain it in its current form

Don’t know

% of adults

Widespread support for the founding principles of the NHS

62%

65%

67%

26%

20%

23%

8%

10%

6%

3%

5%

3%

1%

The NHS shouldbe primarily

funded throughtaxation

The NHS shouldprovide a

comprehensiveservice available

to everyone

The NHS shouldbe free at the

point of delivery

Definitely Probably Probably should not Definitely not Don't know

Source: The King’s Fund/Ipsos MORI

Q. For each of the following statements, please tell me the extent to which you think the principle should still apply to NHS services today.

Base: 1,151 English adults, aged 15+, conducted face-to-face in August 2017

91%

85%

88%

9%

15%

11%

Public willing to pay more in tax to maintain current NHS services

62%19%

12%6%

Source: The King’s Fund/Ipsos MORI

Q. Many experts argue that it is becoming more expensive to fund the NHS because of increasing costs of treatments …. This means that even in order to maintain the current level of care and services, spending on the NHS would have to increase. With that in mind, which, if any, of the following would you most like to see?

Bases on chart, aged 15+, conducted face-to-face in August 2017

HALF SAMPLE (583):Increase taxes in order to maintain the level of spending needed

Reduce spending on other services such as education and welfare

Reduce the level of care and services provided by the NHS

66%

20%

10%5%

HALF SAMPLE (568): I would be willing to pay more taxes in order to maintain the level of spending needed

None

Local versus national

Two thirds think treatments should be available to everyone – and not just based on local need

4

23

73

4

28

67

2

31

67

Don't know

The availability of NHS treatments and servicesshould be based on local need rather than a 'one size

fits all' approach across the country

Treatments and services should only be available onthe NHS if they are available to everyone and not

dependent on where you live

2017

2011

2008

Source: SMF/ Ipsos MORI (2008)Nuffield Trust / Ipsos MORI (2011)King’s Fund / Ipsos MORI (2017)

Q. Thinking about the treatments and services that are available on the NHS, which of these statements most closely matches your opinion?

Base: c. 1,000 English adults, interviewed face-to-face, February 2011 and August 2017

Decision-making

Who should be making decisions?

5

20

54

20

1

14

56

29

2017 2008

Source: 2017: King’s Fund / Ipsos MORI2008: SMF/ / Ipsos MORI

Q. And thinking of how decisions about treatments and services should be made, which of these statements most closely matches your opinion?

Base: c. 1,000 English adults, interviewed face-to-face, August 2017

Decisions about which NHS treatments and services are available should be made solely by qualified health professionalsand not the general public

The public should be consulted on decisions shaping which NHS treatments and services should be available but the final decisions should be made by qualified health professionals

The general public should be much more actively involved in shaping which NHS treatments and services are available, e.g. deciding local priorities and allocating budgets

Don’t know

Rising patient expectations?

Majority think that people’s expectations of the NHS are realistic

8%

55%

30%

6%2%

Very realistic

Fairly realistic

Not very realistic

Not at all realistic

Don't know

Source: The King’s Fund/Ipsos MORI

Q. How realistic, if at all, would you say people's expectations are of the service they should get from the NHS?

Base: 1,151 English adults, interviewed face-to-face, August 2017

63%36%

Majority think NHS meets or exceeds expectations

20%

53%

18%

8% 1%Exceed expectations

Are about what youexpect

Fall short ofexpectations

I don't have anyexpectations

Don't know

73% meets/exceeds expectations

Source: The King’s Fund/Ipsos MORI

Q. And thinking generally about what you expect of NHS services, would you say they... ?

Base: 1,151 English adults, interviewed face-to-face, August 2017

New ways of working together - opportunities

Opportunity in new systems to share insight and understanding about populations

Where we come from and where public comes from are often different places

Healthcare system• Ageing population• Rising demand• Increasing

expectations• New technologies• Integration

Public› Waste › Immigration › Postcode lottery› Treating the wrong

people › Staff under

pressure

Questions…

• Is our support for the NHS a barrier to change?

• How does the NHS manage the local versus national question?

• What is the right model for decision-making?• Who do patient groups represent? • Are our expectations of the NHS too low?• How can we understand people better?