Source: The Conversation – UK – By Joseph Freer, Academic Clinical Fellow, Population Health, Queen Mary University of London
For a health service long defined by waiting lists, staff shortages and steady erosion of public confidence, the latest figures offer something unfamiliar: a sense that the mood is shifting. A new survey by The King’s Fund and Nuffield Trust records a six-point increase in satisfaction, and the sharpest fall in dissatisfaction with the NHS since 1998.
Puzzlingly, while overall satisfaction rose, there was no corresponding rise in satisfaction with each individual NHS service: GPs, A&E, dentistry and hospital care. There are two possible explanations for this.
The first explanation is that services did genuinely improve, but the survey simply did not poll enough people about each individual service to reliably detect small improvements.
There are some tentative signs that the NHS may be improving. Hospital waiting lists fell by around 200,000 in the year following the 2024 general election – down from a record high of 7.8 million in 2023. GP appointments have risen by 8.3 million in the past year.
But the picture is uneven. In October 2025, waits of over four weeks for GP appointments were at a record 4.1 million, and 12-hour waits in A&E hit an all-time high in January 2026.
A report from the Health Foundation suggested that the drop in waiting lists isn’t only because hospitals are treating more patients. Instead, some of the decrease may be because patients are being taken off the list for administrative reasons, such as missing appointments, rather than actually receiving treatment.
The second explanation is that the NHS has not shifted, but the political context has. A study of 21 European countries found that patients’ actual experiences of care only explain about 10% of how satisfied they are with the health system. Most of how people feel about the health system is influenced by things outside it, like what they expect, the political climate and what they see in the media.
In a study published in the BMJ, researchers tracked how the NHS was reported in the media between August and November 1991. During that time, overall public dissatisfaction dropped by almost eight percentage points, even though the services hadn’t really changed.
Dissatisfaction with individual services did not change over that period. The researchers’ explanation was that people answer questions about specific services, such as A&E, on the basis of their personal experience. But a general question about the NHS as an institution additionally draws on political views, social attitudes and media coverage. In this case, a new policy called the Patient’s Charter changed how the media talked about the NHS. Waiting lists, which used to be reported as a sign of crisis, were now presented as targets the government was trying to improve.
A similar shift in the wider context happened between 2024 and 2025. In 2024, the survey was conducted just after the election, when health secretary Wes Streeting said the NHS was “broken”. Experts at the Nuffield Trust and the King’s Fund suggested this negative message may have stopped the usual boost in public satisfaction that often follows a new government.
By contrast, the 2025 survey took place just after the government published its new ten-year NHS plan, when the tone had shifted from talking about a “broken” system to focusing on fixing and improving it.
A change in context, not in care
Sharp rises and falls in satisfaction in the wake of political announcements have multiple precedents. When the coalition government’s health and social care bill attracted intense critical media coverage in 2011, satisfaction fell 12 points in a single year, which was widely attributed to public anxiety about the reforms.
Conversely, in 2019, satisfaction jumped from 53% to 60%, despite worsening waiting times and staff shortages. The Nuffield Trust and King’s Fund concluded the rise was probably due to the announcement of a funding settlement worth an extra £20.5 billion per year, which had received substantial media coverage throughout 2019.
The increase in satisfaction in the 2025 survey was statistically significant (in other words, unlikely to be due to chance) among Labour and Liberal Democrat voters, but not among supporters of the Conservatives or Reform. This pattern is also not new.
Following the 1997 election, the first survey afterwards recorded an eight percentage point rise in satisfaction, driven disproportionately by Labour voters’ views. It was hard to attribute such a rapid rise in satisfaction to anything the NHS had actually done in the time since Labour took office. Indeed, that bounce faded within two years.
Satisfaction only began its sustained rise when substantial investment reached frontline services in the early 2000s, eventually peaking at 70% in 2010 – the highest in the survey’s history, and 44 percentage points above this year’s figure.
These two explanations may have operated together. But the weight of the evidence – a Labour voter-concentrated improvement, individual service satisfaction that has remained at historic lows, and a fall in dissatisfaction of precisely the scale the 1991 research attributes to media framing – points more towards a change in context than a change in care.
That distinction matters. A shift in public mood, however welcome, does nothing for the person waiting 18 months for a hip replacement, or unable to get through to their GP. The survey measures how people feel about the NHS. It says less about what the NHS is doing for their health.
Joseph Freer receives funding in the form of salary from the NHS and Queen Mary University of London. He was previously funded by the National Institute for Health and Care Research.
– ref. NHS dissatisfaction is falling – is this a turning point or is something else at play? – https://theconversation.com/nhs-dissatisfaction-is-falling-is-this-a-turning-point-or-is-something-else-at-play-279385