Dissatisfaction with the NHS is falling – is it a tipping point or is something else at play?

For a health service defined by long waiting lists, staff shortages and a steady erosion of public confidence, the latest figures suggest something unexpected: a sense that the mood is changing. A new survey by the King’s Fund and Nuffield Trust records a six-point rise in satisfaction, and the sharpest fall in dissatisfaction with the NHS since 1998.

Surprisingly, while overall satisfaction rose, there was not a corresponding increase 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 have indeed improved, but the survey simply did not poll enough people on each individual service to reliably detect small improvements.

There are some short-term signs that the NHS may be improving. Hospital waiting lists fell by around 200,000 a year after the 2024 general election – down from a record 7.8 million in 2023. GP appointments increased by 8.3 million last year.

But the picture is uneven. In October 2025, waiting times of more than four weeks for GP appointments were at a record 4.1 million, and 12-hour waits in A&E reached an all-time high in January 2026.

The Health Foundation report suggested that the reduction in waiting lists is not just because hospitals are treating more patients. Instead, some of the attrition may be that patients are removed from the list for administrative reasons, such as missed appointments, rather than actually receiving treatment.

A second explanation is that the NHS has not changed, but the political context has. A study of 21 European countries found that patients’ actual experiences of care explained only 10% of how satisfied they were with the health system. Much of how people feel about the health system is influenced by things outside of it, such as their expectations, the political climate and what they see in the media.

In a study published in the BMJ, researchers looked at how the NHS was reported in the media between August and November 1991. During that time, the public dissatisfaction rate dropped by almost eight percent, although services did not actually change.

Dissatisfaction with individual services did not change during this period. The researchers’ explanation was that people answer questions about specific services, such as A&E, based on their personal experience. But the general question about the NHS as an institution also refers to political views, social attitudes and media coverage. In this case, a new policy called the Patient Charter changed how the media talked about the NHS. Waiting lists, which have been reported as a symptom of the crisis, are now presented as targets that the government is trying to improve.

A similar change in broad terms occurred 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 from the Nuffield Trust and the King’s Fund suggested that this negative message could prevent the usual growth in public satisfaction that often follows a new government.

By contrast, the 2025 survey was conducted 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 circumstances, not in care

There are many examples of the rapid rise and fall of satisfaction as a result of political advertising. When the Coalition Government’s Health and Social Care Act attracted heavy critical media coverage in 2011, satisfaction fell 12 points in a year, largely attributed to public anxiety about the reforms.

Conversely, in 2019, satisfaction rose from 53% to 60%, despite worsening wait times and staff shortages. The Nuffield Trust and King’s Fund concluded that the increase was probably due to the announcement of an additional $20.5 billion in annual funding, which received significant media coverage during 2019.

The increase in satisfaction in the 2025 survey was statistically significant (in other words, unlikely due to probability) among Labor and Liberal Democrat voters, but not among Conservatives or reform supporters. This pattern is not new either.

After the 1997 election, the first survey subsequently recorded an eight percent increase in satisfaction, driven disproportionately by Labor views. It was hard to attribute such a rapid rise in satisfaction to what the NHS had actually done when Labor took office. In fact, the ball disappeared within two years.

Satisfaction only began its steady rise when significant investment in frontline services began in the early 2000s, eventually reaching 70% in 2010 – the highest in the survey’s history, and up 44 percentage points from this year’s figure.

These two explanations may work together. But the weight of the evidence—the growth of Labor’s voter focus, satisfaction with individual services that remains at historic lows, and a 1991 study of a definite decline in dissatisfaction attributed to media framing—points to a change in circumstances rather than a change in care.

This distinction is important. The change in public mood, however welcome, does nothing for someone who has been waiting 18 months for a hip replacement, or can’t get to their GP. The survey measures how people feel about the NHS. It says little about what the NHS does for their health.