Private care should heed NHS’s lessons

Record dissatisfaction levels with the NHS suggest opportunities for those in private practice, but signal a warning too. Leslie Berry reports.

‘We put the patient at the centre of everything we do.’ 

Commonly trotted out by private providers’ PR teams eager to impress, this catchphrase can easily be dismissed as ‘a statement of the bleedin’ obvious’.

Cynical recipients hearing the slogan for the first time could be excused for responding with: ‘Oh, really – how impressive. So what else is your service aimed at then?’ 

Putting patients at the centre of it all is a well-meant target, but when it comes down to it, the experience can be vastly different. 

Public satisfaction with the NHS has now fallen to the lowest level ever recorded, according to analysis of the latest British Social Attitudes survey (BSA) published by the think-tanks The King’s Fund and the Nuffield Trust.

For the first time in the survey’s 41-year history, under a quarter of people are satisfied with the way the NHS is running. Satisfaction previously peaked in 2010, when seven out of ten people reported being satisfied. 

Overall public satisfaction with how the NHS runs now stands at 24% – a fall of five percentage points from the previous year. Since 2020, satisfaction has fallen by 29 percentage points. Dissatisfaction is also at an all-time high (52%).   

The survey, carried out by the National Centre for Social Research (NatCen) in September and October 2023, is seen as a gold-standard measure of public attitudes in Britain. 

Long waiting times

Nearly three-quarters (71%) of respondents who were dissatisfied with the NHS pointed to long waiting times for GP and hospital appointments as one of their top reasons for dissatisfaction, followed by staffing shortages (54%), and a view that the Government spends too little on the health service (47%). 

Deteriorating public attitudes to the NHS, which only four years ago was receiving huge cheers and weekly standing ovations from a grateful pandemic-hit nation, demonstrate how opinion can so quickly change. 

And there is a warning to heed in there for independent practitioners and their teams – as well as an opportunity.

Private healthcare for many years enjoyed the fruit of its proponents’ promise: ‘Affability, availability and ability’. But work-life balance issues for a new generation of private doctors are increasingly important for them.

Phone calls unanswered

At the same time, consumers demand more from every organisation and person they buy from. Increasingly, they want excellent service for their money but can find themselves on growing waiting lists for private appointments. 

Independent Practitioner Today has highlighted other problems they experience too – such as  struggling to get their phone calls to clinics answered, and frequently finding the ‘patient journey’ hard to navigate due to administrative red tape.

This journal’s ‘Troubleshooter’ columnist, practice management consultant Sue O’Gorman, of Medici Healthcare Consultancy, believes independent practitioners would do well to consider the BSA survey’s findings and implications. 

She says the report clearly highlights the dichotomy of people’s emotional connection with the NHS compared to the service they now struggle to receive and the growing frustrations borne from these challenges.

‘Private healthcare has always set itself apart by offering patients “choice”; where they are seen, by whom and when. This is in contrast to a system where patient choice is becoming rapidly de-”patient centralised” and eroded, particularly post-Covid around accessing primary care. 

‘From a commercial perspective, doctors in private practice should have their finger on the pulse about the real concerns patients have with the current challenges within the NHS around, for example, increasing wait times.

Market opportunity  

‘The self-pay market continues to grow with greater numbers of patients considering paying for their treatment. Despite their political biases, they want access to timely primary care, diagnostics, treatment plans and interventions. 

‘Put bluntly, continued dissatisfaction with the NHS creates a potential market opportunity for private healthcare providers to truly “put the patient at the centre of everything we do”.’

Interestingly, nearly half (48%) of the public indicated they would be prepared to pay more for their care by saying they would support the Government increasing taxes and spending more on the NHS. 

Public support for the founding principles of the NHS, which marked its 75th anniversary in 2023, remains as strong as ever. 

The overwhelming majority of respondents expressed high levels of support for the principles when asked in 2023 if they should still apply: that it is free of charge when you need it (91%), primarily funded through taxation (82%) and available to everyone (82%). 

GP appointments

Consistent with previous years’ surveys, when asked what the most important priorities for the NHS should be, the top two cited by respondents were ‘making it easier to get a GP appointment’ (52%) and ‘increasing the number of staff’ (51%). 

Improving waiting times for planned operations and in A&E were chosen by 47% and 45% of respondents respectively. 

The survey also measures public opinion on specific NHS services. The think-tanks’ analysis reveals that public satisfaction with GP services – historically the service with the highest levels of public satisfaction – now stands at 34%, the lowest level recorded since the survey began. Since 2019, satisfaction with GP services has fallen by 34 percentage points. 

Public satisfaction with inpatient services is at a historically low level (35%) as is satisfaction with outpatient services (44%). 31% said they were satisfied with A&E services, up one percentage point on the previous year. 

Losing confidence

Dan Wellings, senior fellow at The King’s Fund, called the results ‘depressing but sadly not surprising’.

He believes the NHS is now in uncharted territory. ‘The size of the challenge to recover it is growing more difficult with each passing year. Ahead of the upcoming general election, political leaders should take note of just how far satisfaction with this celebrated public institution has fallen.’  

Jessica Morris, fellow at The Nuffield Trust, says political parties should be frank and realistic about the challenges ahead of them if they are to turn things around. 

‘Despite such low levels of satisfaction, the public continues to back the principles underpinning the NHS. The public has not fallen out of love with the idea of a publicly funded, free-at-the-point-of- use NHS, but they are losing confidence that it will support them and their loved-ones in the best possible way when they need it.’