Anastasia Knox, Research Director at BritainThinks presented on the public perception of the health and care system at the 2017 Nuffield Trust Summit.

1. BritainThinks | Private and Confidential
britainthinks.com
Public perspectives on the NHS and social care
March 2017
Nuffield Trust Summit 2017

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Where are the public starting from?
Where are the public starting from?

3. Familiarity with social care is low among most members of the
public
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Where are the public starting from?
Source: Qualitative research for the Richmond Group (2014)

4. Assessing what is happening in the NHS and social care is made
difficult by the fact that the public do not know who to trust
4BritainThinks | Private and Confidential
Where are the public starting from?
Politicians
• Politicians are not trusted to tell the truth about what is happening in the NHS
• Nor to act in the best interests of patients
• This is often attributed to careerism, and the short-term nature of the election cycle
The media
• There is widespread awareness of negative media coverage of the NHS
• And this plays a major part in shaping opinions
• However, they can be hard to reconcile with good personal experiences of the NHS
• And the media itself is not trusted
Source: Qualitative research for the Richmond Group (2016)

5. Despite the dominance of Brexit in the news, the NHS is
increasingly becoming an issue of concern for the public
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Where are the public starting from?
What are the three biggest issues facing Britain today?
NHS/Healthcare
+9 points
since Dec 2016
Source: Qualitative research for the Richmond Group (2016) /
Ipsos MORI Issues Index (January 2017)

6. Negative media stories and, to a lesser extent, personal experiences
create a sense of a system experiencing a range of pressures and
struggling to cope
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Where are the public starting from?
“With my wife in hospital a few months ago, she was
waiting for a bed for ages. They are just sat in
chairs because beds aren’t available.”
(Male, Focus group)
“The news is never good news. You never hear
them praising the NHS.”
(Male, Focus group)
Source: Qualitative research for the Richmond Group (2016)

7. These pressures are seen to come from a range of sources
Limited funding
Staff shortages
Ageing population Immigration
Where are the public starting from?
Decline in caring
ethos
Source: Qualitative research for the Richmond Group (2016)
BritainThinks | Private and Confidential

8. A sense that the pressures are mounting creates some openness to
change
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Where are the public starting from?
”Maybe you can say crisis, because
there’s so many problems and how much
can you fix? So you have to prioritise
what’s important and what needs fixing
first. And we’re not gonna because that
money is not going to suddenly appear.”
(Female, Focus Group)
53% worse
Thinking about the
NHS over the next 5
years, do you expect it
to get better / worse /
stay about the same?
Source: Qualitative research for the Richmond Group (2016) /
BritainThinks polling (2016)

9. But affection for the NHS limits how willing people are in practice to accept
change
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Engaging the public with change
“It is one of the best health
services in the world, and we
should cherish it.”
(Male, Focus Group)
36% of the public say that
the NHS is the thing that
makes them most proud
to be British
Source: Qualitative research for the Richmond Group
(2016) / Opinium Research, Pride of Britain, 2016
These sentiments:
• Limit the range of
reasons for change that
are acceptable
• And the changes that
they will consider
For most, the closure of a local hospital is a clear red line

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Engaging the public with change
Engaging the public with change

11. Public awareness of planned changes to service
delivery is extremely low...
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Engaging the public with change
…And most are unlikely to engage until they see
something that crosses a red line
Source: Qualitative research for the Richmond Group (2016)

12. When communicating planned changes, it is helpful to…
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Engaging the public with change
BritainThinks | Private and Confidential
Frame it as an essential response to ensure the NHS survives
1
Make the argument from a position of patient experience
2
Play back the issues people have experienced in their own areas
3
Reassure that the system will still be recognisable to patients
4
Communicate that the plan has been carefully considered
5
Source: Qualitative research for the Richmond Group (2016)

13. When communicating planned changes it is unhelpful to…
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Engaging the public with change
BritainThinks | Private and Confidential
Frame it as a cost-saving exercise
1
Create the sense that services would be cut
2
Imply that what is needed is a ‘radical’ change or ‘revolution’
3
Focus on the fine detail of system or treatment processes
4
Appear to take a negative view on the ageing population
5
Source: Qualitative research for the Richmond Group (2016)

14. And always remember the context in which people think about
accessing the NHS…
• Most people think about the NHS through the
frame of an emergency
• Facts about the impact of service
reconfiguration are not, therefore, on their
own enough to win support
• Nor is having a trusted figure (e.g. a doctor)
talk about the benefits of change
• To win over the public, changes have to feel
like they will deliver a benefit to patients
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Engaging the public with change