The public’s perspective: The state of health and social care
About this report
The public’s perspective: The state of health and social care draws on the experiences of over 65,000 people we heard from between October 2022 and September 2023, combined with external data. It helps readers stand back from the headlines and look at what it’s really like to use health and social care services in 2023.
As the system is so vast, we haven’t tried to cover everything. Instead, each of the report’s ten chapters focuses on a key area of healthcare. Topics include:
- The areas we hear about the most, including GPs, dentists, hospital discharge, elective care and social care.
- What it’s like to get help for life-changing issues, like cancer and mental ill health.
- Broader societal changes, including the cost of living, accessibility and advancing technology, and how these impact those using services.
In each section, we’ve shared a snapshot of the positives and negatives we’ve heard, and highlighted where issues disproportionately affect some groups more than others.
What we found
Though many shared stories of excellent healthcare, accessing care in the first place is the biggest challenge people face. People experience delays and barriers all across the healthcare system.
- GPs are the gateway to the NHS, but people can’t get appointments that work for them.
- With more practices closing or going private, it’s getting harder to find an affordable NHS dentist.
- Growing waiting lists mean people are facing longer waits for mental health support.
- People also experience delays when getting cancer care.
- Many people waiting for planned medical procedures aren’t getting the support they need while they wait.
- People often have to navigate a complex health and social care system alone.
Those experiencing inequalities already face challenges accessing care and have poorer health outcomes. Our research found rising financial pressure risks making these worse.
We’re seeing a two-tier system emerge, where healthcare is accessible only to those who can afford it, with one in seven people who responded to our poll advised to seek private care by NHS staff.
- People aren’t getting the healthcare they need because of the associated costs, like prescriptions and travel costs.
- Those struggling to get by often report a worse experience when accessing or waiting for care – and this is especially true for disabled people, people experiencing financial struggles, and people from ethnic minority backgrounds.
- These delays and disruptions can substantially impact people’s lives, leaving them in pain or discomfort, and sometimes allowing their health to worsen.
Our recommendations
You can read our recommendations at the end of each chapter, or in full in our recommendations article. But they focus on five key questions.
Do we understand people’s experiences?
From national plans to daily interactions, services must work with people to understand and improve experiences and confidence.
Can people access the services they need?
People need more choice and control. We need faster progress with national recovery plans, and a greater focus on ending inconsistent experiences across different areas and demographics.
Why do some people face inequalities?
We must involve communities in designing better services to tackle these disparities.
What can be done to improve communications?
By fast-tracking investment in administration and technology, the NHS and social care can reduce preventable errors, keep people informed about their care, and improve access to quality services.
How can we create a better listening culture in health and social care?
The health and social care system must create a better listening culture that sees feedback and public involvement across all levels of decision making as key to preventing harm and improving care and safety.
Downloads
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If you need this report in a different format, please email enquiries@healthwatch.co.uk or call 030000 68 3000.