Picker: The State of Person-Centred Care 2025 (29 January 2026)

Summary

The National Health Service (NHS) in England boasts one of the largest and longest running suites of patient and workforce experience surveys anywhere in the world. Its various national surveys have tracked changes in people’s experiences of care for a quarter of a century and have provided a blueprint for similar collections internationally. Although the NHS gathers feedback from patients, service users, and staff across a broad range of health and care settings, the results of these surveys tend to be viewed separately and in isolation.

This report brings together the results from nine national patient and staff experience surveys that Picker coordinated across 2024 and 2025 on behalf of the Care Quality Commission and NHS England. It maps the results against the Picker Principles of Person Centred Care to give an overview of the state of person centred care in the NHS in England.

Content

Key findings highlighted by this report include:

Quality of care

• Patient perceptions of the overall quality of NHS care are largely positive, although variations in the level of positivity occur dependent on the setting. In particular, adult and child cancer care was viewed positively, while mental health services and accident and emergency (A&E) services1 have clear room for improvement.
• Substantive NHS staff largely reported that they would be happy with the standard of care provided by their organisation if their friends or relatives needed treatment – however, only a small proportion ‘strongly agree’ with this statement

Fast access to reliable healthcare advice

• Patients reported concerns about waiting times, with variation across different care pathways. Patients experienced long waits for care in urgent and emergency and adult inpatient care, and reported that long waits have negatively impacted their health in community mental health and inpatient care settings.

Effective treatment by trusted professionals

• People generally told us that they felt confident in the staff that were treating them. However, results were more mixed when parents of children and young people receiving hospital care were asked this question, and people receiving maternity care reported that their confidence in staff varied at different points along the pathway.
• There is room for improvement in the support offered to patients with pre-existing medical conditions, who require access to their regular medication while in a healthcare setting.
• The proportion of staff reporting that their team regularly meets to discuss effectiveness has improved in recent years, but there remains room for improvement.

Continuity of care and smooth transitions

• Patients and their families/carers generally reported poor experiences when asked whether staff seemed aware of their medical history, particularly in community mental health services and children’s cancer care. However, collaboration between staff and teams was perceived to be strong in adult cancer care.
• Just over half of staff reported that teams in their organisation work well together to meet their objectives.

Clear information, communication and support for self-care

• Patients tend to understand the information they receive about their health and care: however, this is less likely in A&E departments. People would also like to receive clearer information about next steps, particularly when leaving hospital after receiving inpatient or urgent and emergency care.
• People’s experiences of being informed about holistic support varies; adult cancer patients felt well-informed, but those accessing community mental health services did not.
• Staff reported high levels of pressure on their time while at work, which is likely to impact the ability of patients and their families/carers to ask questions

Emotional support, empathy and respect

• The majority of people felt that they are treated with dignity and respect by healthcare staff. However, results from the community mental health and maternity surveys showed poorer patient experiences compared to other patient surveys.
• While most staff reported positive interactions with patients, their families/carers, and the public, we know from the NHS Staff Survey results related to discrimination, abuse, bullying and harassment that some interactions can result in staff experiencing unacceptable behaviours.
• Most staff agreed that they are treated with respect by their colleagues, and that their colleagues are polite, understanding and kind. 

Involvement in decisions and respect for preferences

• National surveys showed that patients currently lack opportunities to feel fully engaged in decisions about their health and care, while only half of staff reported being involved in decisions that affect their work. These results suggest there is room for improvement in wider culture around involvement and decision-making, for both staff and patients.

Involvement and support of families and carers

• People receiving maternity care reported positive experiences of family involvement, but there are challenges in involving families in urgent care and in crisis mental health support.

Attention to physical and environmental needs

• Patients generally felt they were given enough privacy when accessing health care, with the exception of urgent and emergency care where there is room for improvement.
• Patient and staff feedback shows that there is a need to address access to food and amenities in care settings.
• Considering the aspirations for digital transformation outlined in the Ten Year Plan, the lack of access to reliable Wi-Fi suggests there is a fair way to go to improve NHS digital capabilities.