• While individuals feel accountable for their health and wellbeing and want to be empowered to improve it, what became evident is that, frequently, they lack the confidence, tools and technologies to take control as much as they would like.
• We heard that people want more control over their health but need their actions, and the tools they can use, to be endorsed by healthcare professionals. They also want to make better use of health technology, but not at the expense of face-to-face contact with their doctor or other healthcare worker.
• While the vast majority of people use some form of health technology and find that useful, they are not totally satisfied by what is currently on offer.
• Across all age groups more than 7 out of 10 (72 per cent) would use technology to avoid a hospital admission, with a similar proportion happy to use technology to monitor their health and share information and data with their doctors.
• Many individuals are not confident about using technology to manage their health, leading to a fear that they may be locked out of healthcare if they cannot access or use digital tools.
• People think there is a larger role for health technologies in the future; many are not confident in using them now.
• Three areas emerged as necessary building blocks that could enable greater patient empowerment: digital access and inclusion, patient satisfaction, and user confidence.
• This report concludes that the health service must design services in collaboration with patients to address these issues and empower patients. The next phase will explore health leaders’ and practitioners’ experiences and views and identify practical examples that speak to resetting the social contract between the public and the NHS.

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Satisfaction with the NHS overall in 2022

• Overall satisfaction with the NHS fell to 29 per cent – a 7 percentage point decrease from 2021. This is the lowest level of satisfaction recorded since the survey began in 1983. 
• More than half (51 per cent) of respondents were dissatisfied with the NHS, the highest proportion since the survey began. 
• The fall in satisfaction was seen across all ages, income groups, sexes and supporters of different political parties. 
• The main reason people gave for being dissatisfied with the NHS was waiting times for GP and hospital appointments (69 per cent), followed by staff shortages (55 per cent) and a view that the government does not spend enough money on the NHS (50 per cent). 
• Of those who were satisfied with the NHS, the top reason was because NHS care is free at the point of use (74 per cent), followed by the quality of NHS care (55 per cent) and that it has a good range of services and treatments available (49 per cent). 

Satisfaction with social care services in 2022 

• Just 14 per cent of respondents said they were satisfied with social care. Dissatisfaction with social care rose significantly in 2022, with 57 per cent of people saying they were dissatisfied (up from 50 per cent in 2021). 
• Dissatisfaction with social care was high across all ages, income groups, sexes, and supporters of different political parties. People over the age of 65, those on higher incomes and people of white ethnicity were most dissatisfied. 
• The top reason for dissatisfaction with social care was that people don’t get all the social care they need (64 per cent) followed by the pay, working conditions and training for social care workers not being adequate (57 per cent) and there not being enough support for unpaid carers (49 per cent). 
• Dissatisfaction with social care is higher than dissatisfaction with the NHS overall or any of the individual NHS services asked about – general practice, dentistry, inpatient, outpatient, and A&E services. Social care is also the service with the lowest satisfaction levels. 

Satisfaction with different NHS services in 2022 

• Satisfaction with GP services fell to 35 per cent in 2022, down from 38 per cent in 2021. This is the lowest level of satisfaction recorded since the survey began. The fall was much less sharp than between 2019 and 2021, when satisfaction fell by 30 percentage points. 
• Satisfaction with NHS dentistry fell to a record low of 27 per cent and dissatisfaction increased to a record high of 42 per cent. 24 per cent of respondents said they were ‘very dissatisfied’ with NHS dentistry – a higher proportion than for other health and care services asked about in the survey. 
• Satisfaction with inpatient and outpatient services fell to 35 per cent and 45 per cent respectively. Despite falling by 4 percentage points, outpatients remains the highest-rated service. 
• Satisfaction with A&E services dropped 8 percentage points to 30 per cent, also a record low. 40 per cent of respondents said they were dissatisfied with A&E services, an 11 percentage point increase and a new record level of dissatisfaction. This is the largest change in dissatisfaction in a single year since the question on A&E services was first asked in 1999. 

Attitudes to NHS funding, priorities and principles 

• 83 per cent of respondents believed that the NHS had a major or severe funding problem. 
• For the first time since 2015, the most popular option when asked how more money should be raised for the NHS was that ‘the NHS needs to live within its own budget’ (chosen by 28 per cent of respondents). In total, 43 per cent of people chose one of the two options that involved paying more taxes. 
• On being asked what the most important priorities for the NHS should be, the top two cited by survey respondents were: increasing the number of staff in the NHS (51 per cent) and making it easier to get a GP appointment (50 per cent). Improving waiting times for planned operations and in A&E were both chosen by 47 per cent of respondents, with the latter seeing a significant increase since 2021. 
• As in 2021, a large majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2022: that the NHS should be free of charge when you need it (93 per cent), the NHS should primarily be funded through taxes (82 per cent) and the NHS should be available to everyone (84 per cent).