The King's Fund: Still lost in the system: the urgent need for better NHS admin (16 April 2026)

Summary

Latest research from the King's Fund shows no improvement in people’s experiences of NHS admin. NHS admin plays a central role in shaping how people experience and perceive the NHS. Our findings point to a major opportunity for government and NHS leaders to act.

Content

Key findings

• Two thirds (66%) of patients and carers who used NHS services in the past 12 months experienced at least one administrative problem. There has been no improvement since the same polling was conducted the previous year.   
• While the number of people experiencing admin issues has remained unchanged, what has shifted is wider public awareness: administrative failings are increasingly recognised as a frequent and persistent problem across the NHS. 
• In 2025 less than half (43%) of the public said that the NHS is good at communicating with patients about things like appointments and test results, down from 52% in 2024.  
• The percentage of the public who said the NHS was good at keeping people informed about what is happening with their care and treatment has fallen from 42% in 2024 to 32% in 2025.
• 33% of people who had used NHS services in the previous 12 months said they had not been kept updated about how long they would have to wait for care or treatment. 
• Almost 1 in 4 people who had used NHS services in the previous 12 months (23%) reported being invited to an appointment after the date of the appointment – a 3 percentage point increase since 2024. 
• 3 in 5 people who had experienced admin issues (60%) said it made them think that NHS money is being wasted.  
• People living with a long-term health condition are more likely to say the NHS is poor at keeping people informed about what is happening with their care and treatment (45%), compared with 36% of people who do not have a long-term condition. 
• 4 in 5 patients and carers (81%) who report they are struggling financially have experienced an issue with NHS admin, compared with 63% of those who are comfortable financially. 

Related reading on the hub:

• The challenges of navigating the healthcare system