The 2021 British Social Attitudes (BSA) Survey found that patient satisfaction with the NHS overall had dropped to its lowest point in 25 years - with just 36% of the public 'very' or 'quite' satisfied with the health service.
But the 17 percentage point drop in satisfaction with the NHS as a whole reported by the survey is far outstripped by a 30 percentage point drop in satisfaction with general practice. Having been the highest-rated service in every year since the BSA survey began in 1983 until 2018, satisfaction with general practice is now lower than for any NHS service apart from dentistry, the survey suggests.
Making it easier to get a GP appointment was the top priority identified by respondents to improve the NHS, with 48% choosing this option - closely followed by 47% who called for improved waiting times for planned operations and the same proportion who backed increasing NHS staff.
Patient satisfaction
Findings from the poll clash with other measures of satisfaction, however. The 2021 GP patient survey - carried out between January and March 2021, while the BSA survey was conducted between 16 September and 31 October - found that satisfaction with GP services had risen to a three-year high.
A National Audit Office report earlier this year, meanwhile, found that general practice had been the most popular and cost-effective part of the COVID-19 vaccination campaign.
Researchers behind the BSA survey said the fall in satisfaction was 'unprecedented' and that the COVID-19 pandemic had put healthcare services 'under pressure in ways not experienced in their history' at a time when the NHS was already under intense strain.
The survey highlighted that general practice was used by more people than any other NHS service - and that it is the only NHS service in which levels of contact with patients were unchanged in 2021 compared with the previous year, while patient contacts with inpatient, outpatient and A&E services fell away sharply.
NHS waiting list
GPs have repeatedly highlighted the devastating impact on general practice services of the record 6m-strong waiting list for NHS hospital services - with practices forced to manage hundreds of thousands of patients waiting more than a year for hospital treatment.
The survey also pointed to the 'polarised media debate' around access to face-to-face GP services during the pandemic, after practices responded rapidly to official NHS advice to shift to predominantly remote consultations but then faced criticism.
As some media outlets criticised GPs while others reported the abuse practice staff were receiving from patients, the government had added to this 'toxic environment' by publishing a much-criticised GP access plan that had been trailed as a support package for the profession, BSA survey report said.
RCGP chair Professor Martin Marshall said he was 'extremely disappointed and saddened' by the BSA survey findings - and that the figures 'reflect a service working under crippling staffing and resource pressures following the pandemic, which has pushed general practice, and the wider NHS, to its limits'.
Pandemic response
Professor Marshall said: 'Hardworking GPs have been at the forefront of delivering safe and appropriate care throughout the pandemic, ensuring patients received care and services when many other parts of the NHS had to severely limit access or shut down. GP teams also led the complex mass vaccination programmes that have been so successful in protecting patients and bringing the COVID-19 virus under control.
'General practice was stretched to its limits before the pandemic, but the intense workload and workforce pressures have been exacerbated by the crisis. GPs and our teams carry out the vast majority of patient contacts in the NHS, and we are now also managing cases of "long COVID" in the community and the care of patients waiting for operations or specialist consultations while the NHS clears the backlog caused by the pandemic.
'The profession must be supported not only to provide good access to services, but personalised care for patients, which is becoming increasingly difficult to deliver. The GP workforce is no longer big enough to meet demand. Successive governments have failed to invest in our service and GP numbers have declined while our workload has escalated in volume and complexity.'
Patients at risk
BMA chair Dr Chaand Nagpaul said: 'It is unsurprising that impressions of the NHS have suffered some of the sharpest declines ever seen, a direct consequence of a service which has been pushed to the edge of collapse with severe deficits in staffing, in beds, in community services, in facilities and in equipment. As a result it is the public and patients who are suffering the consequences as clearly shown in this survey.
'This should be a wake-up call for the UK government that has been woefully inadequate in its response to the crisis unfolding before them.'
Dr Rachel Ward, a GP in Oxfordshire who is part of the Rebuild General Practice campaign said: 'As a doctor who came into general practice to look after patients, this data is devastating, but it isn’t surprising.
'Years of underfunding and neglect has left general practice in crisis. Recruitment and retention of GPs has not kept up with growing demands, yet patient appointments are at an all-time high. Simply, there are not enough GPs to match patients’ needs - and this is the terrible result. To patients, we want to say that we are on your side and we feel your pain. To government, we ask again for more support to rebuild general practice so that GPs can provide the quality of care our patients deserve.'
A DHSC spokesperson said: 'The pandemic has placed enormous pressure on the NHS which is why we are focused on recovering from the impact of COVID-19 and delivering reform. We have set out our plan to tackle the COVID-19 backlog, backed by our record multi-billion pound investment over the next three years.'
