public perspectives on the nhs and social care

BritainThinks | Private and Confidential

britainthinks.com

Public perspectives on the NHS and social care

March 2017

Nuffield Trust Summit 2017

2 BritainThinks | Private and Confidential

1 Where are the public starting from?

Where are the public starting from?

Familiarity with social care is low among most members of the

public



Source: Qualitative research for the Richmond Group (2014)

Assessing what is happening in the NHS and social care is made

difficult by the fact that the public do not know who to trust



Politicians

• Politicians are not trusted to tell the truth about what is happening in the NHS

• Nor to act in the best interests of patients

• This is often attributed to careerism, and the short-term nature of the election cycle

The media

• There is widespread awareness of negative media coverage of the NHS

• And this plays a major part in shaping opinions

• However, they can be hard to reconcile with good personal experiences of the NHS

• And the media itself is not trusted


Despite the dominance of Brexit in the news, the NHS is

increasingly becoming an issue of concern for the public



What are the three biggest issues facing Britain today?

NHS/Healthcare

+9 points since Dec 2016

Source: Qualitative research for the Richmond Group (2016) /

Ipsos MORI Issues Index (January 2017)

Negative media stories and, to a lesser extent, personal experiences

create a sense of a system experiencing a range of pressures and

struggling to cope



“With my wife in hospital a few months ago, she was

waiting for a bed for ages. They are just sat in

chairs because beds aren’t available.” (Male, Focus group)

“The news is never good news. You never hear

them praising the NHS.” (Male, Focus group)


These pressures are seen to come from a range of sources

Limited funding

Staff shortages

Ageing population Immigration


Decline in caring

ethos



A sense that the pressures are mounting creates some openness to

change



”Maybe you can say crisis, because

there’s so many problems and how much

can you fix? So you have to prioritise

what’s important and what needs fixing

first. And we’re not gonna because that

money is not going to suddenly appear.”

(Female, Focus Group) 53% worse

Thinking about the

NHS over the next 5

years, do you expect it

to get better / worse /

stay about the same?

Source: Qualitative research for the Richmond Group (2016) /

BritainThinks polling (2016)

But affection for the NHS limits how willing people are in practice to accept

change


Engaging the public with change

“It is one of the best health

services in the world, and we

should cherish it.”

(Male, Focus Group)

36% of the public say that

the NHS is the thing that

makes them most proud

to be British

Source: Qualitative research for the Richmond Group

(2016) / Opinium Research, Pride of Britain, 2016

These sentiments:

• Limit the range of

reasons for change that

are acceptable

• And the changes that

they will consider

For most, the closure of a local hospital is a clear red line


2 Engaging the public with change


Public awareness of planned changes to service

delivery is extremely low...



…And most are unlikely to engage until they see

something that crosses a red line


When communicating planned changes, it is helpful to…

12



Frame it as an essential response to ensure the NHS survives 1 Make the argument from a position of patient experience 2

Play back the issues people have experienced in their own areas 3 Reassure that the system will still be recognisable to patients 4

Communicate that the plan has been carefully considered 5


When communicating planned changes it is unhelpful to…

13



Frame it as a cost-saving exercise 1 Create the sense that services would be cut 2

Imply that what is needed is a ‘radical’ change or ‘revolution’ 3 Focus on the fine detail of system or treatment processes 4 Appear to take a negative view on the ageing population 5


And always remember the context in which people think about

accessing the NHS…

• Most people think about the NHS through the

frame of an emergency

• Facts about the impact of service

reconfiguration are not, therefore, on their

own enough to win support

• Nor is having a trusted figure (e.g. a doctor)

talk about the benefits of change

• To win over the public, changes have to feel

like they will deliver a benefit to patients

