Negative public attitudes to social care growing, survey finds

Research for the survey was carried out between 7 September and 30 October 2022, across England, Scotland and Wales. It is the most comprehensive survey of public attitudes to the NHS and Social Care.

Over 3,300 people were asked how satisfied or dissatisfied they were ‘with social care for people who cannot look after themselves because of illness, disability or old age’.

Just two per cent said that they were ‘very satisfied’, and 12 per cent were ‘quite satisfied’, but these levels had changed little compared to the previous year.

However, dissatisfaction with social care increased significantly -- seven per cent more on the previous year -- with a total of 57 per cent of people saying they were ‘very’ or ‘quite’ dissatisfied in 2022.

The report analysing the results, published by The King’s Fund and the Nuffield Trust. It says that this is part of a trend that began in 2014, but which has grown significantly since 2019.

‘Since 2014 there has been a growing gap between satisfaction and dissatisfaction with social care. The gap has grown sharply since 2019 as the number of people dissatisfied with social care has increased significantly whilst satisfaction has fallen at a similar rate.’

As a caveat, the analysts point out that the question wording was changed in 2021 to focus on perceptions of all social care services as opposed to services provided by local authorities. ‘This may have had an impact on how people answered and this should be taken into account when interpreting the data.’

While dissatisfaction with health services was at an all-time low, ‘Social care is…the service with the lowest satisfaction levels, 13 percentage points lower than dentistry, the lowest-rated NHS service asked about in the survey.’

People were asked about the reasons for their answers: among those who were satisfied with social care, 53 per cent said it was because the range of services and support available was good; 47 per cent said it was because people are treated with dignity and respect by, and 31 per cent because health and social care services worked well together. ‘Only 17 per cent were satisfied because social care is affordable to those who need it, and just 16 per cent because it is easy to understand how to get social care.’

By far the most common reason for dissatisfaction was that people did not get all the social care they need (63 per cent), followed by 57 per cent of people who said that their dissatisfaction was because pay, working conditions and training for social care staff are bad.

‘49 per cent said they were dissatisfied because there is not enough support for unpaid carers, and 39 per cent were dissatisfied because social care is not affordable to those who need it. 35 per cent of respondents said that health and social care services do not work well together.’

Only 12 per cent of respondents had used or had contact with social care services in the preceding 12 months. In this category, social care had the lowest level of satisfaction (16 per cent) and highest levels of dissatisfaction (67 per cent).

‘This is consistent with results for social care in previous years. There was a much greater level of dissatisfaction (a 20 percentage point difference) among those who had had contact with social care than among respondents who had not.’

The analysis adds that the survey period for the report was carried out across September and October 2022. Problems across the NHS and social care were frequently highlighted in news reports.

The analysis also points out that ‘Following more than a decade of underinvestment and political neglect, social care was hit hard by the pandemic and the effects on people drawing on social care and those delivering it continued to be felt well into 2022. Most notably, workforce pressures have dramatically intensified. For the first time since records began, the workforce has shrunk and the vacancy rate in the sector has reached a new high, with 165,000 vacancies in social care in England in 2021/22.

‘This impedes the ability of care providers to return to the same level of provision seen before the pandemic, with people struggling to access services and social care needs going unmet. From April to June 2022, before the fieldwork period for this year’s BSA survey commenced, an estimated 1.1 million hours of home care (2.5%) could not be delivered due to workforce shortages. In addition, waiting lists are long: in August 2022, an estimated 245,800 adults in England were waiting for an assessment of their needs, with 33% of people waiting over six months.’

The analysis looked at levels of dissatisfaction with social care by age, ethnicity, household income and political preference.

From these perspectives, ‘respondents aged 65 and over (63 per cent) were more dissatisfied than respondents aged 18 to 64 (55 per cent), and white respondents (59 per cent) were more dissatisfied than Asian respondents (30 per cent). In addition, the two highest income groups (62 per cent and 60 per cent, respectively) were more dissatisfied than the lowest income group (48 per cent)…supporters of the Liberal Democrats (67 per cent) and Labour (64 per cent) were more dissatisfied than Conservative supporters (51 per cent) or people with no political affiliation (42 per cent).’