The public wants the next government to shift funding to GP and community services and away from hospital services, according to a new report from the health think-tank The Health Foundation, and is willing to pay more taxes to improve services.

The results of polling, carried out in Autumn 2023 by Ipsos on behalf of The Health Foundation, were combined with outcomes from ‘deliberative’ workshops with the public, leading to the report’s recommendation that the next government ‘give primary care and community services an increasing share of the available resources’. 

Tim Gardner, Assistant Director of Policy at the Health Foundation, said of the research:

‘It is vital that the political parties have a deep understanding of what the public wants and expects. No issue is more crucial than the NHS, which is seen as a top priority among voters.’

‘The public clearly supports the need for greater investment in primary and community care to help our growing, ageing population to live healthier lives, as well as to help people manage illness better and ease the burden on stretched NHS hospitals.

”With such low confidence in the government’s handling of the NHS, the next administration must swiftly restore public confidence and be transparent about the challenges it faces. The good news is that the public fully supports the NHS, its funding model and its principles, which is a solid foundation for building a more resilient and sustainable health service.’

Polling found that 60% of the public in England want the Government to prioritise access to community-based services, within the limits of the current NHS budget.  Only 29% of those surveyed wanted hospital care to be prioritised. 

The ‘deliberative workshop’ approach was, noted the Health Foundation “one of the most extensive exercises of its kind ever carried out with the public in England about the future of the NHS” and enabled the researchers to gather views on issues that are complex and challenging and do not have a simple tick-box answer.

In the deliberative research there was a ‘broad consensus’ for moving funding towards primary care services. Although participants in the research did not want a decline in access to hospital care for those who need it, there was support for a ‘steady rebalancing of funding over time.’

This consensus, noted the Health Foundation, was based on the understanding that effective GP and community services support earlier diagnosis and condition management, which results in preventing the need for hospital care and reduces the demand for hospital services in the longer term.

The polling found that the public’s belief in the NHS’s founding principles remains as strong as ever, with survey respondents in England agreeing that it should continue being free at the point of delivery (88%), providing a comprehensive service available to everyone (84%) and being funded primarily through taxation (83%). The research found that if taxes are to increase, participants wanted the extra revenue to be raised from a combination of taxes, with an additional tax specifically for the NHS and increasing VAT were generally preferred over raising income tax.

Support for the NHS was high, with polling and the participants in the deliberative workshops strongly favouring the current NHS model over a system of social health insurance or with additional patient charges, but there is a widespread mistrust and lack of confidence in the government’s handling of the NHS. The polling found that only 9% of those surveyed think that the government has the right policies for the NHS and 54% believe that the standard of care provided by NHS services will worsen in the coming year.

Results from the research suggest that the public believes the NHS should be given more independence from politics, with a longer-term perspective being taken in policy decisions and more independent scrutiny and public engagement carried out, all of which could help improve the public’s confidence in any government’s handling of the NHS, noted the report.

This research comes at a difficult time for GP services with funding at its lowest in almost a decade, a declining number of GPs, but an increasing number of patients registered. As a result, the average number of patients each full-time equivalent GP is responsible for now stands at 2,295 up 18%, since 2015, demonstrating the ever-mounting workload in general practice.

In March, NHS England imposed a new contract on GPs, despite overwhelming opposition to it. Now the BMA has announced the possibility of strike action at the beginning of August, subject to ballot. GPs have rejected the new 2024/25 contract imposed on them by NHS England and want changes made and funding for GP services back to 2018/19 levels.

RCGP chair Professor Kamila Hawthorne told Pulse that the Health Foundation’s research is ‘highly welcome’ and ‘chimes very clearly’ with the college’s own polling.

She said: ‘It makes absolute sense to better fund general practice and wider primary care given that GPs and our teams make the vast majority of NHS patient contacts, in turn alleviating pressures elsewhere in the health service.

‘Delivering care in general practice is also more cost efficient with the estimated cost of an average GP appointment approximately one tenth the cost of treating a patient at a major Emergency Department.’


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