The public's perspective - the state of health and social care

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Summary of report content

Healthwatch England reports on the state of care between October 2023 and October 2025.  Drawing on the 390,000 pieces of feedback we received in this period plus nationally representative polling, we found:

Since our last report, there are signs that people’s care experiences have improved slightly. But 29% of people are still not confident they can access timely care from most key services we asked about, such as A&E, GPs, dentists and hospitals. 

The five cross-cutting themes we have found in the experiences people share reflect this finding, and its impact. 

1. Access issues remain widespread: Across GPs, dentistry, mental health, elective care, and social care, people face persistent difficulties getting timely appointments, referrals, treatment, and support. These delays often worsen health outcomes and increase reliance on emergency services. 

2. Inequalities in care persist: People and communities already facing inequalities (such as those on low incomes, ethnic minorities, disabled people, and those with communication needs) experience disproportionate barriers to care, leading to poorer health outcomes and higher levels of unmet need. 

3. Waiting for care takes a toll on wellbeing: Long waits for elective care, mental health support, and social care can seriously affect physical health, mental wellbeing, and financial stability. Many people report worsening conditions and a decline in quality of life while they wait. 

4. Digital transformation brings both opportunities and risks: While digital healthcare innovations (e.g. NHS App, virtual wards) improve convenience for some, digital exclusion and poor system integration risk creating a two-tier system and unequal access to care. 

5. Administrative and communication failures undermine care quality: Poor administration, inaccessible information, and ineffective complaint handling erode trust and the patient experience. Problems like missing records, lack of updates, and failure to meet accessibility standards persist.

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General details

Local Healthwatch
Healthwatch England
Publication date
Date evidence capture began
Date evidence capture finished
Key themes
Access to services
Accessibility and reasonable adjustments
Administration (records, letters, results)
Booking appointments
Caring, kindness, respect and dignity
Cleanliness, Hygiene and Infection Control
Communication with patients; treatment explanation; verbal advice
Consent, choice, user involvement and being listened to
Follow-on treatment and continuity of care
Cost and funding of services
Discharge
Health inequality
Lifestyle and wellbeing; wider determinants of health
Prevention of diseases, including vaccination, screening and public hygiene
Referrals
Remote appointments and digital services
Service organisation, delivery, change and closure
Waiting for appointments or treatment; waiting lists for treatment
Written information, guidance and publicity

Methodology and approach

Was the work undertaken in partnership with another organisation?
No
Primary research method used
General feedback
Survey
If an Enter and View methodology was applied, was the visit announced or unannounced?
N/A

Details of health and care services included in the report

Details of health and care services included in the report
Adult social care, including care packages and social workers
Ambulances and paramedics
Care home
Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools Services (TaMHS)
Community Mental Health Team (CMHT) and specialist MH services
Dentist
Diagnostic centre/hub
Emergency department (inc A&E)
General outpatients and hospital-based consultants
General Practice (GP)
Hospital services- not stated
Inpatient care/General inpatients
Mental health crisis service
Oncology and cancer care
Ophthalmology
Optometry services/opticians
Pharmacy
Services for people with Autism/on the Autism spectrum
Urgent primary care, including Urgent Treatment Centres, walk-in care, out of hours GP services, minor injury and treatment centres
Vaccination clinics, including Covid 19 vaccine

Details of people who shared their views

Number of people who shared their views
390,000
Gender
Women
Men
Non-binary people
Is the gender identity of people in the report the same as the sex they were assigned at birth?
Yes
No
Types of long term conditions
Blindness or severe visual impairment
Cancer
Deafness or severe hearing impairment
Mental health condition
Does this report feature carers?
Yes
Seldom heard groups
People who are geographically isolated
People on low incomes
People with or recovering from addictions
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