November 2023: Engage Britain has now merged with Demos. You can still find all our work from 2019-2023 here, but to get in touch or find out about our new ventures, go to https://demos.co.uk/

What people are saying about their experiences with stretched services

Headlines
I think the NHS and social care are overstretched and underfunded
I’m worried about paying for social care
I think money is driving decisions that don’t help patients or carers
I think money could be spent better

I think the NHS and social care are overstretched and underfunded

We’ve been speaking to people all over Britain who say health and social care systems are overstretched and at breaking point. 

Alongside our Community Conversations, our large-scale survey also shows most people (71%) think health and care services are underfunded. People are especially worried that mental health support and elderly care aren’t getting enough funding.

Lots of people link negative experiences to these overstretched systems. People are concerned about waiting times, especially for mental health support.

And NHS staff worry about how understaffing effects the quality of care they can offer. Disabled and elderly people talk about not getting enough money to pay for even their basic care needs.

A Local Government Association survey of council leaders found that 83% thought there was a problem in their area when it came to funding sustainable adult social care.

Many people say they want the government to spend more money on health and care. Some are happy to pay more tax to cover the cost.  

I’m worried about paying for social care

There is a lot of worry about paying for social care from people who need to draw on this support.

Many have to fund their care costs themselves. Some elderly people and their relatives talk about having to sell their homes or their life savings being wiped out to fund the care they need.

For others, knowing they may have to do this causes a great deal of stress.

Disabled people talk about not always being able to afford the cost of even the most basic care. Some people say they can’t afford the care support they need to let them to live an “ordinary life”.

Staff in social care talk about the problems of being on a low wage and still having to cover things like work-related travel expenses themselves.

Some want to see social care made free at the point of use or even brought into the NHS. 

I think money is driving decisions that don’t help patients or carers

People say they think squeezed NHS and council budgets can lead to decisions that don’t help people who need health and care services. 

In our Community Conversations, people spoke about how the way the NHS treats some conditions saves money. But it isn’t in the best interest of patients.

For example, that it’s cheaper to offer mental health support to people who reach crisis point instead of investing in preventative support that stops it happening in the first place.

And some Disabled people who have social care packages that work for them talk about constantly worrying about them being taken away. Even those who need more money are reluctant to be re-assessed in case their package is cut.

Staff talk about debates over who should pay for support. Whether someone has health needs which the NHS should pay for or care ones which the local authority funds. They worry these conversations unnecessarily delay support being given.

And people worry that an ageing population and rising need for social care will make this worse in future.

Even just over the course of the pandemic, an ADASS survey found that 82% of adult social care directors had experienced rising demands for help from people being discharged from hospital.

I think money could be spent better

People also think money could be better spent, particularly in the NHS.

Some people feel too much money is spent on middle management and not enough on frontline staff.

And for others, the NHS wastes too much money on medicines that aren’t used, expensive private sector contracts and other inefficiencies.