Two‑tier healthcare increases as confidence in timely access remains low
Our new research shows a sharp rise in the number of people turning to private care.
We commissioned Savanta to poll 2,593 adults (18+) to understand people’s use of NHS and private healthcare, and their confidence in NHS services.
Key findings
- Nearly one in seven people, 16%, have used private services such as non‑urgent treatment and diagnostic tests in the past year, almost double the proportion in 2023, 9%.
- Long waits are now the leading reason people choose private care. Nearly four in ten, 39%, cited this as their main motivation, compared with 2023, when the most common reason was perceived better quality, 37%.
- Other reasons people gave for going private included better quality of care, 31%, convenience, 30%, and being ineligible for the procedure on the NHS, 20%.
- Income strongly shapes access to private treatment. Only 10% of people earning under £20,000 used private care, compared with 35% of those earning £80,000 or more.
Confidence remains low
The shift towards private care comes as confidence in accessing NHS hospital services remains low.
Only 32% said they were confident in getting timely hospital outpatient treatment, just a slight increase from 28% in 2023. Confidence remains particularly low for timely access to non‑urgent operations, 22%, and scans and diagnostics, 28%.
People also continue to have low confidence in getting other services without delay including mental health care, 22%, and GP appointments, 31%.
Context
National data shows that demand for elective appointments continues to exceed capacity.
Although the waiting list has fallen slightly over the past year, an estimated 6.13m people were waiting for planned care at the end of January 2026, including 2.7m people of whom had been waiting longer than the target time of 18 weeks.
Chris McCann, Acting Chief Executive at Healthwatch England, said:
“The NHS 10-Year Plan aims to tackle long waits for elective care. However, this work needs to move faster if we want to boost patient confidence, stop the move towards two-tier healthcare, and restore the NHS as a truly universal service for all.
“As part of this, the Government must keep its pledge to make sure most people are seen and treated within 18 weeks of referral, including meeting the interim target of 65% of people by the end of this month.”
“To build people’s confidence, the government should introduce the promised minimum patient experience standards for elective care. Everyone waiting for hospital care, no matter where they live or which hospital they were referred to, should get the same level of service and communication. This includes timely confirmation that their referral has been received and accepted, not lost in an administrative black hole, and information on managing their symptoms while they wait.
“Hospitals should also provide patients with regular updates to confirm they are still on the waiting list and give enough notice of any planned cancellations. Importantly, these standards should be tracked and progress shared publicly to increase public confidence in the NHS approach to reducing backlogs.”
Chloe's story: "I was pushed into private care"
Chloe Leckie, 51, from Buckinghamshire, says she was effectively pushed into private healthcare after being unable to access the treatment she needed on the NHS.
She was first referred for an emergency hysterectomy following a severe episode of sepsis in 2023. However, the hospital declined to carry out the operation, describing it as too complex. Chloe was then referred to the Oxford endometriosis clinic, where she was told she would need physiotherapy before surgery could go ahead. Nearly two years later, she is still waiting for that physiotherapy.
“I have been left disabled by the lack of treatment,” Chloe said.
With no progress on the NHS, Chloe eventually underwent the hysterectomy privately, an option she says was only possible because her husband’s employer had recently expanded his health insurance to include pre-existing conditions.
“I went private as I had no other option,” she explained. “We pay a monthly amount for our insurance, but the surgery and all the pre- and post-op procedures would have cost close to £20,000. The insurance doesn’t cover any ongoing investigations or further monitoring.”
Chloe is now back on NHS waiting lists. She is awaiting an MRI scan to investigate bowel issues and is still waiting to see the physiotherapy team.
Want to find out more?
Last week we published separate findings from the polling about people’s access to NHS dentistry.
You can also read our full report showing what care feels like for the people using it, and our recommendations to fix what isn’t working.
Read our report
The poll of 2,593 people in England, aged 18 and above, was run by Savanta between 31 October and 7 November 2025. We asked about the public’s use of NHS and private health care, and their confidence in accessing timely NHS care. This included a boost of 500 people from ethnic minority backgrounds so that detailed analysis by ethnic origin could take place.
It supplements “The public’s perspective: The state of health and social care”, an analysis of people’s experiences of health and adult social care, drawing on 390,000 pieces of feedback shared with Healthwatch England between October 2023 and September 2025.
