The state of health and social care in 2026
The NHS is saturated with statistics that aim to tell government, managers and clinicians how services are performing. Yet these only tell part of the story.
Our new report aims to show what care feels like for the people using it, and make recommendations to fix what isn’t working. With Healthwatch due to close, it’s essential that those who take over our work continue to value the public's voice and act on the issues they raise.
The report draws on the 390,000 experiences we heard between October 2023 and September 2025. We combine these with external data to explore ten areas of care that people talk to us about the most. And while each one faces individual issues, key themes emerge over and over.
Top five key takeaways
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.
Stopping the move towards a two-tier system
In 2023, we raised concerns that persistent issues with access and excessive waits for care, particularly for communities already facing inequalities, were creating a two-tier system, where only those who can afford it can access some healthcare. Over the last two years, use of private healthcare has increased significantly.
In 2023, 9% of those we polled had accessed private healthcare in the last year. By 2025, this figure nearly doubled to 16%. The use of private dental care increased from 22% to 32% over the same period. And when we asked people why, the 2025 results show growing concerns around waiting times, convenience and eligibility.
These findings highlight the urgency of addressing persistent issues people tell us about. The NHS 10 Year Health Plan aims to tackle many of the challenges highlighted in this report.
However, this work must happen faster if we are to improve patient confidence, prevent a permanent two-tier system and re-establish the NHS as a truly universal service, available to all. And it needs to be done in partnership with patients if the services of tomorrow are to meet people’s needs.
In each chapter of our report, we provide:
- A snapshot of what aspects of access, care, and support people say are working well, and where things are falling short.
- A look back at themes in feedback since Healthwatch began, showing how experiences have shifted over time and the impact we’ve made.
- Key steps policymakers can take to improve care.
These steps are based directly on what the public is telling us. With Healthwatch due to close and the Department of Health and Social Care, Integrated Care Boards and local government to take up our work, it’s vital they act on these recommendations and continue to listen to the public voice.
