After a period of immense social trauma and a collective health crisis, what are the British people thinking and feeling about their health and healthcare today?
In 2018, our Truth about Britain study revealed that for many Britons, the NHS was felt to be the ‘beating heart of the nation’. At that time, the NHS was by far the public institution that made people most proud of being British (66%). The next highest ranked institution was the Armed forces (45%). In our latest wave of this research, the people of Britain feel even greater pride in the NHS (68%) while pride has declined in all other public institutions. This holds true across all age groups, and social demographic categories.
Yet, the NHS is in the crosshairs of vociferous debates about the future shape and structure of British society, politics, and commerce. The central role the NHS plays in the lives of every person in Britain as well as its place in the public imagination provides an insightful vector through which to understand the enormous potential of all types of institutions from government (NHS, police, national security, etc.) and social (religion, sports, etc.) to businesses and brands.
The Shape of Wellness in Contemporary Britain
First, a few words about the health and wellness conversation today. We recognise that any discussion about quality of life today in Britain also reflects major shifts that characterise the global wellness conversation. There is a growing awareness of the complex interconnections between various aspects of wellness as well as an appreciation of additional factors that contribute to wellness, including the sexual and environmental dimensions. In the UK, increasing efforts towards ‘green social prescribing’ for better health are evidence of this broader set of considerations that contribute to an optimal and multi-dimensional state of wellbeing.
Fortunately, 57% of people across Britain today feel as though their lives are easier – and quite possibly qualitatively better – than those of their parents. The likelihood of holding this belief is higher the more advanced one’s educational attainment (67% for advanced degree-holders vs 50% for those obtaining A-levels). Nevertheless, the current cost of living crisis has the potential to upend many of these gains given the centrality of financial wellness feeding into other aspects of wellbeing; Britons rank its importance just after the physical, mental, and emotional dimensions of wellness.
Each dimension of wellbeing is constantly changing across one’s life and affected by individual behaviours and choices. While personal life events affect individuals, macro-economic or public health shocks can have profound effect on the health and wellbeing of entire populations and communities. Over the past decade, the UK government has been tracking ten determinants of national wellbeing
including subjective wellbeing, physical and mental health, quality of work, quality of neighbourhoods, personal finance, economy, education, civic engagement, natural environment, and quality of relationships. Each of these determinants is being significantly shaped by institutions whether public or private, from the local to the global.
In the space of social relationships, the Truth about Britain shows that Britons are remarkably committed to self-sufficiency. When provided with a range of options to describe their personal circumstances, 44% answered, “I'm independent and self-sufficient in most all matters of my life”; the highest level of agreement is amongst those over the age of 55. About 26% of people stated that they rely on a small circle of friends and family, while even fewer say that they rely on a loose local network versus a diverse extended network (10% vs 7%). The strength of this conviction of personal autonomy and self-sufficiency among a large part of the population has implications for how individuals think of their relationship to organisations of any kind, and especially those that are dedicated to their health and wellness.
Contemporary expectations for healthcare in the UK
Views about the quality of healthcare (NHS) in the UK is split somewhat equally across three segments. First, there are those who believe that Britain continues to provide some of the best publicly provided healthcare in the world (38%). Second, those who believe that shortages and delays are typical of British healthcare today (39%). Lastly, the smallest group believes that access to healthcare requires leveraging personal connections or relying on privately funded services (24%).
In our ethnographic research for the study, we heard from individuals representing each of these three perspectives:
“I think the NHS is an essential part of being British, as a health care for all system [it] is really treasured and is integral to British society and "Britishness" (52, Manchester)
“I have a long-standing health condition - I'd be worried about losing the NHS as I think it is a wonderful concept but is grossly undervalued and is at breaking point.” (36, Northern Ireland)
“There have been times in the past where either myself or my partner have had injuries/illnesses…but due to waiting lists we opted to self-care.” (29, Lincolnshire)
Multiple factors are influencing the public’s generally positive view of the healthcare system. First, people in Britain are living longer but not necessarily healthier lives, ultimately requiring greater reliance on the NHS for chronic illnesses. People are also generally less tolerant of discomfort today than they were in the past, particularly people who are socio-economically better off. Rising levels of education and greater access to medical knowledge have empowered people to be more proactive regarding their health. People are motivated to engage with healthcare whether to catch serious illnesses early, or to minimise the impact on the capability to work or childcare, or to avoid prolonged discomfort. There has also been a significant shift in the sources of support that Britons are seeking from the healthcare system, with the rising importance and need for mental healthcare spurred by the psychological crisis that the global pandemic has catalysed.
This complexity in expectations coupled with actual experiences explains in part why some of the immense improvements in the quality of healthcare have not been given more attention. Consistently, the NHS ranks first if not among the best in global surveys about quality. People appear to be dissatisfied not with the quality of healthcare but the quantity, namely the experience with or fear of long waiting lists for non-urgent care and staff shortages. In the face of real or perceived resource constraints in the healthcare system, people point to the need for personal connection or relying on private healthcare. Of course, all of this does not take away from the point that the NHS does have face problems including oversight failures, racism affecting both staff and patients, and staff vacancies.
An Invitation to overcome the Wellness Gap
In a country where 71% of the population believes that there are too many conflicting voices regarding wellness, authoritative views and respect for personal autonomy require a delicate balance. While the NHS continues to benefit from a strong sense of national pride, this is in a context where trust in all other national institutions is shrinking, and social cohesion is under threat due to sharpening polarisation.
To be sure, there is a wellness gap in the public imagination. While there is great pride in the NHS (68%), and it is one of the areas of life where people are experiencing the highest level of improvement, only 24% say they have personally experienced these improvements. This dynamic is mirrored in perceptions of brands and business. On the one hand, 83% of Britons say that brands need to think more about the role in improving wellness; on the other hand, only 25% believe that brands and business truly care about their health and wellness. The British public has effectively extended an open invitation for brands and businesses to support and champion health and wellness on par with their expectations of traditional healthcare organisations and to match expectation with fulfilment.
Given the success of its covid-19 vaccine, it’s unsurprising that Pfizer is the company that Britons are mostly likely to say is helping improve an individual’s wellness. Perhaps more surprising is the fact that 1/3 of people say that YouTube is making a difference when it comes to improving people’s wellness. Britons, like other populations in the world, are seeking out knowledge, skills, and tools to improve their health and wellness. Brands and businesses are uniquely positioned to collaborate to enrich the resource pool available to a British public increasingly conscientious about the potential for a more well tomorrow. At the end of the day, all brands and businesses should be aiming to improve people’s quality of life.
Dr. Rodney Collins, PhD, SVP, Director, McCann Worldgroup Truth Central
Dr. Sridhar Venkatapuram, Associate Professor, King's College London
McCann Worldgroup's Truth About Britain 2022 study builds on 15 years of trended data and research about the nation’s cultural, social, and political fabric. Conducted by McCann Worldgroup Truth Central, the organisation's global intelligence unit, the quantitative study surveyed more than 1,200 people (nationally representative across regions, ethnicity, age, LGBTQ+ status, disability). Truth Central also built an online ethnographic community of 55 individuals from across the nation. For more information, visit www.truthaboutbritain.mccannworldgroup.com or email TruthAboutBritain@mccann.com