Guidance

Change NHS survey: your priorities for change

Updated 1 April 2025

Applies to England

This GOV.UK page gives an outline of the questions asked for public reference.

Background

The NHS has been there for us for over 76 years, but as set out in Lord Darzi’s independent report, it is in ‘critical condition’. To make sure it’s here for the next 76 years, doing all it can to support the health of everyone, we need your help. 

We launched Change NHS in October 2024 to hear your views, experiences and ideas, which will shape a new 10 Year Health Plan for England. Since then, we’ve had over 175,000 contributions from people.

You’ve shared your pride in the NHS and your support for its founding principles, but also the hard truths about your experiences. Too often, you cannot get a GP appointment, ambulance or treatment when you need it. Staff do not have the resources they need to provide the care they want to give to patients. 

We know it will not be easy to turn the NHS around and that’s why we’ve started to tackle the immediate pressures head on:

• we’ve put in an extra £26 billion into the NHS
• we’re increasing the number of GPs
• we’ve delivered on our promise of 2 million more appointments for patients, meaning waiting lists are starting to come down

We’re also:

• introducing a ban on junk food advertising for children
• bringing in new laws to create the first smoke-free generation
• boosting funding for social care 

But there’s more to do. We now need you to tell us your priorities for change on some of the ideas from the engagement so far.

Survey overview

Our 10 Year Health Plan will set out from day one how we will fix the underlying problems set out in Lord Darzi’s independent report that said the NHS was in ‘critical condition’.

The 3 shifts - hospital to community, analogue to digital and sickness to prevention - can deliver what you want:

• better, quicker access to care in your community and hospitals, delivering world class care to those who need it
• staff with the technology they need to care for you
• an NHS that helps prevent illness and spots diseases like cancer early, to give the best chance of survival

If we get this right then we can deliver what you’ve told us matters - shorter waits, supported staff and better care.

Help us make this a reality by telling us what you think about some of the emerging ideas for change. There are 5 sections and some questions for you to answer. All of the questions are optional.

How to respond

Respond by 5pm on Monday 14 April 2025 for your views to be considered as part of the development of the 10 Year Health Plan.

Go to the Change NHS online portal to give your views on your priorities for change.

If you prefer to submit your response in another format, for example in a video in British Sign Language or by written email response, email changenhs@thinksinsight.com.

If you are preparing a written response, structure your response using the questions below.

You can also send your submission by post to:

Thinks Insight and Strategy
West Wing
Somerset House
London
WC2R 1LA

If you’re completing the easy read version of the survey, you can send this by email or post.

If you have any other questions about taking part, email the Thinks team at: changenhs@thinksinsight.com.

Section 1: empowering you to make choices throughout your life

Over the last few months, we’ve heard lots about the challenges people have faced in accessing and experiencing care. You told us you want you and your loved ones to live healthier lives, being supported to make good choices at every stage of your life.

This means empowering people to be able to make better choices for their own health, whether that’s attending a screening or taking up support to quit smoking. You told us that these prevention services need to be accessible to everyone, whatever their starting point.

It’s also about working with organisations outside the NHS who also have a role in supporting people to stay healthy - whether that’s schools, employers or community or voluntary organisations. This could include:

• employers giving you resources to stay healthy (good working conditions, access to healthy food, access to health apps, wearable tech, access to a work-health adviser, and so on) and support to be able to attend health appointments or exercise
• education organisations providing information on healthy eating and staying healthy
• local government (such as councils) and/or voluntary organisations providing signposting and access to local services that support a healthy lifestyle (for example, affordable gyms, swimming, parks and advice)

Finally, an NHS fit for the future needs to support people to make the best choices for them throughout their life, including when they are approaching end of life, through earlier, better quality conversations about patients’ wishes and preferences.

Many of you have told us that more can be done to support people with their physical and mental health.

Which 3 things would help you most to stay healthy? (Please select up to 3)

• Easier access to your health record with personalised information about any risks to your health and how to manage them
• Access to fitness and mental wellbeing apps which support you to stay healthy (Couch to 5K, mindfulness apps, and so on)
• Reminders from the NHS App to support you to manage your health (notifications to remind you to take medicines, book follow-up appointments, follow medical advice, and so on)
• A healthcare professional signposting to activities in the community that can help your mental and physical health (exercise classes, nutrition and cooking classes, meditation, and so on)
• Easier access to tests and diagnostics to help spot any health issues you may have
• Regular check-ins with a healthcare professional on your physical and mental health
• Don’t know
• None of these

We also heard that, while you see a big role for the NHS to help individuals stay healthy, you also think others in society have a role to play.

Beyond the NHS, who should have the biggest role in helping people manage their health and wellbeing? (Please select all that apply)

• Local government (councils, local services, elected local leaders)
• Voluntary organisations (charities that provide support on conditions and health - for example, cancer, and so on)
• My family and friends
• Employers (providing good working conditions, access to healthy food, access to health apps, wearable tech, access to a work-health adviser, and so on)
• Public figures (sportspeople, social media influencers, and so on)
• Education organisations (schools or universities)
• Fitness organisations (gyms, personal trainers, sports clubs, parkrun, and so on)
• Other - please specify
• Don’t know
• None of the above - it should mainly be the responsibility of the NHS and healthcare staff

Palliative care is an approach that improves the quality of life of patients and their families who are facing a life-limiting illness. Usually, this is an illness that worsens over time.

This care prevents and relieves suffering by managing pain and other problems, whether physical, mental, social or spiritual. End of life care is a form of palliative care you receive when you are close to the end of your life.

One suggestion is that early conversations about people’s preferences for their future care, including end of life care, may help ensure people’s wishes are respected.

How do you feel about having an early conversation about palliative care with a healthcare professional, including an opportunity to discuss what a good death would mean for you? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

What, if any, concerns would you have with discussing your preferences for palliative care? (Please select all that apply)

• I would rather not talk about palliative care while I am healthy
• I am uncomfortable talking about palliative care with a healthcare professional
• I do not have enough information to have this conversation
• This does not feel relevant to me at the moment
• Other - please specify
• Don’t know
• None

Section 2: delivering care where it’s needed

One of the greatest challenges we’ve heard from people is accessing care, whether that’s for GP appointments or long wait times for referrals and hospital procedures.

Meeting the standards of care that the public expects from the NHS requires a different approach, including delivering more care in the community and a wider range of health and care professionals to reduce pressure on hospitals and GPs. This should also mean that patients have greater choice about where they can receive care.

However, this could mean patients being cared for by different people, in different places - for example, speaking to a pharmacist or nurse before speaking to their GP, and in a different care setting - to be able to be seen more quickly.

Accessing care is one of the top concerns you’ve shared during the engagement so far. One suggestion to address this could be seeing other healthcare professionals for specific issues to be seen sooner, instead of going to your GP first.

Which other healthcare professionals would you be happy to speak to first instead of a GP, if it meant you were seen sooner? (Please select all that apply)

• A pharmacist to discuss a prescription to treat common health conditions and/or check and review a prescription
• A nurse to discuss a minor illness
• A relevant specialist (consultant, dietitian, and so on) instead of waiting for a referral
• A mental health practitioner to discuss your mental health
• A physiotherapist to discuss an injury
• Other - please specify
• Don’t know
• None - I would want to speak to a GP first

Which settings would you be happy to speak to a healthcare professional in, outside of a GP surgery or hospital? (Please select all that apply)

• A mobile screening clinic (for cancer tests, blood tests, and so on)
• A community centre (a pop-up clinic)
• Faith buildings (a pop-up clinic)
• Your home
• Schools and colleges
• Pharmacies
• By digital appointment (on your phone, tablet, laptop, and so on)
• Don’t know
• None - I want to be seen in a GP surgery or hospital

What, if any, concerns would you have about speaking to a different healthcare professional instead of a GP? (Please select all that apply)

• Care not feeling joined up between different healthcare staff and services
• Receiving worse care
• Unfamiliarity
• Lack of availability
• Other - please specify
• Don’t know
• None

We heard that to feel confident using services in new settings and with new healthcare professionals, you need to know that there will be proper safeguards in place and that this will benefit you.

Which of the following is most important to you? (Please select the top 3 that are most important to you)

• That my personal data will be handled safely and securely
• That my concerns and issues will be taken seriously
• That healthcare professionals will have access to my records, so they know how to treat me and what my history is
• That my GP should have a record of every appointment and conversation, so nothing gets missed
• That I will be seen sooner than if I went to a GP
• That I will be seen at a more convenient time and/or location
• That healthcare professionals that are not GPs are trained to spot things that could be signs of more serious illness
• Other - please specify
• Don’t know
• None of these

Section 3: supporting staff to care for patients

You told us that one of the best things about the NHS is the hard-working, dedicated staff who deliver a high quality of care. However, thousands of you have experienced challenges with:

• accessing that care
• care feeling disjointed and inconsistent across services
• poor communication surrounding that care

An NHS fit for the future needs to put patient needs, preferences and choices at the centre of care - so people feel it is easier to engage with the NHS, feel heard and listened to by staff, and feel supported to make informed decisions about their care.

An important part of realising this is supporting staff to deliver personalised healthcare in partnership with patients, families and carers - so it truly reflects what you want and need. This could mean supporting staff to take an approach that focuses on your overall health, not just a specific health concern you have.

Another suggestion is that appointments with people with more complex health needs are prioritised to get them the right help as early as possible, and to give them more time to talk about their needs.

A common challenge people face is having to book lots of separate appointments with different healthcare professionals if they have multiple health conditions or concerns.

How do you feel about all healthcare staff having more information about your overall health and your health risks to give you broader advice instead of focusing on one specific health issue? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

What concerns, if any, would you have with healthcare staff taking a broader approach to your health, and not just the specific health issue or concern you have?

• I am uncomfortable with healthcare staff having access to all of my health information and would prefer to talk only to specialists about specific issues
• Healthcare staff should focus on developing expertise in their specialist areas rather than giving general advice
• I am concerned about health professionals telling me what to do when it comes to my overall health
• Other - please specify
• Don’t know
• None of these, I am comfortable with staff taking a broader approach to my health

In the NHS, there are non-clinical staff who help people to use the NHS and co-ordinate their care. One idea to improve healthcare is to increase the use of these staff across the NHS. These staff would not provide you with medical treatment but could:

• ensure you can access the right services
• make sure clinicians share information with you and other staff
• get answers to any questions or concerns you might have

How do you feel about dedicated staff helping you to use the NHS and to access the right services and information? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

Section 4: improving health for everyone, especially those with the greatest need

We know that those in greatest need often have the poorest access to care - and thousands of you told us about what you feel is a ‘postcode lottery’ for people’s experience of care, access and health outcomes.

The NHS needs to deliver for everyone, no matter who they are or where they live. There are some different suggestions for ensuring that everyone has access to high quality care - whether that’s targeting resources, reaching out to people with greater needs, or making sure staff and services are in the right places so that everyone has equal access.

One suggestion to improve health for everyone is to target resources to people and areas that have the greatest need. This could include prioritising more spending in specific areas, such as pop-up or mobile clinics in areas of need to make healthcare more accessible in communities, and to provide more outreach to communities.

How do you feel about targeting more resources on prevention and healthcare to people and areas who are more in need than others? (Please select a number from 1 to 5, where 5 means you strongly support this, and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

Another suggestion is that staff are encouraged to work in areas of the country with the greatest needs or that have higher levels of staff shortages. This could be through getting a higher wage or having their student loan repayments reduced.

How do you feel about giving staff higher wages or reductions in student loan repayments to encourage them to work in places where they are most needed? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

People with complex needs could be prioritised for appointments to get the right healthcare as early as possible. This could mean that people with complex needs may have access to longer appointments with a GP and could be seen sooner, while there is a standard offer for everyone to see a healthcare professional as soon as possible.

How do you feel about people with more complex needs being prioritised for appointments? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

Section 5: using technology to improve your care and experience

You told us you see real potential for the role of technology in improving health and care, and the way in which care is delivered. 

Much of this is about ‘getting the basics right’ - whether that’s staff having IT that works to help them do their job more efficiently, or better communication and co-ordination across health and care services to stop you having to tell your story again and again.

There are a number of specific ideas that could help unlock the potential of technology:

• making greater use of the NHS App to book and manage appointments across different services and view personalised health advice and resources
• patients having a single, digital care record which healthcare professionals can access to help care feel more joined up across different services

How do you feel about having the NHS App as your main way to access NHS services and information? (Please select a number from 1 to 5, where 5 means you strongly support this and 1 means you are strongly against this)

• 1 - Strongly against this
• 2
• 3
• 4
• 5 - Strongly support this
• Don’t know

How likely would you be to use the NHS App if it became the main way to access NHS services and information?

• Very likely
• Fairly likely
• Neither likely nor unlikely
• Fairly unlikely
• Very unlikely
• Don’t know

What concerns do you have, if any, with making greater use of the NHS App? (Please select all that apply)

• I don’t have access to the right technology to access services through an app (for example, a smartphone or tablet)
• I don’t feel I have the digital skills to access NHS services through an app
• I wouldn’t feel comfortable entering personal information online
• I would have concerns about data sharing and privacy
• I don’t want to use an app to access NHS services
• Other - please specify
• Don’t know
• None - I don’t have any concerns about using an app to access the NHS

A single patient record is a way of bringing together all health and care data about a person in one place, that all the people who care for you can access. What do you think should be prioritised when it comes to rolling out a single patient record? (Please select your top priority)

• Staff having access to all your records from across different services so you don’t have to repeat yourself
• Giving you access to your entire record, tailored health advice and access to testing and diagnostics on the NHS App or website based on your health and any health risks
• Being able to choose to integrate the record with other apps and wearable technology to help you manage your own health
• Saving staff time and freeing up staff resources by making processes more efficient
• Other - please specify
• Don’t know
• None of these

About you

It’s really important that the 10 Year Plan reflects the views, experiences and ideas of the widest possible range of people. Help us understand whether we are reaching lots of different kinds of people by telling us a bit about yourself. Your answers will be kept anonymous and confidential.

What is your age?

• Under 16
• 16 to 24
• 25 to 34
• 35 to 44
• 45 to 54
• 55 to 64
• 65 to 74
• 75 to 84
• 85 to 94
• 95 or above
• Prefer not to say

What is your sex?

The answer you give can be different from what is on your birth certificate.

If you’re not sure how to answer, use the sex registered on your official documents, such as passport or driving licence, or whichever answer best describes your sex.

The next question gives the option to tell us if your gender is different from your sex registered at birth.

• Male
• Female
• Prefer not to say

Is the gender you identify with the same as your sex registered at birth?

• Yes
• No
• Prefer not to say

If no, please tell us your gender identity.

Where are you currently living?

• Greater London
• South East England
• South West England
• East Midlands
• West Midlands
• North East England
• North West England
• East of England
• Yorkshire and the Humber
• Wales
• Scotland
• Northern Ireland
• Prefer not to say
• I do not live within the UK

Please share the first half of your postcode if you feel comfortable doing so.

As with all other questions, sharing the first half of your postcode is optional. This information will only be used for research purposes to help with analysis

What is your ethnicity?

• White - English, Welsh, Scottish or Northern Irish
• White - Irish
• White - Gypsy or Irish Traveller
• White - Other
• Mixed or Multiple - White and Black Caribbean
• Mixed or Multiple - White and Black African
• Mixed or Multiple - White and Asian
• Mixed or Multiple - Other
• Asian or Asian British - Bangladeshi
• Asian or Asian British - Chinese
• Asian or Asian British - Indian
• Asian or Asian British - Pakistani
• Asian or Asian British - Other
• Black, African, Caribbean or Black British - African
• Black, African, Caribbean or Black British - Caribbean
• Black, African, Caribbean or Black British - Other
• Other ethnic group - Arab
• Other (specify)
• Prefer not to say

Do you consider yourself as having a disability or long term health condition? (Select as many as you like)

• Yes - sensory impairment - for example, hearing or visual
• Yes - physical or mobility impairment
• Yes - mental health condition
• Yes - neurodivergent condition
• Yes - learning disability or difficulty
• Yes - long-standing illness or health condition
• No
• Prefer not to say

Do you currently provide any informal care or support for family members, friends or others?

By informal, we mean that you are not providing this care or support in a professional paid capacity. This may be due to their illness, disability or age-related needs.

• No caring responsibilities
• Child or children
• Parents
• Spouse or partner
• Siblings
• Other family members
• Friends
• Neighbours

Have you worked for a health or care organisation in the last 12 months?

• Yes
• No, but I have previously worked for a health and care organisation
• No, and I have never done so
• Prefer not to say

The following questions are for those who have worked for a health or care organisation in the last 12 months.

Which type of health and care organisation do you primarily work for?

• Community interest company (CIC) or social enterprise
• Educational institution (for example, university or medical school)
• Government department or agency
• Integrated care system (ICS) or integrated care board (ICB)
• Local authority or council
• NHS arm’s length body (for example, NHS England)
• NHS primary care - community pharmacy
• NHS primary care - dental practice
• NHS primary care - GP practice
• NHS primary care - optometry
• NHS trust - acute
• NHS trust - ambulance
• NHS trust - community
• NHS trust - mental health
• Other health and care organisation
• Private healthcare provider
• Public health agency
• Regulatory or professional body
• Social care organisation
• Voluntary or charitable organisation
• Prefer not to say

In which region of England do you primarily work?

• East of England
• East Midlands
• Greater London
• North East
• North West
• South East
• South West
• West Midlands
• Yorkshire and the Humber
• None of these
• Prefer not to say

What is your current primary role within the health and care sector?

• Administrative or clerical staff
• Allied health professional (for example, physiotherapist, occupational therapist, speech and language therapist)
• Ambulance worker
• Associate doctor
• Community pharmacist
• Consultant
• Dentist or dental care professional
• Direct care worker - social care
• Estates and facilities staff  (for example, porter, cleaner or maintenance)
• General practitioner
• General practice manager and wider staff
• General practice nurse
• Healthcare assistant or clinical support worker
• Healthcare scientist or technician 
• Health visitors
• Managerial or executive staff
• Midwife
• Nurse
• Optometrist or optician
• Other healthcare professional
• Paramedic
• Pharmacist or pharmacy technician
• Physician associate
• Psychologist or psychological therapist
• Public health nurse
• Public health practitioner or trainer
• Public health consultant or specialist
• Resident doctor
• Specialist doctor
• Social worker
• Support staff - social care
• Student or trainee in a healthcare profession
• School nurse
• Prefer not to say
• Other - please specify

How long have you been working in the health and care sector overall?

• Less than 1 year
• 1 to 2 years
• 3 to 5 years
• 6 to 10 years
• 11 to 20 years
• More than 20 years
• Prefer not to say