Public satisfaction with the way the NHS runs across the UK fell by 12% last year, to 58% from 70% in 2010, according to the latest British Social Attitudes Survey.

This is the biggest fall in one year since the Survey began in 1983, although this still remains the third highest recorded level of satisfaction in its history, says health policy think tank The King's Fund, which sponsored the health questions in the Survey.

Satisfaction with individual NHS services also fell, for GPs by four percentage to 73%, for inpatient services by five percentage points to 55%, for outpatient services by six points to 61% and for A&E by seven points to 54%.

Examining the reasons for this sharp fall in satisfaction,The King's Fund notes that more than 1,000 people were surveyed for the study from July to November last year, a period that coincided with the first year in a four-year real-terms freeze on NHS spending and sustained media coverage about the government's health reforms.

With the NHS having been performing well in a number of key indicators and patient experience surveys, the Fund believes that the most likely explanation for the new drop in public satisfaction recorded by the Survey is that "concern about the government's health reforms, reaction to funding pressures and ministerial rhetoric to justify the reforms may have combined to dent public confidence in the way the NHS runs." 

"The value of this survey is that is has tracked public satisfaction over a long period, providing an important barometer of how the public view the NHS," said John Appleby, chief economist at The King's Fund. "The run of year-on-year increases had to come to an end at some stage, and it is not surprising this has happened when the NHS is facing a well-publicised spending squeeze. Nevertheless, it is something of a shock that it has fallen so significantly. This will be a concern to the government, given it appears to be closely liked with the debate on its NHS reforms," he added.

The NHS Confederation also believes that the survey's indication that the public have become worried and confused about what is going on at the NHS relates largely to understanding and support for the reforms.

"It is really important that politicians and NHS leaders are engaging the public in the major debate about the NHS and how we need to change in order to sustain and improve the services they have come to expect and value over recent years," said the Confederation's chief executive, Mike Farrar.

Over the coming months, it will be more important than ever for the government and the NHS to communicate effectively the financial challenges being faced, he said.

"The NHS has got to respond to massive financial pressure and the changing nature of health and social care in a way that takes patients and the public with us. It will be much harder to make the changes to services necessary if public perception and confidence deteriorates," Mr Farrar warned.