The report finds nearly a quarter (23%) of people who used the NHS in the past 12 months received an appointment invitation after the appointment had already happened, an increase of 3 percentage points on the previous year.

Dan Wellings, senior fellow at The King's Fund and co-author of the report, said: ‘These findings should be a real cause for concern for Government and NHS leaders. Not only has there been no improvement in patients' experiences of these issues over the past year, but wider public awareness of these administrative failings is growing. Once negative perceptions take hold, they are difficult to reverse. Recent gains in public satisfaction with the NHS may be short‑lived unless rapid action is taken to tackle this problem.'

The analysis finds two thirds of patients and carers (66%) experienced at least one NHS administrative problem in the past year. These included not being kept informed about waiting times, having to chase test results, not being told who to contact while waiting for care, or being given incorrect information.

The key issues experienced include:

• 33% of patients were not kept updated about how long they would have to wait for care or treatment
• 32% of patients have had to chase test or scan results
• 24% of patients did not know who to contact while waiting for care
• 18% of patients tried to contact the NHS to change or cancel an existing appointment but were not able to
• 15% of patients were not told or sent information they could not understand
• 15% of patients were told or sent the wrong appointment date or time
• 4 out of 10 (41%) of patients said these experiences made them less likely to seek care in the future.

The research also finds:

• The percentage of the public who said NHS was good at communicating with patients about things like appointments and test results has fallen from 52% in 2024 to 43% in 2025
• The percentage of the public who said the NHS was good at keeping people informed about what is happening with their care and treatment has fallen from 42% in 2024 to 32% in 2025
• The percentage of the public who say the NHS is good at ensuring there is someone for patients to contact about their ongoing care if they need to has fallen from 43% to 32%
• 60% of those who experienced at least one problem over the last year with NHS admin say it made them think NHS money is being wasted.

People more likely to suffer the consequences of poor admin included those with long-term conditions, people from ethnic minority backgrounds and those struggling financially. Over 4 in 5 (81%) patients and carers who report they are struggling financially have experienced an issue with NHS admin, compared with 3 in 5 (63%) of those who are comfortable financially.

Over half of people (57%) say poor admin makes them believe the NHS wastes valuable staff time.  

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Jenny King, chief research Officer at Picker, said: ‘We agree that improving NHS admin must be a national priority, with clear expectations, measurement, and meaningful patient involvement. Getting admin right will not only improve people's day-to-day experiences, but also make better use of staff time and NHS resources - enabling a more efficient, more person centred health service.'

Unison head of health Helga Pile said: ‘If ministers are serious about cutting waiting lists, they must invest in the admin workforce that keeps the system running.'

An NHS spokesperson said: ‘While the hard work of staff has driven real progress in waiting times and public satisfaction over the past year, these findings are a timely reminder of how much more there is to do to better join-up NHS care and ensure we get our services back to the level patients deserve.  

‘For too long, local NHS teams' communications have been hamstrung by outdated systems – and that's why we are investing to revamp our technology and join-up data, while expanding and improving the NHS App, to fully shift the service from analogue to digital and build an NHS fit for the future.'