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The National Health Service (NHS)

Formal rating
BBB+Outlook: Stable
As of 2026-Q2
This week’s trust-pressure signal
Negative pressure3–9 Aug 2026

Continued focus on waiting times, workforce pressures and service performance.

Provisional indicator only · Does not change the formal rating

Current standing

Overall public satisfaction remains near historic lows despite a modest recent uptick. Access and experience metrics are weak, while founding principles retain strong public support.

25-year trajectory

2000 baselineA
2026 formalBBB+
Deteriorating
  • BSA satisfaction recovered slightly in 2025 but remains very low by historical standards.
  • Waiting lists and workforce shortages are binding constraints.
  • Symbolic attachment to the NHS remains high.

Visual comparison

The National Health Service (NHS) vs international peers

2000 baseline (left) vs 2026 formal (right) · Higher bar = stronger rating

20002026
BBBBB–A–AA–AAAABBB+UKThe National Heal…A+AFranceFrench healthca…AA–A+GermanyGerman GKV syst…AAAA–SwedenNordic universa…A+A–CanadaCanadian Medica…A+AAustraliaAustralian Medi…AA–A+NetherlandsDutch regulated…

Five pillars (formal assessment)

Public Trust & Respect

Deteriorating
Mixed – high attachment, low satisfaction

Founding principles strongly supported; delivery satisfaction low.

Performance & Effectiveness

Deteriorating
Under clear pressure

Access and waiting-time performance remain weak.

Financial / Operational Sustainability

Deteriorating
Under severe pressure

Demand, workforce and funding pressures interact strongly.

International Standing

Stable
Adequate

Clinical outcomes mixed; system design still widely studied.

Shock Absorption & Adaptive Capacity

Deteriorating
Under pressure

Has absorbed major shocks but recovery capacity is constrained.

International peers

Formal ratings only · 2000 baseline → 2026 current · No weekly signals

InstitutionCountry20002026Outlook
French healthcare systemFranceA+AStable
German GKV systemGermanyAA–A+Stable
Nordic universal systemsSweden / NordicAAAA–Stable
Canadian MedicareCanadaA+A–Negative
Australian Medicare + public hospitalsAustraliaA+AStable
Dutch regulated competition systemNetherlandsAA–A+Stable