The vast majority of NHS staff want health services to be merged with social care in order to help ensure the NHS survives amid the growing pressures of ageing, tight budgets and the need to look after older people better.

Four out of five of the 1,069 respondents to the latest survey of members of the Guardian's Healthcare Network, who do a wide range of clinical and management roles in the NHS, said they backed a policy aim sometimes described as the "holy grail" of healthcare.

Participants from a range of NHS organisations, including GPs, consultants, nurses, strategy and policy managers at NHS trusts, and officials from NHS England, shared their views just before the first anniversary of the coalition's radical restructuring of the service in England.

When asked, "Are you in favour of integrating health and social care?", 81% said yes, 9% said no and 11% were unsure.

A much smaller majority (61%) believed that merging the two services into one was achievable, – though 18% disagreed, with 21% unsure – but given that integration would inevitably involve change, pain and a loss of autonomy and control, that is a fairly positive response.

Supporters of integration said the move was "essential with an ageing population" and "vital to improving patient-centred healthcare". Another said: "We waste so much money by having different systems and it prevents continuity for patients."

But there were sceptics too. "We integrated four years ago and the services are still fragmented, with patients falling between the two", said one. "Collaborative working is better than integration", said another, and further comments backed integration "as long as [it's] not under the control of local authorities".

Comments on the achievability of this widely desired aim highlighted the complications involved. "It will take a monumental shift in budgets, staffing and services", said one. It "will require pooled health and social care budgets, but everyone is so desperate for funds that no one can commit to taking the plunge in case they appear to lose out. Current funding issues lead to constant short-termism", said another.

One suggested "joint appointments to senior posts, but at present what I've seen is duplication of senior posts as each organisation wants to keep control of 'their' budget".

Ministers are trying to encourage health and social care providers to come together and offer joint services across England through the creation, from April 2015, of the Better Care Fund. The Department of Health (DH) says its fund would "bring £3.8bn of health and social care funding together into a single seamless service to keep our elderly and most vulnerable well for longer." It will lead to pooled budgets in every part of England, with £200m to help smooth the integration. It is seen as a vital way of prompting the joint working, and possibly ultimately the merger, of services experts believe are needed to keep the NHS sustainable.

Surprisingly, given how piecemeal integration has proved so far, as many as 49% of respondents said their organisation was already involved in integrated working with social care providers in its area. Of those, 13% were part of an integration pioneer project. Less positively, when asked to identify the barriers to integration, respondents mentioned structural differences (78%), incompatible IT systems (66%), cultural differences (64%) and different regulatory systems (59%) as well as "lack of interest at senior level" (33%).

Many of the rest of the findings make worrying reading, both for the health secretary, Jeremy Hunt, and for staff, bosses and supporters of the NHS. For example, 77% said their job was harder now than last year, with just 5% disagreeing, and 50% said they now had less time with patients than before the 2013 shakeup, while a mere 6% said they had more time. "Increased workload", "less staff, more patients" and "pressure to make more savings" were among respondents' comments.

Crucially, 52% said patient care had not improved over the last year, despite the heavy pressure on NHS providers to improve the quality and safety of care in the wake of Robert Francis's report into the Mid Staffordshire scandal in February 2013, although 20% said it had got better.

"Staffing levels are unsafe, unreliable and unpredictable" was one comment. Another respondent said: "Mantra is to discharge as soon as possible. If they are re-referred it counts as a new referral –we get paid again." Others talked about heightened stress and unfilled vacancies.

After his high-profile drive to raise care standards, Hunt may react with anxiety to such findings.

Further doubts about the wisdom of last year's massive upheaval emerged in the finding that 79% do not believe the NHS is more financially sustainable than it was a year ago. Just 4% think it is.

Is the NHS fit for purpose? While 47% said it was, a significant minority (35%) disagreed. The majority view among survey respondents echoes the consensus among key health policy thinkers.

Two weeks ago, Sir David Nicholson, the NHS's outgoing boss, reshaped the growing debate on how to keep the NHS functioning properly in the years ahead when he told the Guardian that the service would need extra funding throughout the five years of the next parliament to smooth its transition from its "unsustainable" present to a future in which many services happen outside hospitals.

Some 57% of respondents want greater taxation for deeper NHS investment. Of those, 38% favour higher taxes and 19% a hypothecated tax, though perhaps surprisingly, 23% back charging patients for services and 21% endorse more rationing of treatment.

The money question is becoming urgent. Anita Charlesworth, the authoritative chief economist at the Nuffield Trust health thinktank, warns that: "If we want to maintain the current NHS with a growing and ageing population, and tackle concerns about quality, we will have to pay for it one day. There is now a serious chance that the NHS will hit the financial buffers before and not after the next election."

Four in five (79%) believe the NHS is under too much political control, a concern shared at senior levels in supposedly quasi-independent organisations such as NHS England and the regulator Monitor. Few believe the Health and Social Care Act's intention of "liberating" the NHS from political direction and interference has become a reality. And 61% back a database of patient records, though fewer (56% ) would allow their own records to go into it.

Hunt evokes strong feelings. In all, 77% said they did not have confidence in him; just 6% did. After alienating key staff groups such as GPs, nurses and managers, and cancelling the NHS workforce's recommended 1% pay rise, that vote of no confidence is to be expected.

Jamie Reed, a shadow health minister, calls it "a damning indictment of his [Hunt's] record. It is little wonder people feel this way after his persistent attempts to run down the NHS".

Christine McAnea, head of health at union, Unison, agrees. "It comes as no surprise that an overwhelming majority of health workers have no confidence in a secretary of state who has put the NHS under attack. Staff are on average 10% worse off than when the coalition came to power," she says.

A DH spokesman says: "The health secretary recognises the extremely hard work of NHS staff but makes no apology for pushing for greater transparency and higher standards for patients."

Labour and Unison blame the problems highlighted in our survey on the NHS shakeup last year. "The reforms have had a devastating impact on the NHS as a service and on staff morale. Staff are feeling increasingly demotivated and demoralised. They are concerned about the quality of care they are able to provide as they struggle with growing number of patients and staff shortages", says McAnea.

The top priorities for the new NHS England chief executive, Simon Stevens, who starts next week, say Healthcare Network members, should be to improve staff morale, somehow get more money for the NHS and to drive forward the integration of health and social care that so many people working in the health service clearly believe is so important. All of these, though, are the responsibility of ministers, not Stevens.

More on the survey at theguardian.com/healthcare-network