Age UK’s briefing on the health and care of older people in England 2015 paints a stark picture of the threat to future quality of care. Whether you work in the NHS or the wider care sector, you will need no reminder of the paradox in which costs must be saved while quality of care must be improved. At the time of writing, 13 of the 26 hospitals recently inspected by the Care Quality Commission were rated as ‘requires improvement’, four as ‘inadequate’, and only nine as ‘good’. None was rated as ‘outstanding’.