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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’.

Frustratingly, the situation has been largely created by years of structural and financial tinkering. It is reinforced by a rating system that polarises provider organisations into positive or negative categories, excluding recognition of overall services that are ‘satisfactory’.

There is plenty of evidence that quality of care is directly linked to staffing levels (RCN 2012), which means that many nurses will struggle to maintain or improve standards without incurring additional costs. The Age UK report adds to the call for recognition of the strain healthcare services are under, and for solutions.

You will need no reminder of the paradox in which costs must be saved while quality of care must be improved

In Nursing Older People we can at least highlight the value of nurses’ contribution to the health and wellbeing of older people, and to the development of future services.

I hope you will take heart from this month’s features, which address staff-awareness training and standardised pain assessment in dementia, supporting people to remain at home through rapid response, reducing social isolation through participation in creative arts projects and developing a nurse-led ‘red legs’ service. After promoting these positive and patient-centred pages, I wish you all a happy Christmas and new year.

Nursing Older People takes a break in January but will return in February.