We have a workforce under pressure and a 30 billion funding gap.

Services are adapting to meet the needs of many hundreds of thousands more of us living with multiple long-term conditions.

And if that weren’t enough for the health service to be facing up to, service pressures are mounting as our population ages and the costs of delivering health and social care continue to grow.

None of this is particularly new. But attending various fringe events at the party conferences this past fortnight, it is starting to feel like the situation has reached code red. Health leaders are genuinely worried that unless we fix the short-term ‘crisis’, there won’t be a long-term future for the NHS to consider or debate.

Although of course all of us who are concerned about the future of the health service naturally worry about the next six months, Independent Age has tried to do some long-term thinking – about the next 15 years. And not just about the future of the NHS, but health and social care.

By 2025, Skills for Care believe we need another one million care workers to meet rising levels of demand. Projections show that in just 10 years time, there will be one million people living with dementia. And by 2030, there will be a doubling in the number of over-85s, compared with the situation in 2010. We are not convinced we are doing the necessary planning to get ready for ageing.

To put this right, we wanted to speak to older people and their families about their hopes – and fears – for future provision of health and care. We worry their voices can all too often get lost as part of the policy-making process: but it is their experiences we need to understand if we are going to build a health and care service “built on bricks, not straw” (the theme of the morning’s – quite calorific – fringe event hosted by the Health Foundation).

What we heard (and have now set out in our new report 2030 Vision: Building a Better Future for Older People in the UK) is sobering.

Over the past 18 months we have been carrying out surveys, supporting polls and asking older people direct what their priorities are. While a number of people praised the high quality care they receive, far too often for the views we gathered to feel unrepresentative, we heard anger and frustration. Services were not always responsive; older people experienced the indignity of ‘flying’ care visits; and many genuinely feared what services would be there in the future.

Many people want to feel sure that whatever reforms to health and social care take place, they have the autonomy and independence they have always prized in their working lives.

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