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Purpose

The purpose of this paper is to discuss the impact of demographic pressures on health and social care services and provide readers with a simple way of assessing their impact on local organisations.

Design/methodology/approach

The major forces affecting health systems are identified and the likely impact discussed.

Findings

It is likely that between 4 and 8 per cent of existing budgets need to be released to deal effectively with increasing demand over the next decade. Systems that work in an integrated way are more likely to achieve this.

Practical implications

By developing a quick numerical model, it is possible to assess the viability and effectiveness of proposed strategies.

Originality/value

The paper provides a quick way to think about the major forces affecting strategy enabling the reader to contribute to the identification of possible solutions.

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