The health and care system in England has come under increasing pressure during 2014/15, driven by changing care needs and financial demands on all public services. Providers and staff are being asked to deliver significant efficiency savings, to meet the more complex needs of an older, changing population, while ensuring that the health and care system remains sustainable for the future. In the NHS the main focus has been on handling increasing pressures at a time when the NHS budget increased at a significantly lower rate than before. In adult social care, services have been asked to deliver more with less, as local authority funding has been reduced. Many services have responded well, despite the increasing pressures, and managed to improve or maintain quality. The report celebrates the many services across the country that are delivering high-quality care to the people they care for. Although the Commission has not yet rated all services, more than 80% of the GP practices rated so far were good or outstanding. In adult social care, nearly 60% of services were good or outstanding.