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"The enormous pressures that are facing social care will spill over into the NHS unless there is action to shore up the whole system.  

NHS and local government as one on this issue

"The NHS is absolutely as one with local government on this issue. We need a solution, otherwise there will be a financial crisis, patients and carers across the country will suffer and the cost to the taxpayer will be greater." 

The NHS Confederation says that policymakers need to make difficult decisions now so that the new system covers as many people as possible and the public are clear how much they will have to start contributing towards social care. 

Everyone needs to contribute to social care

Mr Farrar said: "The NHS needs a new system where everyone contributes towards social care. A voluntary scheme will not give us the model we need. We cannot have old people stuck in NHS wards because social care arrangements are not in place. 

Honesty

"We also need to be honest with the public about how much they will need to contribute to funding the new social care system and what they will be entitled to based on their needs." 

Longer term and immediate future

While policymakers face a series of difficult decisions for the longer-term future, they must also tackle the immediate future. New money will need to be made available to move from our current system of care and funding to a new one. 

Mr Farrar said: "Even if the Dilnot proposals are both workable and enacted, they are unlikely to deliver a penny until 2014. That looks like a long time to those delivering health and social care services.  The Government will need to invest to ensure we get there. 

"The NHS is facing an enormous financial challenge already so it is crucial that we set out clearly how the health