"Bold, clinically-led changes" to how NHS services are delivered must be instilled over the next couple of years to address a funding gap that could hit a whopping £30 billion over the next few years, NHS England has warned.

Flat budgets and rising demand on services means that the health service will be grappling with a cash dearth of £30 billion between 2013/14 and 2020/21 based on current models of care, on top of the £20 billion efficiency savings being made.

"This gap cannot be solved from the public purse but by freeing up NHS services and staff from old style practices and buildings,” stressed NHS England chief Sir David Nicholson, as the group said "it will not contemplate reducing or charging for core services".

To have a hope of remaining free of the point of use for patients, the focus must shift from buildings and onto patients and services in a reshuffle of primary and secondary care, with better use of new technology and medicines.

"Without bold and transformative change to how services are delivered, a high quality yet free at the point of use health service will not be available to future generations," it warned.

Call to action

As such, NHS England has set out a national call to action to staff, public and politicians to help the health service meet future demand and tackle funding gap through "honest and realistic" debate.

Alongside a long list of partner organisations, NHS England said it will support local GPs, charities and patient groups to hold meetings to discuss the key issues facing the service, the feedback from which will be channeled into a longer-term strategy for the NHS.

According to Chris Ham, Chief Executive of The King’s Fund, the government's recent reforms failed to address the key challenges of an ageing population, changing burden of disease and rising patient expectations. 

"This time politicians and policy-makers must deliver - this means having the courage to transform services, rather than making further bureaucratic and structural changes", he said.

The King's Fund has also launched its own independent commission to explore whether the post-war settlement - that created separate systems for health and social care - is still fit for purpose.