Video report from ITV News Deputy Political Editor Chris Ship
The NHS in England requires more money and a "radical" shake-up to prevent "severe consequences" for patients, health bosses have warned.
The health service needs an extra £8 billion by 2020 to close a £30 billion funding black hole, Simon Stevens, NHS England chief executive, said.
The current budget stands at £100 billion a year, and a £8 billion increase would mean spending rising by 1.5% extra a year above inflation for the next five years.
Outlining the "NHS Forward View", a five-year blueprint for the NHS, Mr Stevens said: "We have no choice but to do this. If we do it a better NHS is possible, if we don't the consequences for patients will be severe."
The report says that towards the end of the next parliament the NHS may be able to achieve annual efficiency savings of 3% if services are reformed to improve efficiency.
The report proposes a number of new care models, including "breaking down the boundaries" between GPs and hospitals:
- The creation of new bodies to provide GP and hospital services along with mental health and social care
- In areas where GPs are under strain hospitals will be allowed to open their own GP surgeries
- Creating urgent care networks that run seven days a week
- Giving ambulance services power to make more decisions
- Measures to make it easier for groups of midwives to set up NHS-funded midwifery services so mothers have more options to give birth outside hospital
Health chiefs warned said more needed to be done to tackle the root causes of ill health such as the UK's growing obesity crisis, alcohol and smoking.
It proposed encouraging employers to reward overweight employees to lose weight with cash and shopping voucher incentives.
Mr Stevens said the NHS was now at a "crossroads", and the country needed to decide "which way to go".
The future "sustainability of the NHS and the economic prosperity of Britain" depend on a drastic upgrade in prevention in public health, the report said.
Bruce Keogh, national medical director of NHS England, said the NHS remains "one of the best healthcare systems in the world" but added: "We've squeezed the orange really hard over the last four years. People working in the NHS are really beginning to feel the pressure."