The health service is facing a "defining moment", according to new NHS England chief executive Simon Stevens.
Speaking to the Daily Telegraph he says: "The reason I took this job is because I think the NHS is at a defining moment, a point when it needs to 'future proof' itself against the challenges ahead,"
"We need to take a proper look at the sort of changes that are going to be needed over the next five years and beyond to put the NHS on a sustainable footing."
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Teachers and managers in particularly are putting in hundreds of hours of overtime free of charge.