Commenting on today's (4 July) report from the Institute for Fiscal Studies and Nuffield Trust on NHS and social care funding in the next decade, Mike Farrar, NHS Confederation chief executive, said: "The figures from this report back our recent calls for Government and NHS leaders to urgently start the difficult yet necessary dialogue with the public about why the health service needs to change frontline care.  

What the NHS can and cannot afford to provide

"We need to be honest about the action necessary to deal with a decade of spending squeezes and the rising cost of healthcare. We need to forensically examine what services and treatments provide the best outcomes for patients and local communities, and what the NHS can and cannot afford to provide in the future.  

Decisive and swift action necessary

"This will be far from pain free, but decisive action is necessary if we are to maintain high quality services and stay in the black. We do not have the luxury of time to bring about change. Support from politicians and the public is crucial if we are to take necessary steps as soon as possible, moving more care out of hospital and in to people's homes, and looking at our biggest cost - our workforce. 

"If the NHS does not change, it will not be fit for the future. We need swift action before the financial pressures overcome us."