More must be done to improve the efficiency of the NHS and address the "budget crisis" affecting it as people enjoy longer life expectancies, experts have warned.
In a letter to The Times, senior health figures including Sir Richard Thompson, president of the Royal College of Physicians, and Dr Maureen Baker, chairwoman of the Royal College of General Practitioners, say two and a half times as many people will suffer multiple problems over the next 50 years, and call for a "national conversation" on the issue.
The letter warns that unless action is taken, by 2020 the NHS will require an additional £30 billion to maintain the current level of service provision.
"More must be done by us all to eliminate inefficiencies and wasteful variation in care, and apply technology to transform care delivery," the letter adds.
"Resources and vigorous service reform must go hand-in-hand. Business as usual won't do."
The nine signatories call for an " honest, open dialogue" on the issue, adding: " We need a new settlement; a fundamental, holistic agreement with the country on what health and social care should be, how and where it is delivered to maximise the quality of care, and how it should be paid for.
"We believe the route is an all-party-mandated, independently conducted 'national conversation' on the scope, provision and funding of health and social care."
The letter was also signed by Sir John Oldham of the Independent Commission on Whole Person Care, Jeremy Hughes of the Alzheimer's Society, Dr Jean-Pierre Van Besouw of the Royal College of Anaesthetists, Ciaran Devane of Macmillan Cancer Support, L ord Adebowale of Turning Point and Chris Hopson of the Foundation Trust Network.