A report by the NHS Confederation two weeks ago warned that the health service needed to prepare for cuts of £8 billion to £10 billion between 2011 and 2014, resulting from "extremely challenging" conditions thanks to the economic downturn.
However, NHS chief executive David Nicholson told directors that the real figure was between £15 billion and £20 billion, according to reports in the Telegraph at the weekend.
Chris Roebuck, an expert in management and leadership who advises a number of firms in the healthcare sector, says the NHS will need to ensure it engages its staff fully in order to achieve more with less.
"Steps need to be taken over the next 18 months to build a cadre of world class leaders at all levels in the NHS that have the ability to identify the most efficient way to deliver patient care and inspire staff," he says.
"If the NHS can leverage the full 30% discretionary extra effort that everyone can give through great leadership, then it will rise to the challenge."
He adds that the NHS will need to have "real clarity of purpose".
"Departments and teams will need to be restructured to focus more on delivery. Responsibilities and accountablities will need to be clearer and management spans of control more effective."
The NHS is Europe's largest employer, with 1.3 million employees.
