A survey published by the NHS Confederation has revealed disillusionment with the government's move towards integrated care.
Close to 95% of respondents said that only 'slight progress' or 'no progress' is being made to integrate care.
The majority of respondents believe the lack of integration will lead to services becoming unsustainable.
Responding to the survey, NHS Confederation chief executive Mike Farrar said sticking plasters on parts of the NHS that are “creaking” can only last so long.
Speaking ahead of the NHS Confederation’s annual conference later this week, Farrar said NHS leaders must respond to the increasing pressures ahead.
Mike Farrar said: “Change is absolutely necessary if the NHS is to remain fit for the future - the risks of not doing so are simply too great to ignore.
“Effective long-term change will require NHS leaders, with the support of the public and politicians, to take up the gauntlet and see through some radical changes to the way we deliver care.”
Nearly three-quarters (74%) of those polled are confident that they will meet their savings targets over the next 12 months.
Yet financial pressures appear serious for the substantial majority of respondents with over one in five (62%) of NHS leaders describing the pressures facing their organisation as “the worst they have ever experienced”.
And 83% of respondents believe that financial pressures on their organisations will increase over the next 12 months.
Farrar said: “Although our members tell us they are confident about meeting their savings challenges over the next year, a substantial majority describe the financial pressures on their organisations as serious.
“The NHS and its staff face yet another year of pressure - demands on resources are growing and finances are tightening.”
However, Farrar added that there is “cause for optimism”, with the survey revealing that 91% of NHS chairs and chief executives have made “good” or “reasonable” progress in setting out how they will respond to the Francis Inquiry.
Farrar said: “The NHS remains one of the most internationally renowned health services in the world and there is much we should all be proud of.
"It is crystal clear that we need to change our NHS if we want to improve the standards of care patients receive. The Francis report is a sharp reminder that as individuals and collectively as a health service we should never be complacent.”