A report has warned that the health service will have a £15bn funding shortfall in the next decade, posing its biggest financial challenge to date.
According to the NHS Confederation's Dealing with the downturn: The greatest ever leadership challenge for the NHS? report, the recession and rising costs will create a funding shortfall leaving some "difficult choices to be made".
The confederation, which represents 90% of all NHS organisations, said that although the next two years will be "tough but manageable", after 2010/11 the situation will be "very different and extremely challenging".
NHS Confederation chief executive Steve Barnett (pictured) said: "If [the NHS] does not prepare itself for real-terms reductions, then the mistakes of the past could be repeated and shortages in funding will translate to the kind of across-the-board cuts, which could see waiting lists lengthen, standards fall and dissatisfaction with the service grow among patients and staff."
But the Department of Health is trying to manage the problem, with the NHS set to receive a £102.7bn budget in 2009/10, 7.5% more than the previous year.
The year after the budget will increase again by 1.6% to £105.8bn.