By Thomas Moore, Health and Science Correspondent
The NHS needs an extra £8bn a year in funding and must undergo a major shake-up if it is to survive, according to a "radical" plan to safeguard services in England.
A range of measures are outlined in the report by NHS England, including a shift in resources from treating disease to preventing ill-health and a massive migration of services from hospitals into GP surgeries.
But it warns the upgrade to services will only be possible with a series of savings and an £8bn-a-year rise in government funding by 2020, to help make up a projected £30bn annual shortfall.
Health Secretary Jeremy Hunt told Sky News there was "massive pressure" on frontline services.
"We have nearly a million more over-65s than we had four years ago and doctors and nurses are working really hard," he said.
"What this report says ... is that we need to change the model of care, so that we're not just depending on hospitals.
"We need to be so much better at looking after people in the community and in their homes, using GP practices (and) catching people before they get seriously ill.
"It's not an easy process ... but if we do that, the £30bn gap that people have been talking about can be bridged, and actually we can get it right down to zero."
Simon Stevens, chief executive of NHS England said the country had "no choice" but to follow the plan.
"If we do it, a better NHS is possible," he said.
"If we don't the consequences for patients will be severe."
The report warns there needs to be "hard-hitting national action" on obesity, smoking and alcohol.
It wants employers to offer workers incentives to lose weight, including shopping vouchers, cash or prizes.
NHS staff will also be urged to "set a national example" with healthier lifestyles.
Local authorities should take tougher action on fast-food and alcohol outlets to improve the health of their populations.
"Put bluntly, as the nation's waistline keeps piling on the pounds, we're piling on billions of pounds in future taxes just to pay for preventable illnesses," the report says.
NHS England also wants to move more services out of hospitals, which are expensive to run.
It says GPs could group together to provide tests that have traditionally required a referral, and even employ consultants to run specialist clinics.
The NHS 111, 999 and out of hours GP services also need to be overhauled so patients know where to go for urgent care.
The report says changes to health services and a switch to disease prevention will make the NHS far more efficient.
But David Bennett, chief executive of the NHS regulator Monitor, warned there will still be an £8bn hole in the NHS budget unless the Government increases funding by 1.5% above inflation every year.
He said: "If we get the investment we need... we see no reason why it's not possible to sustain a comprehensive tax-funded NHS which is actually better for patients and an NHS which is really fit for the 21st Century."
Chris Ham, chief executive of health charity The King's Fund, said the report "throws down the gauntlet to the political parties".
"Politicians now need to explain whether and how they will find this money," he said.
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