The NHS faces financial ruin and is no longer sustainable in its current form, doctors, managers and patients warned.

Hospitals may have to be closed and major changes to the way the health service is run should be brought in to help pull it back from the brink of collapse.

The Academy of Royal Colleges, the NHS Confederation and patient group National Voices have urged politicians to “show more courage” in dealing with the NHS’s multi-billion pound deficit, The Times said.

The alliance has set out a series of recommendations to rescue the crisis-hit service, including a major transfer of services away from hospitals and into the community, an increase in the number of GP surgeries and health centres and greater investment in district nursing and social care.

Mike Farrar, chief executive of the NHS Confederation, which represents health service managers, said the NHS would otherwise “descend into a vicious spiral of poorly planned, reactive responses resulting in unsustainable demand”.

But he warned that the revolution needed would be “like changing the engine while the car is still running”.

He said: “We simply cannot continue as we are at the moment. The problems in A&E will get worse and waiting lists for treatment will get longer.

“Emergency work has to take priority over planned work, which earns more income for hospitals. So more hospitals will find themselves in financial difficulty.”

Mr Farrar warned that the NHS in England was likely to be underfunded to the tune of £54bn by 2022.

He referred to a report from the Royal College of Nursing, which suggested that up to 6,000 beds - the equivalent of 20 hospitals - could be lost in an effort to make the NHS sustainable.

He said the proposed restructuring would mean fewer hospitals but more specialists on regular duty, improving the quality of care.

“Communities do feel strongly about their hospitals,” he said. “But they also feel a strong bond with their GP surgeries, and people love district nurses. What I am not saying is that care will disappear from the community.

“Most people would agree if I said I could spend some of this money to help you to live independently in your own home for longer. It is up to all of us to make the case.”

He added: “It is really important that politicians take stewardship of £110bn of taxpayers’ money every year. But we are asking for politicians to show more courage.”

Jeremy Taylor, chief executive of National Voices, said: “Patients are not best served by the current pattern of services. For the safest, highest quality care, hospitals need to be organised differently and more services are needed closer to people’s homes.

“But the changes needed are often highly controversial. The NHS has often failed to make a good case; to involve patients and communities in ways that would build trust and to follow through to ensure that the new pattern of services is better than the old.

“And the public are rightly suspicious of closures and downgrades that seem to be more to do with money than quality of care.”