Most health trusts believe that “major change” is necessary in the way services are delivered to patients, a survey has found.

Nine in 10 trusts said that major local changes - including hospital mergers, closures or changing the way services are provided - are necessary in the next two years, according to the research conducted by the Foundation Trust Network.

The body, which represents the majority of trusts and foundation trusts, said members of the public must be involved with the decisions to reconfigure local health services.

The FTN, which conducted a survey on 67 leaders of NHS organisations, found that 78 per cent of trusts felt that a reconfiguration in their area would lead to improved patient outcomes.

FTN chief executive Chris Hopson said: “It’s completely clear to the people running trusts, and to many patients, that we need to change how we deliver care.

“This doesn’t necessarily mean changing the structure of entire organisations - it could be as simple as altering the setting in which services are provided.

“Most of the public debate about service reconfiguration up to now assumes that such changes are all about cost savings.

“But they are only part of the story - what matters most is patient outcomes and quality of care.

“This survey is unequivocal, the NHS has to radically change how its services are delivered if trusts are to maintain or improve patient care.”

He added: “Now is the time to have a proper debate about how to ensure local services are strong enough to face the challenges of the next two years.

“This must involve the public, their representatives, politicians and all NHS organisations, whether providers or commissioners.”