Leaders of NHS organisations need 'agility and adaptability' in order to survive the reform process, according to the prime minister's health adviser Professor Paul Corrigan.

Professor Corrigan said organisations now had to think about earning money rather than just spending it, and needed leaders who had the skills to do both.

'However much we plan, we are in a culture that eats plans for breakfast and asks: 'is that the best you can do?'' he said.

Speaking at the Westminster Diet and Health Forum's December seminar, he warned leaders not to forget the 'N' in the NHS and said leaders had to be 'active' in working out what national policy meant locally for staff and organisations.

'We don't pay money to people to just pass things on, the role of the leader is to make sense of all of this,' he said.

Professor Corrigan said the 'pride of earning money' was a 'different emotional reality' from the one where money was simply 'doled out'.

He added: 'There are large numbers of people saying they have Cinderella services out there, but this is a leadership issue'. He said it was the job of leaders of those services' to 'integrate' them into the mainstream.

He also said he was confident there was a 'pretty good debate' going on in the Department of Health and at strategic health authority-level about how to 'implement' leadership.

'We need to focus on talent-spotting and building careers, and all the things that happen in the private sector.'