Andrew Lansley has urged the health service to “regain the momentum” lost in the “flux” sparked by the government’s reform plans.

In his set piece address to the NHS Confederation conference in Manchester, the health secretary sought to regain the initiative by announcing the fifth wave of clinical commissioning group pathfinders.

The 35 new groups announced mean the pathfinder CCGs cover 97 per cent of England’s population, he said.

Mr Lansley admitted that many had been unwilling to commit to long-term changes during the controversy over the reform and the pause that followed it, but he said now was the “time to act” following the end of the pause.

“Now time to regain the momentum: to get back on the front foot, to focus again on the challenges we all face,” he said.

He also emphasised the importance of managers, saying that “without good managers, we can’t achieve the efficiency gains so vital to the NHS”.

“Modernisation is every bit as much about organisational leadership as they are about clinical leadership,” he said.