At least one in four NHS patients would be better off being treated at home under new community-based services, the head of the NHS Confederation has said.

In a New Year message, Mike Farrar said the health service must convince people to give up on an outdated “hospital-or-bust” version of medical care.

Mr Farrar said 2012 would be a key year for the NHS as it undertakes a drive for £20 billion in efficiencies by 2015.

He said: “We have had a lot of talk about changing services but 2012 must be the year we convert talk into action.

“Hospitals play a vital role but we do rely on them for some services which could be provided elsewhere. We should be concentrating onreducing hospital stays where this is right for patients, shifting resources into community services, raising standards of general practice, and promoting early intervention and self-care.

“There is a value-for-money argument for doing this but it is not just about money and the public need to be told that - this is about building an NHS for the future.”

Mr Farrar said the NHS needed strong leadership from bothpoliticians and clinicians and a change to the way health services are paid for. He also called for the NHS to listen more to the public.

Among the changes required is a focus on treating frail people inthe comfort of their homes and minimising hospital stays wherever possible, Mr Farrar said.

He added that quality of care cannot be maintained if the NHS is not sustainable.

He went on: “The NHS absolutely must rise to these challenges.

“Those doing the day job, however, face major pressures intrying to keep the NHS’s head above water. They will be trying to stop waiting times getting out of control. They will be focusing on making all the new structures work as a result of NHS reform.

“There is a real danger of distraction. We must not allow that to happen if we want 2012 to be a success.”

Health minister Simon Burns said: “The independent NHS Future Forum has confirmed that every health system in the developed world faces the challenges of rising demand, an ageing population and increasing costs of treatment, and that these challenges won’t be met by the NHS doing more of the same. That is why our plans give doctors, nurses and frontline professionals the freedom to make the best decisions for patients.

“Modernising the NHS will both safeguard the future of our health service, and will deliver a world-class service that puts patients atthe heart of everything it does.”