The NHS chief executive said the management style of the service will have to make a “great leap forward” if it is to survive with little or no investment in the future.

Sir David Nicholson, who is also NHS Commissioning Board chief executive, told a King’s Fund summit on leadership that the NHS had to shift from its “pace-setting” management-style.

He said: “The kind of leadership we had in the past isn’t going to work in the future.

“If you think we can deliver quality improvement in the financial circumstances we find ourselves in by driving efficiencies further and further we will fail. The kinds of change we need to drive in the future are all about the ways different bits of the system work together.”

Sir David added: “This is the time to make a great leap forward in how leadership is developed and nurtured in the NHS.”

His comments came as the King’s Fund published its Leadership and Engagement for Improvement in the NHS report.

Interim managing director of NHS workforce and the NHS Leadership Academy Jan Sobieraj also told the conference management would have “no choice” but to change.

He said: “The future will be dominated by the way you behave in the system. It will be as [important a change] as something like the tariff.”