Any funding deal worth less than 4 per cent in real terms each year would see the service in ”managed decline”, NHS Confederation chief executive Niall Dickson has told HSJ.

In an HSJ interview ahead of a speech to the NHS Confederation’s annual conference this afternoon Mr Dickson said 4 per cent was ”not the radical option, that’s simply trying to keep up with demand”.

The government is expected announce increased spending growth for the NHS in coming days or weeks, something heavily trailed by the health and social care secretary and the prime minister in recent months.

HSJ and others have predicted an increase will be between 3 and 3.9 per cent, but Mr Dickson warned that would not be enough.

He told HSJ: ”This is a seminal moment for the NHS. The question is whether the government recognises it. Unless we make that fundamental change the best we are going to see is managed decline, a further disintegration of the service. It is completely unavoidable if we look at the figures.

“If we just try and apply the current model we’ll need to increase acute beds by 50 per cent, just to keep up. Bed occupancy levels are already unsafe.

“They really have to seize this, I know the secretary of state has been really pushing this hard but we still have to see whether the government is going to take this seriously enough to not just sustain the service but to meet these huge challenges going forward.”

Referring to a report the NHS Confederation has prepared with the Institute of Fiscal Studies and the Nuffield Trust he did say that providing steady growth over the next 15 years - as opposed to a feast and famine approach - would pay some dividends in itself.

His comments came as NHS Improvement chief executive Ian Dalton told the Confederation conference in Manchester that he could not yet say whether the provider sector would break even in 2018-19.