NHS chief executive Sir David Nicholson has called for the “best” staff to be transferred into community services in order to “revolutionise” patient care.

Sir David was speaking at the NHS Employers conference in Liverpool this week about the challenges presented by the white paper and need to save £15-20bn over four years.

He said: “Community services are going to be the thing that makes the difference between success and failure.

“Let’s get our best people into community services to revolutionise the experience of patients and the way services are delivered.”

He said one of the biggest challenges facing the NHS was improving care for people with long term conditions, and that better staff training was needed to achieve this.

He said: “We need to create a completely new healthcare business and to do that we need to move people across healthcare boundaries.”

He also announced that staff may have a second chance to apply for a payoff worth up to a year’s salary, in return for leaving the NHS.

The Department of Health is considering the move after around 2,200 employees successfully applied for severance pay in the first national round of what is known as the mutually agreed resignation scheme, or MARS.

The scheme, launched in October, is aimed mainly at those working in primary care trusts and strategic health authorities, which will be scrapped under white paper plans.

Sir David said there were three types of people currently in the service. The first included “those who hate” the reforms and should leave – possibly via MARS – as they would be a “drag on the system”.

Secondly there were those who wanted to stay for the transition but may not have a job after that and, thirdly, there were staff who would need support to move into new roles.

So far Mars has cost the NHS £40m, mainly in payoffs, but NHS East of England chief executive Sir Neil McKay told sister magazine HSJ that it will save £75m a year in salary costs.

Sir Neil also said he was looking at how a “facility” could be established to encourage “mission critical” staff – defined locally – to stay in the NHS during the transition.