Liz McAnulty, Chair of the Patients Association, said: “The NAO’s report confirms not only the inadequate, hand-to-mouth nature of the NHS’s finances, but also that this cash crisis is obstructing service transformation.

“It is essential for patients that NHS services are transformed to meet changing patterns of need. In particular, older people with multiple long-term conditions need to be kept well in the community, rather than being left until they reach a crisis and then hospitalised.

“Politicians of all stripes must urgently commit to adequate long-term funding for health and social care – this means a step-change in funding, measurable in terms of a percentage of GDP, not the short-term approach of a few extra billion here and there. This is vital both for service transformation and to alleviate the immediate deterioration in NHS performance that is so obviously harming patients.

“As calls for ‘reform’ in response to the ongoing problems grow louder, NHS England should consider how to re-present its transformation programme under the Five Year Forward View. These are the reforms that are needed, but they suffer from low awareness, and people who are aware often misunderstand them. The alphabet soup of STPs, ACSs and so on probably isn’t serving these vital vital reforms well.”