Community services may be taken over by hospitals and scaled down as they look to survive the NHS reforms that are set to come into effect, a health expert has warned.
Sir David Nicholson (pictured, left) said that many hospitals would have to merge with their neighbouring trusts in order to survive the changes, which could spell the end for some community-based care.
The reforms will see commissioning responsibilities transferred from primary care trusts, which will be axed, to a consortia of GPs. Sir David will assume the role of chief executive of the NHS Commissioning Board when the reforms are implemented.
He said that while the changes would mean that some services would be scaled down, the "expectation" was that no hospital in England would completely close.
Speaking to the BBC he said: "Those hospitals whose business model is based on increasing capacity have got to seriously look at the way they operate. That is why some hospitals are looking towards taking over community services."
He also added that some may be taken over by private companies to ensure their survival.
The health chief described the NHS's financial situation, which will see an annual budget rise of 0.1% above inflation for the next four years, as "difficult".