An NHS document has claimed the health service will not survive unless radical changes are made to the delivery of health – such as the controversial a&e closures proposed at Epsom and St Helier hospitals.

In a report launched this morning NHS England warned that, by the 2020-21 financial year, the NHS could be facing a £30bn funding black hole.

Sir David Nicholson, chief executive of the NHS, said services needed to be concentrated in fewer hospitals because pressures could lead to another tragedy like the one at Stafford Hospital.

The Better Services Better Value (BSBV) healthcare review, which aims to axe A&E, maternity and children’s services at Epsom and St Helier hospitals, has issued a release this morning in support of Sir David’s comments.

The review has been highly controversial and lead to demonstrations across south west London and north Surrey. There have been large protests and criticism from residents, politicians and even clinicians involved in the review.

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Michael Bailey, consultant urologist and joint medical director for BSBV, said Sir David’s comments back up what they have been saying for some time.

He said: “Both the funding gap he highlights and the impact on the quality of care of expertise being spread too thinly and too focused on hospitals are very real threats to the future sustainability of the NHS.

“It is clear that this cannot be fixed without reorganising the way we deliver healthcare. The only way in which we can provide the round the clock care patients need is to offer it in fewer, larger units. There are not enough doctors available or even in training to do this across the five hospitals in south west London and Epsom which are part of BSBV.

“We cannot let our local services be left behind as Sir David’s comments today again demonstrate why change is urgently needed.”

BSBV argue that “better out of hospital care” is at the heart of their vision but campaigners argue their plans are insufficient and it is not clear how tens-of-thousands of people will be treated in the community if two A&E departments are axed.

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