The National Health Service in England must cut 10 per cent of its workforce – including potentially 100,000 doctors, nurses and other clinical staff – if it is to make the £20bn of savings likely to be needed by 2014, management consultants have told the Department of Health.

It will also need to control the drugs bill, increase productivity and raise £8bn by rationalising its estate, including renegotiating private finance initiative contracts to take advantage of lower interest rates.