The health secretary has said the NHS must change to meet the demands of people with long-term conditions such as diabetes and asthma.
Andrew Lansley warned of a 252% rise in the number of over-65s with one or more such conditions by 2050.
Already, nearly a third of people have a long-term condition, such as asthma, heart and lung disease, arthritis, high blood pressure or diabetes and Mr Lansley highlighted developments he considered necessary to tackle this – such as provision of more support to keep people out of hospital, a move which also saves money.
But the head of the Royal College of Nursing (RCN) said Mr Lansley's NHS reforms are leading to thousands of job cuts, including among nurses who specialise in long-term conditions.
Dr Peter Carter said the cuts will put vulnerable patients at risk and the reforms will cost billions.
Mr Lansley's overhaul of the NHS, which will see 80% of the budget handed to GPs to commission services, has come in for widespread criticism. Several unions have raised fears over the increased use of private companies, while doctors, nurses and midwives have raised concerns about the impact on patient care.
Figures from the Department of Health show people with long-term conditions are the biggest users of the NHS, accounting for about 50% of GP appointments and 70% of inpatient hospital beds.
Mr Lansley said: "An increasing number of people are living with long-term illness, and increasingly two or more serious illnesses. The average cost of someone without a long-term condition is around £1,000, which rises to £3,000 for someone with one condition and to £8,000 for people with three or more conditions.
"The additional associated cost pressure of caring for people with multiple comorbidities could reach £4bn by 2016. That's one reason why we need to modernise the health service and the way we care for patients. There isn't a one-size-fits-all solution to our health – particularly for those who have a number of different conditions."
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