Speaking at The King's Fund this week to mark the first anniversary of the 10-Year Health Plan, Dash said the ‘10-year bit of the 10-Year Plan had logged a bit too heavily in people's minds because it feels that we'll do that in 10 years' time'.

Dash said: ‘The reality is, if we are to deliver the scale of change described in the 10-Year Plan, we need to do it on now.'

The NHS England chair called for a ‘very different model of UEC'.

She commented: ‘This will be my sixth year as an NHS chair with exactly the same paper on winter planning coming to a board.

‘We can't keep going in the same when we know that we've got 40% of people turning up at A&E who don't need to be in an A&E.

‘We've got over 20% of emergency admissions who don't need to be admitted. We're just doing Groundhog Day, trying to make an existing system, which is a suboptimal system, work better. We need to go on and do the redesign for UEC.'

Dash added the redesign of pathways through NHS Online would mean ‘we can't stick with our current model of out of hospital care'.

‘We need to improve the processes,' Dash added. ‘We need more multidisciplinary working. We need to differentiate according to need. We need to do a much better job at planning care. Everybody should have a care plan.'

In addition, the health leader said the NHS needed to use technology and innovation as well as a new financial framework.

‘We need to go further and faster,' she told her audience.

Dash said the NHS had ‘got the grip on the money' in the last year but added ‘it's not acceptable that we don't know where the money goes'.

‘We don't have a detailed ledger, nor actually do individual trusts,' she added.

‘We've got to get back to that level of financial discipline. It has existed in the past in the NHS, and we have to get back to that level of financial discipline.'

Asked for her priorities for change over the next year, Dash identified workforce and mental health with the expected publication of the Workforce Plan and Mental Health Strategy.

‘Added to that, we have got to sort out UEC, electives, neighbourhoods and then the productivity that enables us to do that,' she concluded.