Speaking at an event hosted by the Medical Journalists' Association last week Sir Jim said the NHS would receive ‘some growth in the Spending Review' but added it ‘it's never enough'.

Sir Jim said: ‘The NHS is such a big part of public spending now we are pretty much maxed out on what's affordable. It is really now about delivering better value for money, getting more change, getting back to reasonable productivity levels, but in a way that's human and is about standards and about quality.'

The NHS chief's comments followed a NHS Providers survey last week that showed trusts are planning to cuts thousands of jobs in order to balance their books.

Sir Jim said ‘unacceptable' care had become normalised in recent years, adding: ‘Ten years ago, we would have never accepted old ladies being on corridors next to an [emergency] department for hours on end and they have become normal in the NHS. We've got to get ourselves out of that, and everybody wants to get out of it.'

He said the NHS had become used to ‘learning to walk with a limp'.

The NHS boss said managers were having to be reskilled in certain areas, commenting: ‘We are having to re-skill [and] train people again in things like waiting list management, some stuff on flow and ED management, those sorts of things. So, they are being rebuilt, and people are being re-coached and re-educated.'