Published on the the first day of our 2009 annual conference and exhibition (10 June), Dealing with the downturn says that, in just under two years, the NHS will face the most severe constriction ever in its finances. It also says that action is required now if the service is to remain true to its founding principles and continue to provide care free at the point of need.
In the five years from 2011 the paper forecasts that the impact of the recession, allied to rising costs mean it is likely the NHS will face a real terms shortfall of £15bn.
It also warns many of the options of past slowdowns in funding could prove counter-productive and ultimately lead to extra costs.
In his opening to speech to Conference NHS Confederation chief executive, Steve Barnett, is expected to challenge the NHS to innovate its way through the funding crisis.
Download the paper.
Listen to the new secretary of state for health Andy Burnham and shadow secretary of state for health Andrew Lansley CBE MP respond to the paper on the BBC's Today programme
Keep up to date with news from Local leadership: a national service, our 2009 annual conference and exhibition, taking place between 10 and 12 June in Liverpool.