Nine out of ten NHS trusts are planning major change - hospital merger, closure or changing the way services are provided - in the next two years.
Critically, the Foundation Trust Network, the membership organisation for NHS public provider trusts, also found 78% trusts were reconfiguring as maintained or improved patient outcomes would not be possible without change.
However, Chris Hopson, chief executive at the Foundation Trust Network , pointed out that technology and patient expectations also drove change.
He said: "It's completely clear to the people running NHS trusts - and to many patients - that we need to change how we deliver care.
"Most of the public debate about service reconfiguration up to now assumes that such changes are all about cost savings. But they are only part of the story- what matters most is patient outcomes and quality of care.
"This survey is unequivocal - the NHS has to radically changes how it services are delivered if Trusts are to maintain or improve patient care.
"NHS trusts are up for change but the power to deliver those changes doesn't always lie in their hands.
"Now is the time to have a proper debate about how to ensure local services are strong enough to face the challenges of the next two years."
