None of the main political parties has yet set out convincing plans on how they will improve the NHS, a leading health think tank says. The Health Foundation said on current spending projections there appeared to be a £38bn-a-year shortfall in England in what would be needed by the end of the next Parliament. The think tank said that would put plans such as tackling the NHS backlog, improving GP care and redeveloping hospitals at risk.

Neither Labour nor the Conservatives have said how much they will invest in the NHS, while the Liberal Democrats' pledge is well short of what the Health Foundation says is needed. These were the only three parties the think tank looked at for its analysis. Anita Charlesworth, a health economist from the Health Foundation, who used to be the Treasury’s director of public spending, said: “The health service is in crisis and all the main political parties have said they want to fix it – yet the funding they have so far promised falls well short of the level needed to make improvements.

“Politicians need to be honest with the public about the scale of the challenge the NHS faces and the reality that an NHS fit for the future needs long-term sustainable investment. “Honesty about this has so far been conspicuously lacking from the general election debate, with both the main parties unwilling to spell out the difficult choices on public spending and taxation that will confront the next government. “The scenario we have set out is not ov.