NHS chiefs wrote new prime minister Rishi Sunak warns him not to “watch while the health service collapses”.

Mr. Sunak NHS chiefs have asked not to demand further savings from health budgets, which have “no fat left to trim”.

The NHS Confederation, which represents trusts and GPs across the country, has warned the Prime Minister that patient safety will be “at real risk” if further cuts are introduced.

The letter, sent by chief executive Matthew Taylor and chairman Lord Victor Adebowale, said: “While we understand the complexity of the current economic challenges, our members are also fearful at the prospect of advertised cuts to public services.

“Without adequate funding and support for the NHS and social care, and the communities they serve, NHS leaders are concerned that your ambitions for a more prosperous country will not be realised.”

It added: “As you acknowledged over the summer, the challenges facing the NHS – many of which are beyond the services’ control – are unprecedented. These include rising treatment backlogs, slipping waiting time standards, rising staff vacancies, the growing threat of mass actions and the social security system on the brink of collapse.

“These concerns are heightened as we approach winter and as Prime Minister it is important that you start your new role with your eyes wide open.”

The NHS Confederation called on the Prime Minister to commit to fully funding a long-term workforce plan for the NHS – something the Treasury reportedly fought against when Mr Sunak was chancellor.

Mr Sunak is heading to Downing Street ahead of an upcoming strike by NHS staff, with nurses’ unions set to make a decision after a vote next week.

The NHS Confederation has warned that staff are “exhausted” and told the Prime Minister that his tenure could be determined by his response to the threat of industrial action.

Organizations have called for funding for social care and said the £500m hospital discharge funding announced by former health secretary Therese Coffey last month has yet to reach any services.

The letter added: “There are 165,000 vacant roles in the social care system in England, which our members and partners say are compounded by low pay in the sector and leading to more people choosing to move into more competitive industries.”

The cost of closing the backlog of hospital building repairs is now in excess of £10 billion, recent NHS figures have revealed.

Downing Street has been contacted for comment.