GPs must take on out-of-hours care, with patients getting the same quality of care at weekends, in order to be sustainable in future, Health Secretary Jeremy Hunt said as he stepped up efforts to persuade doctors to accept sweeping reforms to the way they work.
He called for GPs to strengthen their relationship with patients in their care, including taking a greater responsibility for vulnerable people on their lists.
Hunt also outlined plans for a seven-day NHS, with hospital patients receiving the same quality of care at the weekend.
Out of 146 acute trusts, 129 had higher death rates at the weekend in 2011-12. In some trusts, death rates rose by more than 20%.
The Health Secretary used an interview with the Sunday Times to set out plans for a hit squad of specially trained senior doctors who could be sent in to take over failing hospitals.
Asked if the NHS was sustainable in its present form, Hunt told the newspaper: "I think it's sustainable in the medium term if we are prepared to take some difficult decisions about how we deliver healthcare. But we are up for those decisions."
He added: "If we're really going to be sustainable we need to have proper out-of-hospital care."
This meant family doctors had to "go back to the days" when they checked on vulnerable patients in their area.
"It may not be the GP personally doing every single home visit, but I think we need to rediscover and strengthen the doctor-patient relationship and that sense of accountability and responsibility for the most vulnerable people on GPs' lists," he said.
He also stressed the need for the NHS to embrace technology in order to tackle inefficiency and said he wants the NHS to be paperless by 2018.
"People are actually dying because we haven't gone electronic, " he said.
He described his pledge to turn around the 11 hospitals recently identified as having fundamental breaches of care as the "biggest challenge" he has ever faced.
External teams will be sent into the hospitals to make dramatic changes within 12 months, after mortality data said thousands of patients may have died.
He told the Sunday Times: "It's a huge responsibility to the people in those 11 areas.
"I have to make sure with every drop of my blood I have that the system focuses on turning round those failing hospitals."
He insisted that the NHS could survive if it reformed.
He said: "My own view is that over the next 10 years, if we embrace technology, if we put a real effort into transforming out-of-hospital care, then for the next 10 years the NHS can be sustainable - but we have to do this properly."
A Labour spokesman said: "On David Cameron's watch almost 5000 nursing jobs have been lost and now one in 10 hospitals are understaffed - at the same time as wasting £3bn on a back office reorganisation.
"Patients want to know their hospitals are properly staffed, but the Health Secretary fails to even acknowledge the problem of staffing shortages.
"Ministers are ignoring expert warnings on ward staffing. They must get an urgent grip."