A 10-year road map to transform Northern Ireland's under-pressure health service has been announced.
The Stormont blueprint is the response to an independent analysis of the struggling system by a panel of experts.
Describing the current health and social care system being at "breaking point", Health Minister Michelle O'Neill stressed the need for radical change.
Hospital closures are not envisaged in the action plan, but there will be a reconfiguration of the services provided by the network of existing facilities.
The Health and Wellbeing 2016: Delivering Together document is short on definitive targets and detailed goals, and is not costed.
Mrs O'Neill said it was crucial to redesign the system in conjunction with health service workers and patients, with agreed actions only materialising after that engagement is conducted.
One of the more short-term objectives is the formulation of a plan by January to tackle lengthy waiting lists.
The plan emphasises the need to improve the health of the wider population with preventative steps and also to provide more care away from acute hospital settings.
Criteria will be developed to determine how to redesign the delivery of specific services such as stroke, diabetes and pathology. Five services will be examined each year of the plan.
Mrs O'Neill said consensus on the Stormont Executive on the need for a major overhaul had presented the opportunity for a "fresh start".
"There is total agreement across the Executive that this needs to be done," she said.
"Changing the health system is the right thing to do, it's the right time to do it and it is right for the people who use it.
"This change will be planned, managed, incremental- this is not a 'Big Bang'.
"Meaningful change does not happen overnight - this will take time, money and the support of staff, those who use our health and social care services as well as the support of Government.
"I want to acknowledge the hard work and dedication of all those working in the service; the depth of their commitment and compassion continues to astound me. Thank you for all that you do to improve the health and wellbeing of those who live in the north.
"That being said, the system itself is at breaking point. We face a number of challenges, not least demographic changes and considerable health inequalities which continue to persist. The way services are organised is constraining transformation and our ability to provide high-quality services."
She added: "My vision also sets out a series of actions I will lead within the next 12 months to start the journey of transformation.
"I recognise the pressure that our system is under and it is important that we start now."
The six-person expert panel that assessed how the system is functioning and what changes are required was led by Spanish Professor Rafael Bengoa.
"Health and social care (HSC) systems across the developed world are currently struggling with the question of how to adapt their services to deal with continuously rising and changing patterns of demand," he said.
"I and my colleagues on the panel believe that the HSC system faces a stark choice. It can either resist change and see services deteriorate to the point of collapse over time, or embrace transformation and work to create a modern, sustainable service that is properly equipped to help people stay as healthy as possible and to provide them with the right type of care when they need it.
"We have tried to produce a report that will make a practical contribution to implementing change and which will support the minister's ambitious, and wholly necessary, road map to reform. Transformation will not be simple, but the panel has no doubt that Northern Ireland has both the people and the energy to deliver a world-class health and care system."
The plan was officially endorsed at a meeting of the executive on Tuesday morning.
After Mrs O'Neill outlined the strategy to the Assembly, First Minister Arlene Foster and Deputy First Minister Martin McGuinness voiced their determination to make it work.
"We are very grateful to Professor Bengoa and his colleagues for their work," said Mrs Foster.
"Their report sets out a frank assessment of the existing situation and the need for change.
"It represents a challenge to politicians, but it is a challenge this Executive is going to meet head-on.
"We are committed to increasing our substantial investment in the health service year in and year out. However, it is clear the present configuration of services needs to change to ensure the best outcomes for patients."
Mr McGuinness said: "This is a time for leadership and this Executive is going to provide it. Change has to happen and the only question is whether it will happen in a controlled, planned fashion or unfold out of control. There is only one responsible choice to make.
"We need to show leadership and take the decisions necessary to provide a health service which empowers staff and directs the resources available in the most effective way.
"Today is a powerful example of the Executive working together. We will deliver a Fresh Start for the health service."