Speaking first on her overall views on the plan, Dr Birju Bartoli, chief executive of NHS Northumbria, said the time was right to deliver on its vision of a shift from hospital to community. 

Dr Bartoli said some elements of the plan, including the shift to digital and preventative areas around genomic testing, were ‘very ambitious'. 

She said delivering on the plan's goals would be a real challenge, noting it felt more like a three-year, followed by a seven-year, plan. 

The chief executive said acute trusts would be faced with the tough task of continuing to meet access targets while also planning for the future. 

‘I think the big part for me is what we do next to make it happen,' Dr Bartoli said. 

She said the onus would be on providers to turn the plan into a reality within their local communities. 

‘I think that's really quite exciting from my perspective as a provider to say "how do I work with my partners in the system at place level and say look, we've got a common purpose to turn some of this into reality"', she noted. 

Dr Bartoli said the trick will be in implementing the Government's goal of shifting the share of NHS spending from hospitals to the community. 

As the chief executive of the largest community trust in the country, Central London Community Healthcare Trust, James Benson welcomed the plan's shift to out-of-hospital care. 

Benson said the plan was ‘bold', agreeing it posed big questions about deliverability. 

‘I think it is the responsibility of every individual place now to set out where there is a gap in terms of what we are doing today and where we want to go and how we work together differently to get there,' he noted. 

The chief executive said some ‘very different leadership styles, skills and relationships' will be needed to deliver the plan. 

Benson observed a lot of things in the plan already existed, noting its reference to community health workers (Chewies) in Westminster who provide a bridge between midwives and health visitors, social workers, other professionals and residents. 

The community trust head noted the plan raised ‘an awful lot of questions around capital' and where that is going to come from, particularly regarding digital and estates. 

‘I work with some of the most expensive estate in the country,' Benson observed. 

‘How might we actually think about repurposing some of that and what does that look like forward?' 

Benson said he was ‘less worried' about revenue shifts over time arguing that money flows would follow if providers can understand how they are making an impact in terms of a reduction in acute spend. 

The chief executive said one of the things providers will have to get to grips with is what happens not just at individual neighbourhood level but what needed to happen at place level in terms of borough or unitary authority, system and national level. 

He said the timescale for things such as virtual wards as a single way of managing population health needed to be made clear ‘otherwise we run the risk of people going forward with digital transformation that would be supplanted later'. 

Laurie Lee, chief executive of Guy's & St Thomas' Foundation, welcomed the overall vision of putting the patient voice at the heart of healthcare reform and addressing healthcare inequalities. 

Lee also welcomed the plan's target of halving the life expectancy gap between the most deprived and least deprived areas. 

‘We know that in our part of south east London, you can walk a mile and healthy life expectancy will drop by 17 years,' he said. 

‘That is outrageous and it's right that reducing that is at the heart of the vision.'

The chief executive welcomed the plan's strong chapter on prevention but noted a lot of the document felt like more of an NHS than a health plan. 

‘There's further the Government needs to go to make health a truly whole of Government effort,' Lee added. ‘But this is an excellent start.'

Sarah Arnold, senior policy lead, The King's Fund, said she agreed the plan was ‘hugely ambitious in scope, but somewhat light in detail'. 

‘The overall vision, I think, is the right one,' Arnold said. She said the plan also needed to be clearer about the ‘trade-offs' required in delivery. 

‘There's a huge list of what the public might get under the right conditions, but that's going to need to be delivered with below average funding and also with less workforce than has previously been projected in the 2023 Workforce Plan,' she noted. 

‘I think it will be helpful in the next few weeks and months for the Government to be honest about what might not be delivered, or prioritise to free up space for what's set out here.' 

Former chair of the Health and Social Care Select Committee, Steve Brine, said the plan posed many more questions than answers. 

Looking from a political angle, Brine said the test would be in whether people ‘felt the difference'. 

Brine said Wes Streeting faced ‘difficult conversations' about the hospital to community shift with colleagues who had campaigned on new hospitals in their communities. 

‘We clearly aren't going to need new acute hospitals,' Brine said. ‘Forty new hospitals was only ever a figment of Boris's imagination.' 

Brine said there would be further ‘difficult conversations around the use of the independent sector and what that means in practice to burn those waiting lists'. 

The former Tory MP warned the Government could face further obstacles in terms of getting its Health Bill required for NHS reorganisation passed by Parliament. 

‘Will they be able to resist an NHS first amendment from an increasingly emboldened backbench?' he wondered. 

‘The question is do they have the resources in place to do it? Do they have the implementation will to do it? And do they have the political space and stomach for the fight? Ultimately everything is about politics because the NHS is funded by the public purse and that comes through Parliament and Parliament is inherently a political place.'