Delivery and implementation is key and if we are going to achieve the 5 YFR we are going to have to have the best possible implementation plans.  That is where Management should shine.  Implementation is about making the plans happen and as HSJ pointed out Mr Stevens was at pains to stress the purpose of the refresh was not to have “a philosophical argument about 2020”, but to focus the service’s collective mind on what can be achieved between now and March 2019. From my experience working within and with the NHS there are some very effective techniques which can make plans happen.  The NHS is not always the most robust in applying these.  Our members area which will be live in May will aim to share what we have found works.  If you are an member you can access this resource and share your own positive tool and approaches.