The Five Year Forward View has radically changed the health and social care landscape. It reiterates long-held ambitions of breaking down barriers between ‘silos’ in the health service – between GPs and hospitals, health and social care and physical and mental health – and this is to be welcomed, as long as money follows the plan. Devolution will bring radical change. The first model, Devo Manc, went live on April 1. Greater Manchester (GM) makes local rather than national politicians responsible for health as the ten authorities of GM come together to manage a range of services.