The new chief executive of the NHS has laid out his vision of a patient-centred service forged through links with key stakeholders.

Nigel Crisp took on what must be the biggest public sector brief in Europe last week - heading up both the NHS Executive and the Department of Health.

Most managers are cheered by the appointment of a health service insider, assessing him as bright, considered and careful. But some doubts remain about his ability to stand up to ministers.

In his first interviews, Mr Crisp said the time had come for the NHS to behave 'much more as one organisation'.

Delivering a service centred around patients required a move away from thinking they could be treated only in single organisations.

Using cancer networks as an example, Mr Crisp said: 'We need to think in terms of staff providing care across institutions. It's about alliances with social care, the voluntary sector and stakeholders.'

Mr Crisp, a career health service manager who joined the NHS in 1986, was the first chief executive of Oxford Radcliffe Hospital trust from 1993 to 1997.

Megan Turmezei, secretary to its trust board, said he was 'a joy and a delight to work for'.

'We always expected Nigel to be running the NHS, 'she said. 'He gave us a strong sense of identity, purpose and vision.'

Mr Crisp went on to become South Thames regional director, then London regional director.

He takes up his new job on 1 November, but has already listed his priorities as 'implementing the NHS plan, emergency care including winter planning and getting staffing right'.

The health service is 'suffering under a lot of pressure' but that had been recognised in the NHS plan, he said.

He felt the plan provided 'a very clear vision, some objectives that go with that and some money'. But he warned its success would stand or fall on whether staff could be recruited, retained and motivated.

He also seemed to hedge his bets when asked whether he thought the extra billions allocated to health over the next five years would be enough.

In response, he said that 'unexpected things' would crop up, but there was substantially more money available than previously 'if we target it well'.

Mr Crisp is taking up the NHS chief executive job left by Sir Alan Langlands, and the DoH permanent secretary role formerly held by Chris Kelly.

It was 'clearly a management job, but it was also a Whitehall job', Mr Crisp said. But he added: 'I won't be remote. I'll be accessible to the NHS and the social care community.'

There was also speculation about the future of Neil McKay, acting NHS chief executive since the departure of Sir Alan.

One source said: 'With Nigel's post being so much broader, and his role being more that of a chair, it could be that the deputy role becomes much more critical, dealing with the frontline issues'.

But others suggested there was an 'outside chance' that Mr McKay could be tempted by the post Mr Crisp has vacated at London region.

NHS Confederation chief executive Stephen Thornton said Mr Crisp was a 'man of immense integrity', which was crucially important in a 'values-driven organisation'.

But he said the 'jury was out' on whether he would be able to resist pressure from ministers when it was necessary to do so.

One HSJ source was much more pessimistic: 'He's got no guts, and that's a shame, because that's what ministers need at the moment.'