Ann McGauran's article on supertrusts describes the development of academic health science centres (exclusively in London) in terms of strategic alliances leading to global competitiveness.

Internationally, several models exist, from full integration of hospital and partner academic institutions, through partial integration to a federated approach.

In Manchester, the university and six partners established the Manchester academic health science centre this June, codified by a memorandum of understanding that links the organisations together in a federated system.

The bespoke Manchester model brings together, for the first time in the UK, specialist cancer and mental health trusts along with specialist services and primary care.

The article leaves the impression that it is only in London that such centres can flourish, and the analogy to the hierarchy of football's Premier League is made. Perhaps the author overlooked where the world's most successful football team is based.

Alan North, director, Manchester academic health science centre, and vice president and dean, Manchester University