It was with surprise and disappointment that I read Andrew Wall's article on The New NHS white paper ('From paper to practice', pages 28- 29, 19 February).
Surprise that in his analysis he focuses on all the reasons why primary care groups (PCGs) could fail to develop and deliver the expected outcomes. Disappointment that such a narrow reading and interpretation have failed to grasp that the mandate given for involvement at all levels is a major lesson learned from the past.
He does not acknowledge the wealth of knowledge in community trusts and - in particular - roles such as locality managers, the implication being that PCGs can only be managed by GP staff.
Of course there is political rhetoric, and the problems of implementation should not be underestimated. However, the white paper should not be seen in isolation, but as one of a number of approaches and papers with a common goal - improved health gain.
In Nottingham, and in many other parts of the country, work started before publication of The New NHS in developing philosophies which sit comfortably with the proposed way forward.
A Primary Care Act pilot (GPs/community trust/health authority) is about to start in a deprived area of Nottingham, serving about 70,000 people, with a major thrust in collaborative, multi-agency work.
Management will be simplified, and provision of services will be based on health needs. The total commissioning pilot in Nottingham already has established good working relationships with the HA, and will be working closely with all involved in delivering services. We have the ingredients to be considered as a potential model for a PCG.
We are striving towards a patient-led NHS, exploring different models to achieve the best outcomes - the white paper lets us be flexible. We should seize that opportunity as a challenge, and not become paralysed by whatever obstacles are perceived to exist.
Nottingham Community Health trust.