I was disappointed to read the feature 'All change' (pages 24-27, 27 July). I have every respect for the Association of Medical Secretaries, Practice managers, Administrators and Receptionists as an organisation that has for many years led support for receptionists and secretaries working in healthcare.

However, it has been the Association of Managers in General Practice that has put many resources and much energy, enthusiasm and expertise into leading the development of management in primary care.

It is this association that has worked with the Institute of Health Services Management to form the Institute of Healthcare Management, which spans all sectors of healthcare. While still in its infancy, the IHM already provides invaluable support.

Those in general practice realise they can no longer work in an isolated environment, and have to collaborate with managers in primary care groups and trusts.

The IHM education committee is dedicated to exploring all development opportunities for managers working in this modern NHS, while the continuing professional development programme supports this aim, and other developments are planned.

It would have been helpful to managers had this article also explored these avenues.

Brenda Sawyer Fellow, IHM Chandlers Ford Hants