Your news focus on the public health role of acute trusts ('Wheeler dealers', pages 12-13, 22 February) provided a useful reminder that all trusts can play an active part in improving the health (in its broadest sense) of the communities of which they are a part. But the piece did not mention that a growing number of trusts have already acknowledged public health as being about more than just the important task of infection control, and have begun to develop themselves accordingly.

The World Health Organisation's network of healthpromoting hospitals is made up of over 300 hospitals and 320 other organisations from 44 countries. These organisations have made a long-term commitment to improving the health of patients, staff and the community primarily through a process of organisational development aimed at improving the effectiveness, efficiency and equity of healthcare; the relationships between the organisation and the community;

staff working conditions; and the services and support provided to patients and relatives. This fusion oforganisational development and health-promoting principles not only enables trusts to make a more rounded contribution to national and local public health improvements, but also provides them with the opportunity to integrate quality improvement across the breadth of their activities.

While it probably would be advantageous for public health specialists to have an active role within trusts, this alone is unlikely to pay real dividends unless it is part of a genuine attempt to establish health improvement at the core of the organisational cultures. With its emphasis on multidisciplinary working (and its insistence on overall responsibility lying with a member of the executive team), the health-promoting hospitals initiative provides a strong vehicle by which trusts can galvanise their public health potential for the benefit of their patients, staff and communities.

Soumen Sengupta Deputy head of health promotion, David Shilton Executive director of nursing and clinical governance South Tyneside Health Care trust