What do you think about when you hear the phrase 'community cohesion'? Is it only important in inner cities? And do we have a role to play?

When Oldham primary care trust was set up, we were forced to learn lessons about community cohesion quickly. Established soon after the community disturbances in the summer of 2001, we recognised that the images that gained Oldham notoriety could not be ignored.

The 2001 Oldham independent review (the Ritchie report) challenged the PCT to play its full part in addressing the disempowerment that some communities felt. We had to make our slogan of 'working with our communities to improve health' truly mean what it said.

In particular, this meant setting out a borough-wide approach to service development, assuring equitable access to core services and only then targeting interventions clearly based on the health and social care needs of different areas and communities (a hard-won argument at the time as this was not in line with neighbourhood renewal policy).

Targeting specific groups to meet highest need is important, as is harnessing social marketing and community development approaches to develop interventions that have the greatest chance of success. But that is not sufficient. Our experience shows that unless we also develop more sophisticated approaches to explaining our commissioning intentions, describing the rationale behind our decisions and sitting down with different community groups, ward councillors and patient groups we risk undermining community confidence that such decisions are fair.

We also need to capitalise on the opportunities the NHS has to create common ground. Are our healthcare facilities always accessible to all? We participate in shared social events and we need to create new routes into employment, available to all.

Locally, we have participated fully in training and engagement events, which are helping to bring about a more honest dialogue with local communities. The work undertaken by all players led to Oldham Partnership winning the Partnership Award in the 2006 HSJ/LGC Sustainable Communities Awards.

Professor Ted Cantle's recent review of community cohesion in Oldham highlighted the progress that had been made but also underlined the biggest challenge we still face: 'involving, engaging and mobilising our communities to take greater responsibility for change'.

It is vital that we do not lose sight of the NHS's role in building healthy communities at a time when budgets are under pressure, delivery of national targets is under the microscope and organisational changes risk sapping energy. The NHS's core priorities are important. But to succeed in tackling poor morbidity and mortality and gain local support for the changes we want to make and be in a position to commission a patient-led NHS we need increasingly cohesive communities. In Oldham, we are in this for the long haul.

Gail Richards is chief executive of Oldham PCT. The deadline for entries to Sustainable Communities Awards 2007, run by HSJ and its sister title Local Government Chronicle, is 9 November. To find out more go to wwww.sca2007.com