I read your cover feature on patient advocacy with great interest ('Winning ways', pages 20-23, 10 May). I am full of admiration for the work that Penny Dunman is doing. However, I do feel that both you and she are somewhat behind the times.

While we are all struggling with the NHS plan and the changes therein, surely we should not be talking about advocacy in the old-fashioned sense of the almoner?

Advocates need to be (and usually are) totally independent of any trust or health authority. Chapter 10 of the NHS plan goes to some lengths to point out (paragraph 7: 'independent patient advocates') that patients' concerns cannot always be resolved by the new patient advocacy and liaison service, 'when a patient is not comfortable with seeking help from a service based within the trust'.

In these difficult times for us all, I do feel that your magazine is misleading its readers into believing that advocacy can be provided within trusts. The reality is that totally independent advocacy services are being set up so that patients can feel there is someone out there who can sit alongside them as they raise issues of concern.

Sue Henderson Complaints manager North Hampshire primary care trust