Anna Coote, in her article 'Local heroes get stuck in' (Think tank, 25 February) highlights the central role communities can play in improving health, but underlines the need to reconcile and harness the dynamics of a locally driven process with the bureaucracy of the statutory and other interested agencies. She concludes that health authorities have a crucial role in providing a framework of support.

The Civic Trust's experience working with communities certainly bears out the need for NHS organisations to get involved. While HAs have been given responsibility for the health improvement programme, primary care groups have the potential to become an even more direct and potent influence in supporting 'healthy neighbourhoods'. They are responsible not just for the patients coming through the surgery door, but for the health of their whole population, and are close to the communities that make this up.

On the evidence from community development initiatives, such as the reduction in GP referrals through providing more appropriate forms of community support, PCGs have a strong incentive to take an early lead, in partnership with other agencies, in promoting community development in their patch. So come on, PCGs - get stuck in with your local heroes.

Chris Davidson

Civic Trust