I was interested and amused by Carole Appleby's letter (4 March) regarding use of the web to promote communication in the NHS. But while I agree with the concept of sharing information and innovations, I think we should learn to walk before we can run.

Often we develop innovative ways of communication that overtake the last fad: for example, fax, e-mail and now the web. With each development there is a tendency to jump on the bandwagon and allocate financial and human resources without prior knowledge of the benefits to ourselves as managers and clinicians and, more importantly, patients.

Are we confident that patients and the public are well informed about the services we provide through 'normal' channels of communication, before we add further complexity to the system?

I feel senior managers should be out there communicating to the masses, rather than sitting at a remote computer terminal.

Bruce Archibald

Service development co-ordinator

Grampian Healthcare trust