Published: 12/12/2001, Volume II2, No. 5835 Page 22

I was saddened to read Mid Devon primary care trust professional executive committee chair David Jenner's comments on clinical networks (news focus, page 12, 21 November). There was mention of South West Peninsula cardiac managed clinical network (PCMCN) in relation to a lack of involvement of primary care. This is disappointing as we strive to involve everyone, including primary care.

When the network was first mooted, a consultation paper was sent to every acute trust and PCT in the peninsula. There followed an open meeting from which ten volunteers drafted an outline proposal for a network in terms of reference and structure.

Two of these volunteers were GPs and another was a PCT coronary heart disease manager, providing equal representation with secondary and tertiary care.

The proposal was again circulated to acute trusts and PCTs. At a second open meeting, there was a decision to recruit a clinical director and a manager.

The clinical director was recruited by open advertisement and panel interview. Primary care was represented on the panel by a PCT chief executive and a GP PCT CHD lead, and a GP PCT CHD lead stood as a candidate.

Following the appointment of the clinical director and manager, a provisional network management group was set up comprising people who had demonstrated an active interest in the network. The group set up a website which described the network's purpose, structure and terms of reference and wrote to everyone involved in cardiac services, including every GP in the peninsula. Two GPs and a PCT chief executive sit on the network management group, and within the first few weeks the clinical director wrote to all the chairs of the PCT executive committee requesting nominations to sit on the network management group.

PCMCN seeks to improve the care of cardiac patients and wishes to break down barriers between primary, secondary and tertiary care. The website invites all members of the wider cardiac network to raise issues that the network management group can prioritise and make the subject of task-specific working groups. At the moment, the network management group has initiated three working groups which have extensive primary care involvement.

We welcome Mr Jenner's interest in the contribution of primary care. We hope he and his colleagues accept PCMCN's invitation to participate actively in the work programme, so ensuring it reflects issues important of the care of patients with cardiac diseases and overcome the tribalism which has been so destructive in the past.

Dr David Smith Clinical director South West Peninsula cardiac managed clinical network