As primary care trust chief executives in the Core Cities group - England's eight largest cities outside London - we would like to reply to your article on resource allocation.

We need to move beyond the principle of allocating resources to achieve "equal access", towards the aspiration of "equal health" - particularly in primary and community care, and public health and prevention.

Through strengthened "additional needs weighting", we can take the significant actions required to prevent the further increase in geographical health inequalities, as evidenced by the disparities in life expectancy and mortality figures. Undoubtedly "real differences can be made by addressing such causes of ill health as housing, employment and education", but it is also true that a whole range of public health and primary care interventions can and do add years to life and life to years.

Systematic approach

This might involve finding people who will not seek help, working with GPs in deprived areas to offer systematic chronic disease management, investing in understanding local service use, working with local and voluntary groups to ensure better uptake of health and prevention services, or targeting particular populations to support smoking cessation.

We need the government to allocate NHS resources, via a stronger additional needs weighting, to help us tackle inequalities in the poorest health areas.

Sandy Bradbrook, Derek Campbell, Sophia Christie, Moira Dumma, Deborah Evans, Andrew Kenworthy, Chris Outram, Chris Reed, Laura Roberts, Jan Sobieraj