'Merry Christmas - war is over', was penned by John Lennon, but with the coda: 'if you want it'.
As a child I wasn't sure what he meant, although it sounded good. But it was his Christmas present to the world - and in a similar vein, here's my present to you.
Have you come across the Sapir-Whorf hypothesis?
It's nothing to do with Star Trek, but it relates to the suggestion that language influences action. There's a lot of evidence backing it, plenty of soft science research on the issue, even down to how nationalities differ in saving habits due to language.
So, look at the health service and tell me what's a discharge?
Usually unpleasant, better out than in? Painful, nauseating, pus-filled?
No, actually they are our customer, our treasure, our reason for being.
We should pass them on like heirlooms, like eggs in baskets.
So I'm calling for an end to discharges - everywhere across the NHS.
One quick and easy way to end discharges would be to only have 'transfers of care'. Six years ago I blogged about discharging from primary care, into hospital. That was wrong, but said as a way of shifting a paradigm it can open the door to change.
Provision of teams who take complex patients home to establish viability before transfer to primary care offers an end to re-admissions. Early supported discharge teams are supposed to do this - but they don't - maybe because they have discharges.
Similarly, hospital rounds carried out by hospitalists who collect the inpatient data, enter it on EMIS Web, send prescriptions via electronic prescribing to community pharmacy, who actually deliver, will end discharge letters, avoid waiting for letters and deliver the patient back into the arms of primary care while still in hospital.
I know some places are doing this, but it's not universal.
My point, just like John Lennon, is - discharge is over, if you want it.
- Dr Chris Mimnagh is a GP in Liverpool and co-director of clinical strategy at the NHS partnership organisation Liverpool Health Partners