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Specialist discharge, child psychiatry, PIMs, and Facebook.

Specialist discharge. Type 2 diabetes takes up much NHS funding and it remains an important condition in both primary and secondary care. One of the important transition points in the health system is when patients are discharged from hospital clinics back to their GP. An article in the Canadian Journal of Diabetes describes an interview study, which sought to elucidate patients’ experiences of the discharge process from specialist clinics to primary care.1 The participants had assumed, at the time of initial referral, that they would receive diabetic care from the hospital indefinitely and, generally, the specialist care had met or exceeded their expectations. However participants were not informed, were unclear, or made their own assumptions about the rationale for discharge. The few patients who understood the rationale spoke positively about their disease being ‘back in control’. The authors suggest clinicians should psychologically prepare patients for discharge from the initial referral, informing them of the rationale for discharge and discuss concrete plans for primary care follow-up.