title: Continuing care after cancer treatment.
abstract: BACKGROUND
  Despite nearly three decades of debate and policy guidance there is evidence that, in the United Kingdom, patient hospital discharge remains problematic. District nurses, who deliver skilled home nursing care, receive referrals from hospitals for continuing nursing care needs. However, district nurses' expectations of appropriate patient referral from hospitals are not always achieved. In an attempt to improve services after hospital discharge, government policy has emphasized partnership between care providers, highlighting the need for smooth transition between care settings.
  
  
  OBJECTIVE
  To explore hospital discharge and referral procedures for patients with cancer, with particular emphasis on referrals made by hospital nurses to district nurses.
  
  
  METHODS
  In-depth interviews were carried out with nurses actively involved in the discharge process as both referrers and recipients of referrals. Twenty nurses from a regional cancer centre and 20 district nurses from three adjacent primary care trusts were interviewed. Interviews were transcribed and analysed thematically, and themes compared between the two care settings.
  
  
  CONCLUSIONS
  We conclude that competing sets of expectations, not only between hospital and community nursing settings, but amongst district nurses themselves, are a major factor impeding agreement on referral criteria and satisfaction with the referral process.
authors.affiliation: School of Nursing, Midwifery and Health Visiting, University of Manchester, UK. brian.pateman@man.ac.uk
authors.forename: Brian
authors.initials: B
authors.lastname: Pateman
authors.forename: Kate
authors.initials: K
authors.lastname: Wilson
authors.forename: Gretl
authors.initials: G
authors.lastname: McHugh
authors.forename: Karen A
authors.initials: KA
authors.lastname: Luker
mesh_terms: D000359:Aftercare; D001291:Attitude of Health Personnel; D003142:Communication; D003152:Community Health Nursing / Q000592:standards*; D006801:Humans; D020380:Needs Assessment; D009369:Neoplasms / Q000451:nursing*; D009730:Nursing Assessment; D010166:Palliative Care / Q000592:standards*; D010351:Patient Discharge / Q000592:standards; D012017:Referral and Consultation