My frustration with the language we use, and its potential to influence our collective thinking, has continued unabated in the last few weeks. Last week I discussed with some senior nurse colleagues the reasons why we continue to speak about 'hospital care' and 'out of hospital care', rather than 'hospital-based care' and 'community-based care'.
It is as if the hospital is at the centre of all healthcare, rather than being one of several services in the community, to which people are referred by their GP for an episode of care. Or the place people attend in an emergency which cannot be managed by the GP service and community nursing team.
The general media are hugely influential in the public's perception of the health service. One glance at the media coverage of healthcare would lead you to believe that hospitals were the only NHS service provided. In fact, 90% of all healthcare contacts take place in the community - and just 10% inside hospital walls. That 10% is hugely important and critical to people's lives of course - and I in no way wish to reduce the importance of the hospital as a critical element within our national health service.
With a phenomenal 1 million consultations happening every 36 hours in the NHS, we know, logically, that the vast majority of these consultations and interventions are taking place in the community and primary care settings.
When language centres around references to the hospital, even when speaking about the community, it supports the notion that the health service is centred on hospitals rather than communities. The profile of community services is diminished: in particular, the community nursing services, including those in general practice. This means that nurses working in primary and community care settings are less visible to the general public, as well as to aspiring nurses, those in training and those working in hospital settings.
Perhaps we might challenge our colleagues (in the nicest possible way) when they refer to 'out of hospital care' to say instead community or primary care? This is my ongoing mission in 2014!