EditorThe article on PEG Tubes by Lowry and Johnston1 fails to mention if the patients in the survey were referred to the District Nursing Service which is best placed for the seamless transfer from secondary to primary care. The successful discharge of a patient requiring enteral feeding requires good forward planning and liaison between hospital and community nursing staff. Best practice would dictate the District Nurse visiting the patient in the ward for an holistic assessment but if this is not possible, a visit to the home before discharge to introduce herself, to assess the layout and equipment requirements and let the family know who to contact and what support to expect when the patient comes home.Most families require time to adjust and need the support of the evening nursing service to help set up the night feed and a morning call to supervise disconnecting and flushing the tube until they feel confident enough to do this themselves. The time is well spent and forges the supportive, trusting relationships essential in primary care and possible palliative and terminal care at home.This level of care is available to all patients in this trust and yet your article mentioned the District Nursing Service only in saying that we ‘may not have been trained in the insertion of balloon gastrostomy replacement tubes’. Although many of us are, this is not pertinent to research looking at ‘appropriate community follow up’ six months following discharge from hospital when this needs to be performed in a hospital environment.The article also mentioned ‘patients attending busy Accident & Emergency departments when the PEG tube falls out’. However it failed to mention the number of patients discharged from these units with totally inadequate Foley catheters inserted due to the lack of adequately trained personnel, which is my experience! I welcome the debate but please remember, come 5pm on a Friday, where are the Dietician and the Speech & Language Therapist!