The COVID-19 pandemic caused changes to how healthcare services are utilised and delivered.

We examine the impact of COVID-19 on the pattern of emergency patient presentations referred on to the community mental health team and the impact of utilising telemedicine on time to follow-up.

We retrospectively reviewed all clinical records of patients currently attending our service. We identified presentations to the emergency department (N=119) who were subsequently referred on for mental health follow-up.

Patients being referred to our team from emergency departments were significantly younger during, mean age 33.1 years (SD=12.3) compared to before the pandemic, mean age 40.0 years (SD=14.5), p=0.006 and a higher proportion were new patients during, 55.8%, compared to pre-pandemic period 33.3%, p=0.015. There was also a higher proportion of patients presenting with suicidal ideation and lower proportions of affective, psychosis and suicidal/self-injurious acts during the pandemic period compared to before, p=0.006. The ratio of female to male patients on the other hand were similar during both periods, p=0.853. There appeared to be no difference in median time to follow-up pre and during the pandemic (6.0 vs 5.5 days, p=0.995). Further analysis also found no significant impact on time to follow-up upon implementing telemedicine consultations, with median days to initial follow-up of 6 days pre-pandemic, 4.5 days during pandemic + prior to telemedicine and 6.5 days during pandemic + telemedicine, p=0.602.

This study provides preliminary data on the impact of COVID-19 on mental health emergency presentations and utilization of telemedicine on time to follow-up by CMHTs.

No significant relationships.

The aim of this study was to evaluate the use of Eclipse’s beam angle optimiser (BAO) for three-dimensional conformal radiotherapy planning.

Eleven 3D conformal lung plans, with varied tumour volumes, were retrospectively studied. For each clinical plan, a BAO plan was produced and then optimised by an experienced planner. Plan quality was assessed using International Commission on Radiation Units and Measurements (ICRU)-83 and  Radiation Therapy Oncology Group (RTOG) recommended dose reporting metrics for dose volume prescribing and reporting.

Differences in dose volume histograms for both methods showed no clinical significance. Planning target volume Dmax for both plans was comparable and within ICRU guidelines. Reported spinal cord Dmax and the doses to 33% and 67% volume of the heart were within the RTOG recommended limits. Mean lung V20 values for BAO and non-BAO plans were 20 and 16%, respectively. The average monitor units for the BAO plans were about 11% lower. The conformity and homogeneity indices were within the acceptable range for both cases. On average, it took 23 minutes to plan using the BAO compared to 68 minutes for the non-BAO plans.

Eclipse BAO shows the potential to produce good quality conformal plans and reduce planning time. This process could be further refined with multi-leaf collimator and optimal collimator angle options.