We retrospectively audited premature discharges of in-patients undergoing alcohol or opioid detoxification. Recommendations for good practice aimed at reducing premature discharge rates were implemented, following which a prospective audit was completed.

The retrospective phase of the audit cycle showed a premature discharge rate of 30.8%, compared with a rate of 13.2% for the prospective phase. The difference in these rates is both clinically and statistically significant at the 5% level, with Fisher's exact test producing a two-sided P = 0.0119.

Implementing good practice guidelines improved outcomes, with more patients successfully completing detoxifications and a more effective use of resources.

National clinical guidance states that patients on antipsychotics should have their metabolic profile regularly monitored. The aim of this study was to assess whether we are effectively monitoring metabolic profiles and to improve the detection, communication and intervention of metabolic abnormalities among patients on atypical antipsychotics. We describe a full audit cycle.

The audit resulted in a 24% increase in the number of patients on atypical antipsychotics being referred to the metabolic clinic. The number of abnormal results communicated to primary care showed a significant improvement of 25% (P <0.001), and ultimately the number of patients who received intervention improved by 17% (P = 0.001).

Audit feedback has been effective in changing clinical practice. The audit demonstrated the potential value of a metabolic clinic and shared care between primary and secondary practitioners for this group of high-risk patients.

To identify the outcomes of patients in the obstetric screening clinic. In 2 years, 180 women were referred by midwives to a clinic run by specialist community perinatal team. ‘Ultra-high risk’ patients were identified. There were four outcome measures predicated on level of care.

Of those referred, 69 women were managed in primary care/generic community mental health teams, 90 by specialist perinatal team and 21 did not attend; 23 women were ultra-high risk. The majority of the ultra-high risk patients required treatment with specialist teams.

Specialist community perinatal screening clinics are successful at identifying those at high risk of developing mental health problems. Ultra-high risk women needed a higher level of service. High morbidity in women who fail to attend the services demands more assertive follow-up. Cumulative personal and family history is an important risk factor.

We conducted a retrospective audit of 100 discharge summaries to evaluate the accuracy of medication recording and the recording of as required (PRN) prescribing, and to see whether or not general practitioners were advised on how long to continue the latter. After a formal guideline was introduced we conducted a re-audit.

There was an improvement in summaries recording medication correctly (from 64 to 83%). The number of summaries with one or more missing medications halved and PRN sedative prescribing reduced from 18 to 3%, but provision of advice on the latter did not improve.

Accurate recording of medication in the discharge summary is an important element of the transfer of patient care to the general practitioner. Medication errors may pose serious health risks and undermine patient confidence in the service. The clinical audit and interventions implemented helped to reduce errors in medication recording in discharge summaries.

The Annual Review of Competence Progression (ARCP) is a process of checking and evaluating evidence of competency attainment collected by a trainee over the preceding year. There has been no study evaluating trainees' perception of this new process. Two cross-sectional electronic surveys were conducted a year apart in the north of England. Out of 92 psychiatry trainees 58 (63%) completed the survey in 2008; 60 (63%) out of 96 trainees completed the second round in 2009.

Over the year there was a significant improvement in trainees' perception of the new process: 75% of respondents highlighted non-availability of a list of acceptable evidence for the portfolio in 2008, which reduced to 22% in 2009 (P <0.001). The percentage of trainees facing difficulty in accessing the electronic portal reduced from 73 to 28% (P <0.001). The trainees continued to express the need for explicit feedback at ARCP and improved training of the assessors in addition to other parameters.

The process of ARCP seems to have become robust over the year studied. There is scope for further refining of the process according to trainees' needs.

To generate a list of topics for ‘core curriculum’ that can be used as a guide for trainees and trainers carrying out workplace-based assessments (WPBAs). A three-stage Delphi consultation was carried out.

Generation of a list of topics for WPBA appropriate for each year of core training with a mean rating of importance in curriculum.

In the absence of formal guidance, the list generated can serve as an informal guide.

This study aimed to establish the variations in the pre-defined aspects of postgraduate psychiatric training within the member countries of the European Federation of Psychiatric Trainees and illustrate the diversity of training experiences within Europe. Participants were required to complete a structured questionnaire.

There are wide variations in the length, content and structure of postgraduate psychiatric training across Europe. There are differing requirements for, and access to, psychotherapy training. Some countries have no examinations or formal assessments.

An understanding of the postgraduate training systems across Europe is essential not only for making informed choices about the development of trainees recruited from the European Economic Area but also for enhancing postgraduate training and patient care in all European countries.

The audit aimed to assess current senior registrar posts in child and adolescent psychiatry in Ireland in terms of working environment, conditions and training issues. The posts were compared with standards set down by the Child and Adolescent Psychiatry Specialist Advisory Committee of the Royal College of Psychiatrists and the National Higher Training Subcommittee of the Irish Psychiatric Training Committee.

The audit cycle was completed twice and a 100% response rate was achieved on both occasions.

Higher training posts in child and adolescent psychiatry in Ireland compare favourably to standards for training and education, but poorly for working environment, case-load and educational supervision.

The effective management of patients with anxiety, depression or somatisation, who commonly present across all medical disciplines, requires an understanding of both pharmacological and psychological approaches such as cognitive-behavioural therapy (CBT). However, there is little research addressing effective ways of delivering CBT training that is relevant for doctors. We provided CBT skills training that included supervised casework to medical students at Oxford University and assessed participants' experiences.

The training was feasible, sustainable and highly valued. Students reported marked improvements in knowledge and skills related to CBT and felt more convinced of its effectiveness for patients and its relevance for doctors. They also gained generic medical skills and an increased understanding of mental health problems.

Supervised casework appears to be an effective format for learning. It allowed students enhanced responsibility for patient care and an opportunity to practise using cognitive-behavioural strategies, some of which would be transferable to medical consultations.