Happy New Year, and welcome to what some are predicting will be the year of continuing professional development/ continuing medical education!

One of the most valuable commodities in the NHS is the individual consultant's time. This is what patients, their relatives, and other staff want most, and they complain that it is not sufficiently available. We increasingly examine the use of our resources and the quality of our service but do not pay sufficient attention to this variable. This article aims to highlight the importance of the clinician's time and suggests that it should be subjected to periodic audit, along with other aspects of the service, and that the duration of face-to-face contact with patients should be introduced as one of a series of quality measures.

Jealousy has traditionally been treated by offering medication, support, or various forms of individual psychotherapy or counselling. However, jealousy is usually a condition which has a profound effect on the sexual partner of the jealous person, and they may actually suffer more from the condition than the person him/herself. While accepting that medication and other individual approaches have their place in the management of jealousy, there seem to be several advantages in seeing the problem from the standpoint of the couple relationship. Firstly, couple therapy reduces the almost inevitable labelling of the jealous person as a psychiatric case. Secondly, one might argue a priori that any changes which take place as a result of two people changing their behaviour are likely to be more stable and long-lasting than if just one person changes. There is another consideration, namely that, since the relationship is bound to be affected by the jealousy, it will need attention regardless of the means used to treat the jealousy itself.

Liaison child and adolescent psychiatry has been described as the “partnership of child psychiatrists, paediatricians and other specialities concerned with children to provide integrated medical and psychological care for children” (Black et al, 1990). Although liaison work conjures up visions of the psychiatrist on the paediatric ward, it may also involve collaboration with community paediatric and primary care services. Indeed, the number of different professionals that may be involved with even quite mildly ill children is large (see Box 1). Much of the work is indirect (e.g. consultation with other professionals), but this and direct therapeutic work with children and families may continue long after discharge from the paediatric wards and clinics.

Case registers have very little to do with computers or any other form of mechanical calculating machine. To write an article on case registers which concentrated on information technology would be as logical as an article on open heart surgery which confined itself to the finer points of scalpel technology. The creation of a case register is as simple or as complicated as the clinician wishes it to be; a case register at its purest is simply a list of contacts with patients, organised to a predetermined format, which allows the clinician to gain information from the list for education, research, planning or administration. The work needed to establish a case register, however, should not be underestimated, and the time spent in thinking through reasons for development of a register is a worthwhile investment. An understanding of the history of the development of psychiatric case registers may help those wishing to develop new registers to avoid treading well worn cul-de-sacs, while reviewing some of the work which has resulted from case registers may demonstrate the enormous potential of a well-designed register in facilitating the extension of knowledge about treatment and provision of services.