Leeds and York Partnership NHS Foundation Trust
Recent publications
Background People with dementia frequently develop behavioural and psychological symptoms, sometimes necessitating care in specialist dementia mental health wards. There has been little research on their life expectancy following admission or need for palliative care. The work presented here explores the mortality of these patients and whether this can be predicted at their time of admission to the ward. Method We conducted a retrospective analysis of 576 patients admitted to the Cambridgeshire and Peterborough NHS Foundation Trust dementia mental health wards in the United Kingdom, and built a Kaplan‐Meier survival curve as well as machine learning models. Next, to examine changes in deaths occurring over time, a retrospective service evaluation was conducted involving four mental health wards for people with dementia in the United Kingdom, encompassing a further 1,976 patients. Result The median survival length post‐admission was 1201 days. Clinical data collected on admission did not predict mortality in machine learning models at a level of accuracy likely to have clinical utility. Data from four different wards show that the number of patients dying in dementia mental health wards has increased over time. Conclusion Our cohort had a high mortality, although with a wide range of survival times. We suggest all people admitted to these units should have discussions and access to high‐quality end‐of‐life care.
Despite the high prevalence of use, evidence for the efficacy of the pharmacological management of aggressive inpatient behaviour is currently lacking. As such, when psychiatric emergencies occur and medications become necessary, medication should be as non-traumatic and non-coercive as possible and client preference should guide choice of type and route of administration of medication. A broad range of pharmacological approaches to manage psychiatric inpatient aggression has been investigated and are described in this chapter. We briefly summarise pertinent systematic reviews and guidelines and recommend general approaches to manage inpatient aggression based on these. Behavioural and pharmacological management of aggression on psychiatric wards ideally involves patients as partners as early in the process as possible.
Background Autistic children can experience mental health, social and emotional difficulties. Carol Gray's Social Stories™ are a highly personalised intervention that provide social information in a short individually tailored story. Methods A multi‐site pragmatic cluster randomised controlled trial to evaluate the clinical and cost‐effectiveness of Social Stories™ alongside care as usual in autistic children aged 4–11 years. The primary outcome was the Social Responsiveness Scale‐2 completed by teachers 6 months post‐randomisation, analysed on an intention‐to‐treat basis. Trial Registration: ISRCTN11634810. Results Eighty‐seven schools, including 249 children, were randomised (intervention 44 schools with 129 children, and usual care 43 schools with 120 children). After 6 months, a reduction of 1.61 points was found on the Social Responsiveness Scale‐2 in the intervention group (95% CI −4.18 to 0.96, p = .220) and for those who attended at least six sessions a reduction of 3.37 points (CACE 95% CI −6.65 to −0.10, p = .043). Children in the intervention group met their individual socio‐emotional goal more frequently than children receiving usual care alone and this was statistically significant. No statistically significant differences were found in other secondary outcomes including anxiety, depression, general health or parental stress. Conclusions Social Stories™ represent a low‐cost, low‐burden intervention. Benefits are seen in individual socio‐emotional goals but without clinically evident impact on social responsiveness, anxiety, depression, parental stress or general health.
Objective The objective of this study is to identify the top 10 research priorities on reducing and stopping psychiatric medication that reflect the perspectives and unmet needs of three key stakeholder groups (people with lived experience, family members/carers/supporters and healthcare professionals). Methods A priority-setting partnership was conducted using the James Lind Alliance’s seven-step process. This involved (1) creating an international Steering Group of key stakeholder representatives and (2) identifying potential partners; (3) gathering stakeholders’ uncertainties about reducing and stopping psychiatric medication using an online survey and summarising the survey responses; (4) checking the summary questions against existing evidence and verifying uncertainties; (5) shortlisting the questions using a second online survey; (6) determining the top 10 research questions through a prioritisation workshop; and (7) disseminating the results. Results A total of 3635 questions were collected in the initial survey from 884 respondents of which 32 questions were verified as uncertainties. These questions were then ranked in a second online survey by 526 respondents and the findings discussed in a final prioritisation workshop by 30 participants to produce the final top 10 list of research questions. These questions cover a range of areas including the most effective ways of safely reducing/stopping psychiatric medication and providing support to individuals undergoing the discontinuation process, as well as the best ways to educate healthcare professionals on this topic. Conclusion The top 10 list of research priorities was produced through extensive engagement with key stakeholders and highlights important uncertainties and gaps in the existing evidence base that need to be addressed by future research.
Background Positive, negative and disorganised psychotic symptom dimensions are associated with clinical and developmental variables, but differing definitions complicate interpretation. Additionally, some variables have had little investigation. Aims To investigate associations of psychotic symptom dimensions with clinical and developmental variables, and familial aggregation of symptom dimensions, in multiple samples employing the same definitions. Method We investigated associations between lifetime symptom dimensions and clinical and developmental variables in two twin and two general psychosis samples. Dimension symptom scores and most other variables were from the Operational Criteria Checklist. We used logistic regression in generalised linear mixed models for combined sample analysis ( n = 875 probands). We also investigated correlations of dimensions within monozygotic (MZ) twin pairs concordant for psychosis ( n = 96 pairs). Results Higher symptom scores on all three dimensions were associated with poor premorbid social adjustment, never marrying/cohabiting and earlier age at onset, and with a chronic course, most strongly for the negative dimension. The positive dimension was also associated with Black and minority ethnicity and lifetime cannabis use; the negative dimension with male gender; and the disorganised dimension with gradual onset, lower premorbid IQ and substantial within twin-pair correlation. In secondary analysis, disorganised symptoms in MZ twin probands were associated with lower premorbid IQ in their co-twins. Conclusions These results confirm associations that dimensions share in common and strengthen the evidence for distinct associations of co-occurring positive symptoms with ethnic minority status, negative symptoms with male gender and disorganised symptoms with substantial familial influences, which may overlap with influences on premorbid IQ.
Purpose: People with Persistent Physical Symptoms experience physical symptoms that are not wholly explained by a medical disorder or disease. Multidisciplinary treatment is recommended for people with severe difficulties and is provided in a small number of specialist centres in the UK. Only brief descriptions of this treatment are available, and the experiences of people receiving this treatment as an inpatient have not been explored. This study aimed to explore how people with persistent physical symptoms experience inpatient treatment from a specialist multidisciplinary team, and to identify which factors facilitated their engagement in the rehabilitation. Materials and methods: 18 people who had received inpatient multidisciplinary treatment for persistent physical symptoms participated in semi-structured interviews. The transcripts were analysed using reflexive thematic analysis. Results: Participants' experiences were influenced by whether they felt believed by the healthcare team, and whether they could place their own trust and belief in the staff team and the treatment approach. Their experiences involved a series of transitions; both in environment and understanding. Conclusions: Improvements are possible for people receiving inpatient multidisciplinary treatment for severe PPS. Trusting relationships between patients and staff members take time to develop but play a major role in patients' experiences of treatment.
Background Children in foster care are at high risk of future mental health and developmental difficulties. A number of interventions may be helpful; however, the effectiveness of interventions specifically for pre‐school children in foster care is not well established. This is an important omission, since infancy and early childhood may be the optimal period for interventions to prevent future problems. The current systematic review set out to establish the existing evidence base for interventions to improve social‐emotional, developmental and relational outcomes for pre‐school children in foster and kinship care. Methods Searches of online databases were undertaken in June 2023 with keyword search terms related to the study population and design. Studies utilising a randomised control design to measure the effectiveness of interventions for foster children aged 0–7 years were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias (ROB‐2) tool and effects evaluated using narrative synthesis and GRADE assessments of included interventions and outcomes. Results Searches identified 6815 results. Twenty studies, describing seven interventions, met inclusion criteria. Fifteen studies reported intervention benefits comparative to control in at least one outcome domain, with particularly good evidence for Attachment and Behaviour Catch‐Up (ABC) in improving developmental outcomes. There was also evidence for Multi‐Treatment Foster Care for Pre‐Schoolers (MTFC‐P), Kids In Transition To School (KITS), Parent‐Child Interaction Therapy (PCIT) and HeadStart in improving behavioural outcomes. The findings for relational outcomes, including attachment, were mixed; however, there was some evidence for MTFC‐P and ABC in reducing avoidant attachment. Conclusions This systematic review contributes to our current understanding of how we might best support pre‐school children in foster care. It remains unclear whether the effectiveness of particular interventions may be moderated by participant or intervention characteristics. Further research is needed to understand which interventions work best for whom in this group. Despite some variability in methodological quality and heterogeneity across studies, our findings suggest that certain interventions are likely to be helpful for young children in foster care. Dissemination and ongoing evaluation of the evidence‐based interventions highlighted within this review should be implemented in clinical practice.
There have been growing concerns about the well-being of staff in inpatient mental health settings, with studies suggesting that they have higher burnout and greater work-related stress levels than staff in other healthcare sectors. When addressing staff well-being, psychological safety can be a useful concept. However, there is no measure of psychological safety that is suitable for use in inpatient mental health settings. Edmondson (1999) is the most commonly used measure of psychological safety, but it was designed for use in general physical healthcare settings. As inpatient mental health settings are unique environments, transferability of knowledge from physical to mental healthcare settings cannot be assumed. We sought to develop questionnaire items that capture psychological safety among healthcare staff working in acute inpatient mental healthcare settings. We used the nominal group technique, a consensus method involving rounds of discussion, idea generation, and item rating/ranking to identify priorities. Twenty-eight stakeholders participated, including 4 who had lived experience of mental health problems, 11 academics and 18 healthcare professionals (8 participants identified with more than 1 category). The study involved a workshop with three parts: (i) an overview of current research and limitations of the Edmondson (1999) measure as outlined above, (ii) discussion on what items should be retained from the Edmondson (1999) measure, and (iii) discussion on what items should be added to the Edmondson (1999) measure. Twenty-one items were generated and retained to capture psychological safety in inpatient mental health settings. These measure professionals’ sense of being valued by their team and organization, feeling supported at work, feeling physically safe and protected from physical harm, and knowing they can raise concerns about risk and safety. This is the first study to generate questionnaire items suitable for measuring staff psychological safety in mental health settings. These have been generated via a consensus method to ensure stakeholders’ views are reflected. Further research is needed to evaluate factor structure, internal reliability, and convergent validity. Full text available here https://academic.oup.com/intqhc/article/36/3/mzae086/7746667?utm_source=etoc&utm_campaign=intqhc&utm_medium=email
Self-harming behaviours can include cutting the skin, ligaturing and taking overdoses. These actions can result in infection, blood loss, or even death. A young person's risk of dying by suicide increases if they engage in self-harm. Self-help empowers people to utilise different coping strategies and implement life changes without reliance on a clinical intervention, "helping people to help themselves". Self-help toolkits contain a variety of items that are selected by the person to help them manage the urge to self-harm. The items included sensory objects, distractions, prompts to seek help and creative prompts such as colouring books and pens and personal items that trigger positive memories. AMED, EMBASE, APA Psycinfo and MEDLINE were searched with no language restriction or date restriction. Of the 368 studies screened, 13 met the inclusion criteria. The studies were mainly small scale or case studies pertaining to the use of self-help toolkits or similar. They described the need for a flexible and/or individualised approach to self-help toolkits. Abstracts and studies were screened separately by two members of the research team for inclusion. Qualitative data was analysed using Grounded Theory. Nine themes were identified: Creativity, Hope, Social contact/help seeking, calming/relaxing, sensory items, reflection, distractions, therapeutic prompts and emotional release. Self-efficacy and self-awareness were the two main mechanisms identified. Self-help toolkits were found to be acceptable and helpful, but the limited evidence base means their efficacy for reducing self-harm episodes has not been established.
Aims To quantify and evaluate the gender differences regarding the development of PTSD. This meta-analysis calculates (a) the difference between males and females who develop PTSD, and (b) the difference in gendered relative risk of PTSD development. Methods Study selection criteria included participant mean age above 18 years, single and direct exposure to a terrorism related traumatic event, and a confirmed diagnosis based on Diagnostic and Statistical Manual of Mental Disorders 5 th edition. Data extraction included year and location of terrorist event, the total number of participants in the study, the total numbers of males and females diagnosed with PTSD, and time (in months) of diagnosis following the traumatic event. The number of males and females affected by PTSD was pooled using random effects inverse variance weighted meta-analysis and relative risks (95% confidence interval) were calculated. Results Twenty-seven studies met the inclusion criteria of which five had significant information to be included in the meta-analysis. The total number of males in the pooled sample size was 328, and the total number of females was 354 out which a total number of 34 males and 66 females met the PTSD criteria. The mean average of males and females affected by PTSD was 6 and 11, respectively. An independent samples Mann Whitney U test rejected the null hypothesis ( p < 0.05) and concluded that the distribution of PTSD between males and females was significantly different. The meta-analysis found an overall relative risk of a diagnosis of PTSD in females to be 1.82 (95% CI 1.25–2.65) compared with males. Conclusion This meta-analysis found females to have an elevated risk of developing PTSD following a single terrorism traumatic event. The results of our study are supported by previously published research, which has found females to be at higher risks of developing PTSD. However, such research has proposed gender differences secondary to the types of stressful events experienced, which does not apply to our meta-analysis given the uniformity of the traumatic event we explore. Other factors, therefore, need investigating to understand this phenomenon. We acknowledge that researching psychological consequences in communities affected by terrorism is complicated and limited by lack of healthcare access, trained clinicians, cultural diversity in the expression and articulation of a community's traumatic experience and of course, the instability of the ground fabric. Other limitations of the included studies are the binary of gender reporting, which limits a fuller understanding of a minoritized community.
Aims We undertook a service evaluation obtaining feedback from service users in an inpatient rehabilitation setting about a weekly Boxercise class. The aim was to assess the experiences of service users, and the role it has in their recovery. We hypothesised that the class would be well received by service users in aspects of enjoyment, impact on biopsychosocial wellbeing and recovery based on positive comments made by service users. There is an increasing trend to utilise physical activity as an adjunct to improve mental health within healthcare settings; to increase motivation, educate on healthier lifestyles and to enhance well-being outcomes. This Boxercise programme has been developed by the Healthy Living Advisor within the rehabilitation inpatient facility at Leeds and York Partnership Trust. The programme has run for one year, and there has been a large uptake of service users who participate in the group. The Boxercise classes aim to encourage discipline, communication, spatial awareness, and cognitive skills in a modality that is interesting to service users. Methods Service users who are regular participants in a Boxercise programme at an inpatient rehabilitation centre completed a questionnaire. A five-point Likert scale assessed participant views across seven domains. Participants were then asked to write three words that describe their feelings about the Boxercise programme, complete a drawing showing their thoughts after a Boxercise class and provide suggestions for improvement. Results Eleven participants completed the questionnaire. Average scores for the domains were as follows: enjoyability 4.45/5 (89%), physical health 4.55/5 (91%), mental health 4.27/5 (85%), recovery 4.09/5 (82%), socialising 3.91/5 (82%), safety 4.64/5 (93%), continue after discharge 3.36/5 (67%). The ‘three words' were put in a word cloud generator with highest weighted words: ‘Fun', ‘Good', ‘Energetic', ‘Confident'. Common themes from the pictures shown were smiling faces and ‘strongman' images. Six participants gave feedback that more equipment (pads and gloves) would help to improve their experience in the classes. Conclusion The Boxercise programme received positive feedback from participants that aligns with the hypothesis; particularly in safety, enjoyability, benefit to physical health and benefit to mental health. The participants had positive views on the class as an adjunct to the management of their physical and mental wellbeing. The feedback from all the participants is that they felt safe during the classes. This service evaluation indicates that the participants value the Boxercise classes as an enjoyable activity and as an adjunct to their treatment.
Aims To evaluate the adherence to shared care guidelines for ADHD patients by assessing if their Blood Pressure, Pulse Rate, and Weight have been monitored at least twice within the last year by their GP, as recommended by NICE guidelines. Following initiation and stabilization on an ADHD medication, shared care with the GP is initiated whereby the GP is responsible for prescribing the medication, and monitoring physical observations every 6 months. Methods Data Collection: a. Collate the list of patients that were due for annual structured review in August and September 2023 from the team's shared drive. b. Randomly select 50 patients from this list. Inclusion criteria: 1. Patient must have been on ADHD medication in the past 12 months. Data Assessment: a. Access the GP records (Patient Practice Management system) for the selected 50 patients. b. Review the patient records for each of these 50 patients to identify when Blood Pressure, Pulse Rate, and Weight measurements were recorded within the last 12 months. c. Record the date and results of the Blood Pressure, Pulse Rate, and Weight measurements for each patient. d. Determine if each patient had these measurements done at least twice within the last year as per NICE guidelines. e. Calculate the percentage of patients who met this guideline. Results Sample size: 22 patients patients met the inclusion criteria. • Blood pressure checked within the last 6 months – 22/22 (100%) Blood pressure checked within the last 1 year – 19/22 (86%) • Pulse rate checked within the last 6 months – 20/22 (90%) Pulse rate checked within the last 1 year – 18/22 (81%) • Weight checked within the last 6 months – 21/22 (95%) Weight checked within the last 1 year – 20/22 (90%) 8 out of 22 had a “significant” change in their BP reading. This significance is in keeping with NICE Guidelines that is, an increase of 2–4 mmHg for patients on ADHD medication, but this is generally not significant in terms of risk. How was the project outcome disseminated? A letter was sent out to GP practices commending the positive outcome of the audit. Recommendations for further improvement were suggested flagging up a review if there is a reduction of 10% or more in body weight within 12 months of treatment. Conclusion The positive outcome of the audit shows the effectiveness of current practices. However, it's important to maintain a commitment to ongoing improvement. Regular evaluations and audits remain essential to adapt to evolving guidelines, address emerging challenges, and sustain a culture of excellence in healthcare delivery.
Aims Out-of-hours (‘on-call') work can be perceived as daunting by junior doctors. When psychiatry trainees progress from core trainee to higher trainee, what entails ‘on-call' work often shifts dramatically. Current allocation policy in Yorkshire and Humber Deanery means most of the higher trainees (HTs) begin their first on-call as a HT in a trust where they have never worked before. This frequently entails navigating an unfamiliar patient record system and various OOH care pathways in a new work environment, which can make the first few on-call shifts extremely stressful and potentially increase the risk of clinical errors. We aim to evaluate the on-call experiences among higher trainees, collect feedback on ways of improving induction programme relating to OOH work and re-evaluation after the interventions implemented in the latest induction. Methods • A short survey using Likert scale was designed to capture HTs' experience and knowledge in relation to OOH work plus free text feedback at the end of each question. • An online survey link was disseminated by email in May 2023 among HTs who joined LYPFT between August 2022 to Feb 2023. • Interventions: a) A face to face induction in August 2023 to replace the online induction; b) ‘A walkabout tour at Crisis office’ led by Crisis consultant as part of the induction programme. • Re-survey link was sent out in October 2023 to HTs who joined in August 2023. Results 1st Survey: 11 out 16 new HTs completed the survey. 5 out of 11 had never worked in LYPFT. 2nd Survey: 11 out of 19 new HTs completed the survey. 8 out of 11 had never worked in LYPFT. 2nd Survey showed significant improvement in HTs' level of familiarity to on-call office environment, awareness of the multi-agency S136 pathway and local policy as well as alternative local crisis provisions other than hospital admission, and the relevant referral procedures. HTs' confidence of navigating OOH local care pathway was markedly enhanced. Overwhelming positive feedback were received regarding the ‘Walkabout tour' as part of the Induction programme. Conclusion • Simple interventions at Induction programme can significantly improve HTs' confidence for OOH work. • HTs valued high on practical support such as the ‘Walkabout tour at Crisis office' and would like it to be expanded to other OOH services such as Seclusion unit and Acute Liaise Psychiatry Service.
Aims High doses of antipsychotic therapy (HDAT) are often prescribed in secondary mental health services and has been the subject of many audits and service improvements. This interest is largely due to the increased morbidity and mortality related to HDAT, and strong advocacy for clear rationales to guide this decision. There is a need for continuous review and monitoring to prevent unnecessary prescribing. Our audit was used to determine the prevalence of HDAT in East Suffolk inpatient settings and assess whether review planning and monitoring of HDAT was practiced. Standards for antipsychotic dosage were established using British National Formulary and Maudsley Prescribing Guidelines for Psychiatry. Methods Retrospective data was collected using electronic records of patients 18 years and above who were discharged from inpatient psychiatric wards located in East Suffolk between 1st July and 31st December 2021. Data available included discharge medication letters, discharge summaries and inpatient clinical notes. Results A total of 256 patients were discharged from East Suffolk wards in the 6-month period between 1st July and 31st December 2021. Majority of the patients (80%) were above 65 years of age with more than half of patients being male 114 (56.3%). Ninety-seven (37.9%) patients had a diagnosis of schizophrenia or schizophrenia-like and delusional disorders, while approximately 25% of the audited population had a mood disorder. 9% had a singular diagnosis of personality disorder. One hundred and sixty-six (64.6%) patients were on antipsychotic medications and two (1.2%) patients were discharged on HDAT. Conclusion High dose antipsychotic prescribing was not as prevalent as initially assumed. This audit noted only one of the two patients on HDAT did not have the appropriate monitoring form completed. Good clinical practice recommends the need for the completion of a high dose antipsychotic therapy (HDAT) form for each patient, which would allow proper monitoring.
Aims Rapid tranquillisation – the parenteral administration of a sedating psychotropic – is frequently utilised to manage acute behavioural disturbances. Each mental health trust in England utilises independent guidelines for rapid tranquillisation, which vary geographically in both recommendations for therapeutic agents, as well as the format in which this information presented. Audits have identified that there is currently poor adherence to rapid tranquillisation protocol guidelines; this may be due to a lack of guideline clarity allowing for personal interpretation. This service evaluation aims to determine the clarity and uniformity of protocols outlined in mental health trust guidelines, in addition to analysing the outcomes of guideline testing to identify if there is consistency between policies, or whether outcomes varied depending on the trust guidelines used. Methods Five reviewers (of differing positions throughout clinical training) utilised 52 guidelines from each mental health trust in England, as well as Maudsley and NICE. These were assessed using the same fictional scenario, which simulated a common presentation in which the use of rapid tranquillisation is required. Reviewers deduced the most appropriate therapeutic agent according to the guideline, rated the clarity of each guideline and were invited to leave comments highlighting the guideline's useability. Results Seven different management plans were generated by the majority of respondents from the 52 guidelines. Lorazepam was the most frequently selected therapeutic agent. Guidelines with better subjective ratings of clarity had more agreement between reviewers, but full agreement between reviewers was only present for 10 out of 52 guidelines. For 11 guidelines, consensual agreement between reviewers was not reached. Qualitative analysis of comments identified the inclusion of past medical history, drug history and flow charts as positive sub-themes. Redundant language, contradictions and the suggestion to seek senior intervention before trialling a second agent were viewed negatively. Many guidelines did not sufficiently emphasise the need for performing an ECG before administering therapeutic agents, such as haloperidol, which may lead to potentially fatal arrhythmias. Conclusion There is no national consensus on the most appropriate rapid tranquillisation agents, with the available evidence being interpreted variously by different trusts and organisations. Poor guideline comprehensibility impacts clinician adherence and allows for personal preference to influence choice of drug. Clear guidelines utilising flow charts to succinctly outline relevant doses and absolute contraindications were viewed favourably by reviewers. The findings of this project highlights to relevant stakeholders the attributes that should be implemented when improving guidelines for the future.
Aims The Royal College of Psychiatrists provides guidance regarding the experience of Foundation Doctors and Core Trainees, during their Psychiatry rotations. At The Mount, an Older Adult Mental Health unit in Leeds, it was observed by trainees that management of physical health conditions was occupying a large portion of their time. Aims: 1. Measure how much time is spent on physical health activities, between Foundation Doctors and Core Trainees at The Mount. 2. Consider the impact of physical health workload on the doctors’ experience of Psychiatry. 3. Explore the mental health experience of doctors during this rotation. Methods This Audit was conducted in three stages: 1. Anonymous collection of quantitative data regarding the proportion of time spent on physical health work. This data was collected for current doctors across all wards, for a two-week period in October 2023. 2. A focus group of junior and senior doctors, to consider onward actions. 3. An anonymous qualitative survey regarding mental health experiences and suggestions for improvement. This was circulated to any Foundation Doctor or Core Trainee who worked at The Mount in the past 12-months, via an online survey. Results The quantitative survey showed that Foundation Doctors and Core Trainees at The Mount were spending at least half their time on physical health jobs, such as: clinical reviews, skills such as blood tests and ECGs, and referrals to other clinicians or specialties. This was considered unsurprising by doctors at all levels during the focus group. The qualitative survey explored this further, with observations that doctors were sometimes unable to attend MDT meetings, tribunals or CPAs due to the high physical health workload. It was felt that senior staff were proactive in offering support, however trainees still felt that opportunities for mental health experience were limited. Suggestions for improvement were made during the survey, including: 1. Increased input by senior medical staff, such as GPs or Geriatric Trainees. 2. Additional staff to support with upkeep of equipment, or skills such as phlebotomy. 3. Increased use of technology rather than paper charts. 4. Greater clarity regarding minimum staffing and whether locum doctors can be arranged to cover gaps. Conclusion In summary, the physical health workload for Foundation Doctors and Core Trainees was noted to be significant and impacting their mental health experience. Following this Audit, consultants at The Mount will be meeting with Senior Leadership to discuss methods for improving the training experience.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.
133 members
Ian Rory Owen
  • Department of Psychiatry
William R Jones
  • Yorkshire Centre for Eating Disorders
Ellen Kingsley
  • COMIC Research Team
Information
Address
Leeds, United Kingdom