In 1992, Pippard reported a comprehensive audit of electroconvulsive treatment, (ECT), in two NHS regions. He found deficiencies in most aspects of ECT administration (Pippard, 1992), particularly the training and supervision of the administering doctor, usually an SHO or registrar. Regrettably, the competence of a trainee to administer ECT appeared to have improved but little in the 11 years since the same author first reported on the subject (Pippard & Ellam, 1981). In particular, it failed to meet the guidelines issued by the Royal College of Psychiatrists in 1989. This was reflected in inadequate administration of ECT as assessed by direct observation and by determining the provision made for teaching and supervision of ECT by senior staff. Pippard concluded that the overall standard of training was inadequate and that “The responsibility for this mediocrity rests squarely on the consultants as a whole and not just on those whose nomination to be in charge appears to absolve the rest…”.
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