Dr Smithies writes about her experience in moving consultant post (Psychiatric Bulletin, February 2005, 29, 65-66). We compared the characteristics of consultants who remained in post (stills) with those who moved to a new post (movers) using two surveys of workload and stress in consultant old age psychiatrists (Reference Jolley and BenbowJolley & Benbow, 1997; Reference Benbow and JolleyBenbow & Jolley, 2002). Of those who contributed to both surveys, one-quarter changed post over 4 years. Movers did not differ significantly from stills in relation to age, gender, marital status or work pattern. Individual doctors described similar stress levels in both surveys, suggesting that stress profiles remain stable. Movers were slightly younger than stills, and more often came from small teams, rather than working alone or in a larger team (but these findings were not statistically significant). Measures of stress in the second survey did not differentiate between the groups.

The mobility of consultant psychiatrists is an important feature of National Health Service practice. Moving is not, however, associated with an abnormal stress profile, or a change in an individual's perceived level of stress.

A mobile workforce brings with it advantages and disadvantages. Bringing new ideas and approaches from one culture to another is enlivening and stimulating. It avoids the risk of staff losing enthusiasm through boredom and sameness. For patients and carers, it reduces the risk that institutionalisation will mask, conceal, excuse or condone poor or exploitative behaviour. However, too much change can be counterproductive: promoting uncertainty and undermining confidence, and reducing the efficiency derived from established interpersonal links.