Discharge summaries are the mainstay of intra and inter-departmental communication, ensuring continuity of care. Local instructions fail to provide clear guidance to foundation doctors to ensure standardised discharge summaries.

The audit aimed to assess the inclusion of information within discharge summaries at Mount Carmel Hospital, Malta. A secondary objective was to update the current online discharge summary framework.

Stratified random sampling was used to select 120 discharge summaries, issued between October 2018 and September 2019. These were chosen out of a total of 956 discharge summaries issued during the period. The inclusion of information was analysed against the National Standard for Patient Discharge Summary Information issued by the Health Information and Quality Authority, Ireland. Data was collected and grouped into seven categories each containing multiple data points.

Patient details were present in all discharge summaries while no details relating to the primary care healthcare professional were documented. The average information inclusion rate regarding admission, discharge and medications was 85%. Average clinical information was documented in 50% while that of future management and person completing discharge summary was found in 41% and 28% respectively (as per Table 1). Encouragingly, discharge summaries contained mandatory information more frequently than conditional or optional information.

This audit has identified deficiencies in current discharge summary practices and gives recommendations for the development of local guidelines.

No significant relationships.

There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.

Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.

A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).

A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.