The Medicines Reconciliation 'Med Rec' is a important, structured process which takes place on admission. It involves comparing the patient’s current medication list from various sources such as the primary care record, previous discharge letters and the patient themselves. This audit aims to highlight the invaluable support of the pharmacy department in ensuring safe prescribing for psychiatric inpatients - a population with a known potential for significant comorbid physical health conditions and high rates of polypharmacy.

NICE guidelines state that “people who are inpatients in an acute setting (including mental health inpatient wards) should have a reconciled list of their medicines within 24 hours of admission.” Sussex Partnership NHS Foundation Trust local targets specify that 60% of Level 2 (pharmacy-led) medicines reconciliations should be completed within 24 hours of admission, or 90% by the next working day by 5pm.

A total of 100 records were reviewed for patients admitted to Bodiam Ward, an adult male inpatient psychiatric ward in East Sussex, between 2024 and 2025. Of the records reviewed, 73 were retrospective admissions and 27 were prospective records.

In this audit, 66% of medicine reconciliations were completed within 24 hours, and 87% were completed by the next working day. The majority (84%) were completed by Pharmacy Technicians, with the remaining 16% completed by Pharmacists. Of the completed medicine reconciliations, 54% identified at least one omitted drug. The most omitted drug classes were analgesics (13.7%), benzodiazepines (13.1%), and regular oral antipsychotics (10.2%). Other notable omissions included physical health medications, such as cardiovascular drugs (including antihypertensives and statins), and medications related to alcohol dependence (such as thiamine and chlordiazepoxide). In addition, 7% identified ‘other errors’, including missing or incorrect doses, incorrect formulations (immediate-release versus modified-release), and in one instance, an entirely different medication being erroneously prescribed.

This audit demonstrates that medicine reconciliation is more than a 'tick-box exercise' and plays a critical role in identifying prescribing errors on admission. The findings emphasise the significant timely contribution of the pharmacy team to patient safety in adultin patient psychiatric settings. Based on these findings, future education could focus on reminding resident doctors to thoroughly review previous discharge summaries and primary care records when clerking a patient, and to liaise with the pharmacy team for a better standard of care.

Extended Discharge Documents (EDD) are central to safe transitions of care in forensic psychiatry, providing GPs and community teams with information on treatment, risk management, legal status, and followup plans. National standards recommend issuing the EDD within 7–14 days of discharge. A baseline audit in March–August 2025 at the forensic unit in Royal Cornhill Hospital showed low EDD completion and variation between wards. Several service changes were introduced, and a reaudit was conducted. The aim was to assess whether these changes improved EDD completion and timeliness for forensic discharges.

This was a retrospective clinical audit of all forensic inpatient discharges across two periods: the baseline cycle (March–August 2025) and the reaudit cycle (September 2025–January 2026). Patients transferred to other hospitals were excluded, as an EDD was not required for those cases. Data were collected from electronic records, including EDD eligibility, completion status, dispatch dates, and ward of discharge. The main outcome measures were the proportion of eligible discharges with a completed EDD, and the proportion completed within 14 days.

The intervention implemented between cycles included assigning each EDD to a named doctor at the point of discharge planning and reinforcing standards during induction for rotating trainees. A shared forensic handover template (digital and paper versions) was introduced to help track outstanding EDDs.

There were 42 discharge episodes in the baseline period, of which 41 required an EDD. Only 8 were completed (19.5%), and 1 of these (12.5%) was delayed beyond 14 days.

In the re-audit period, there were 29 discharge episodes, of which 27 required an EDD. Of these, 22 were completed (81.5%). Completion was consistently above 75% across all months, reaching 100% in January. The improvement was observed across most wards.

Timeliness remained a key concern. Sixteen of the 22 completed EDDs (72.7%) were issued more than 14 days after discharge, with higher delay rates noted in specific.

Introducing system-level changes like assigning named doctors at discharge, strengthening induction, and introducing a shared handover template were associated with a marked improvement in overall EDD completion, rising from 19.5% to 81.5%. However, delays in issuing the EDD remain frequent and represent the key area for further improvement. Strengthening early drafting, adding timeliness checkpoints, and embedding automated reminders may help close this gap in the next audit cycle.

To assess documentation of driving status and fitness to drive among older adult psychiatric inpatients, implement interventions, and evaluate subsequent improvement in both documentation and compliance with Driver and Vehicle Licensing Agency (DVLA) guidance.

Older adult psychiatric inpatients may be unfit to drive, yet documentation of driving status is often poor, posing patient safety and medico-legal risks. A retrospective review of electronic medical records was conducted for patients discharged from a single older adult psychiatric ward over two three-month audit cycles. Data collected included documentation of driving status, presence of psychiatric diagnoses relevant to DVLA guidance, and, where relevant, whether the patients had been advised about fitness to drive. Following the initial audit, interventions were implemented, including clinician education and addition of prompts within the ward round template. The audit was then repeated as a retrospective review of records for a separate three-month period to assess the impact of these interventions.

In the first audit cycle, 20 patients were discharged. Driving status was documented in only 5 patients (25%), despite 18 patients (90%) having diagnoses relevant to DVLA guidance. Among those with documented driving status, only 3 patients had recorded discussion of DVLA advice, allowing adherence to be assessed. For the majority of patients, adherence could not be reliably assessed due to missing documentation, highlighting a significant gap in clinical recording and medico-legal risk.

In the re-audit cycle, 11 patients were discharged. Driving status was documented in 10 patients (90.9%), and 9 patients (81.8%) had diagnoses relevant to guidance. 7 patients were documented as not driving. Both patients documented as driving and for whom guidance applied, had evidence that DVLA advice had been discussed. Adherence could not be assessed for one patient whose driving status was not recorded. These findings indicate improved documentation and consistent discussion of driving advice following targeted interventions.

This audit identified substantial deficiencies in baseline documentation of driving status and discussion of DVLA guidance, posing safety and medico-legal risks. Targeted interventions improved recording of driving status and consistent documentation of advice for those driving, demonstrating enhanced staff awareness and compliance with guidance. Some gaps remain, emphasizing the need for ongoing routine assessment, documentation, and staff education to ensure sustained patient safety and adherence to national guidance.

Depression and anxiety in geriatric inpatients are linked to functional decline and prolonged hospital stays. While antidepressants are the standard of care, polypharmacy and poor tolerability often limit their effectiveness. This study examined whether a six-week structured mind-body programme achieved greater symptom reduction than treatment as usual (TAU) in an older adult psychiatric inpatient setting.

This longitudinal, parallel, controlled study involved 26 in patients (aged 60 years or older) with a diagnosis of depression and comorbid anxiety. All participants were receiving standard antidepressant pharmacotherapy. Thirteen patients elected to participate in a structured mind-body programme, while 13 continued with TAU alone. The intervention consisted of weekly supervised sessions (3–5 sessions total based on clinical availability), integrating physical movement with mental engagement through yoga, tai chi, strength training, walking, and gardening. Symptoms were assessed via the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7) at baseline and six weeks.

Data analysis involved paired-sample t-tests and Wilcoxon signed-rank tests for within-group changes, with between-group comparisons conducted using independent-sample t-tests or Mann–Whitney U tests as appropriate for the data distribution.

Baseline scores were statistically comparable between groups (p >0.05). Both cohorts demonstrated significant within-group reductions in symptoms over the six-week period (p <0.001). In the activity group, mean PHQ-9 scores decreased from 17.15 to 8.46(reduction 8.69, SD 3.54). In the TAU group, scores fell from 14.69 to 10.38 (reduction 4.31, SD 2.10).

Between-group analysis demonstrated a significantly greater reduction in depressive symptoms for the mind-body group (mean difference 4.38; 95% CI 1.99 to 6.77; p=0.001), with a large effect size (Hedges’ g=1.46). While anxiety symptoms improved in both groups (mean GAD-7 reduction 3.62 vs. 3.23), no significant between-group difference was observed (p=0.875; Hedges’ g=0.16).

Participation in structured mind-body activities was associated with greater reductions in depressive symptoms among older adult psychiatric inpatients compared with treatment as usual alone. While anxiety symptoms improved in both groups, no additional benefit was observed for anxiety reduction. Although self-selection should be considered, these findings suggest mind-body programmes may represent a feasible and potentially effective non-pharmacological adjunct for late-life depression in inpatient psychiatric settings.

The APOE-ε4 allele is the most significant genetic risk factor for developing late-onset Alzheimer’s disease (AD), with an estimated lifetime risk of 30% in ε4 heterozygotes. Previous guidelines have recommended against APOE genotyping based on its limited clinical utility in routine practice. This has changed with the advent of amyloid-targeting immunotherapies, multimodal interventions for reducing AD risk and commercially available APOE genotyping services. Given this changing landscape, there is a need to formulate APOE-ε4 genetic counselling tailored to the UK context. We set out to study the attitudes of UK adults to genetic testing and counselling for the APOE-ε4 gene.

We carried out a digital survey on the online POrtal for Patient and Public Engagement in Research (POPPED, https://popped.org.uk). This was advertised via research register mailing lists and is still ongoing. The survey queried respondent demographics, motivations and concerns regarding APOE-ε4 testing, content and format of genetic counselling, and willingness to undertake preventative interventions. Responses were collected with a combination of 5-point Likert scales, ranking and multiple choice questions. Ethical approval was obtained from a university ethics committee and all respondents consented to have their responses stored anonymously on a secure server.

794 responses were received from 7 January – 4 February 2026. Most respondents were aged 65–74 years (38.7%) or 75–84 years (23%), 66.9% were female, and 61.8% had a family member with dementia. 82.7% of respondents were ‘likely’ or ‘some what likely’ to get tested for the APOE-ε4 gene. The main motivations were to contribute to research (85.4%), to adjust life plans accordingly (71.9%) or to understand their dementia risk (70.9%). The main concerns were that no cure for dementia exists (50.4%), inaccurate risk estimation (50.4%), and emotional upset (44.1%). The preferred format of genetic counselling was a face-to-face appointment (86.1% rated this as ‘very appropriate’), and 73.4% of respondents would be likely to accept subsequent preventative lifestyle interventions.

A high proportion of our respondents would be likely to seek out APOE-ε4 testing and counselling, and to subsequently accept lifestyle interventions and be involved in research. While our sample may not be completely representative of the general population, these initial results suggest that there is a need to develop guidelines for face-to-face genetic counselling for UK adults who choose to undergo APOE-ε4 testing.

The clinical presentation of autism has been summarised in the 5th edition of the American Psychological Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM–5). Assessment tools such as the Autism Diagnostic Observation Schedule have been developed to provide clinicians with the practical means to diagnose autism according to DSM–5. These medicalised assessments are deficit-based, focussing on what the autistic person cannot do compared to a non-autistic person. This juxtaposition can adversely affect the mental health of the autistic person and those who support them. The assessment can also place emotional burden upon the clinicians conducting them. The wider implication of the negative framing used in traditional tools is to perpetuate the stigma surrounding autism. Neurodiversity-affirmative identification is a new approach for clinicians. This methodology reframes the tragedy narrative of Autism to offer clinicians the means to work in collaboration with their clients to explore their autistic identity and not only identify their specific support needs but also their strengths. An understanding and acceptance of one’s sense of self world facilitates nurturing good mental health and improved life trajectories. This novel study examined the effect of the neurodiversity-affirmative way of working upon clinicians and how they make sense of the experience.

The experiential qualitative methodology of interpretative phenomenological approach was used. Phenomenology is relevant as it is the philosophical study of what it is like to be human in our lived experiences and what matters to the individual. Secondly, and more specifically, interpretative phenomenology is appropriate as it is more than merely gathering a description, but an analysis of the participants’ attempts to interpret their personal and subjective lived experiences. Semi-structured, qualitative interviews were conducted with clinicians who are practicing neurodiversity-affirmatively between September and October 2025. The sample size of five clinicians complied with the usual approach for such qualitative projects.

Five Group Experiential Themes were identified: pressure to accept traditional framing of Autism, haunted by the past, wrong assumptions, more than a job, it’s a vocation and validating Autistic experience.

The impact of conducting medical model assessments has been long-lasting and traumatic upon the clinicians. The results charted their intellectual transitioning from passive acceptance of the traditional assessment status quo to actively questioning it and finally being resolute that it needs to be revised and reframed and that the neurodiversity-affirmative approach needs to be widely adopted to better validate the autistic people they serve.

This study explores the historical roots of phobic disorders through an analysis of Abu Zayd al-Balkhi’s ninth-century written venture into mental health and wellbeing, “Sustenance of the Soul”. It compares al-Balkhi’s descriptions, differentiation, and management of phobia with the current ICD-11 framework. Previous comparative research has demonstrated consistencies in his writings when compared to contemporary framework. As such, we hypothesised that al-Balkhi’s account would show substantial conceptual overlap with modern nosology while offering a more integrated phenomenological perspective that remains relevant to current psychiatric practice.

A multi-stage content analysis was undertaken using the manifest analysis method. First, relevant thematic premises were identified through examination of al Bakhli’s text. Second, focussing on aetiology, symptomatology, and therapeutic approaches, psychological terminology and their implied meanings were extracted. Finally, these findings were compared directly with the ICD-11 phobia-related classification and associated diagnostic constructs. The analytical process and mappings were independently cross-checked by a secondary researcher.

Al-Balkhi described phobia as an excessive, maladaptive fear response–referred in his work as “terror”–that exceeds the individual’s control and impairs functioning. He distinguished normative fear states from the pathological using description of threat appraisal and temporal proximity, paralleling modern distinctions between general anxiety and phobia. He also described symptoms of physiological arousal and cognitive interferences during fear states, including restricted clarity of thought. Management strategies included education regarding feared stimuli and desensitisation-like techniques, anticipating the core principles of contemporary psychological treatments.

Al-Balkhi’s account of phobia correlates to a significant degree with ICD-11 categorisations of anxiety and phobic disorders. Although some of the ideology lacks modern political correctness which reflects its era, the underlying clinical observations are notably consistent with modern phenomenology and psychologically informed care. These findings support the value of historical psychiatric scholarship in refining contemporary understanding and suggests that pre-modern consolidative models may still enrich current diagnostic and therapeutic approaches.

Hypoxia-ischaemia (HI) is one of the leading causes of neurological injury and death among newborns. In developed countries, its incidence is estimated in approximately 1/1000 neonates, while globally it can represent up to 23% of children’s mortality rate. In those who survive, long-term neuropsychological impairments may emerge as a consequence of HI, causing a significant impact in quality of life.

Using a preclinical model of neonatal HI, the aim of this study was to investigate whether a progression in HI severity (from moderate to severe) may be associated with worsened functional and psycho-behavioural performance.

Seven-day-old (P7) Sprague Dawley neonatal rats were randomly assigned to: i) HI-moderate (left common carotid artery ligation + 120 min of 8%O2/92%N2 hypoxia; n=13); ii) HI-severe (same surgical procedure and 150min of hypoxia; n=18); Sham (without HI, n=36). At P42 (early young equivalent) and P90 (adult), animals underwent three behavioural tests: the novel object recognition (NOR) test to analyse cognitive deficits in recognition memory, the cylinder test to measure sensorimotor asymmetries and deficits, and the T-maze test to evaluate possible cognitive disabilities.

When evaluating cognitive deficits in recognition memory with NOR test, both moderate (p<0.01) and severe (p<0.05) injured animals showed worse performance than sham at P42. At P90, this was also observed in moderate-injured animals (p<0.001). In the cylinder test, HI-moderate (p<0.01) and HI-severe (p<0.001) groups showed significant sensorimotor asymmetries when compared to sham at P42 and P90, which were independent of HI severity. Similarly, all HI-animals revealed a reduction in alternation in the T-maze test, thus suggesting cognitive disabilities in both moderate (p<0.05) and severe (p<0.0001)models vs sham. Again, no differences were found when comparing severities.

Psycho-behavioural assessments showed the development of cognitive deficits and neuromotor impairments in the long term after neonatal HI. Further studies may confirm if the absence of differences between moderate and severe HI models may relate to a critical threshold reached in the former and/or to possible compensatory mechanisms in the latter.

Innovative teaching methods and gamification are increasingly sought in medical education to promote active learning and engagement amongst students. This interactive andnovel approach has gained popularity within medical education and allows students to consolidate their clinical knowledge and apply their skills to unfamiliar scenarios.Students are encouraged to think in a holistic manner, and this teaching intervention facilitates experiential learning.

The aim of this study was to design and deliver a psychiatry-themed escape room for Fourth year medical students at Bushey Fields Hospital. This is a novel approach to undergraduate psychiatric teaching, which focused on consolidating clinical knowledge regarding basic principles of psychiatry and encouraging collaborative problem-solving.

A 45–60minute escape room was developed, centred around a fictional patient who was admitted to hospital after experiencing psychosis. Students were given a backpack with a padlock that contained clues and five tasks to solve. Working in groups of 3–5, students solved tasks centred around history taking, mental state examinations, assessing risk, physical health monitoring and contemplating management approaches.

A mixed method approach was undertaken, and pre- and post-session questionnaires (Likert scaled) assessed student-rated confidence regarding management of psychiatric situations, assessing risk, formulating differentials and management plans were distributed. Further qualitative data was gathered from students regarding their learning and experiences regarding the psychiatry-themed escape room.

Eighteen students participated over four escape room sessions. Post-session confidence scores increased across all measured domains, especially when undertaking risk assessments and knowledge of the Mental Health Act.

Qualitative data was thematically analysed and students reported that this was a useful opportunity to apply their skills and knowledge, using a simulated case.

The results of this study suggest that this approach helped students to engage with psychiatric teaching in a novel and innovative manner. Students reported that they felt that consolidating their psychiatric knowledge using a simulated case was a safe environment to learn further.

Students reported a greater appreciation regarding the use of legal frameworks, history taking skills and undertaking mental state examinations. These are key considerations and skills used within psychiatry, which will lead to resident doctors being well equipped with key psychiatric principles, improvement in future practice and patient care.

This psychiatry-themed escape room will be offered at other sites within the Trust, and future work includes possible expansion to resident doctors early within their training based locally.

People with severe mental health problems are affected by disparities in physical health outcomes compared to the general population. The risk of physical deterioration increases as patients grow older and comorbidities accumulate. This risk is particularly relevant in the population affected by functional and cognitive psychiatric disorders, where patients’ ability to detect and report symptoms can be impaired. This places a key responsibility on staff in older adult mental health services, who are well positioned to identify deterioration through routine physical health monitoring. However, confidence gaps exist amongst multidisciplinary team members in the recognition and escalation of physical health deterioration. To address this, the physical health teaching programme was implemented.

Hypothesis: The teaching programme will result in an improvement in the perceived confidence of staff in identifying physical health deterioration and escalating concerns.

Weekly teaching sessions were conducted in an older adult mental health service over a period of three months. All members of the multidisciplinary team across both inpatient and community settings were invited to participate. Teaching was delivered using posters and interactive worksheets, covering topics such as vital signs, fluid intake, bowel output monitoring and delirium. Pre- and post-teaching questionnaires were designed to evaluate confidence levels using a Likert scale and knowledge was assessed via multiple-choice questions.

Results were analysed from 17 participants who completed both pre- and post-teaching questionnaires. The first two teaching sessions focused on vital signs and fluid intake. Preliminary findings demonstrated an overall improvement in staff confidence. However, pre-teaching knowledge scores were high for these topics and minimal improvement was seen on repeating the multiple-choice questions. These findings demonstrate the feasibility of a targeted physical health teaching programme.

A physical health teaching programme can improve staff confidence in identifying and escalating physical health deterioration in an older adult mental health service.

The Balint group was established in the 1950s as an avenue for doctors to bring forththeir experiences and feelings relating to patient interactions, in a humanistic rather than clinical way. Commonplace in Psychiatry, the use of Balint groups is spreading. Building on a previous pilot, we ran a Medical Student Balint Group weekly in a confidential, consistent space. We aimed to assess their knowledge of Balint, empathy, and communication skills and style, at the start and end of the group. This was alongside a tool for assessment of Burnout levels at the start and end of the group.

A weekly Balint group cohort of 10 third year medical students was facilitated by a Core Trainee and supervised by a Consultant Medical Psychotherapist. The students were given a set of questions about the psychological factors pertaining to doctor-patient interactions, including 2 questions about their prior knowledge of these groups, and the same questionnaire was given at the end, but with 2 open-ended questions about their reflections of the process. A validated burnout self-test was also given at the start and end.

Weekly attendance varied slightly. All participants returned both initial questionnaires, with 8 returning both ending questionnaires. Burnout scores showed significant reduction, and students generally showed eagerness to attend Balint groups in future. On starting, half the students felt that the application of a Balint group was ‘interesting’ but afterwards most felt an expanded perspective on the doctor–patient relationship and able relate to patients better. Self-awareness and confidence with communication also improved. Qualitative results supported above quantitative results.

Balint groups for medical students now have an increased evidence base as part of the undergraduate medical curriculum. They enhance their ability to see their patients’ perspectives, improving empathy, and markedly reducing burnout. They also enhance self-awareness and communication in medical students.

People with severe mental illness have a life expectancy that is 10 to 20 years shorter than the general population. Cardiovascular disease plays a major role in this gap. Additionally, forensic inpatient population often experiences prolonged admissions and has limited access to community physical health services. QRISK3 is a tool that estimates an individual's 10-year risk of having a heart attack or stroke. This project aimed to assessQRISK3 scores in forensic low and medium-secure male wards and offer atorvastatin for primary prevention when appropriate.

A snapshot review was conducted in November 2025 among 59 inpatients in Brockfield House low and medium secure male wards. 5 patients younger than 25 years old were excluded as QRISK tool is only valid for patients aged 25–84 years. QRISK3 scores were calculated for all eligible individuals using Mobius (an electronic record system) and patient interviews. Patients with a QRISK3 score of 10% or higher were informed of their increased cardiovascular risk and offered atorvastatin based on primary prevention guidelines (https://cks.nice.org.uk/topics/cvd-risk-assessment-management).The collected data was saved in a password-protected Excelspreadsheet.

A total of 54 patients were included in the analysis. The mean age was 41.98 years (range 25–69).14% of patients were current smokers (n=8), 50% were ex-smokers (n=27), 31% had diabetes mellitus (n=17), and 11% were prescribed antihypertensive medication (n=6). The mean BMI was 32.33 kg/m², 91% of patients had a BMI ≥25 kg/m² (n=49), indicating overweight or obesity. 16 patients had a QRISK3 score ≥10%. Of these, 11 patients were already prescribed a statin. The remaining 5 patients were offered atorvastatin for primary prevention; 4 agreed to commence treatment following consultation, while one declined. QRISK3 scores were documented in Care Programme Approach (CPA) reports for all patients in whom they were calculated. On average, it took 12 minutes and 36 seconds to gather information and calculate the QRISK3 score.

This QIP demonstrates that cardiovascular risk assessment using QRISK3 in forensic psychiatric inpatient settings is practical, time-efficient, and clinically valuable.Integrating QRISK3 scoring into routine CPA documentation may improve identification of patients at increased cardiovascular risk and increase appropriate statin prescribing for primary prevention in line with NICE guidelines.

Under the Mental Health Act (MHA) 1983, patients detained under Section 3 must have their capacity to consent to treatment assessed on admission and reassessed at the three-month point. Failure to complete these assessments risks breaching patient rights, including those protected under the Human Rights Act, and undermines lawful and person-centred clinical practice.

Aims were (1) To determine compliance with documentation of capacity assessment at admission and at the three-month point for Section 3 inpatients; (2) to identify practical improvements to enhance compliance.

A retrospective audit was conducted on 13 inpatients detained under Section 3 on Vales Ward, Discovery House (LPFT). Admission dates and capacity-assessment records were extracted from the RiO electronic patient record for the period December2019–November 2022. The primary outcomes were the presence or absence of documented capacity assessment at admission and at the three-month review.

Capacity assessment at admission was documented in 46.2%(6/13) and not documented in 53.8%(7/13).

Three-month reassessment was documented in 7.7%(1/13) and not documented in 92.3%(12/13).

Compliance with MHA Section 3 statutory requirements for capacity assessment was poor, particularly at the three-month review. We recommend: (1) implementing automated RiO reminders to clinical and MHA administration teams at −1 month, −1 week, and −1 day before the three-month point; (2) delivering targeted staff education on the legal and clinical significance of capacity reassessment; and (3) providing patient information leaflets regarding consent and MHA rights. A reauditis planned to evaluate the impact of these interventions.

Undergraduate psychiatry education is frequently limited by variable clinical exposure, ethical constraints in involving acutely unwell patients, and restricted opportunitiesfor students to practise high-stakes consultations. Generative artificial intelligence (AI) simulation platforms offer a potential solution by enabling students to rehearse clinical encounters in a structured and safe environment. This poster aims to present lessons learned from the implementation of generative AI-supported simulations for fourth-year medical students at Aston Medical School. Specifically, it explores how students and tutors experienced the integration of AI-facilitated consultations into the curriculum and identifies factors that influenced engagement, learning value, and trust in assessment.

A mixed-methods educational evaluation was conducted following the introduction of AI-based consultation simulations within the fourth-year psychiatry programme. Feedback was gathered through anonymised student questionnaires, facilitated debrief sessions after simulation use, and structured discussions with clinical tutors involved in teaching and assessment. Data focused on students’ perceived learning value, alignment with clinical placements, clarity of feedback and marking criteria, and overall usability of the platform. Tutor reflections on feasibility, integration with existing teaching, and impact on small-group learning were also collected. Qualitative themes were identified through thematic review of student and tutor comments.

Students generally recognised the potential value of generative AI simulation as a safe environment to practise structured consultations, particularly for OSCE preparation and rehearsal of high-risk scenarios such as suicide risk assessment and capacity evaluations. Many reported that the tool was most effective when used after formal teaching or placement exposure, supporting consolidation and revision. However, engagement was reduced when simulations were used as a first exposure to unfamiliar clinical material or were misaligned with placement timing. Some students expressed uncertainty about AI-generated markingcriteria and pass thresholds, noting that checklist-based feedback could sometimes feel disconnected from authentic clinical reasoning. Mandatory debrief sessions were valued when they facilitated reflection and discussion but were perceived as less helpful when they repeated automated feedback. Tutors highlighted the importance of clear learning objectives, integration with small-group teaching, and transparency around assessment processes.

Generative AI simulation can enhance undergraduate psychiatry education by providing scalable opportunities for structured practice and feedback. Its effectiveness depends on thoughtful curriculum integration, alignment with clinical teaching, and clarity around assessment and feedback. Student and tutor perspectives suggest that AI is most beneficial when used to augment, rather than replace, traditional teaching and reflective debriefing. These lessons offer practical insights for educators seeking to incorporate generative AI into medical education in a pedagogically meaningful and learner-centred way.

Women accessing perinatal mental health services face marked physical health inequalities, exacerbated by pregnancy-related risks and the metabolic burden of psychotropic medication. Despite national guidance, compliance with physical health monitoring is poor, lifestyle interventions are inconsistently delivered, and engagement with external services is limited. This quality improvement project (QIP) aimed to address these gaps by establishing a dedicated in-house perinatal physical health clinic within our perinatal mental health service.

To improve compliance with NICE recommended physical health monitoring for women prescribed antipsychotics; improve staff knowledge and confidence in physical health assessment and monitoring and increase access to holistic lifestyle and women’s health support.

A baseline audit evaluated compliance with antipsychotic physical health monitoring (weight, blood pressure, glucose/Hbs-362c-glycated haemoglobin, lipid profile,ECG-electrocardiography, and movement disorder assessment) and the provision of lifestyle and women’s health advice. Staff knowledge and confidence were assessed using a pre-intervention survey. A twice-weekly physical health clinic was introduced, offering comprehensive physical health checks, structured lifestyle questionnaires and advice (diet, exercise, smoking and alcohol), and women’s health education (contraception and screening). Targeted teaching sessions were delivered to staff, and a repeat audit and post-intervention staff survey were completed following a four-week pilot.

Post-intervention audit data demonstrated substantial improvements in all monitoring domains, with completion rates for baseline physical health measures increasing from 40–60% to 100%. Monitoring for movement disorders and metabolic risk factors also significantly improved, whilst completion of lifestyle questionnaires increased from 0% to 100%, and documentation of dietary, contraceptive, and breast and cervical screening advice became universal. Staff confidence markedly improved, with only 14% initially reporting very good understanding of antipsychotic monitoring, compared to 100% reporting good to excellent understanding following teaching. All respondents reported increased confidence and would recommend the programme.

Introducing a dedicated in-house perinatal physical health clinic resulted in significantly improved compliance with national guidance, enhanced staff confidence, and strengthened the provision of holistic care. This model demonstrates a sustainable, transferable and scalable approach to reducing physical health inequalities within perinatal mental health services.

Assertive Outreach Teams (AOT) provide enhanced community support for people with serious mental illness and complex needs, amongst whom there is a higher risk of comorbid alcohol use, for which engagement in structured interventions can be challenging. Mental health professionals can deliver ‘Bitesized’ interventions directly to patients, however this can represent a relatively infrequent window of opportunity. AOT patients often have regular contact with care and support staff who may not have clinical expertise. Empowering this wider support network to discuss alcohol use with patients could reduce alcohol-related harm.

A teaching session was delivered to non-clinical staff at a residential home which supports patients under the care of the AOT. The session covered background knowledgeregarding alcohol use and health, and how the staff could deliver informal ‘Bitesized’ interventions through their daily interactions with residents. Pre- and post-session feedback was obtained through questionnaires which utilised Likert scales to assess confidence in discussing key topics and the likelihood they would talk to patients about alcohol use. The questionnaire also assessed specific knowledge markers including safer alcohol limits and risk levels.

8 questionnaires were returned.

Post-session, 100% of respondents reported confidence in discussing alcohol use with residents, including a 33% increase in those feeling ‘very confident’. The same results were found when asked about discussing relevant physical health risks. In the pre-session questionnaire, high-risk drinking levels were correctly identified by 50% of respondents, increasing to 88% post-session.

When asked pre-session about confidence discussing mental health risks relating to alcohol use, 25% of respondents selected ‘very confident’ and 13% selected ‘not confident’. Post-session, 100% reported confidence, with 71% selecting ‘very confident’.

Following the session, 86% of respondents said they would talk to residents more frequently about alcohol use, with 100% of respondents reporting the session to be helpful.

Results suggest that brief teaching delivered to non-clinical staff can improve confidence in discussing alcohol use, and related risks, with mental health patients, and increase the likelihood they will have these discussions more frequently. This project offers only a small sample and does not provide information about whether the results will translate into meaningful change in patient outcomes. It offers a platform for ongoing rehabilitationwork and demonstrates the utility in multidisciplinary working in delivering holistic care for patients with complex mental health needs. Future directions may include trialling similar or substance-related interventions elsewhere and designing sessions for delivery directly to patients.

The psychiatry workforce faces persistent shortages driven by high attrition and poor retention across training and consultant grades. This scoping review aimed to map the existing evidence on psychiatry workforce retention and attrition, identify factors influencing decisions to stay or leave, and examine interventions, strategies, or policies designed to address workforce instability.

We conducted a scoping review following Arksey and O’Malley’s five-stage framework, reported in line with PRISMA-ScR guidance. MEDLINE, EMBASE, PsycINFO, Scopus, and Web of Science were searched alongside grey literature sources. Studies addressing retention, attrition, turnover, progression, or intention to stay or leave among psychiatrists or psychiatry trainees were included. Data were synthesised using descriptive mapping and inductive thematic analysis.

Screening identified 4110 articles. Of 193 articles selected for full-text review, 65 articles were included. Attrition was consistently associated with excessive workload,burnout, inadequate staffing, unsafe working environments, administrative burden, and poor supervision or training quality. Retention was linked to supportive supervision, meaningful clinical work, flexible job design, professional development, and a sense of belonging. Migration decisions were shaped by systemic push factors, including low pay and under-resourced services, and pull factors such as better working conditions, training quality, and social stability. Few proposed retention strategies had been formally evaluated.

The psychiatry workforce is characterised by substantial instability driven by multi-level factors spanning individual, organisational, and system domains. Although many retention strategies are proposed, robust evaluation is lacking. Addressing workforce sustainability will require system-level investment and evidence-based interventions targeting workload, training environments, supervision, and career flexibility.

To examine trends and identify potential contributing factors among young people who were supported by the Alliance Team prior to admission to a Tier 4 bed over a one-year period.

To examine the impact of Alliance Team involvement in implementing national guidance regarding avoiding unncessary admissions and improving the experience of those for whom admission was unavoidable.

A retrospective review of the Alliance Team caseload between April 2024 and April 2025 was undertaken. Electronic patient records were reviewed using the West London RiO system. Data collected included age, gender, referral reason, legal status at the time of admission, reason for admission, location and duration of admission, prior community team involvement, Alliance Team involvement in gatekeeping decisions, and recorded diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD). Data were collated and descriptively analysed using Microsoft Excel.

During the study period, the Alliance Team received 465 referrals, with 20 young people admitted to Tier 4 services (4.3%). Most admitted patients were female (70%) and aged 17 years (65%). The majority were admitted under the Mental Health Act, with only one informal admission. 65% were admitted to local beds. The most common reason for admission was risk to self that could not be managed in the community, followed by psychosis. Admission duration varied, with 35% staying less than 30 days, while 35% had admissions exceeding 100 days. Most patients (80%) were already known to community Child and Adolescent Mental Health Services (CAMHS), and the Alliance Team was involved in gatekeeping decisions in 70% of cases. 60% of the young people did not have a recorded diagnosis of ADHD or ASD at the time of admission.

The Alliance Team maintained a low Tier 4 admission rate (4.3%), with further improvement compared to previous years. Admissions were predominantly among older adolescents with high clinical complexity, which is reflected in an increased use of the Mental Health Act and prolonged inpatient stay. This shows the success of community-based crisis intervention in avoiding Tier 4 admissions, in all but the most severe of case. A substantial minority (35%) continued to be admitted out of area, likely due to ongoing system pressures. The high proportion of patients already known to CAMHS (80%) and involvement of the Alliance Team in gatekeeping decisions (70%) suggest opportunities for early collaborative intervention to reduce admissions. For future, Alliance Team should focus on improving support for 17-year-olds, improving clinician’s understanding of psychosis, and further evaluation of factors impacting length of stay and admission locality.