The National Institute for Clinical Excellence (NICE) has issued guidance on the use of atypical antipsychotic drugs and recommended that patients be involved in a discussion about the antipsychotic prescribed to them. We undertook a study to evaluate information provision and patient choice subsequent to the publication of this guidance. Patients were recruited from the South London and Maudsley Trust and interviewed. Case notes were examined for documentation of informed discussions.

Thirty patients were interviewed, of whom 15 claimed to have received no information. Twenty-seven patients felt that they had had no choice in regard to antipsychotic prescribed. None of the patients had documentation in their notes to suggest that they were involved in informed discussions about the antipsychotic they were prescribed.

Patients were not involved in decisions regarding the antipsychotic medication prescribed. Practice did not follow the NICE guidance.

To examine whether driving is discussed with patients attending a specialist day hospital for dementia and whether appropriate action is taken. Patients' notes were reviewed for evidence of such discussion. A questionnaire was implemented before the audit was repeated 6 months later.

During the first cycle 44 patients' notes were assessed and 38 were assessed on repeat audit. The documentation of discussions regarding driving increased from 23 to 95% of notes following implementation of the questionnaire.

By discussing driving status, important legal, insurance and safety issues can be addressed. Routine use of a simple questionnaire dramatically improved the likelihood of such discussion. These findings apply for all conditions requiring Driver and Vehicle Licensing Agency notification.

Through a postal survey we sought to determine the current retirement intentions of consultant psychiatrists working in Scotland. Consultants were asked their likely date of retirement, whether they might return as a locum and what might induce them to retire later.

Full data were returned by 180 consultants. The mean planned age at retirement was 58.0 years. Women intended to retire significantly earlier than men. Most respondents could be persuaded to retire later through changes in services, conditions or job content; only 7% regarded their proposed retirement date as immutable.

Early retirement among consultants is likely to contribute to an even more seriously understaffed service. It is necessary to seek national and individual changes to the factors that give rise to early retirement in psychiatry.

Clozapine is an effective drug in treatment-resistant schizophrenia, but it seems to be prescribed for few patients under the age of 18 years. This study reports a survey of consultant psychiatrists working in adolescent units in the UK, looking at their use of clozapine and experience with it.

Out of 83 clinicians, 59 responded (71%). More than 40% of respondents do not use clozapine, and those who do may not always be following best practice recommendations. Reasons for not using clozapine, beliefs about its effectiveness and problems encountered in its use are described.

Clozapine may not always be made available to young people with treatment-resistant schizophrenia. There is a need for more education, guidance and debate on clozapine use in child and adolescent psychiatry.

Special interest sessions are a means of developing additional clinical interests in higher specialist training. We investigated the educational value of developing a group treatment programme for people with multiple sclerosis as well as its benefits for participants.

Feedback from those attending the groups indicated the programme was rated highly or very highly. There was a trend towards improvement in quality of life measures.

The group programme provided an excellent opportunity for shared interdisciplinary learning. The use of special interest sessions in psychiatry was important in building relationships with a department without direct psychiatric input and allowed the psychiatric trainee to acquire specific disease knowledge.