To investigate the effectiveness of the Women's Service crisis house in Croydon we performed an observational study prospectively measuring functioning, symptom severity and unmet needs before and after admission. Use of mainstream mental health services was also measured.

Women using the service had high use of mainstream mental health services, with 137 out of 269 (51%) requiring admission to a mainstream acute ward in the 4 years studied. The service was effective with an improvement in Global Assessment of Functioning scores from a median of 48 on admission to 67 on discharge (P<0.001).

The women's crisis house was effective in providing for women who required high levels of mainstream mental health services, suggesting that it provides a valuable alternative to standard in-patient care.

To establish whether psychiatrists believe that medicine should be practised according to the principles of the Hippocratic Oath, an anonymised postal questionnaire survey was conducted of all medical staff at the Caludon Centre, an 80-bed in-patient mental health unit in Coventry.

Thirty-three respondents (82.5%) believed that medicine should be practised according to the Oath. Support for the 15 separate statements derived from the Oath varied considerably.

The principles of the Oath remain an important guide to the ethical basis of medical practice for most medical staff surveyed.

We gathered detailed prospective data for first on-call activity of senior house officers (SHOs) in order to help plan changes in service provision so that SHOs in psychiatry complied with the Working Time Directive and to determine whether service changes affected training experience while on call. The incumbent SHOs designed a simple form to monitor on-call activity in West Berkshire.

Admissions and assessments make up a quarter of calls but three-quarters of the work. An overnight crisis service reduced the number of assessments made by SHOs out of hours by 68%. Screening of calls by a senior nurse reduced the number of calls about in-patients by 60% on weekday nights. Between 73% and 100% of calls about in-patients after midnight were for assessment of patients in seclusion and rapid tranquillisation.

This survey helped to plan service delivery and to monitor the training of SHOs during on call. Screening of calls by a senior nurse, alternatives to seclusion and nurse-led prescribing for rapid tranquillisation would have the largest impact on the work generated by in-patients. The overnight crisis service reduced the number of assessments, but might have an adverse impact on training.

We used a complete audit cycle to assess the quality and completeness of current admission bookings by junior doctors and whether the introduction of a standardised admission form led to improvements.

Following the introduction of the standardised form significant improvements were found in almost all areas, including the recording of basic data, history, mental state, physical examination, risk assessments and diagnosis.

The introduction of a standardised admission form improved the completeness of information obtained. The form may also be used as an educational tool and to assist trainees preparing for examinations.

A satellite methadone prescribing service was set up in a hostel in London's West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile.

At 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days, P<0.001) and in the frequency of injecting (from 25.9 to 15.9 days, P<0.001).

This outreach clinic offers a model for developing services to homeless people with substance misuse problems.

To understand the benefits and limitations of using psychological formulations for patients with severe mental illness, a qualitative study of staff views was conducted, based on semi-structured interviews with 25 staff working in a high-dependency rehabilitation service.

Participants believed that formulations benefited care planning, staff–patient relationships, staff satisfaction and teamworking, through increasing understanding of patients, bringing together staff with different views and encouraging more creative thinking. They particularly valued meeting together to develop the formulations. Some staff accepted formulations as tentative and provisional, whereas others regarded them as statements of conviction.

The study suggests that using psychological formulations in the care of psychiatric patients may well be valuable, but needs further exploration.

Following the introduction of a new research mentoring process, a survey was conducted of Wessex specialist registrars' views on research training.

Of 34 respondents, 26 (76.5%) had agreed a plan with a research mentor and 31 (91.2%) were making good use of their research day for specified purposes. Of 24 trainees undertaking research, 21 (87.5%) felt adequately supported, 20 (83.3%) were interested in their research, 16 (66.7%) enjoyed it and 21 (87.5%) gained research knowledge/skills.

Agreeing a research training plan with a mentor, coupled with regularly reviewed support and supervision through a newly developed mentoring process, was associated with high levels of trainee satisfaction. Compared with a previous survey, these results indicate considerable improvement in research training.