Commentary: audit of case-load and case mix of higher specialist trainees in child and adolescent psychiatry

Abstract

The Child and Adolescent Psychiatry Specialist Advisory Sub-Committee (CAPSAC) of the Royal College of Psychiatrists has produced a detailed set of advisory papers covering all aspects of training in child and adolescent psychiatry, the existence of which makes the audit of training a more straightforward task than in the past (Royal College of Psychiatrists Higher Specialist Training Committee, 1999). The paper by Sharp and Morris (see pp. 212–215, this issue) is part of a continuing tradition of audit and evaluation of higher training in child and adolescent psychiatry (Garralda et al, 1983; Bools & Cottrell, 1990; Smart & Cottrell, 2000). In the past, supervision (or lack of it) has been a preoccupation (see Kingsbury & Allsopp, 1994). However, the most recent national survey of higher trainees in child and adolescent psychiatry suggests that the number of trainees receiving inadequate supervision is continuing to fall (Smart & Cottrell, 2000). Sharp and Morris focus instead on case-load and case mix and are to be commended for persevering over three annual cycles with an audit that clearly demonstrates changes being made in the light of data collected, followed by re-audit and re-evaluation – audit projects rarely ‘close the loop’ so clearly.