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Aims and MethodTo survey the attitudes of in-patients on an all-female ward to staff gender. All patients were invited to complete an anonymous questionnaire which was then repeated on a four-weekly basis for 4 months. Staff members were surveyed once within this period.ResultsOnly 15% of patients (n = 52) wanted all staff members to be female, whereas 87% reported feeling comfortable with male staff; 51% would prefer a predominantly female, mixed-gender staff. All staff (n = 11) were in favour of mixed-gender staffing.Clinical ImplicationsCurrent best practice for staffing single-gender acute in-patient units is unclear. This survey is in line with findings from other studies in that a large majority of female in-patients prefer to be in a unit with mixed staff.

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SummaryThis is a review of the key criteria and implications of the Mental Capacity Act 2005 for patients in forensic care detained under the Mental Health Act 1983. Both Acts were amended by the Mental Health Act 2007 and its subsequent Code of Practice; the impact of these changes will be explored here. Through review of the Code of Practice and hypothetical clinical scenarios, I argue that capacity judgements in mental disorder are inherently complex, unreliable and inextricably linked to risk assessment, and that an overemphasis on capacity when making decisions about patient management in secure care can paradoxically obscure the more central issue of risk and proportionality. the key clinical implication is a call for secure services to be balanced in how they adopt best practice principles from the new Mental Capacity Act so that the spirit of the Act, such as valuing patient autonomy, is preserved and that the debate about what practices in secure care are truly proportionate and justified remains at the forefront of clinical thinking.

have highlighted some of theimportant positive aspects of foundationyear placements in influencing careerchoice into psychiatry.The jubilant articlecarries an optimistic account from trainersand trainees who share the champagne ofsuccessful mentoring. Unfortunately, thedarker side of wider experience whileseeking foundation placements inpsychiatry has been overlooked.The number of places available for FY1and FY2 placements in psychiatry are verylimited, and as of now not representa-tional of subsequent requirements thespecialty has during core training.There isan urgent need for such ‘potentialdemand’ v. supply statistics to be madeclear and compared across variousspecialties.The perennial recruitment issuecould be seen in correct perspective whenlevel playing fields are ensured followingthe implementation of ModernisingMedical Careers.Despite being a trainee with significantinterest in exploring psychiatry as a careerchoice, the placements in my current FY2rotation were ready-made with noelement of choice. On the wake of Boyleet al’s account, it is important to solicitand analyse national data on foundationplacements in psychiatry and rate ofconversion into core psychiatric training.Creating such foundation maps ofpotential psychiatry placements acrossdeaneries may help interested trainees toplan their careers. One could argue thatpsychiatry must be given more foundationslots than some relatively oversubscribedspecialties.If one is allowed to make a deductionfrom personal experience, mostspecialties look at foundation doctors asinconsequential cogs in the churningwheel of hospital machinery.Very fewminutes in the 120 days of a foundationplacement are spent in motivating thetrainee to consider a specific specialtycareer. In addition, the educationalmeetings and professional activities inmost hospital units tend to concentrateeither on core trainees or making a ‘safedoctor’out of foundation trainees.Thereis an immense hidden potential forpsychiatry to convert a substantialnumber of hesitant doctors into promisingand passionate specialists for the future, ifsome collective and timely effort is takento recognise the prospect here.Bearing in mind that at least a quarterof all psychiatrists explore other special-ties before choosing psychiatry as theircareer,

Aims and MethodA national survey of members of the Scottish division of the Royal College of Psychiatrists to establish the training in neuropsychology they have received, their views on neuropsychology service provision and on potential formal postgraduate neuropsychology training opportunities.ResultsA 54% (n = 288) consultant psychiatrist response rate was achieved. the responses suggest that where specialist neuropsychology services exist, they are not perceived to be sufficient to deal with clinical demand. Consultant psychiatrists indicated that there are limited training opportunities in neuropsychology for psychiatrists, and this seems to be reflected in their limited confidence in interpreting basic recommended neuropsychological assessment tools. There seems to be a definite desire among consultant psychiatrists for postgraduate training opportunities.Clinical ImplicationsScottish psychiatrists desire an increase in formal neuropsychology training opportunities.

SummaryThis commentary discusses the problems with workplace-based assessments and questions whether these methods are fit for purpose. It suggests that there is a risk that assessment methods that focus on competence may undermine the need for trainees to aspire to acquire excellent skills rather than merely be competent, which is no more than a rigid adherence to standardised and routinised procedures.

SummaryThis paper presents the case of an elderly gentleman who sustained a fractured neck of femur following a fall at home but refused to go to hospital. His general practitioner determined that he lacked capacity but ambulance and police crews refused to escort him due to concerns regarding deprivation of liberty.The legal grounds for treating people who lack capacity in emergencies are discussed and the development of the common law into the Mental Capacity Act 2005 is demonstrated. the Mental Health Act 1983 is inappropriate to treat primarily physical conditions, whereas deprivation of liberty cannot be authorised by the Mental Capacity Act 2005 without a means of challenging the lawfulness of the detention. In response, the government has produced Deprivation of Liberty Safeguards, which came into force in April 2009.