South West Thames Region Research Articles

Psychotherapy Supervision: The Attitudes of General Psychiatrists

Do consultant psychiatrists believe that psychotherapy supervision should be an integral part of the training of the junior doctors? If they do, when, where, for how long and by whom do they feel that supervision should be done? In the South West Thames Region we circulated a questionnaire to all general psychiatric consultants in an attempt to answer these questions. We report on some results of our survey and raise important immediate issues which would seem a subject for debate. The major issue is the debate about specialist psychotherapists versus psychodynamic psychiatrists. Although the College seems to favour strongly that psychotherapy teaching for general psychiatrists should be done by psychotherapy specialists, the ‘consumer’ appears to have a conflicting view, at least in our region.

South-west Thames region dental survey. The dental health of children of 5, 12 and 15 years of age in 1979/80.

South-west Thames region dental survey. The dental health of children of 5, 12 and 15 years of age in 1979/80

Trends in the hospital care of acute childhood asthma 1970-8: a regional study.

In the South-west Thames Region over the period 1970-8 the number of admissions for asthma in children aged 5-14 years increased from 256 to 684, an increase of 167%. Factors associated with this trend were investigated by an analysis of routine hospital statistics and examination of case notes for 1970 and 1978 from every hospital in the region. The trend was caused partly by an increase in readmission rates. There was a more than fivefold increase in self-referrals; these patients had less severe asthma on admission and a higher readmission rate than patients referred by general practitioners. Drug management before and after admission changed considerably over the nine years, as did hospital investigations. Overall, there was little change in the level of severity on admission. The increase in admissions was not associated with a reduction in deaths from asthma in the region and occurred in spite of major advances in the drug control of asthma; this indicates an inadequacy of ambulatory care. The shift in the balance of care towards the hospital and the increasing adoption of a primary care function by the hospital indicate a need for hospitals and general practice to agree jointly on management policies for acute asthma.

General professional training in psychiatry in the South-west Thames Region.

General professional training in psychiatry usually requires a minimum of three years' in-service training in senior house officer and registrar posts, leading to membership of the Royal College of Psychiatrists (MRCPsych) by examination. In 1974 the postgraduate dean of this region and his adviser from the Royal College of Psychiatrists set up a psychiatric subcommittee of the regional postgraduate medical committee, to consider and advise on the planning of training in psychiatry in the region. At that time, four clinical tutors ran well-known weekend and week-long block release courses which took place every six months, either at Brookwood psychiatric hospital or at the University of Surrey, in addition to their local teaching responsibilities. These courses were intended to prepare candidates for the professional examination, which occurred twice yearly. In addition one of the tutors had organised a two-term day release basic medical science course for Part A of the Diploma of Psychological Medicine (which be came also suitable for the preliminary MRCPsych examination). Early on, the subcommittee recommended the setting up of a regional two-year day release course (consisting of six seven-week terms), which was designed to equip candidates for the final part of the MRCPsych examination. After two years the entire course was held at St George's Hospital Medical

Regional survey of femoral neck fractures.

In the South-west Thames Region 2619 patients (2105 women and 514 men) were discharged with a diagnosis of femoral neck fracture in 1974. The equivalent of a 250-bedded hospital was occupied throughout the year. The incidence, average length of stay, and mortality rate rose with increasing age and there were differences in these indices in the five health areas. These results confirm the enormous burden placed on the hospital service by patients with fracture of the femoral neck but suggest that differences in practice in the five areas may contribute to the size of the problem.