The Modified Early Warning Score (MEWS) is now commonly used in the assessment of physically unwell patients in non‐acute hospital wards. The effect of the introduction of MEWS on the confidence of inpatient psychiatric nurses in identifying the severity of a physically deteriorating patient, and taking appropriate clinical action, has not been reported previously. The authors undertook a cross sectional survey looking at the level of confidence of qualified mental health nurses, and their ability to make correct clinical decisions, before and after introduction of the MEWS tool. Copyright © 2014 John Wiley & Sons

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A recent Royal College of Physicians' study on assessment raises serious questions for workplace assessment. To address these, a system is recommended that bridges the gap from competence to performance and integrates supervised learning events (SLEs) that are formative in purpose with summative assessment of performance by entrustable professional activities (EPAs).

Access to specialised therapeutic communities (TCs) for people with intellectual disabilities (IDs) such as ‘Camphill communities’ and ‘TCs plus’ is limited and patchy in the UK. Nonetheless, the emphasis for some time now has been to enable people with IDs to access mainstream services, which have a legal duty to make reasonable adjustments to facilitate this. Here, the authors propose a set of recommendations in order to improve the access of people with ID to mainstream therapeutic communities and enhance the services they receive.

Eye Movement Desensitization and Reprocessing (EMDR) is a structured, eight-phase, mainly non-verbal psychotherapeutic approach that is developed to resolve symptoms that have stemmed from disturbing and unprocessed life experiences. EMDR is well known for the treatment of Post-Traumatic Stress Disorder (PTSD). However, modified protocols have been developed for the treatment of other anxiety and mood disorders; especially if rooted from a traumatic experience in the past.People with Intellectual Disability (ID) are more likely to suffer from adverse experiences during their lives and psychiatric consequences are common among them. In addition, they are more likely to have difficulty in verbal communication which is a requirement in other psychological interventions but less so in EMDR. All these point towards EMDR as a potential add-on tool in this group of clients.Unfortunately there is limited, yet encouraging, published literature about the use of EMDR in people with ID. In this paper, I will report a successful use of EMDR for the treatment of PTSD and Obsessive Compulsive Disorder (OCD) in a 35 year old patient with moderate ID and then use this to discuss the advantages and disadvantages of using EMDR for people with ID in a wider context.