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T he number of homeless people in England has started to rise in recent years; this is thought to be a result of the economic climate, cuts to benefits and the housing shortage. 1 In 2013 the estimated number of people sleeping rough on any one night in England was 2414 -an increase of 36% since 2010; in the same year 113 260 people approached their council as homeless, which is an 11% increase over 2 years. 1 As has traditionally been the case, the majority of homeless people are men, who comprise four in five service users in day centres and hostels. 2 Around a third of homeless people are from black and minority ethnic groups 3 and a recent Broadway report highlighted that, of those people seen sleeping rough in London in 2012/13, 47% were of UK nationality, 28% were from central and Eastern Europe and 12% were from other European countries. 4

The Broadening the Foundation Programme report has led to an expansion in the number of psychiatry foundation placements. This change will have far-reaching benefits for foundation doctors doing psychiatry, no matter what their future career intentions. Doctors will develop a better understanding of mental illness, they will improve their communication skills and they will gain experience of working within multidisciplinary teams. Recruitment into psychiatry is also likely to improve. The Royal College of Psychiatrists is putting in place a number of measures to ensure that placements are of a high quality so that foundation doctors have a good experience of psychiatry.

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The GMC Survey June 2011 highlighted that trainees in Barnet, Enfield and Haringey Mental Health Trust (BEH-MHT) were dissatisfied with the Trust's handover process. At this time there were no Trust guidelines on handovers.A quality improvement project was developed to create a consistent out of hours handover process and to improve staff satisfaction thereafter. Handover guidelines were implemented throughout the Trust on 1/2/12. An audit was carried out to measure staff compliance with handovers. A questionnaire was sent out to staff before and after implementation of the guidelines to assess satisfaction with handovers.The audit results highlighted that handovers occurred relatively consistently across the Trust following implementation of the guidelines. The questionnaire results showed an improvement in staff satisfaction with the handover process.The clinical implication of this project is an improved process of out of hours handover across BEH-MHT.