BackgroundADHD has long been considered to affect males more than females. It has been suggested that this difference is not as marked in the adult population. Differences in prevalence in adolescents may be contributed to by underdiagnosis in females. While these differences have been explored in children, there are limited data for the adult population with ADHD. Our study looked at a community sample of adults with ADHD and we examined differences in varying areas of comorbidity between males and females.MethodWe looked at a sample of 50 patients in the adult ADHD clinic. On the basis of gender, differences were recorded in a variety of areas including alcohol and illicit drug use (including cannabis), forensic history, age of diagnosis of ADHD, family history and psychiatric comorbidity.ResultsThe full results are pending. Preliminary findings suggest an increased prevalence of substance misuse amongst males. Male patients were more likely to have a forensic history. Female patients are more likely to suffer with comordid anxiety and depression while male patients have a higher prevalence of autistic spectrum disorders and learning difficulties.ConclusionsService provision for adult ADHD has to be structured according to the needs of the population served rather than focussing on provison of prescribing services alone. The treatment approach for females with ADHD may diiffer from that for males. The use of psychotherapy in this population is particularly benficial. Comorbidity amongst females may complicate treatment with stimulants as this may worsen features of anxiety and depression.

Aim:To describe the development of a service addressing the needs of adults with ADHD, and to survey the caseload of this service.Method:This review describes the process of setting up a new service for adults with ADHD. This includes drawing up a service plan to look at the resources required, and arranging shared-care agreements with general practitioners. The service was developed in two phases, with the initial phase accepting transitional patients with an established diagnosis of ADHD, and phase two looking at the assessment of individuals without a previous diagnosis. All referrals to the service were surveyed, and information was collated on age, gender, diagnosis, co-morbidity, medication and employment.Results:The service was set up in November 2007, and over a period of 10 months, 32 referrals were accepted, having met the criteria for assessment. Cases were accepted on the basis that they had a previous diagnosis of ADHD, the majority originating from Child and Adolescent services.The caseload review revealed high levels of comorbidity. The majority of patients were treated with stimulant medication. The ratio of male to females was higher, as expected. The incidence of substance misuse and conduct disorder was consistent with other studies.Conclusion:The demand for a service addressing the needs of adults with ADHD has been high, as evidenced by the volume of referrals received. ADHD persists into adulthood in approximately 50% of children with the diagnosis so follow up into adulthood is crucial.

AimsSerious incidents according to NHS England (2015) are incidents where the consequences to patients, families and carers, staff or organisations are so significant or potential for learning are so great that a heightened response is justified. There is anectoctal evidence that this process is potentially difficult for junior doctors and the primary purpose of learning may be lost due to the stress involved.Our aim was to evaluate junior doctors perspective of serious incident reviews. A secondary aim was to organise local and regional workshops based on the outcome of our findings to address misconceptions around serious incident investigations.MethodA survey was developed using survey monkey and distributed to all trainees across the Mersey region through the Medical Education teams.The junior doctors range from core trainees to higher trainees. The survey encouraged the use of free texting if necessary.Results from the survey were then analysedResult18 junior doctors across the 3 mental health Trusts in the Mersey region responded.12 respondents have been involved in a serious incident investigation in the past and 9 of the respondents stated that they did not recieve any support during the process. Out of the 3 that were supported, one rated the support as poor and frightening.55.56% af all respondents found the process of serious incident reviews hard to understand.66% of all respondents admitted that they are aware that the purpose of the review is for learning purposes.100% of respondents agreed that a workshop to discuss the purpose and process of serious incidents investigation to aid their understanding would be useful.ConclusionFrom the survey, we concluded that junior doctors do have some understanding of incident reviews process but they still do not feel comfortable with the idea of being under ‘investigation'.It is also important that formal support is made available during the process.We organised a workshop in one of the 3 Trusts which was well attended and junior doctors asked if they could sit on review panels for experiential learning. This is to be presented to govenance teams across the mental health trusts in the region.Further workshop across the 2 remaining Trusts could not be organised due to COVID-19 pandemic.

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A doctor can apply for a CESR in psychiatry if they can demonstrate to the GMC that they have six months of training in the specialty being applied for and/or a postgraduate qualification in the specialty attained anywhere in the world. Once successful in their application, the doctor is entered onto the Specialist Register for a psychiatry specialty, that is, given 'specialist registration' by the GMC. If they are overseas doctors who at the point of application do not have GMC registration at all, they are given both full GMC registration and specialist registration at the same time.To practise medicine in the UK, all doctors need to hold registration with a licence to practise, undergo annual appraisal and participate in revalidation every five years. In addition, doctors also pay an annual fee. Doctors who are not practising medicine or who practise overseas can choose to hold registration without a licence to show they continue to be in good standing with the GMC. This shows that they continue to follow the principles and standards of good medical practice. Why Apply for Specialist Registration?The final aim of a CESR application is to attain specialist registration with the GMC and to be included on the Specialist Register. It is an acknowledgement of the applicant's knowledge, skills and competences to practise as a consultant in the UK.