Aims: Emergency admission to hospital is associated with an economic burden and mortality. Echocardiography is often the first-line cardiovascular imaging investigation. Repeat testing is common; however, there are sparse data on the prevalence, appropriateness, or outcome of repeat testing. Methods:We performed an electronic database search for patients with emergency admissions to our institution in February 2015. An electronic patient record review of inpatient echocardiograms was undertaken. Indications for echocardiography were classified as appropriate, may be appropriate, or rarely appropriate. One-year followup for repeat testing and mortality was investigated.

Purpose Doctors are more likely to suffer from mental illness in comparison to the wider population. This is particularly true for junior doctors, who are at increased risk in comparison to their senior colleagues. This study aims to identify whether junior doctors in North London are comfortable discussing mental health problems with their peers and supervisors and to compare how comfortable they are discussing mental and physical health problems. Design/methodology/approach An anonymous online questionnaire was designed with demographic data, multiple-choice questions and free-text boxes. This was distributed via email to core psychiatry trainees and foundation doctors in North London. Drug- and alcohol-related disorders were excluded from our definition of mental illness in this survey, as these are reportable to the General Medical Council. Findings A total of 51 junior doctors responded to the survey. The respondents were significantly more likely to discuss mental health problems with their peers in comparison to their supervisors. They were also less likely to discuss mental health problems in comparison to physical health problems with their peers, supervisors or general practitioner. Qualitative analysis of the free-text comments elucidated several themes including the stigmatisation of mental health. Originality/value To the best of the authors’ knowledge, there has been no prior research in the UK comparing the attitudes of junior doctors towards physical and mental ill-health. The questionnaire highlights the continued stigma towards mental health within the medical profession. The difference in attitudes towards physical and mental ill-health has important implications for the training and well-being of junior doctors.

AimsThere was understandable anxiety from trainees about the transition to the online format of the CASC due to the pandemic. There is also significant variability between trusts in the availability of lectures tailored specifically to the CASC exam. Having recent experience of the CASC exam, including the online format, we developed a free online lecture series. We aimed to address common questions relating to the exam, and selected topics that trainees may find daunting or had less experience with through clinical care. The topics covered were: An Introduction to the CASC, Mental State Examinations, Psychological Therapies, Pharmacology and a Q&A Session.MethodThe course was designed to tackle areas that trainees often find difficult based on our own experiences as well as surveying course attendees. Prior to the course, we liaised with consultant site tutors & junior doctor representatives to integrate the course into the local academic programme, and to facilitate promotion of the session to trainees across sites. We subsequently offered registration to trainees nationally. The course was planned and delivered by the organisers through interactive lecture-based presentations with handouts, ahead of the January 2021 examinations. Content was based on national guidelines and published research. 5 sessions were delivered with the final session including guest consultant panellists to answer trainee questions. Quantitative and qualitative feedback was collected from the attendees.Result172 doctors registered onto the course, with 44 NHS trusts represented. Doctors from a variety of grades attended, with 55% CT3s, 17% Specialty Doctors, 16% CT2s, 8% CT1s, 4% in other roles. 100% of attendees stated that they would recommend the course to any doctor sitting the CASC. 97% of attendees rated the course as either ‘Excellent’ or ‘Good’. Qualitative feedback was positive and 3 themes were identified- communication, content and the online format.ConclusionThe CASC course provided an opportunity to deliver national teaching to trainees based on national guidelines and peer-reviewed research, with a focus on addressing areas that trainees may feel less confident with. The course received significant positive feedback from attendees. The significant number of pre-CT3 trainees attending the course suggests that there may be an interest from this group for further support in developing the complex communication skills that ultimately are assessed by the CASC exam.

AimsThe primary aim of the project was to improve attitudes towards the COVID-19 vaccine in forensic mental health staff at a large regional tertiary forensic psychiatry unit. The main variable examined was attitudes towards safety of the vaccine. Secondary aims included decreasing misinformation about the vaccine and improving vaccine uptake.MethodPaper questionnaires were distributed to willing staff members across 6 forensic inpatient wards within the North London Forensic Service. Participants included a range of allied health professionals including nurses, health care assistants, ward managers, occupational therapists, assistant therapists and administrative staff. Questionnaires used a mixture of Likert scale for agreement/disagreement with statements and yes/no questions.Plan-Do-Study-Act (PDSA) methodology was utilised in implementing changes, and repeat questionnaires used to measure changes in attitude and behaviour. Change ideas implemented included the creation of ‘mythbusters’ posters which target vaccine misinformation, the creation and distribution of posters of staff members who had already taken their vaccine, the creation of vaccine champions to aid engagement in conversation about the vaccine, vaccine information packs being distributed to all wards and the opportunity for staff to ‘drop-in’ to clinics for information about the vaccine.ResultVaccine uptake improved from 7% before interventions to 69% after interventions.The proportion of people very unlikely or unlikely to get the vaccine reduced from 25% to just 9%. The proportion of those feeling neutral reduced from 32% to 6%. The proportion of those either likely or very likely to get the vaccine increased from 34% to 85%.Before interventions only 20% felt that the vaccine was either safe or very safe. This improved to 63% after interventionsBefore interventions, only 27% of respondents felt they had received enough information by the trust to make an informed decision. After interventions, 80% said they had received enough information.The project was successful in reducing misinformation in every domain. Particularly reassuring was the reduction to zero of some of the most harmful misinformation claims, such as the presence of a tracking chip in the vaccine and the belief that COVID does not exist.71% of respondents indicated the interventions we set out changed their view on the COVID-19 vaccine.ConclusionThe changes implemented lead to clear improvements in all domains measured, suggesting targeted information is an effective strategy in improving uptake and attitudes around the vaccination program.