Purpose The purpose of this paper is to explore the validity and reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) to determine if it has predictive accuracy in relation to physical aggression, severe verbal aggression, property damage and self-harm, in a medium secure setting. In addition, the authors hoped to provide some of the first descriptive data available for the START:AV among a UK adolescent population in a medium secure adolescent unit. Design/methodology/approach The sample consisted of 90 female and male adolescents, with and without developmental disabilities. It was important to explore the measure’s predictive accuracy across specific population groups, such as between males and females, as well as those with developmental disabilities, and those without. Findings Some significant relationships were found between the START:AV and adverse outcomes. For instance, total strength and vulnerability scores were predictive for verbal and physical aggression. Differences in predictive validity were evident when comparisons were made between males and females, with relationships being evident amongst the male population only. When splitting the male sample into developmental disability and non-developmental disability groups, significant relationships were found between strength and vulnerability scores and verbal and physical aggression. Practical implications A number of practical implications are considered, such as the START:AV is relevant for use with adolescents in hospital settings and the significant inverse relationship between strength scores and negative outcomes supports the importance of considering protective/strength factors when working with at risk youths. Originality/value There is currently limited validation data for the START:AV in the UK or elsewhere.

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Purpose -To report on the clinical governance work of the NHS Clinical Governance Support Team's, Primary Care Team. Design/methodology/approach -The review describes the formation of the NHS Clinical Governance Support Team's Primary Care Team and the development of a range of national clinical governance activities, drawing on a case study example. Findings -The Team have been developing appraisal, and revalidation for general practitioners across the UK, supporting front-line staff in primary care to improve patient experience by embedding principles of clinical governance into day-to-day practice, and are providing an online education and training programme to develop primary care managers. It has established links, and worked collaboratively with a range of partners in its activities. Originality/value -The article provides a summary of the activities of the Primary Care Team and its activities to date. An example of supporting clinical governance in primary care is given in a case study of facilitating an influenza vaccination campaign.

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