Memory clinics have become very popular in old age psychiatry and there is some pressure for them to be developed in old age services. However, there is little evidence to suggest that they are more advantageous over the traditional domiciliary visits or who should be seen in clinic. This was a naturalistic comparison of 76 consecutive new referrals to a memory clinic, with 74 consecutive new domiciliary requests within the same service over the same period of time. A retrospective case note review collected the clinical features and an 18-month prospective follow-up examined the subsequent clinical management.

The two groups were characterised more by their similarities than their differences. However, the domiciliary group had greater behavioural and psychological complications. The memory clinic patients were less likely to receive psychotropic medication and here more likely to be followed up.

We conclude that memory clinics might be less suitable for patients with prominent psychiatric complications. Memory clinics could complement the domiciliary model by providing early psychosocial/neuropsychiatric approaches, although this is likely to lead to an increased clinical case-load.

The UK Government is promoting three types of specialist team in psychiatry: assertive outreach, crisis resolution and early intervention in psychosis. Policy guidance suggests that psychiatrists be recruited to work exclusively within these teams, but little is known about the views of psychiatrists regarding their development. A postal survey was undertaken to seek the views of consultant psychiatrists in the North West.

Seventy per cent of psychiatrists responded to the questionnaire. Equal numbers agreed and disagreed with the development of specialist roles. Few services had been able to recruit to extra consultant sessions within the new teams and only a third of consultants believed the resources so far available to be reasonable. Overall views of the new teams were positive (mean scores 6.36, 6.51 and 6.03 on a 1–10 visual analogue scale for assertive outreach, crisis resolution and early onset psychosis teams). Consultants are particularly likely to believe that the new teams will increase patient satisfaction and provide a welcome change in role for some psychiatrists. A total of 64% of consultants believe that crisis resolution services could reduce hospital admissions, compared with 41% for assertive outreach and 31% for early onset psychosis teams. The concern most often voiced was that new services are being developed at the expense of existing teams.

Consultants perceive benefits associated with the new teams but are concerned about their impact on the rest of the organisation. If resource and recruitment issues can be addressed, consultants could prove to be supportive of these new models of service.

All psychiatry trainees and supervisors on the Southeast Scotland scheme were invited to complete a questionnaire about the regularity, responsibility, structure, content and value of supervision.

Significantly more supervisors (87%) than trainees (69%) reported regular supervision. Some trainees still find it difficult to obtain regular supervision. Although it is seen as a joint responsibility, there is uncertainty about the role and responsibility of each trainee and supervisor. Most trainees and supervisors feel that supervision is useful, but supervisors are likely to rate their quality of supervision better than their trainees. Guidelines for the structure, content and boundaries of supervision might be useful. Supervision is viewed as useful for discussing clinical management, including the trainee's own case-load.

Training in the use of supervision should be available to all trainees and supervisors. Regular supervision should be a priority, and it is a joint responsibility to ensure that it happens. There should be greater accountability to the College and Trusts. Discussion of the trainee's clinical case-load during supervision is a necessary part of training and the supervision process.

We surveyed all our senior house officers (SHOs) in 1998 to ascertain the nature and quality of their psychotherapy training. Following the introduction of a structured psychotherapy training programme, we wished to see what difference this had made to their training experience. The same questionnaire was used to survey all SHOs currently training in our trust, and compared their responses with those of the earlier cohort.

There was a statistically significant increase in the number of trainees seeing patients, in the number of psychotherapy patients being seen, and in the expectations of trainees of being able to fulfil College requirements.

Our results demonstrate the value of a formal psychotherapy training programme for the quality of psychotherapy training at SHO level. In particular, the introduction of protected time may have been crucial in allowing the SHOs to gain the necessary experience.