Psychiatrist experience of remote consultations by telephone in an outpatient psychiatric department during the COVID-19 pandemic.

OBJECTIVE: In response to the COVID-19 pandemic, there has been a shift globally from face-to-face consultations to remote consultations. In our department, remote consultations have taken in the form of telephone consultations. In this paper, we set out to study a group of Irish psychiatrists' experience of these consultations. METHODS: We identified recurrent themes in the existing literature on doctors' experience of telephone consultations with a view to determining the applicability of these themes to a group of Irish psychiatrists. A questionnaire was developed based on themes in the literature. This was sent to all psychiatrists working in a busy psychiatric service in Dublin. RESULTS: The questionnaire response rate was 72% (n = 26/35). Diagnostic challenges, the effect of phone consultation on the therapeutic alliance, challenges associated with the use of technology and ethical concerns were identified as issues. Flexibility in the working day and convenience were identified as possible benefits to telephone consultations. CONCLUSIONS: The group that participated in this research study identified a number of challenges to carrying out successful phone consultations. This study highlights the need at our clinical site for interventions to address the issues identified by staff. The findings also highlight the requirement for larger studies with stronger methodologies to determine the generalisability of our results.

The quantitative impact of COVID-19 on surgical training in the United Kingdom.

BACKGROUND: COVID-19 has had a global impact on all aspects of healthcare including surgical training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the UK. METHODS: Anonymized operative logbook numbers were collated from electronic logbook and ARCP outcome data from the Intercollegiate Surgical Curriculum Programme database for trainees in the 10 surgical specialty training specialties.Operative logbook numbers and awarded ARCP outcomes were compared between predefined dates. Effect sizes are reported as incident rate ratios (IRR) with 95 per cent confidence intervals. RESULTS: Some 5599 surgical trainees in 2019, and 5310 in surgical specialty training in 2020 were included. The IRR was reduced across all specialties as a result of the COVID-19 pandemic (0.62; 95 per cent c.i. 0.60 to 0.64). Elective surgery (0.53; 95 per cent c.i. 0.50 to 0.56) was affected more than emergency surgery (0.85; 95 per cent c.i. 0.84 to 0.87). Regional variation indicating reduced operative activity was demonstrated across all specialties. More than 1 in 8 trainees in the final year of training have had their training extended and more than a quarter of trainees entering their final year of training are behind their expected training trajectory. CONCLUSION: The COVID-19 pandemic has had a major effect on surgical training in the UK. Urgent, coordinated action is required to minimize the impacts from the reduction in training in 2020.

How governments manage personal assistance schemes in response to the United Nations Convention on the Rights of Persons with Disabilities: A Scoping Review

Governments are obligated to safeguard social inclusion for disabled people through user-led personal assistance (PA) under Article 19 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). This scoping review was carried out to map and explore current knowledge on how governments internationally have managed PA schemes in response to the UNCRPD. The review examined 99 documents, and categorised the literature into the following themes;legislation, funding, model of service provision, governance and regulation, and the COVID-19 pandemic response. We include recommendations to co-design legislation and quality improvement policies to ensure that PA schemes are underpinned by a social model of disability mindset. Further research needs to be undertaken to guarantee that policymakers include the voice of PA users in the management of PA schemes. Points of interest This article looked at 99 documents to find out how governments are managing personal assistance (PA). It found out that governments can often decide to spend less money on a PA scheme rather than protect our rights. To overcome this problem the documents recommended that legislation for PA schemes must be designed with disabled people. Governments must redirect their money from institutional services to community-based services. Eligibility criteria to control access and the costs of PA should be removed. This paper suggests that we need to have the voice of the PA user to direct the design and delivery of PA schemes. Supplemental data for this article is available online at https://doi.org/10.1080/09687599.2021.1877114. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.