We conducted a postal questionnaire survey of all psychiatric day hospitals in England to identify the range of aims, organisational structure and content of service provision.

Of 102 identified day hospitals, 77% responded to the questionnaire. The findings confirmed that there is great heterogeneity in English day hospital service provision. The function or aim with the highest mean rating was ‘providing an alternative to in-patient care’, with 66% of day hospitals giving this a rating of great or greatest importance. However, the majority of respondents prioritised multiple roles, with many day hospitals aiming to provide acute and chronic care concurrently.

The label ‘day hospital’ covers a considerable range of community psychiatric services. The heterogeneity of service provision in existing day hospitals could lead to difficulties in generalising research findings on day hospital efficacy.

To evaluate a psychosocial intervention for patients treated with antipsychotics with body mass index (BMI) > 25. A total of 44 patients (mean age (s.e.) 37.6 (1.2); 28 female, 16 male) received dietary and exercise advice with motivational interviewing. Weight and BMI were measured at baseline and monthly thereafter. Patients were offered weight monitoring for 1 year.

Overall mean weight loss was 3.1 kg (mean 3.22%). Modal (range) weight change was 74.2 (719.2 kg to +8.7 kg).

Overall weight loss was not significant after 355.7 (32.5) (mean, s.e.) days. Determinants of response remain unclear. Avoiding weight gain in the first instance is critical. Further research will explore determinants of antipsychotic-induced weight gain and prevention strategies.

A prospective descriptive study was set up to evaluate the feasibility, acceptability and activity of an innovative weekly primary care service for patients admitted for acute psychiatric care.

During 10 months, 36 clinics were held and 123 appointments were attended. Presenting complaints included a wide range of acute and chronic conditions, affecting all body systems. As well as treating specific complaints, the doctor providing this service undertook considerable health promotion work and gave advice about patient management to junior psychiatrists.

It appears that there is considerable need for primary care expertise within an acute psychiatric unit, and that a weekly clinic is a feasible model of care.

At a London teaching hospital, the existing off-site consultation model psychiatric liaison service for older people was replaced with an on-site liaison model service in December 2000. Several indicators of the functioning of the service were audited using identical methods before and after this change.

The case-load increased by 50%, but the liaison psychiatrists were more satisfied with the appropriateness of referrals. The case mix did not change. The new service achieved target waiting times more consistently, particularly for urgent referrals. Referring teams were more satisfied with the speed of response, while the new service maintained the salience and clarity of advice.

Findings are on the whole favourable, and support the wider introduction of specialist old-age liaison psychiatric services.

There has been much discussion about the productivity and training value of protected research sessions at specialist registrar (SpR) level. We used questionnaire survey to investigate the research experience of senior psychiatric SpRs and first-year psychiatric consultants in Scotland.

The survey had an 80% response rate. Two-thirds of respondents were able to take protected research sessions, and a similar proportion had published research work during their higher training. Specific difficulties in conducting research are identified and discussed.

Scottish SpRs in psychiatry are usually able to protect research sessions, but experience difficulties with lack of experience, resources and supervision. Almost a third of those near the end of their training have published nothing. It is important to explore options other than research projects to gain relevant research experience.