PurposeActive patient participation in safety pathways has demonstrated benefits in reducing preventable errors, especially in relation to hand hygiene and surgical site marking. The authors sought to examine patient participation in a range of safety-related behaviours as well as factors that influence this, such as gender, education, age and language.DesignA 20-point questionnaire was employed in a London teaching hospital to explore safety-related behaviours, particularly assessing patient’s willingness to challenge healthcare professionals and engagement in taking an active role in their own care while in hospital. Data was also collected on participant demographic details including gender, age, ethnicity, English language proficiency and education status.Results85% of the 175 patients surveyed would consider bringing a list of their medications to hospital, but only 60% would bring a list of previous surgeries. Only 45% would actively engage in the WHO Safer Surgery Checklist and over three quarters (80%) would not challenge doctors and nurses regarding hand hygiene, believing that they would cause offence. Female patients who had tertiary education, were fluent in English and less than 60 years of age were statistically more likely to feel responsible for their own safety and take an active role in safety-related behaviour while in hospital (p<0.05).ConclusionsMany patients are not engaged in safety-related behaviour and do not challenge healthcare professionals on safety issues. Older male patients who were not tertiary educated or fluent in English need to be empowered to take an active role in such behaviour. Further research is required to investigate how to achieve this.

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In response to the first COVID-19 surge in 2020, secondary care outpatient services were rapidly reconfigured to provide specialist review for disease sequelae. At our institution, comprising hospitals across three sites in London, we initially implemented a COVID-19 follow-up pathway that was in line with expert opinion at the time but more intensive than initial clinical guidelines suggested. We retrospectively evaluated the resource requirements for this service, which supported 526 patients from April 2020 to October 2020. At the 6-week review, 193/403 (47.9%) patients reported persistent Authors: A specialty trainee in respiratory medicine and general internal medicine,

AimsYoung people with their first episode of psychosis can feel lonely and isolated. Psychoeducation has been shown to increase patient insight, reduce the risk of relapse and forms part of the Quality Standards for Early Intervention in Psychosis Services. Our aim was to increase knowledge of psychosis in service users in an urban cohort by delivering psychoeducation in an interactive online format, due to the restrictions on socialising during the COVID-19 pandemic. We hoped this would serve to empower service users, allow them to connect with each other and offer hope through understanding.MethodsAppropriate service users aged 18–35 years were recruited from the caseload with the support of care coordinators, with 28 participating overall over a period of ten months. One-hour Zoom sessions of 2–4 participants were facilitated by a junior doctor. Each session consisted of a mix of teaching about basic neuroscience, including brain structure and the dopamine hypothesis theory, interspersed with factual quiz questions and opportunities for free-form answers in ‘thought clouds’. These explored feelings and experiences associated with psychosis. Data were also collected quantitatively in the form of anonymous self-rated pre- and post- session questionnaires on a 10-point Likert scale. These included self-reported questions about the understanding of the brain, psychosis, symptoms, medications and fear associated with the illness. Engagement was increased through the creation of flyers and reminder messages.ResultsThought clouds constructed during the sessions described feelings such as ‘panic’, ‘unease’, ‘dreamy’ and ‘broken reality’. On average over all sessions, there was an increase of 1.2 points in understanding of the brain, 2.6 points in understanding of ‘psychosis’, 2 points in understanding of how symptoms relate to the brain, 1.8 points in the belief that psychosis can be managed with therapy, 1.5 points in the belief that psychosis can be managed by medication, and unfortunately a 0.1 point increase in fear of the disease – perhaps associated with increased knowledge of the disease process. Encouragingly, 91% of final responses in the sessions were positive, demonstrating hopefulness.ConclusionWe have demonstrated that innovative digital psychoeducation sessions provide a highly effective way to deliver information to young people with psychosis whilst also allowing connection with peers. This model represents a great learning opportunity for trainees, and could be easily replicated in other geographical locations, or mental health conditions. We have also invited and encouraged co-production with service users.