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Arthroscopic Bankart repair is now a well-established technique for the treatment of shoulder instability. However, failure rates are considerable when significant bony defects are not addressed. Hill-Sachs lesions, present in the vast majority of those with recurrent anterior instability, when of significant dimension and location, may account for some of these failures. The remplissage procedure involves capsulotenodesis of the posterior capsule and the infraspinatus tendon to fill the Hill-Sachs lesion. “Double-pulley” remplissage is a transtendinous technique that has been described elsewhere and that may simplify the procedure. We present a modification of this technique, the “tripod-pulley” technique, which we feel may potentiate healing of the Hills-Sachs lesions of the capsule and infraspinatus by increasing the surface contact area. At the same time, this technique minimizes the risk of potential damage to the infraspinatus as it uses 2.3-mm “all-suture” anchors.

A near-peer departmental induction using simulated ward rounds may improve the preparedness of junior doctors for their role within a new department, potentially improving patient care and the junior doctors' learning experiences.

Introduction: Job satisfaction is directly connected to job performance. This correlation is very important in the health service, where employee performance is linked to patient care. It has been reported in other organisations that workplace learning enhances job satisfaction. The aim of this study is to investigate if such a correlation exists within the health service. Methods: Job satisfaction and workplace learning questionnaires were distributed to healthcare employees at aN NHS hospital. The participants were directly involved in patient care. The professionals who participated in the study were doctors, nurses, paramedics, physiotherapists and radiographers. Results: In total, 102 questionnaires were collected. There was a direct significant correlation between job satisfaction and workplace learning (Pearson's correlation=0.38). Compared to doctors, nurses felt that workplace training was better (P=0.001). Moreover, total job experience and the time spent in the Trust had a mild negative correlation with job satisfaction. Frequent departmental teaching also had a significant positive impact on employee job satisfaction (P=0.05). Conclusion: Workplace learning is directly linked to employee job satisfaction in the NHS, and frequently scheduled departmental teaching enhances staff satisfaction.

Those who have difficulty walking are eligible for a ‘blue badge’, which gives extra parking rights. An evidence-based assessment was introduced to assess applicants' eligibility for this badge. The assessment consisted of an interview, symptom scaling, falls risk assessment (including functional reach) and a walk test. In total, 226 assessments were carried out in a 6-month period. The discriminant analysis using all parts of the assessment gave 95% compliance and a cross validation value of 88%. Post-assessment, awards of badges decreased by 12% and appeals decreased by 25%. All parts of the assessment were found to be useful in helping to make a decision. Answers from the assessment could predict the eligibility for 88% of the time. Consequently, therapists' knowledge and experience is still necessary. Using a face-to-face evidence-based assessment reduced the potential for abuse, decreased the amount of appeals and made the decision-making process more transparent.