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Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new 'hubs' were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children's hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To identify and profile the available orthodontic smartphone apps published on the UK Apple App Store and Google Play Store., Design: A review of available smartphone apps., Setting: London, UK., Methods: The Apple App Store and Google Play Store were accessed in October 2018; all orthodontic apps with a title and description available in English were included. Each app was classified according to the following criteria: name; target audience (patient or clinician); focus; platform (Apple App Store and/or Google Play Store); cost; rating and number of ratings; size; creation date; country of development and developer., Results: A total of 305 orthodontic related apps were identified for inclusion. The majority of apps were aimed at patients (n = 241) and the most of these were focussed on gaming (n = 136), many apps were also found to be developed by specialist practices (n = 63) and to provide knowledge for patients (n = 56). Two hundred and ninety-five apps were free, with some of these including the option of paying for in-app purchases. Most apps were developed in the USA (n = 84)., Conclusions: There has been an increase in the availability of orthodontic apps in recent years. The majority of available apps are patient-focused, most commonly games. A number of apps aim to elicit a behaviour change in our patients; therefore, there is a need to assess the quality and educational content of these.

Introduction Social media is an integral part of modern society and is increasingly being used by patients and clinical staff alike. The General Dental Council and most employers have social media guidelines to ensure employees use social media responsibly and do not bring their organisations into disrepute.Aims To establish the accessibility of Facebook profiles of the staff and students at Eastman Dental Hospital (EDH) and to assess compliance with the latest social media guidance from the General Dental Council as well as the employing trust and university.Design and setting A hospital-wide prospective audit conducted from January to March 2018 at Eastman Dental Hospital.Gold standard One-hundred percent compliance with: a) General Dental Council (GDC); b) University College London (UCL); and c) University College London Hospitals (UCLH) social media policies.Materials and methods The names of all clinical staff/students at EDH were searched for on Facebook using a dummy profile account, to simulate a member of the public. The profiles were assessed for the accessibility of personal information, affiliations to UCL/UCLH, personal views, social networking and conduct.Results A total of 219 out of 440 profiles (50%) were identified and were accessible to varying degrees. Many accessible profiles had a profile picture and personal information visible such as gender and location. No violations of patient confidentiality were seen. Overall, 6% (n = 14) and 2% (n = 4) of profiles displayed unprofessional behaviour and substance abuse, respectively.Discussion This audit highlighted Eastman Dental Hospital's compliance to local and national social media policies.Conclusion It was not possible to identify all staff/students through the Facebook search function. No serious professional misconduct was identified, however a small minority displayed unprofessional behaviour.