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Folks, We are continuing to face the problem of increasingly junior staff trying to see increasing numbers of patients, whilst their supervision is by junior or locum middle grades and only a few consultants. This inevitably leads to errors. We already have guidelines available but you cannot guarantee staff read them, and even if they do follow them. Audit just highlights the problem but by then they have moved on to another job. A suggested solution is the use of proformas but this just makes my heart sink as it seems a cheap alternative to good (continuing) education, supervision and experience. Surely we need to encourage free thinking and understanding of the subtleties of medicine, something I'm convinced proformas will do. I've seen similar things used before and juniors either loose sight of the big picture or shoe horn cases that don't quite fit in to these systems. I can see the short term financial, time and clinical risk gains but aren't the loss of developing good clinical skills and that 6th sense inevitable and unwanted? Or am I being an old fashioned fuddy duddy and worrying about nothing. Simon McCormick Rotherham