Published: 06/05/2004, Volume II4, No. 5904 Page 20

I enjoyed the feature 'Lost in Liaison' (clinical management, 1 April, pages 30-31, 1 April).

But as only England and Scotland were covered, I am writing to let readers know about the situation in Wales.

To match Leeds - with four consultant liaison psychiatrists for a total population of 715,000 - Wales (population 2.9 million) needs 16 consultants. I surveyed all Welsh trusts in 2003 and found there were only 2.6 whole-time equivalents in post.

This means Wales needs 600 per cent more liaison psychiatrists to match a situation which is already a shortfall on nationally agreed standards.

As in England, the Welsh national service framework for mental health had little specific mention of psychiatry in the general hospital setting, with the emphasis on severe enduring mental illness in psychiatric and community settings. Also in Wales, we do not have a fourhour wait target in accident and emergency - something that has driven the development of psychiatric services in A&E departments in England.

But all is not bleak. The last 12 months have seen the development of liaison nurse posts at several sites in Wales.

These areas, as well as those trusts that have consultant liaison psychiatrists, have started to see the benefits this type of service can bring.

With the National Assembly's forthcoming review of emergency care, it is hoped that many more will be developed.

Dr Stephen Davies Consultant in general hospital psychiatry Swansea trust