Accident and Emergency Medicine is the specialty responsible for assessing the immediate needs of acutely ill and injured people. Urgent treatment is provided where necessary; if required, the patient’s admission to an appropriate hospital bed is organised. Every part of the UK has nominated key hospitals with the appropriately trained staﬀ and necessary facilities to deal with acutely ill or injured patients. It is well-recognised that prompt treatment in the ﬁrst hour or so after an accident or after the onset of an acute illness – the so-called ‘golden hour’ – can make the diﬀerence between the patient’s recovery and serious disability or death.
A&E Medicine is a relatively new specialty in the UK and there are still inadequate numbers of consultants and trainees, despite an inexorable rise in the number of patients attending A&E departments. With a similar rise in hospital admissions there is often no bed available immediately for casualties, resulting in backlogs of patients waiting for treatment. A major debate in the specialty is about the likely need to centralise services by downgrading or closing smaller units, in order to make the most eﬃcient use of staﬀ.