We were intrigued by Mr Leaman’s provocatively “spun” commentary on the state of emergency medicine in the UK.1 His paper rightly addresses a range of key clinical and political subjects, but appears to contain a number of inaccuracies that motivated us to respond with what we hope is a more balanced view.

In broad terms, Leaman’s criticisms span four domains: branding, modernisation, impact of National Health Service reconfiguration, and finally the vision for our future.

BRANDING

Emergency medicine is certainly in the midst of dramatic change, but is also responding to the opportunities within that change, commanding greater respect and resources than ever before. The “4 h target” and urgent care agenda are complex, and not always to our liking, but have led to the allocation of substantial resources to many emergency departments (EDs), a steady growth in staff numbers, increased efficiency and improved delivery of quality care. This is fortunate since, contrary to Mr Leaman’s assertion, our patients do not seem to have been deterred by the change in specialty name (to fit with international standards), and ever-increasing numbers are attending year on year.

Indeed, it is this spiralling demand that ensures our long-term future; despite many new initiatives instigated nationally and by various primary care trusts there has been no convincing fall in patient attendances or emergency admissions.2 3 In common with many colleagues we have recently seen and experienced our fair share of urgent …