Following the publication in March this year of the Healthcare Commission’s report into the debacle that was the Mid Staffordshire NHS Foundation Trust, two follow-up reviews have recently been released by the Department of Health, one from Sir George Alberti and one from Dr David Colin Thomé, the respective national clinical directors for emergency and primary care.1 The Alberti report, brief and succinct at 21 pages, will be of more interest to readers of this journal than the second (a slightly longer 34 pages), for which the target audience is primarily health commissioners and performance managers.

Alberti’s observations include:

• The A&E [sic] department has appointed four new consultants, improved nursing skills, handles emergency cases more efficiently, improved training of junior doctors and is now providing safe, good quality care. It is worth noting that the department processed 99% of its patients within 4 h but, as many readers know, this is not necessarily a marker of quality care; it is just a marker of processing. There is no other reference to …