• Emergency care systems

International readers may need reminding that in April 2011 a new set of clinical quality (A&E) indicators was introduced in the NHS in England to replace the previous 4 h waiting time standard, the new indicators providing a platform with which to measure the quality of care delivered in A&E departments in England. The indicators were developed by the national clinical director for urgent and emergency care, working with the College of Emergency Medicine, the Royal College of Nursing and informed patient representatives.

At the beginning of October last year the government released data for May 2011, related to A&E attendances for that month and drawing on just over 1.4 million detailed records of attendances at major A&E departments, single specialty A&E departments (eg, dental), minor injury units and walk-in centres in England.1

Five indicators are reported:

• left department before being seen for treatment rate;

• re-attendance rate;

• time to initial assessment;

• time to …