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I was waiting for people with more knowledge about this to comment, but no one has ! This system of parallel streams seems a waste of resources. Surely what is needed is a properly funded afterhours primary care system and adequately resourced emergency departments. Triage works - most australian and NZ emergency departments keep within their triage times, the problem is resources not the actual system itself. Why not spend the money funding the current system properly ? As I read this there will be up to 5 parallel systems on one site, and if one stream is overloaded then the others wont help - because their priority is to their own stream. So if your resus stream is overloaded, you wont be able to take your minors staff to see the more serious cases ? So sprained ankle ahead of chest pain. I dont understand the logic of this. Or are all the streams going to be well enough staffed with appropriate doctors and nurses for this not to be a problem :-). Im sure all these issues have been thought about, they have, havent they ? Who is going to be overseeing all the streams ? What is the role of the ED consultant ? It certainly has some good points - early analgesia, sorting problems out quickly at triage is good idea in theory - but again will this be maintained in the face of unstable patients waiting for nursing and medical care. Surely the whole point of a triage system is so that resources are delivered appropriately in an appropriate time frame. What emergency care in the UK needs is a MAJOR cash injection - more consultants, more middle grades, more SHO's, more nurses. IMO all the current system needs is this (with some other less radical fine tuning) - its fine to change the system but without the cash this will just rearrange the deck chairs Or have I missed the point entirely cheers Craig _________________________________________________________________ Join the world’s largest e-mail service with MSN Hotmail. http://www.hotmail.com