Current issues · September 2026
The service problems shaping Emergency Medicine now
A useful interview answer moves from evidence to patient consequence, then to a realistic clinical or departmental response. It avoids slogans and does not pretend an ST1 can fix hospital-wide flow alone.
Crowding, corridor care and mortality
Issue → sustained occupancy and long waits
RCEM's June 2026 State of Emergency Medicine in England analysis estimated 15,860 excess deaths associated with long ED waits in 2025. July 2026 then produced a record number of 12-hour waits for that month. Candidate angle: recognise deterioration and dignity risks, escalate unsafe care, maintain observation and handover, and discuss bed flow as a whole-system safety problem.
Care in temporary spaces
Issue → privacy, monitoring and ownership
Corridor and escalation-area care makes examination, confidentiality, infection control, medicines and deterioration detection harder. Candidate angle: use named clinical ownership, observation standards, reliable escalation and incident learning while advocating for flow rather than normalising the environment.
Workforce, culture and retention
Issue → senior decision-makers and sustainable teams
RCEM's workforce material describes longstanding staffing gaps, while 2025 training guidance responds to service pressure and trainee feedback. Candidate angle: connect safe staffing with supervision, breaks, civility, flexible careers and retention rather than discussing headcount alone.
Time-critical medication
Issue → routine harm during long stays
RCEM's national QI work includes medicines such as insulin and levodopa that can cause harm when delayed. Candidate angle: medicines reconciliation, patient-carried information, clear prescribing responsibility, pharmacy support and measurement can improve reliability even when the ED is crowded.
Adolescent mental health
Issue → rising complexity and difficult environments
Adolescent mental health is a 2024–27 RCEM QI priority. Candidate angle: address physical risk and safeguarding, adapt communication and the environment, involve family appropriately, and work with mental-health teams while avoiding long waits without therapeutic support.
Older people, frailty and complex disposition
Issue → acute illness plus function and support needs
Care of older people remains an RCEM national QI programme. Candidate angle: screen for delirium and frailty, review medicines, involve therapy and geriatrics early, establish goals of care and build discharge around function and support rather than diagnosis alone.
Research networks changing policy
Issue → generating evidence from real EDs
TERN's multicentre corridor-care research shows how trainee networks can answer urgent operational questions across many departments. Candidate angle: discuss governance, representative data and translating findings into safer escalation design rather than treating research as a publication exercise.
Curriculum and training quality under service pressure
Issue → learning can be crowded out
RCEM updated its curriculum in August 2025 and published refreshed training-quality guidance later that year. Candidate angle: supervised responsibility, feedback, protected teaching and varied clinical exposure protect both trainee progression and patient safety.
From understanding to practice
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