Keynote address: United Kingdom experiences of evaluating performance and quality in emergency medicine.

Demand for emergency care is rising throughout the western world and represents a major public health problem. Increased reliance on professionalized health care by the public means that strategies need to be developed to manage the demand safely and in a way that is achievable and acceptable to both consumers of emergency care, but also to service providers. In the United Kingdom, strategies have previously been aimed at managing demand better and included introducing new emergency services for patients to access, extending the skills within the existing workforce, and more recently, introducing time targets for emergency departments (EDs). This article will review the effect of these strategies on demand for care and discuss the successes and failures with reference to future plans for tackling this increasingly difficult problem in health care.