A system under pressure.

Activity levels within emergency medicine, and the pressures experienced by individual clinicians working within the specialty, continue to increase year on year. In 2016-17 there were 18 691 546 attendances at UK emergency departments. Attendance numbers continue to increase annually, patients are becoming older and more unwell, departments are more crowded and as a result, emergency care standard performance figures are deteriorating. This article describes the impact of this pressure on the staff working within the emergency department and begins to explore the potential for the development of sustainability within the existing and future workforce.