I'm an A&E consultant and I'm tired after a weekend of nights. But this am, I've handed over what I described as a "good department". This was said genuinely and with no hint of irony. We provided great care and have very short waits to see an A&E doctor, but I'd forgotten how unacceptable it was to have 18 patients in the corridor, and elderly patients waiting over 2 days for a ward bed. My lens of what is good and acceptable has been slowly warped by the slow & damaging effect of the working conditions of A&E departments up and down the country. My biggest worry is that I'm starting to accept the unacceptable. This is not about a lack of gp appointments, patients "abusing" the system or poor management - in fact we had excellent hospital management support, with patients boarding on each ward waiting there instead of A&E for a bed. This is a simple case of patient demand being greater than what the overall health economy can cope with. We have to either change the way we work, change demand via expectation management or increase resources. If not, then the unacceptable becomes the norm and that's unacceptable. Our patients and staff deserve better. – at Hove, England