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There are numerous standards currently available that relate to accident and emergency medicine. Some of these relate to organizational structure; others are clinical and relate either to the process of care or to outcomes. Few, if any, deal explicitly with the dimensions of quality mentioned in recent white papers about the NHS. It is suggested, to maximize the effect standards have on care, that they should be developed for existing technologies not just for novel ones, rigorously developed and effectively disseminated and implemented, formally evaluated after their introduction and mutually compatible.