We invited major emergency departments (those providing 24 hour cover and most core services) in England to submit data for each new patient attending during April 2004. We determined the distribution of total time in each department for patients who were admitted to hospital and for those discharged from the department. To assess the generalisability of these findings, we used performance data from the Department of Health to compare trusts in which at least one department had submitted data or in which no department had.3