Hi Tom. I was unfortunate enough to be in a A&E department saturday night just gone, until a little past 2 in the morning. I was just a little surprised by what I seen over the course of those few hours. I don't know if this new handover system is also coming into place in Dorset (anyone?), but one young man was brought in by ambulance, quite obviously worse for wear. He was wheeled in on a chair and left to his own devices in the waiting area, where he slumped over and fell into a drunken sleep. He stayed there for a good hour before anyone realised they didn't actually know who he was. I don't know if there was any sort of handover in the background, but the information didn't seem to get to the people who needed it if there was. It was around this time that one of the security guards there decided he needed to sit up, and manhandled him up in the chair, the mans stomach didn't approve and within a few moments he found himself on the floor in a heap covered in vomit. It took myself and my wife to put the guy in a safe position, as where he was he was in a real danger of choking on the streams of vomit he was bringing up. Both the receptionists and the security guys stood by, waiting for a nurse to come and deal with the situation. The only comment we got from one of the receptionists was "Now I have to clean that up, because the cleaners won't do it, they are not qualified", to which I quipped "And you are...!", which got me a funny look... I don't really know where i'm going wih this post, other than to say I sort of understand where your coming from with regards to the patient safety aspect. Anything that potentially upsets the chain between ambulance and hospital is only going to foster errors, and possibly cause some serious harm to come to some patients. My example (if this is an example, I don't know the system in place here) is a bad one anyway, he was simply a drunk, but of course that wont be the case everytime. I must say I left that place with a little less trust in the NHS.