Burdened with a growing demand and limited space, St. Thomas’ Hospital appointed us to create a new Emergency Care Pathway. We needed to bring together emergency care services from across the hospital to create an efficient, welcoming facility for patients. The most significant challenge was keeping emergency services operating as usual – even during the most intrusive works. We designed a complex phasing system to allow the hospital to continue providing the same level of emergency care, working closely with staff to meet their needs. The new Emergency Care Pathway unites a range of emergency care services, including emergency paediatric services and a children’s short stay unit. Major upgrades to critical facilities – from the Emergency X-Ray Department to the Plastics Hand Trauma Unit – have allowed the hospital to give the highest levels of care to its growing numbers of patients. By collocating different emergency services on a single emergency floor, the Trust can treat patients more efficiently, and bring its models of care in line with new recommendations by the Emergency Care Pathway Programme Board. The project has benefited both the staff who work at the hospital and the patients treated there, providing a space which is clear to use, welcoming, and designed for the highest standards of care.