616 British Journal of Hospital Medicine, November 2015, Vol 76, No 11 © 2 01 5 M A H ea lth ca re L td Last year I wrote an editorial in this journal (Mann, 2014) to accompany six articles, authored by leading emergency medicine physicians, highlighting matters most relevant to UK emergency medicine and accident and emergency departments. One year on and a progress report is required to record success and highlight issues yet to be fully addressed. I must of course begin by recording the defining event of 4 February this year, when we received news from the Cabinet Office that our application for permission to be known as the Royal College of Emergency Medicine had been granted. We thus became the first 21st century medical royal college. This was a great morale boost and reflects the remarkable endeavours of frontline clinicians in UK emergency departments over many years. Although a change in name does not change the circumstances in which the college finds itself, it has emboldened our campaign to ‘rebuild emergency medicine’. In November 2014 we launched the Royal College of Emergency Medicine STEP campaign. This had four domains: Sustainable staffing, Tariff and term reform, Exit block eradication and Primary care co-location.