<p>This paper takes a retrospective view of the development and introduction of a formalised triage assessment into the emergency service of Hammersmith Hospitals NHS Trust’s which has two departments; one based at Charing Cross Hospital (CXH) and the other at Hammersmith Hospital (HH). Prior to 1997, the triage process was ad-hoc and nurses did not receive any formal training or assessment to ensure they were competent to undertake this essential role. This paper will discuss how a triage system was formalised and introduced, examining the educational and assessment implications and how the outcomes were measured. The system devised supports the national triage scale developed jointly by the BAEM and RCN (priorities 1 to 5).</p>