Covid-19 has brought significant disruption to the way medical care is delivered across all areas of clinical practice. As we move from a pandemic to an endemic state, delivery of care must adapt to ensure this – and similar diseases – can be managed safely within emergency departments. This RCEM position statement makes recommendations about how care in emergency departments in the UK needs to be transformed. The recommendations support these five fundamental aims: emergency departments must not become reservoirs of nosocomial (hospital or healthcare acquired) infection for patients; emergency departments must not become crowded ever again; hospitals must not become crowded again; emergency care must be designed to look after vulnerable patients safely; and emergency departments must be safe workplaces for staff.