With this letter we respond to the comments of Chance et al on our recent publication ‘Patient Experience in the Accident and Emergency Department’. We applied three different methods of grouping and summarised the items on the Accident and Emergency (A&E) department questionnaire presented to patients. The best score reliability was provided by the Principal Components Analysis. Chance et al acknowledge the importance of patients’ feedback but questioned whether this measure of patients’ experiences is valuable and valid for comparisons of the quality of care services, and whether selection bias affected the results.

The purpose of our research was to examine alternative ways of obtaining a reliable composite, but we do not negate the important information from separate questions. Single questionnaire items are less reliable than well-constructed composites,1 but are able …