Older people make extensive use of emergency departments, yet there is evidence that optimum care is difficult to provide for those with complex health and social problems. Inappropriate hospital admissions for older people have also been documented. This article describes the establishment of an assessment team for older people (ATOP) that has been created to address these issues in a district general hospital. In the four months of the study period, the ATOP prevented admission of 178 of the 666 patients seen. Of these 178 patients, 19 re-attended the hospital and six were admitted.