A year-long, nurse-led intermediate care pilot project was undertakenat a 120-bed homeless hostel in south London to improve healthcareoutcomes among the clients involved, and to reduce emergency department(ED) attendance, ambulance call outs and use of acute care services. Bythe end of the year, the number of ED and hospital admissions haddropped significantly. The project was recognised by the Department ofHealth in 2010 as an example of innovative practice in work with'at-risk' groups, and was awarded the 2011 Nursing Standard CommunityNursing Award. This article considers reasons for the success of theproject and the lessons that can be learned from it (Author).