To determine the medical needs and survival of patients admitted to NHS continuing care beds for the frail elderly. A retrospective cohort study of admissions during one year to 222 beds in south-east Glasgow. Case-sheet review identified the diagnoses on admission. Medical interventions were allocated to one of six predetermined categories. Mortality data was collected up to four years after admission. One hundred and eighty nine patients (65 male and 133 female) were admitted, 183 (92%) for NHS continuing care. The overall survival at three months was 47.8% and 38.5% at six months. In total 1585 interventions were recorded, 56.3% of admissions required one or more major intervention. Seventy eight (75.7%) of these were managed in the continuing care setting avoiding transfer to an acute hospital bed. Older people resident in NHS continuing care have a short life expectancy and require frequent medical interventions. Much of this can be provided in the NHS continuing care setting avoiding admission to the acute sector. Shift of care for these patients to private nursing homes may not provide such support.