Over the past few years there has been a growing interest in seeking alternatives to traditionally accepted patterns of in patient care. The reasons for this development are probably complex but are partly attributable to the economics of providing health care. Examples of facilities evolved as a result of this trend are units for day surgery, programmed investigation, five-day wards, and short-stay wards. There are many references to the operation of short-stay observation wards attached to accident and emergency depart? ments,1-4 five-day wards,5 programmed investigation,6 7 and day surgery units.8 9 These references mostly described units developed as discrete entities performing one function only. We describe a unit that from its inception was intended to fulfil three functions?namely, a short-stay observation ward for a major accident and emergency department and an in? vestigation and day surgery unit for both medical and surgical specialties. It is our contention, on the basis of the results for six months, that (a) such a unit can function efficiently and (b) it contributes to making the maximum use of expensive capital resources.