The author describes the health problems of homeless people, concentrating on London, and how services for homeless people could be improved. This could be delivered within the National Health Service in an integrated service. The author also looks at why so few homeless people are registered with a general practitioner; examples of good practice which have overcome some of these barriers; planning services for homeless people; introduction of the internal market and the purchaser/provider split into the NHS in 1991; the work of Access to Health; and steps for action in improving services.