This report examines the nature of emergency admissions in London, pointing out that the main peaks in demand appear to be due to respiratory disease during the Christmas period. Chronic disease in the elderly is a major factor, and residents of the East End of London seem to be affected more than average. All these peaks are happening at the same time every year and are therefore highly predictable. Improved management of these patients might alleviate pressures on hospitals during busy periods, and a number of methods by which this can be achieved are proposed.