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This paper describes the results of a research project investigating activity levels and consumer perceptions at two contrasting day hospitals for the elderly. Day hospitals traditionally function on a medical model with an important emphasis placed on treatment and discharge. Their claim to provide a therapeutic regime has been questioned however, the suggestion being that there are higher levels of such activities in day centres. The results of this study demonstrate that activity levels at day hospitals are far higher than previous research indicates but that the emphasis on discharge is contrary to the expressed needs of the majority of consumers. In view of the prevailing demographic trends the paper concludes with suggestions for service innovation with specific reference to the role of the nursing profession.