Admissions to a hospital for people with intellectual disabilities over a 20-year period were examined against the background of changes in community-based social and health-care provision. Short-and long-term admissions were analysed in the three phases: baseline (prior to the development of community support teams), community support teams only and community support teams plus specialist services for behaviouraYpsychiatric and social needs. The development of community support teams had no significant impact on the rate of overall hospital admissions but was associated with a reduction in long-stay admissions (an increase also occurred in community residential provision, however). The introduction of specialist services was associated with reductions in rates of both long-and short-term admissions. The new infrastructure of community services appeared to reduce the dependency on hospital provision over the study period, although it had not proved possible to completely eradicate new long-stay admissions. Methodological problems with the study are discussed.