Background In recent years, there has been a growing impetus to offer services for people with early psychosis. This paper describes a survey undertaken as the basis for the development of an early psychosis service. Rates of psychosis are known to differ between cities and rural areas and between ethnic groups. Identifying service needs is enhanced if the social and demographic characteristics, as well as the incidence, of people with psychosis in a given catchment area are known. Method The present study identified all presentations of people aged 16 or over with first and second episodes of psychosis in a 6-month period within a specified South London catchment area. A follow-up was carried out at 1 year. Results This survey confirmed existing knowledge on the social and service needs of this population, in finding high rates of unemployment and homelessness, poor engagement with services and frequent involuntary pathways to mental healthcare. Sub-groups were also identified with specific needs, which are less often cited in the literature, such as groups of asylum seekers and people with young dependants. Conclusions The results of the survey indicated that existing services were not adequately meeting the needs of people with early psychosis. They have been used to inform the development of an innovative service for people with early psychosis. The plans for this service are described.