There have been a plethora of studies investigating access issues in relation to health services but until recently a relative lack of research on geographical factors that may be influencing utilisation patterns. This paper includes a timely review on what is known from existing studies, a description of the main methodological concerns highlighted by such studies and draws on the review to present some ideas for more research in this area. The use of Geographical Information Systems (GIS) in investigating the relative importance of geographical factors on utilisation patterns is advocated through a review of published studies and a call made for more research to examine potential relationships with for example health outcomes. Recent advances with regard to the availability of detailed geographically disaggregate data and new location-based techniques such as developments in Global Positioning Systems (GPS) hold out great promise in such regards. Finally the policy relevance of such studies is re-iterated in terms of helping to tackle perceived inequities in the system, addressing health inequalities as well as gauging the effectiveness of current and planned service configurations.