NHS :: NHS walk-in centers do not cut GP waiting times

There is no evidence that walk-in centers shorten waiting times to see a general practitioner, say researchers in a BMJ study published online today.

NHS walk-in centres are primarily nurse-led, have wide opening hours and provide information and treatment for minor conditions without the need for appointments. One of their aims is to relieve the pressure on access to primary care by freeing up time during normal practice surgery hours for patients who need to see their GP.

There are concerns that they increase demand rather than reduce the workload for primary care, but the evidence to date is inconclusive.

The study took place from April 2003 to December 2004 and involved 2,509 general practices in 56 primary care trusts in England, and 32 walk-in centres within 3km of at least one of these practices. Data collection included distance from a practice to the nearest walk-in centre.

There was a clear increase in the percentage of practices achieving the target waiting time of less than 48 hours to see a GP over the 21 month study period, but there was no evidence that walk-in centres contributed to shorter waiting times. Waiting times were longer in more deprived areas and shorter in larger practices.

These results are consistent with a previous study that found no effect of a single walk-in centre on workload or waiting times in nearby practices, say the authors.

There are a number of possible explanations for this apparent lack of effect. Walk-in centres may have created more demand by seeing patients who would otherwise not have attended for health care. Alternatively, duplication of services could have arisen due to patients being referred back to their GPs.

Walk-in centres are part of an increasingly complex network of primary care and first contact services for health care and may extend and at times potentially duplicate rather than offer an alternative for care provided by GPs, they say.

“We found no evidence that walk-in centres shortened primary care access waiting times and our study does not support the use of walk-in centres for this purpose.”

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