Elsevier

Public Health

Volume 119, Issue 1, January 2005, Pages 39-44
Public Health

What do other local providers think of NHS walk-in centres? Results of a postal survey

https://doi.org/10.1016/j.puhe.2003.12.014Get rights and content

Abstract

Objectives. To ascertain the views of other providers of primary and emergency healthcare services about their local walk-in centre.

Design. Postal survey.

Setting and participants. National Health Service healthcare providers (general practitioners (GPs), practice nurses, pharmacists, Accident and Emergency (A and E) consultants) working in close proximity to 20 English walk-in centres.

Results. The overall response rate to the survey was 79% (n=1591). Nearly one-third of respondents felt that patient expectations had increased since their local walk-in centre opened, although this varied across the different sites. Some providers had noticed a reduction in their workload, but 15% claimed that workloads had increased since their local walk-in centre opened. There was broad agreement that these new centres did address issues of access and that they provided appropriate care of a reasonable quality. Communication between walk-in centres and other local healthcare providers was an area of considerable concern; GPs, in particular, were anxious about the impact of the service on continuity of care. There were clear differences of opinion between different types of health professional, with doctors tending to be more critical and practice nurses being more supportive.

Conclusion. It has been suggested that healthcare professionals, notably GPs, are universally opposed to the concept of walk-in centres. This survey shows that opinions were divided, but overall, more local providers were in favour of this new service than were opposed to it. There was more support for centres co-located with A and E departments than ‘shop-front’-type facilities, but there were concerns that the service offered was too limited. The success or otherwise of the walk-in centre initiative will depend, in part, on building good relationships between the centres and other local providers. Understanding the views of local providers is important for those developing walk-in centres, and for those engaged in planning services in the wider health economies where these services are placed.

Introduction

National Health Service (NHS) walk-in centres were created in January 2000 to address issues of access and unmet need in primary care, and to meet public expectations about the delivery of modern primary care services. Earlier national survey work had revealed that one-quarter of patients waited 4 or more days for an appointment with their GP, and nearly one-fifth of those surveyed felt that this was unacceptable.1 Over the following 2 years, 43 walk-in centres were established as pilot sites in major towns and cities across England. Their brief was to provide nurse-led primary care for minor illnesses and injuries (such as sore throat, sprains, etc.), and they had extended opening times, typically opening between 7 a.m. and 10 p.m. to facilitate access without appointment systems. The first 40 of these centres were part of a national multimethod evaluation commissioned by the Department of Health, conducted by an independent research team based at the University of Bristol, between June 2000 and November 2001.

The establishment of these walk-in centres within the NHS was highly controversial. Other providers of health care were reported to be sceptical or hostile towards this new type of service.2., 3., 4., 5. As part of the national evaluation, we sought the views of healthcare providers working close to 20 of the pilot sites. The opinions of these healthcare professionals are important because: (1) they are perceived as being one of the most important potential barriers to the success of walk-in centres;6 (2) they offer insight into whether walk-in centres enhance the efficiency of other healthcare services in the area (one of the key intended roles of walk-in centres); and (3) they may suggest ways in which these centres might be improved.

Section snippets

Methods

The evaluation identified four types of walk-in centre according to location and proximity to other types of health service. These were: ‘high street or shop front’, ‘co-located with primary care’ and ‘hospital site’—subdivided into those sites with or without Accident and Emergency (A and E) facilities.7 Six shop-front, six co-located and eight hospital (five with and three without A and E) walk-in centres were selected for the survey as broadly representative of the 40 sites in the

Results

A total of 1584 completed questionnaires and seven incomplete questionnaires were returned following two reminders. Eighty-six of the original sample had to be excluded as their questionnaires were returned as ‘not listed at this address’. The overall response rate was 79% (1591/2019), comprising a 77% (n=914) response rate from GPs, 86% (n=341) from practice nurses, 76% (n=44) from A and E consultants and 78% (n=285) from community pharmacists. The response rates related to individual walk-in

Discussion

Although it is important to learn lessons about walk-in centres at an early stage, it was difficult to assess their impact on other local healthcare services when some centres had only been operational for a matter of months. This survey complements existing work that has explored public and users' views of this new service,9., 10. and benefited from a large sample and high response rate, such that the findings can be regarded as representative of providers working close to walk-in centres.

Acknowledgements

This research was funded by the Department of Health. The views expressed are those of the authors and not necessarily those of the Department of Health.

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Cited by (0)

1

On behalf of the National Walk-in Centre Evaluation Team, Bristol.

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