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