This site is intended for health professionals only

At the heart of general practice since 1960

Walk-in centre linked with 26% reduction in daytime A&E visits

Researchers have linked the opening of a walk-in centre to a significant fall in the numbers of daytime attendances for minor ailments at A&E.

The first-ever study of the impact of a new GP-led walk-in centre on other NHS services found a statistically significant 26% reduction in daytime attendances at the adult emergency department after the opening of the centre.

There was also a 7% reduction after the walk-in centre opened at the children’s A&E department, after attendances were adjusted for seasonal fluctuations.

GP led walk-in centres, also known as Darzi centres, or polyclinics, were established in England in 2009 to improve access to GPs as well cut A&E attendances.

However, a recent review by the competition regulator Monitor suggested CCGs were closing walk-in centres as they believe they are ‘paying twice’ for primary care services when patients were registered with local GPs.

But the researchers surveyed over 500 patients visiting the walk-in centre in Sheffield - over a three week period during September and October 2011 – and found 14% said they were diverted from going to the emergency department during the survey period as a result of the establishment of the walk-in centre, the researchers said.

Lead author Dr Mubashir Arain, postgraduate research student at the University of Sheffield said: ‘This reduction was not mirrored in changes in night-time attendances (when the walk-in centre was closed) and our survey responses suggested people some people were diverted from going to the emergency department, it is possible that the opening of the walk-in centre caused this reduction.’

The study was published this month in the journal Emergency Medicine.

Readers' comments (8)

  • What was the overall increase in demand across both services? Generally, the increase in demand as a result of making getting in easier will outstrip the shift.

    Unsuitable or offensive? Report this comment

  • Walk in centres were rolled out country wide. If this truely did make a significant shit in work load, why has AED attendance increase proportionately as expected over the last 10 years?

    It just doesn't make sense, I think they are deliverately looking at macroscopic picture to validate their point, rather then looking at the whole picture.

    Unsuitable or offensive? Report this comment

  • What isnt quoted is what the walk in centre was being paid per patient, compared to A&E. Having closed a walk in centre that was being paid £120 per attendance which usually lasted only a few minutes, you can see that costs are very relevant. A study of only 500 patients over three weeks is statistically too small to arrive at a trend especially as only 70 thought they might have gone to A & E. An analysis of what the patients had gone to the walk in centre for would have been useful as well as what the access times to their practices were.

    Unsuitable or offensive? Report this comment

  • As a medical Director for a group of practices and Walk in centres and as a practicing GP, I was involved in the opening of many and the shutting diwn if a few too.
    The Walk in centre closure phenomenon was purely due to knee jerk cost cutting by PCTs and small minded GP colleagues in CCGs who looked in at the WICs as a threat to their own General practices.
    Frankly, the whole process of forced closures was ill thought out. We as Gps could have worked with the new providers and used this service to the advantage if our own patients and practices as our services are getting increasingly stretched. Patient demand and a rise in expectations is to contribute to increase in A&E attendances.
    If you are a CCG commissioner, Place a privately procured WIC right next door to A&E and charge a national GP led WIC tariff of £40 per patient attendance (still lesser than A&E tariff) and see the unscheduled care attendance tumble at A&E. The only additional costs might be a set up cost in year one. We as GPs need to learn to procure more cleverly and be more commercially savvy which our CCG colleagues are only learning to gradually.
    I have come across wasteful costs for community Nursing treatment room services and nurse led walk in services that cost over £70 per appointment and is a sheet waste of resources.

    Unsuitable or offensive? Report this comment

  • 500 patients : 14% said diverted from A/E = 70 patients in the 2 month study period = 1/day cost per case diverted = 500*£120/70 = £858

    Unsuitable or offensive? Report this comment

  • Ivan Benett

    WIC is only a short term fix, which is why we need to be cautious about such interventions. It leads to altrered behaviour of the local population that ultimately means higher attendances in innappropriate settings.
    If a drug leads to reduced hospitalisations, that's great, but we would also want to know long term consequences like all-cause mortality, functional recovery etc. So too we need to be aware of the long term consequences of changes in access....that's why were going to keep a close eye on the longterm consequences of increasing GP availability 8-8 and at weekends, as well as the short term benefits.

    Unsuitable or offensive? Report this comment

  • We dont need in WIC we need more GPs so access is better

    Unsuitable or offensive? Report this comment

  • Bring back the GP led WIC, as mentioned above , place them in front of A&Es and see the unscheduled attendance including admissions costs falling and patient satisfaction levels shooting up !
    Gag the ill intentioned loud GPs in neighbouring areas who think they are going to lose patients as happened in Erewash, South Derbyshire. When I worked there as a part time GP for the WIC, the care afforded to patients was of the highest calibre and the patient satisfaction levels highest amongst practices I have worked at. Local GP practices benefitted by sending their urgents into the surgery and the patients did not have to travel to Nottingham or Derby to attend A&E. A neighbouring practice who persistently offered extremely poor access was the loudest anti-WIC voice as hey felt threatened by the WIC and of losing patients to them.
    We are such a conflicted bunch, I am surprised patients trust us as much !'!
    Interestingly there was a nurse led minor injuries unit alongside the same GP led WIC, interestingly the Nurse led "minor injuries "unit was funded almost twice as much as the GP led WIC on a patient by patient basis when the block contract figures were take apart. How sensible are our local CCGs when they make such poorly thought out decisions! He GP lakes WIC is closed and the unaffordable nurse led Minor injuries unit us still open !!

    Unsuitable or offensive? Report this comment

Have your say