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Walk-in centre contracts under review after study exposes high cost-per-patient

By Lilian Anekwe

PCTs across the country are considering the future of their walk-in centres, after research showed they are failing to attract patients and costing hugely more than GP services.

A Department of Health-funded evaluation found some centres in urban areas with populations of millions were seeing as few as 30 patients a day – only around a sixth of projected capacity.

The study focused on commuter walk-in centres in railway stations, but the authors said the findings raised huge question marks about the viability of all 82 of England's centres.

And Pulse has learned a series of PCTs in pilot areas for railway walk-in centres are holding talks about whether the contracts should be renewed when they expire in the next few months.

The research found on average between 33 and 101 patients a day attended each centre – ‘considerably lower than the planned capacity of 150-180'.

If the centres had operated at planned capacity, cost per attendance would have been £13, but it was actually as much as £62 in some centres.

The researchers said this was nearly eight times higher than the £8 per attendance to be seen by a practice nurse for a minor ailment, and more than twice the £30 per attendance with a GP or £35 per attendance at a ‘non-24-hour emergency department'.

The DH launched pilots of six commuter walk-in centres in 2004, awarding five-year contracts to private providers to open three centres in London, and one each at Leeds, Manchester and Newcastle stations. The researchers estimated a total cost to date of £5.6m - ‘a very high price per patient'.

A DH spokesperson insisted the centres provided a ‘valuable service'.

But a spokesperson for NHS Leeds said it was ‘exploring options' and would make a decision on whether to renew the contract by November 2010.

NHS Tower Hamlets said the contract for its centre in Canary Wharf was ‘being reviewed as part of our urgent care strategy'.

A spokesperson for NHS Westminster said its contract was also under review.

Study leader Dr Alicia O'Cathain, senior research fellow at the School of Health and Related Research in Sheffield, questioned ‘whether commuter walk-in centres are the most cost-effective way of increasing access for minor illness'.

Professor Chris Salisbury, who exposed the huge growth in walk-in capacity during his week as guest editor of Pulse last year, was also a researcher on the study.

Professor Salisbury, professor of primary care at the University of Bristol and a GP in the city, said: ‘The DH has to decide whether to encourage continuity of care or, if it wants walk-in centres, it needs to know it has implications for A&E attendance and will waste resources.'

Professor Chris Salisbury: Walk-in centres 'waste resources'

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