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Walk-in centres create more work

Walk-in centres do not reduce the waiting time to see a GP and may actually be increasing demands on general practice, a large study has shown.

This undermines the Government's argument that one of the benefits of nurse-led walk-in centres would be to free up GP time.

Proximity to a walk-in centre did not increase the likelihood of a practice achieving the 48-hour access target, the study published online by the BMJ found. Instead walk-in centres duplicated existing services.

Study leader Dr Ravi Maheswaran, senior clinical lecturer in public health medicine at the University of Sheffield, said: 'Walk-in centres may have mainly extended the role of first-contact services rather than offering an alternative to GPs. They may have created more demand and seen patients who would otherwise not have attended for health care.

'Patients may have used walk-in centres as a source of a second opinion or to gain reassurance. Some nurses in walk-in centres may have sent patients back to the GP.'

Dr Laurence Buckman, GPC deputy chair, said: 'Walk-in centres have created a new work stream of patients who possibly don't need to be seen by anyone.'

Dr Siraj Shah, a GP in Gravesend, Kent, said: 'Walk-in centres give very little value for money. I have yet to come across anybody who has been to one and had their problem resolved.'

He added: 'They are dangerous – they give drugs without knowing patients' histories.'

But a Department of Health spokesman argued that one of the purposes of walk-in centres was to attract patients who

otherwise would not have

visited a GP.

'This suggests that the centres are making it easier for

people to fit in accessing healthcare around their daily lives – exactly our intention.

'NHS walk-in centres see around three million patients a year and offer extended opening, ensuring treatment or advice even during hours when traditional practices are closed.'

The researchers examined data collected for 2,500 practices across 56 PCTs for the monthly primary care access survey between April 2003 and December 2004 (see box left).

Their results back previous studies that found only non-

significant reductions in GP consultation rates and no impact on waiting times.

Value of centres questioned

• A practice's distance from a walk-in centre had no bearing on its performance on 48-hour access

• The proportion of practices achieving the 48-hour access target increased from 67 per cent in April 2003 to 87 per cent in December 2004, but this was down to GPs' efforts and not linked to the availability of a walk-in centre

• Patients in deprived areas had to wait longer for appointments.

In December 2004 86 per cent

of practices in deprived areas achieved the 48-hour target, compared with 92 per cent in more affluent areas

• Waiting times are shorter in larger practices. In December 2004 90 per cent of practices

with more than 6,050 patients achieved the 48-hour target compared with only 85 per cent of smaller practices with fewer than 3,301 patients.

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