Effect of NHS walk-in centre on local primary healthcare services: before and after observational study

doi:10.1136/bmj.326.7388.530

BMJ 2003;326:530 ( 8 March )

Primary care

Effect of NHS walk-in centre on local primary healthcare services: before and after observational study

Ronald T Hsu, clinical lecturer in epidemiology and public health, Paul C Lambert, lecturer in medical statistics, Mary Dixon-Woods, senior lecturer in social science and health, Jennifer J Kurinczuk, senior lecturer in reproductive and perinatal epidemiology.

Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 6TP

Correspondence to: R T Hsu rth4{at}leicester.ac.uk

Objective: To assess the effect of an NHS walk-in centreon local primary and emergency healthcareservices.
Design: Before and after observationalstudy.
Setting: Loughborough, which had an NHS walk-in centre,and Market Harborough, the controltown.
Participants: 12 generalpractices.
Main outcome measures: Mean daily rate of emergency general practitionerconsultations, mean number of half days to the sixth bookableroutine appointment, and attendance rates at out of hours services,minor injuries units, and accident and emergencydepartments.
Results: The change between the before and after studyperiods was not significantly different in the two towns for dailyrate of emergency general practice consultations (mean difference $-$ 0.02/1000 population, 95% confidence interval $-$ 0.75 to 0.71),the time to the sixth bookable routine appointment ( $-$ 0.24 half-days, $-$ 1.85 to 1.37), and daily rate of attendances at out of hoursservices (0.07/1000 population, $-$ 0.06 to 0.19). However, attendanceat the local minor injuries unit was significantly higher in Loughboroughthan Market Harborough (rate ratio 1.22, 1.12 to 1.33). Non-ambulanceattendances at accident and emergency departments fell less inLoughborough than Market Harborough (rate ratio 1.17, 1.03 to1.33).
Conclusions: The NHS walk-in centre did not greatly affectthe workload of local general practitioners. However, the workloadof the local minor injuries unit increased significantly, probablybecause it was in the same building as the walk-incentre.

What is already known on this topic
Walk-in centres are well established in North America but differ from NHS centres as they are run by doctors not nurses

What this study adds
Introduction of an NHS walk-in centre did not affect the workload of local general practitioners

Attendance increased at the minor injuries unit, which was in the same building

Non-ambulance attendances at accident and emergency departments decreased but not by as much as in the control area

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