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

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7388.530 (Published 08 March 2003) Cite this as: BMJ 2003;326:530
  1. Ronald T Hsu, clinical lecturer in epidemiology and public health (rth4{at}leicester.ac.uk),
  2. Paul C Lambert, lecturer in medical statistics,
  3. Mary Dixon-Woods, senior lecturer in social science and health,
  4. Jennifer J Kurinczuk, senior lecturer in reproductive and perinatal epidemiology
  1. Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 6TP
  1. Correspondence to: R T Hsu
  • Accepted 23 December 2002

Abstract

Objective: To assess the effect of an NHS walk-in centre on local primary and emergency healthcare services.

Design: Before and after observational study.

Setting: Loughborough, which had an NHS walk-in centre, and Market Harborough, the control town.

Participants: 12 general practices.

Main outcome measures: Mean daily rate of emergency general practitioner consultations, mean number of half days to the sixth bookable routine appointment, and attendance rates at out of hours services, minor injuries units, and accident and emergency departments.

Results: The change between the before and after study periods was not significantly different in the two towns for daily rate 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 hours services (0.07/1000 population, −0.06 to 0.19). However, attendance at the local minor injuries unit was significantly higher in Loughborough than Market Harborough (rate ratio 1.22, 1.12 to 1.33). Non-ambulance attendances at accident and emergency departments fell less in Loughborough than Market Harborough (rate ratio 1.17, 1.03 to 1.33).

Conclusions: The NHS walk-in centre did not greatly affect the workload of local general practitioners. However, the workload of the local minor injuries unit increased significantly, probably because it was in the same building as the walk-in centre.

What is already known on this topic

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

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

Footnotes

  • Funding NHS walk-in centre local evaluation funding from the Department of Health. JK is funded by a National Public Health Career Scientist Award from the Department of Health and NHS Research and Development Programme (PHCS 022). The guarantor accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

  • Competing interests None declared.

  • Accepted 23 December 2002
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