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

• Published in: BMJ Vol. 326; no. 7388; pp. 530 - 532
• Main Authors: Hsu, Ronald T, Lambert, Paul C, Dixon-Woods, Mary, Kurinczuk, Jennifer J
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 08.03.2003; British Medical Association; BMJ Publishing Group LTD; BMJ Publishing Group; BMJ Publishing Group Ltd
• Edition: International edition
• Subjects: After-Hours Care - utilization; Ambulatory Care - utilization; Ambulatory Care Facilities - utilization; Appointments and Schedules; Biological and medical sciences; Confidence intervals; Data collection; Emergency departments; Emergency Medical Services - utilization; Epidemiology; Family Practice - statistics & numerical data; General practice; Health and social institutions; Health care; Health care industry; Health care services; Health Services Accessibility; Humans; Medical sciences; Observational studies; Organization; Patient Acceptance of Health Care - statistics & numerical data; Physical trauma; Population; Population dynamics; Population growth rate; Primary Care; Primary health care; Primary Health Care - utilization; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; State Medicine - utilization; Studies; Workloads; United Kingdom; Europe; UK; Human; Emergency department; Primary health care; Public health organization; Public health
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.326.7388.530

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 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