Walk-in centres have little effect on inequalities, says report

NHS walk-in centres are having little impact on unequal access to primary care services, with the majority of users being affluent, young and/or white, according to a survey of global evidence and research.

The analysis by Angela Coulter from Picker Institute Europe, and the Healthcare Foundation, examined research from Canada, the US, Australia and the UK.

It says walk-in centres can reduce continuity of care, while there is no evidence that they ease the burden on other services. But it acknowledges the high value placed on the convenience, flexibility 'and in some cases anonymity' of the service, by their users.

The report cites a previous analysis which reported high levels of user satisfaction but high levels of duplication, with about half of users going on to consult their GP about the same problem. The same study found costs in walk-in centres at£22.45 per consultation, compared with£15 for GPs and£7 for nurses.

The study, which reviewed the evidence on a range of 'patient-focused interventions', concludes that while traditional services do not meet the level and flexibility of access demanded by the public, the NHS should explore further options, like e-mail and telemedicine, as well as walk-in centres. It also calls for further research.

Tower Hamlets primary care trust in East London has two walk-in centres, and one of the most diverse populations in the UK in terms of extremes of wealth and diversity of race. Director of primary care Andrew Ridley said the purpose of this type of service was not simply to reduce demand. 'It's about responding to the more consumer-related need for easier access.'

'We have one centre in Whitechapel and one in Canary Wharf. If you live outside London and commute to work how else are you going to see a doctor?'

A Department of Health spokesperson said walk-in centres had been introduced to make primary care services more accessible, and that other initiatives were being introduced to tackle inequalities.

• As HSJ went to press, the company running the Canary Wharf centre said it had launched an investigation into safety concerns raised by the centre's lead GP, who has resigned.