Urgent care centres appear to have low productivity rates and lack clear data allowing commissioners to tell whether they are value for money, according to a report published today.
A review of 15 urgent care centres visited by research organisation the Primary Care Foundation found they treated between 1.5 and three cases per clinical hour.
It said that “most clinicians with whom we discussed these findings, knowing the case mix, felt that this level [rate of treatment] was low”.
The foundation’s report, Urgent Care Centres: what works best?, contrasts the range of 1.5 to three cases per clinical hour at urgent care centres with a range of 1.5 to five cases for out-of-hours services when patients are seen face to face in primary care centres. It also highlighted the confusion faced by the public about the range of services and opening hours at the centres.
Three kinds of urgent care centre were identified: full case mix facilities co-located with an emergency department; stand-alone full case mix centres; and restricted case mix centres - the last of which are “often similar to a walk-in centre but sometimes even more restricted”.
The report found that although there was a wide variation in the treatment available between the 15 centres examined, all of them saw 90-120 cases a day with a predictable pattern of demand.
A literature review accompanying the fieldwork found no “published evidence that urgent care and walk-in centres will reduce attendances at accident and emergency”.
The cost per case at urgent care centres varied from £28-£85 “with most falling in the range of £28-£40” - less than for A&E attendances. However, the authors added: “It proved impossible to obtain comprehensive data that is reliable enough to act as a true cost comparison.”
The publication comes as the Department of Health prepares a report on “A&E nomenclature”, which is expected to attempt to standardise definitions for emergency facilities.
The work being led by Sir John Oldham, a GP and clinical director for the quality, improvement, productivity and prevention programme, could be contentious if it is seen to affect disputes about reconfiguring hospital emergency services.