Impact of NHS walk-in centres on the workload of other local healthcare providers: time series analysis

Abstract

Objectives: To assess the impact of NHS walk-in centres on the workload of local accident and emergency departments, general practices, and out of hours services.

Design: Time series analysis in walk-in centre sites with no-treatment control series in matched sites.

Setting: Walk-in centres and matched control towns without walk-in centres in England.

Participants: 20 accident and emergency departments, 40 general practices, and 14 out of hours services within 3 km of a walk-in centre or the centre of a control town.

Main outcome measures: Mean number (accident and emergency departments) or rate (general practices and out of hours services) of consultations per month in the 12 month periods before and after an index date.

Results: A reduction in consultations at emergency departments (-175 (95% confidence interval -387 to 36) consultations per department per month) and general practices (-19.8 (-53.3 to 13.8) consultations per 1000 patients per month) close to walk-in centres became apparent, although these reductions were not statistically significant. Walk-in centres did not have any impact on consultations on out of hours services.

Conclusion: It will be necessary to assess the impact of walk-in centres in a larger number of sites and over a prolonged period, to determine whether they reduce the demand on other local NHS providers.

Figure 1

Mean number of consultations per month across nine emergency departments in the 12 months before and after the opening of a walk-in centre

Figure 2

Consultation rate per month in general practices in walk-in centre sites and control sites. The lines represent the mean

Figure 3

Mean consultation rate per month across out of hours services in the 12 months before and after the opening of walk-in centres