Walk-in centre closures spark warning on care

The watchdog Monitor said the problems may be worst where there are difficulties accessing local GP services.

The NHS set up 238 walk-in centres in the last decade to improve access to GP care and be more responsive to patients’ needs.

Research for the regulator found 185 were still operating in England which were particularly popular among young adults, women and vulnerable social groups.

But it said significant numbers had closed amid complaints from health chiefs they pay twice for patients registered with their GP and also visiting walk-in services.

Among those which have shut in Yorkshire are centres in Barnsley and a city centre service aimed at commuters in Leeds.

Other surgeries have had their opening hours cut including centres in Todmorden, Halifax, Dewsbury, Scunthorpe and Bradford, which was the first to open in the country under a flagship programme launched by Labour in 2008. Contracts for the service in the city are expected to be extended to next September but a consultation is underway over the future of the centre amid a wider examination of urgent care in Bradford.

Monitor ordered the review amid concerns the closures were hampering access to care.

Researchers were told by NHS chiefs that the centres were generating “unwarranted demand for services” and led to duplication as patients used their own GP practice and the walk-in service for the same problems, leaving them paying twice.

In preliminary findings ahead of a final report in January, the regulator said closures could adversely affect patients’ access to care where there were problems with access to local GP practices, while it also limited the capacity of the NHS to reach people who traditionally did not seek care.

It found that payment mechanisms discouraged NHS chiefs from providing walk-in care even if it was cost-effective and did not encourage GPs to improve the quality of their services in the face of competition from walk-in surgeries.

Monitor’s executive director of co-operation and competition, Catherine Davies, said: “Some commissioners told us they end up paying twice for treating patients at walk-in centres who are already registered with a GP.

“We are now asking for views on whether the payment system should be reformed to fix this.

“While it is for commissioners to decide whether to keep a walk-in centre open, we need to make sure that the needs of patients are fully considered before decisions are taken.”

Most walk-in centres are open seven days a week for extended hours and do not require pre-booked appointments.

Monitor found Mondays or Saturdays are the busiest times for most walk-in centres. Four out of five users it surveyed said they received treatment they needed and would visit again.

David Worksett, chief executive of NHS Partners Network, which represents private providers, some of which provide walk-in services, said the report confirmed concerns it had raised a year ago.

“We particularly support the recommendations around tackling the problems of ‘split commissioning’ and unhelpful payment systems,” he said.

“Walk-in centres play an important role in meeting the health needs of an increasingly large number of people whose lifestyles mean that traditional forms of primary care are not able to meet their needs. It is deeply unsatisfactory that at the time when the importance of new, more flexible ways of accessing GPs is being emphasised, so many walk-in centres have already closed or have an uncertain future.”