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One in four NHS walk-in centres has closed, warns regulator

Almost a quarter of NHS walk-in centres have closed in just three years - leaving patients unable to access the care they need, a health regulator has warned.

The centre closures risk “increasing health inequalities” among patients who have difficulty accessing GP services, including workers unable to take time off to see their family doctors, Monitor said.

Despite the popularity of the centres, since 2010 a total of 53 of England’s 238 walk-in centres have closed, according to the regulator’s review into the service, and more are under threat of closure.

Monitor has suggested that, in areas where the centres have closed, patients may not be able to access the care they need.

The centres are particularly popular among young adults, women and poorer people, according to the preliminary report.

In addition, people who use the service include those who find it difficult to access GP services such as the homeless and groups facing language and cultural barriers.

Workers, students and people not registered at a GP practice also use the centres.

“Accessing traditional GP practices often requires people to take time off work, yet this can be difficult or simply not possible for some,” the report states.

“The extended and weekend opening hours of walk-in centres, as well as the locations of some in city or town centres, allow those finding it difficult to take time off work to attend to primary care needs, including seeking preventative services and routine checks for chronic conditions.”

The authors added: “Overall, the evidence we collected suggests that walk-in centre closures, or possibly relocations/reconfigurations, can risk increasing health inequality if suitable alternatives are not put in place.”

Monitor found that the centres were closed for a number of reasons.

Local health bosses sometimes believed the centres were generating “unwarranted” demand with many “worried well” attending.

But a patient poll carried out among 2,000 walk-in centre users found that just 8% would treat themselves at home if the service was not available, 21% would go to A&E and a third would visit their GPs.

In some cases the attendances exceeded expectations and the centres were shut because they were “too popular”, officials said.

Monitor’s inquiries lead, Sondra Roberto, said: “In some cases they were having increased demand and that led commissioners to look at them and close them because they were too popular.

“Sometimes a concern among commissioners is that people are coming in for very minor conditions, and they would rather not spend the resources on things like coughs and colds. But there is a wide variety of things people come in for.”

The regulator said some commissioners felt they were “paying for services twice” because they are compensating GPs to have patients registered at their practices and are also paying the centres for each attendee.

It suggested that the payment system might need to be reformed to fix this situation.

Monitor’s executive director of co-operation and competition, Catherine Davies, said: “We tried to understand a bit about the effect of the closures of walk-in centres.

“First of all, there is an issue of access to primary care service - people are saying they find it difficult to get an appointment with a GP when they want to get it. Walk-in centres therefore provide an alternative to those people who do have difficulty getting an appointment with their GP.

“The other issue that came through is that walk-in centres provide for vulnerable groups of people who are less likely to register with a GP.

“So if a commissioner is thinking about closing a walk-in centre, we’re suggesting that they really need to think through how the health needs of these groups of people will be met.”

The centres - which treat minor illnesses and injuries without an appointment - were a flagship policy of the previous Labour government.

Shadow health secretary Andy Burnham said: “NHS walk-in centres are popular with patients and an important means of relieving pressure on A&E. When hospitals are under so much pressure, it makes no sense to close so many walk-in centres.

“People need services and support seven days a week and that is why the last government introduced NHS Direct and walk-in centres. The decision to dismantle them is one of this government’s worst acts of vandalism and patients are paying the price.”

Health minister Lord Howe said: “Patients should be able to access good-quality out-of-hours NHS services without having to go to an A&E. Walk-in centres may be part of the answer but this isn’t a one-size-fits-all solution. Family GPs, community services and pharmacists all have a part to play and it’s good that Monitor is looking at how walk-in centres fit in.

“We’re working with NHS England to ensure services are tailored to the local needs of patients and we’ve agreed a £3.8bn integration fund to help join up health and care services.”

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Readers' comments (12)

  • Our WIC at Mitcham was packed week in and week out providing a huge variety of services to many very sick patients who could not get an appointment with their GP. In fact some receptionists were telling their patients that the WIC was an extension of their surgery and to just 'pop down'. The GP opening hours and system for making GP appointments was totally unacceptable hence the popularity of the WIC. But local commissioners did not like it's popularity and were trying to force it to close down- bizarre!!

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  • The excellent Walk-in centre at St George's has closed and supposedly now is working out of the A&E department at St George's. There are even longer waits at A&E now as people go there. I find it incredible that Walk in centres have been closed because they were 'too popular'. Why not work out why? This govenment keeps on interfering with things that are either good or are doing well. If the centres were so popular, ask why? If it is due to poor hours and lack of appointments at GP practices, then invest the money first before closing the W-I centres. I can vouch for the fact that it is so difficult to get an appointment at the GP practice. People want and need a responsive service. A chest infection can escalate to pneumonia; Tonsillitis can escalate to an abcess; Conjunctivitis can get worse and become infected. These may be deemed non-urgent cases but without appropriate advice and care then what appears minor may become urgent. The walk-in centres provided a near instant service. As an example of what was good about the W-I service at our hospital... I was at work and started to get an extremely irritated eye. Nothing helped. I was in extreme pain and the eye got progressively worse and reddened over a matter of a couple of hours. I was not ill but needed to see someone. I could have gone to A&E but because the walk- in centre was on site, I went there and they found an eyelash had become bent under the eyelid and needed removing. I was at risk of possible conjuntival injuy had I not had it seen immediately. Hooray for the walk in centre. In minutes, my eye was better. I could have waited 4 hours plus to been seen in A&E, wasted their time for such a simple thing and waited days to see my GP. I might have ended up taking time off work. The Walk-in centres prevented those people turning up at A&E and minor issues getting worse. So.... either reinstate them or give set up the GP's practices to be able to cope with the obvious demand.

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  • I have needed to use walk in centres on several occasions at weekends for infections or other acute problems that would have got worse if I had not received appropriate timely treatment. Medication I normally take for long term conditions limits when I can drive and get to my own GP, so instead of getting my self to a centre I would otherwise of had to call a doctor out or let an infection take hold before getting an appointment that I could get my self to.The walk In centre is more wheelchair friendly!

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  • Yep, WIC's do an amazing job. Personally, I think many patients would rather have access to a WIC than their GP. Maybe it's time to divert money from certain 'failing' GP practices and use it to fund services that patients actually want.

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  • GPs' have become too greedy and limited in what they are prepared to give. The NHS is at breaking point but GPs' continue to make demands wihout giving much, no wonder so many junior doctors I speak to, want to be a GP, cannot blame them damm good money and good working hours.

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  • The place of WICs in primary care delivery cannot be written off.My colleagues and I have benefited immensely from the readily care available at WICs when most of our GP appointments may be days away and we needed urgent attention.Let's keep with what works!WICs must be maintained and adequately resourced.

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  • I accidentally cut my hand ! A relatively minor injury which required a few sutures.

    The moronic idiot "nurse practitioner" that I consulted at the "walk in center" insisted I had to attend A/E "because a "tendon" might be involved". Totally incorrect advice from a clown. .

    Yes close these places down !

    NB

    I am an A/E nurse practitioner!

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  • Anonymous | 12-Nov-2013 12:51 pm

    you can't colour all nurses in a WIC from one experience. I work with stroke patients, and the number of TIA pts that have been sent home from A&E, only to return with a full blown stroke is devastating. However, it seems getting better, thank goodness, although still happening.

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  • Anonymous | 12-Nov-2013 12:51 pm

    "NB

    I am an A/E nurse practitioner!"

    Well perhaps you should reflect on your need to call a colleague a "moronic idiot" and a "clown". Not the behaviour that is appropriate for someone claiming to be an A&E nurse practitioner. I am sure that you have many mistakes in your life and in your career. You ignorant comment being one for all to see.

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  • Anonymous | 13-Nov-2013 11:44 am

    I agree totally! The comment from: Anonymous | 12-Nov-2013 12:51 pm is disrespectful and unprofessional.

    I have worked in a walk in centre as an ANP as well as A&E and I have to say that I have seen good and bad in both, but I would never call someone a "moronic idiot or clown"! Also if the A&E practitioner was so proficient why didn't he challenge the WIC practitoner and advise him of what was appropriate for his injury!



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  • 'I am an A&E practitioner'
    Are you sure?
    Please reply to your previous posting and let us know if it was?
    Having said that, one must go easy on the typing had it been a tendon or two. As previous posters have commented. Calling a colleague (in a professional context) a 'moronic idiot' on an open forum when the former highlighted the possibility that your injury warranted further investigation! Well, that highlights the need for restraint when posting comments, especially anonymously.
    As a senior, competent and skilled nurse (?). You should be ashamed of yourself? The only reason I have not reported your comment as 'unsuitable or offensive', is so that you may read it again and think about your behaviour. Presently, most nurses are embarrassed for you.
    Damian.

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  • Blackpool would not function without the walk in centre.

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