Salisbury, Chris, Hollinghurst, Sandra, Montgomery, Alan, Cooke, Matthew (Professor of clinical systems design), Munro, James F., Sharp, D. (Deborah) and Chalder, Melanie. (2007) The impact of co-located NHS walk-in centres on emergency departments. Emergency Medicine Journal, Vol.24 (No.4). pp. 265-269. ISSN 1472-0205

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Abstract

Objectives:
To determine the impact of establishing walk-in centres alongside emergency departments
on attendance rates, visit duration, process, costs and outcome of care.
Methods:
Eight hospitals with co-located emergency departments and walk-in centres were compared
with eight matched emergency departments without walk-in centres. Site visits were
conducted. Routine data about attendance numbers and use of resources were analysed. A
random sample of records of patients attending before and after walk-in centres opened
were also assessed. Patients who had not been admitted to hospital were sent a postal
questionnaire.
Results:
In most sites, the walk-in centres did not have a distinct identity and there were few
differences in the way services were provided compared with control sites. Overall, there
was no evidence of an increase in attendance at sites with walk-in centres, but considerable
variability across sites. The proportion of patients managed within the four-hour NHS target
improved at sites both with and without walk-in centres. There was no evidence of any
difference in re-consultation rates, costs of care or patient outcomes at sites with or without
walk-in centres.
Conclusions:
Most hospitals in this study implemented the walk-in centre concept to a very limited extent.
Consequently there was no evidence of any impact on attendance rates, process, costs or
outcome of care.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Emergency medical services -- Great Britain, Triage (Medicine) -- Great Britain, Primary care (Medicine) -- Great Britain, Health services accessibility -- Great Britain
Journal or Publication Title:	Emergency Medicine Journal
Publisher:	BMJ Group
ISSN:	1472-0205
Official Date:	April 2007
Volume:	Vol.24
Number:	No.4
Page Range:	pp. 265-269
Identification Number:	10.1136/emj.2006.042507
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	Great Britain. Dept. of Health (DoH)
References:	(1) NHS Executive. NHS Primary Care Walk-in centres HSC 1999/116. Leeds.1999 (2) Department of Health. Creating a Patient-led NHS. Delivering the NHS Improvement Plan. DH Publications Orderline. 2005 (3) Grant C, Nicholas R, Moore L, Salisbury C. An observational study comparing quality of care in walk-in centres with general practice and NHS Direct using standardised patients. BMJ 2002; 324:1556-1559. (4) Salisbury C, Manku-Scott T, Moore L, Chalder M, Sharp D. Questionnaire survey of users of NHS walk-in centres: observational study. British Journal of General Practice 2002; 52:554-560. (5) Chalder M, Sharp D, Moore L, Salisbury C. Impact of NHS walk-in centres on the workload of other local healthcare providers: time series analysis. BMJ 2003; 326(7388):532. (6) Salisbury C, Chalder M, Manku-Scott T, Nicholas R, Deave T, Noble S et al. The National Evaluation of NHS Walk-in Centres: Final report. Bristol, University of Bristol. 2002 (7) Cooke M, Fisher J, Dale J, McLeod E, Szczepura A, Walley P et al. Reducing Attendances and Waits in Emergency Departments: a systematic review of present innovations. London, NCCSDO. 2004 (8) Munro J, Mason S, Nicholl J. Effectiveness of measures to reduce emergency department waiting times: a natural experiment. Emergency Medicine Journal 2006; 23(1):35-39. (9) Locker TE, Mason SM. Analysis of the distribution of time that patients spend in emergency departments. BMJ 2005; 330:1188-1189. (10) Murphy AW. 'Inappropriate' attenders at accident and emergency departments II: health service responses. Family Practice 1998; 15(1):33-37. (11) The NHS Plan. A plan for investment. A plan for reform. London, Department of Health. 2000
URI:	http://wrap.warwick.ac.uk/id/eprint/3167

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