Jim Bethel, Senior Lecturer in the School of Health and Wellbeing
Closure of Walk-in Centres
Recent government suggestions that walk-in centres be closed as a consequence of them not achieving the necessary reductions in Emergency Department (ED) attendance anticipated are ill-conceived.
The fact that ED attendance has continued to increase since the advent of walk-in centres cannot be entirely attributed to their failure; attendance may well have increased in ED anyway and without the centres may have increased more markedly.
I am of the opinion that the failure to reduce ED attendance is in large part due to the change in GP contracts, negotiated in 2004, that allowed this group of clinicians to opt out of providing out of hours care for their patients.
Under these circumstances, and with a current perceived and actual block to primary care access, patients will naturally default to the ED.
It may be simply that in some areas the presence, nature and scope of the walk-in centres has not been publicised as effectively as it could have been. I am aware that in Blackpool, for instance, the ED of the Royal Victoria Hospital manages the care of around 100,000 patients annually, whilst the walk-in centre manages around another 90,000.
Is it feasible to suggest that the ED in Blackpool, along with GP services, will absorb the care of 90,000 patients annually - almost 250 patients a day?
Where walk-in centres are not deemed to be as effective as they might be, then perhaps an exploration of why this is the case should precede any widespread closure of such units.
After all, the failings of the ED at Mid-Staffordshire Hospitals did not lead to any widespread call for the closure of all EDs.