What is the role of walk-in centres in the NHS?

In April 1999 the Department of Health authorised funding for a pilot scheme of 40 NHS walk-in centres in 30 towns and cities across England,1 the first of which opened in January 2000. The overall aim of walk-in centres is to improve access to high quality health care in a manner that is both efficient and supportive of other local NHS providers. It is hoped that the centres will complement other primary care initiatives such as NHS Direct, playing a major part in the government's commitment to modernise the NHS. Key features of NHS walk-in centres are shown in the box.2 #### Key features of NHS walk-in centres Wide opening hours (usually 7 am to 10 pm every day) Walk-in access, without the need for an appointment Convenient location Provision of information and treatment for minor conditions Offer health promotion, supporting people in caring for themselves Build on, not compete with or duplicate, existing services Maximise the role of nurses; use of skill mix Nurses supported by computerised software for clinical assessment Good links with local general practices Services that meet the needs of their identified population The establishment of walk-in centres within the NHS has been controversial. The claimed advantages are that centres improve access to health care through wide opening hours, a convenient location, and minimal waiting without an appointment. By using software for clinical assessment, nurses should be able to provide high quality care for patients, reducing demand on other NHS services and maximising efficiency. Such centres may also increase the appropriateness of patients' problems seen by other NHS providers by encouraging self care and helping people to identify when they need to consult a doctor. Critics have put forward several counter-arguments.3 Walk-in centres may increase access primarily for affluent people, thus increasing health inequalities. Increased accessibility may increase total demand …