Scrutiny of GP practice access compared to walk-in centres

Scrutiny of GP practice access compared to walk-in centres

The impact of England’s walk-in centres on other health services including GP practices should be scrutinised before their future is decided upon, according to Monitor.


The regulator has also advised that CCGs looking at whether or not to commission walk-in-centres should examine those GP practices whose patients have high attendances at such centres to see if access to practices is a problem for patients.


Monitor has published advice alongside its Walk-in centre review: final report and recommendations in which it recommends that local commissioners involve patients when making decisions about the future of walk-in centres.


Monitor suggests that any proposal to close or change the provision of walk-in centres should consider the impact on other local services such as GP surgeries, urgent care, ambulance, and hospital A&E departments.


Between 2000 and 2010, the NHS opened more than 230 walk-in centres across England with the aim of improving patients’ access to primary care and offering patients more choice at times that suited them.


Since the start of 2010, local commissioners have closed more than 50 walk-in centres and there are now 185 left.


Monitor said in its advice that as commissioners prepared to review many of the contracts for walk-in centres, it suggested that joint decision-making would be in the best interests of patients.


Commissioners should publish more information about how and when decisions are made locally, said Monitor, and they should also investigate what patients and community groups thought before closing a service, by carrying out user surveys, sponsoring discussion forums and focus groups, and liaising with local Healthwatch representatives.


Possible scrutiny of GP access is mentioned in the report, which says: “We recommend that commissioners work with any GP practices that have a high number of their patients using a walk-in centre to identify and correct any access or other problems.


“Long-term solutions are needed to address the difficulties that some patients have in accessing primary care, and the difficulties some GP practices have in responding to increasing demand.”


Walk-in centres would work better for patients if payment mechanisms were reformed as the report authors said: “Current payment mechanisms for GP practices and walk-in centres discourage commissioners from offering walk-in centres, even where these may represent a high quality, cost-effective model for delivering services.


“In addition, the payment mechanisms do not strengthen incentives for GP practices to improve the quality and efficiency of their services so that their patients are more likely to choose the GP’s services rather than a walk-in centre.”


Catherine Davies, Monitor’s executive director for co-operation and competition, said: “We found that walk-in centres are most valued today where they were introduced following a careful assessment of local needs, located in an area of the community where the service could be conveniently accessed by those who need it, and procured using a sound process that resulted in value for money.”


The BMA’s chair of council Dr Mark Porter said: “The BMA has always said that the provision of walk-in centres should be based on patient need.


“Commissioners will need to carefully assess existing service provision, local need and the interests of patients when deciding on the future of walk-in centres and how best to efficiently deliver patient care in their area.”

By Adrian O'Dowd

OnMedica, 20th February 2014

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