By Brian WheelerPolitical reporter, BBC News | 28 June 2012
Walk-in centres are rapidly becoming a casualty of the tougher financial climate in the NHS in England.
The centres – which treat minor ailments without an appointment – were a flagship policy of the previous Labour government.
They are popular with patients but critics say they’re not cost-effective.
Figures suggest a quarter have closed in the past year but the government say the services they offered have not been cut.
The centres were meant to relieve pressure on A&E departments by providing easy access to treatment for minor ailments.
The government says these services are still available when the centres are relocated to hospitals – but critics say patients have to join long queues at A&E or make an appointment rather than simply being able to walk in off the street and see a nurse or doctor.
The Department of Health says it does not have data on how many walk-in centres have been closed, but analysis of weekly NHS hospital activity statistics show there were 75 non-hospital providers of emergency care in June 2012, which could also include urgent care units.
That is 26 fewer than in the same month last year – a reduction of 25%.
‘Not being cut’
Health Minister Simon Burns said: “More people than ever are being treated in these units, almost 20,000 more compared to last year.
“Some of these services have recently been taken over by hospital trusts, whilst others have been integrated into local urgent care services, so while the number of organisations might appear to have fallen, this has not affected access to urgent care services, in fact people using them has increased.”
Labour MP Gloria De Piero, earlier this month asked Prime Minister David Cameron why the “popular” walk-in centre in her Ashfield constituency and “similar walk-in centres are closing all over the country”.
Mr Cameron said it was “certainly not because the money in the NHS is being cut, because it is not being cut” but decisions need to be “taken locally” about how “money in the NHS is spent to deliver better health outcomes”.
The Department of Health said the Ashfield walk-in centre – one of two to be closed in Nottinghamshire – has been replaced by a 24-hour unit at the nearby King’s Mill hospital.
But – in a letter to Health Secretary Andrew Lansley – Ms De Piero says people in need of primary care services now “either have to first present themselves at A&E or make an appointment” and “no longer had the ability to walk-in directly”.
Walk-in centres have been closing down across England for the past two years. Among those to go in recent weeks is a facility in Tooting, in South London, which has been incorporated into the A&E department at nearby St George’s hospital.
“The relocation next to the minor injuries section within A&E is designed to help deliver care to patients in the most appropriate place and improve patient experience,” the hospital said.
A privately-run centre in Victoria, central London closed its doors in December. It was commissioned by the Department of Health but when its five year contract ran out the local Primary Care Trust decided not to keep it open, to save money.
Walk-in centres were used by more than three million people last year and they “have proved to be a successful complementary service to traditional GP and A&E services”, according to the NHS Choices website.
But the Department of Health says they are not a “nationally mandated” policy and GP commissioning groups will be free to shut them down when they take over from Primary Care Trusts as part of the government’s NHS shake-up.
Critics of walk-in centres say they have failed to relieve pressure on A&E services in the way Labour planned and that the cost of treating each patient has gone up from an average of £36 in 2008-09 to £39 in 2010-11.
But patient groups say they remain highly popular with those that use them.
Katherine Murphy, chief executive of the Patients Association, said: “Despite the many promises of patients having choice within the NHS, this is yet another example of having those very choices removed in the name of efficiency savings.
“Walk-in-centres provide a vital function for those who are unable to access their GPs, due to excessive waits and those who do not want to bother the already heavily burdened A&E staff.
“Our helpline regularly hears from callers who have had a range of issues with GPs and hospitals, but we hear almost universally about just how popular walk-in-centres are.”
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