Page last updated at 00:01 GMT, Friday, 11 December 2009

Commuters snub NHS GP surgeries near railway stations

Emma Wilkinson
Health reporter, BBC News online

GP
There has been a drive to open more NHS walk-in centres

NHS walk-in centres near railway stations are not popular with commuters and are a waste of money, say University of Sheffield researchers.

A five-year pilot programme of six centres near stations in London, Newcastle, Manchester and Leeds was set up in 2004 as part of a £50m programme.

But a study has found they are seeing as few as 30 patients a day and cost twice as much as other GP surgeries.

The government said the clinics offered a "valuable service".

The commuter walk-in centres were initially funded by the Department of Health as part of an expansion of GP services.

My conclusion would be I would not go down this route
Dr Alicia O'Cathain, study leader

Unlike other nurse-led walk-in centres, the commuter clinics - which open from 0700 to 1900 Monday to Friday - also offer access to a doctor.

While they are paid for by the NHS, they are actually run by private health firms.

The Department of Health-funded evaluation found that the clinics were seeing between 33 and 101 patients a day, despite having capacity for 150 to 180 patients.

Four of the centres were in a poor location away from the beaten track, the study - reported in the British Journal of General Practice - concluded.

It was estimated that the price per attendance at the clinics was £33 compared with an estimated £13 for walk-in centres provided by the NHS.

At some centres, the cost per patient was as high as £62.

Location

Study leader Dr Alicia O'Cathain said the results showed that walk-in centres should be provided by the NHS, rather than private companies.

And she added that they needed to be placed near where people work, rather than at train stations.

"One of the problems was location, so one for example was near the train station but wasn't on the commuter track and there were very few people who went through that way.

"At the start and end of the day people are in a rush, but the way that people use walk-in centres is to go in their lunchtime."

She said the contracts, which were paid up-front regardless of the number of patients seen, would not expire until next year.

"My conclusion would be I would not go down this route."

Local health trusts have told the BBC they will review the service before the contracts expire over the next year or so.

Professor Steve Field, chairman of the Royal College of GPs, said it was right the scheme was piloted before being rolled out further, but a five-year contract was probably too long.

"Access to quality general practice is important, but clearly these pilots have shown this is not an effective use of resources.

"We still need to look at how we can provide care where patients need it."

A spokesman for the Department of Health said: "It will be for primary care trusts to decide whether to continue providing these services and whether they offer the best value for money.

"These centres have proved a valuable service to young, mobile patients who we know struggle to access existing GP services."



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