Walk-in primary medical care centres: lessons from Canada
Editorial: The place of walk-in clinics in healthcare systems
Canada's walk-in centres and after hours clinics - doctor led services introduced over two decades ago - provide useful lessons for those embarking on a similar exercise for the National Health Service in the UK, and are reviewed in this week's BMJ.
Melvyn Jones of University College London analysed over 20 studies and found that use of walk-in centres was high, with over a quarter (27%) of patients having visited in the past six months. However, continuity of health care was one of the main concerns. Only 47% of Toronto clinics routinely informed the patient's general practitioner of the attendance. In one study, 79% of patients attending these centres had a regular doctor, yet 75% had not tried to contact them.
The most common reasons for attending walk-in centres included convenient location and opening hours. Patients were mainly under 35 and children with minor medical conditions, such as chest infections, reports the author. Centres accounted for 3% of total primary care health expenditure, which is surprisingly low, says the author.
Despite concerns about quality of care by some general practitioners, the future of walk-in centres seems assured, says the author. It seems certain that the growing strength of these clinics "will challenge all doctors to meet the demand for a more convenient service." However, it is unclear how applicable these findings will be to the nurse led services in the United Kingdom, he concludes.
Contact:
Melvyn Jones, Lecturer in General Practice, Royal Free and University College Medical Schools, University College London, UK
Email: melvyn.jones@ucl.ac.uk