Questionnaire survey of users of NHS walk-in centres: observational study.

摘要

BACKGROUND: NHS walk-in centres have recently been established throughout England to improve access to primary health care. AIM: To determine the characteristics and experiences of people consulting NHS walk-in centres compared with general practice. DESIGN OF STUDY: Observational study using questionnaires. SETTING: Thirty-eight walk-in centres and 34 neighbouring general practices. METHOD: People attending randomly selected survey sessions at walk-in centres or neighbouring general practices on a 'same-day' basis were given a self-administered questionnaire. This collected data about socio-demographic characteristics, reasons for consulting, attitudes to continuity, satisfaction, enablement, referrals, and intentions. RESULTS: Walk-in centre visitors were more likely to be owner-occupiers (55% versus 49%; P<0.001), to have further education (25% versus 19%; P = 0.006), and to be white (88% versus 84%; P< 0.001) than general practice visitors. Main reasons for attending a walk-in centre were speed of access and convenience. Walk-in centre visitors were more likely to attend on the first day of illness (28% versus 10%; P<0.001), less likely to expect a prescription (38% versus 70%, P<0.001), and placed less importance on continuity of care (adjusted odds ratio = 0.58; 95% CI = 0.50 to 0.68) than general practice visitors. People were more satisfied with walk-in centres (adjusted mean difference = 6.6%; 95% CI = 5.0% to 8.2%). Enablement scores were slightly higher in general practice (adjusted mean difference = 0.40; 95 % CI = 0.11 to 0. 6). Following the consultation 13% of walk-in centre visitors were referred to general practice, but 32% intended to make an appointment. CONCLUSION: NHS walk-in centres improve access to care, but not necessarily for those people with greatest health needs. People predominantly attend with problems of recent onset as an alternative to existing health providers, and are very satisfied with the care received. These benefits need to be considered in relation to the cost, and in comparison with other ways of improving access to health care.