GRF One Health Summit 2012, Davos: Presentation by Mubashir Aslam Arain, The University of Sheffield, United Kingdom

1. GP led Walk-in Centre in Sheffield and
Rotherham; Another way of urgent
health care provision
by: Dr Mubashir Arain
Prof Jon Nicholl
Prof Mike Campbell
School of Health & Related Research (ScHARR)
The University of Sheffield
United Kingdom

2. Contents
• Background
• Aims and objectives
• Methods
• Results
• Conclusion
• References

3. Background
• Resources are limited & it is important to
allocate them efficiently for the health care
services
• It is evident that Accident and Emergency (A&E)
departments are over loaded with patients
• The increasing load of unnecessary visits to
A&E not only causes delay in urgent care
provision but also increases the overall cost

4. Background cont...
• The Government started a number of urgent
care services to compliment A&E in the last
decade
 Nurse led Walk in Centre
 Minor Injuries Unit
 GP out of hour service
 Urgent Dental Service
 NHS Direct
 Late night pharmacies
 Eye Casualty (Adults)
 Asylum Seeker Service

5. Background cont...
• In 2009, another Walk-in service started, where
GPs, along with trained nurses, provide urgent
care service, called GP Led walk-in centre
• It was assumed that, in the presence of GPs and
longer opening hours, these centre will help in
diverting patients with minor health problems
from A & E

6. Aims & objectives
 Primary
• How efficiently the GP led walk-in centre services are
working in Sheffield and Rotherham (under or over
utilized, patients’ satisfaction, convenience of location etc)
 Secondary
• Effect on other NHS urgent care services in Sheffield &
Rotherham (determined by how many patients use other
services after using the walk-in centre, for the same
problem)

7. Methods
 Design:
• The Cross sectional survey of patients was conducted
in Sept and Oct, 2011
 Study settings:
Sheffield GP-led walk in centre
Rotherham GP-led walk in centre
• Previously validated questionnaire was used with
modification
• Questionnaire included characteristic of patients,
patients choice of service and patients’’ satisfaction and
consent to participate in a POST-VISIT survey

8. Rotherham GP led Walk-in centre
 The centre is located near the
heart of the city (away from the
main hospital)
 1-2 GPs and 1-2 consultant
Nurses are present most of the
time at the centre
 On average 80 – 100 patients
are seen every day by a GP or a
nurse
 Centre is opened 8:00am till
9:00pm, 365days/year

9. Sheffield GP led Walk-in Centre
 The Sheffield Centre is located a
little away from the city centre &
main hospital, near the University
of Sheffield in students’ area
 2-3 GPs and 2-3 consultant
Nurses at the centre
 Opened 8:00am to 10:00pm,
365days/year
 120-130 patients turn over
everyday

10. Survey Results
• We were able to distribute 1821 questionnaires
• 1030 questionnaires were returned (response rate
57%), 64% at Rotherham and 51% at Sheffield
• According to the centre routine data estimates,
around 30% received the questionnaire
• We compared some demographics of patients
participated in the survey with routine data
• Mean age of patients in years was 30.66 in
routine data and 32.1 in the survey data

11. Comparison of Age of the patients
Routine data Survey data
Minimum age= 0 yr Minimum age= 0 yr
Max = 93 yrs Max = 84 yrs
8

12. Results cont…

13. Results cont…

14. Results (Waiting time in minutes)
Waiting time was significantly higher in Sheffield
Sheffield
• Mean waiting time = 74.2 (SD=49)
• Minimum 1 min ; Maximum 270 mins
Rotherham
• Mean waiting time = 40 (SD=32.3)
• Minimum 3mins ; Maximum 240 mins

15. Results cont…
Overall satisfaction is significantly higher in
Rotherham Centre as compared to Sheffield centre

16. Results cont…
Able to look after problem yourself after the visit?

17. Intention to use other NHS service
after visiting the centre

18. Results from the Post visit
survey
(4 weeks after the visit)
N= 260
538 agreed to receive questionnaire (63%
agreeing rate) and 260 responded
(response rate 48%)

19. Use of other NHS service

20. Other services used after visiting
Walk-in Centre

21. Conclusion
• Most of the patients are satisfied with the quality of
service provided at these centres
• These centres have increased accessibility to
health care service through longer opening hour
• High proportion of patients (40%) reported they
used another service
• The next step of project is to evaluate the impact
on A & E by looking at routine data of patients

22. Acknowledgement
We highly acknowledge the support of all
receptionists and staff for helping in data
collection
&
Data analyst for providing routine data sets
&
The centre manager for making it possible to
conduct this study at the centre!!

23. Key References
• O´Cathain A, Coster J, Salisbury C, Pearson T,
Maheswaran R, Nicholl J. Do walk-in centres for
commuters work? A mixed methods evaluation. British
Journal of General Practice 2009;59:934-939.
• Salisbury C, Munro J. Walk-in centres in primary care: a
review of the international literature. Br J Gen Pract
2003; 53 (486): 53-9.
• Maheswaran R, Pearson T, Munro J, Jiwa M, Campbell
MJ, Nicholl J. Impact of NHS walk-in centres on primary
care access times: ecological study. BMJ 2007; 334
(7598): 838.

24. Thank you