OBJECTIVES: To compare the quality of clinical care in walk-in centres with that provided in general practice and by NHS Direct. DESIGN: Observational study involving assessment of clinicians by standardised patients. SETTING: 20 walk-in centres, 20 general practices, and 11 NHS Direct sites. PARTICIPANTS: 297 consultations with standardised patients, 99 in each setting, carried out by professional role players trained to play five clinical scenarios (postcoital contraception, chest pain, sinusitis, headache, and asthma). MAIN OUTCOME MEASURES: Primary outcomes were mean scores on consensus derived checklists of essential items for the management of the clinical scenarios. Data were also collected on access to and referral by walk-in centres, general practices, and NHS Direct. RESULTS: Walk-in centres achieved a significantly greater mean score for all scenarios combined than general practices (difference between groups 8.2, 95% confidence interval 1.7 to 14.6) and NHS Direct (10.8, 5.5 to 16.1). There was considerable between scenario variation, with walk-in centres performing particularly well on postcoital contraception and asthma scenarios. In contrast to general practices, walk-in centres and NHS Direct referred a higher proportion of patients (26% and 82%, respectively). CONCLUSION: Walk-in centres perform adequately and safely compared with general practices and NHS Direct for the range of conditions under study, but the impact of referrals on workload of other healthcare providers requires further research.
OBJECTIVES: To compare the quality of clinical care in walk-in centres with that provided in general practice and by NHS Direct. DESIGN: Observational study involving assessment of clinicians by standardised patients. SETTING: 20 walk-in centres, 20 general practices, and 11 NHS Direct sites. PARTICIPANTS: 297 consultations with standardised patients, 99 in each setting, carried out by professional role players trained to play five clinical scenarios (postcoital contraception, chest pain, sinusitis, headache, and asthma). MAIN OUTCOME MEASURES: Primary outcomes were mean scores on consensus derived checklists of essential items for the management of the clinical scenarios. Data were also collected on access to and referral by walk-in centres, general practices, and NHS Direct. RESULTS: Walk-in centres achieved a significantly greater mean score for all scenarios combined than general practices (difference between groups 8.2, 95% confidence interval 1.7 to 14.6) and NHS Direct (10.8, 5.5 to 16.1). There was considerable between scenario variation, with walk-in centres performing particularly well on postcoital contraception and asthma scenarios. In contrast to general practices, walk-in centres and NHS Direct referred a higher proportion of patients (26% and 82%, respectively). CONCLUSION: Walk-in centres perform adequately and safely compared with general practices and NHS Direct for the range of conditions under study, but the impact of referrals on workload of other healthcare providers requires further research.
Authors: S Gorter; J J Rethans; A Scherpbier; D van der Heijde; H Houben; C van der Vleuten; S van der Linden Journal: Acad Med Date: 2000-11 Impact factor: 6.893
Authors: Chris Salisbury; Sandra Hollinghurst; Alan Montgomery; Matthew Cooke; James Munro; Deborah Sharp; Melanie Chalder Journal: Emerg Med J Date: 2007-04 Impact factor: 2.740
Authors: Brian Hutchison; Truls Østbye; Jan Barnsley; Moira Stewart; Maria Mathews; M Karen Campbell; Eugene Vayda; Stewart B Harris; Vicki Torrance-Rynard; Christine Tyrrell Journal: CMAJ Date: 2003-04-15 Impact factor: 8.262