The report by the Primary Care Foundation looked at 15 urgent care centres (UCCs) in 10 PCT areas and found that the range of services they offered varied widely, causing confusion among the public, patients and even health professionals. Patients and other groups were unclear about how the organisations differed from GP out-of-hours services, walk-in centres and A&E.
In some cases UCCs were co-located with GP out-of-hours services but had no 'operational link between the two separate services'. The report said this was 'strange as often the only difference between the groups of patients treated was how they had chosen to access care'.
Services offered at the centres were inconsistent, the report found. Some opened 24 hours a day but others only 12 to 14 hours a day. Some treated only routine cases that could be managed in primary care, while others had a full range of diagnostic services, and treated injuries including fractures and lacerations.
Clinicians working in the centres said they were underused. The report found that the typical number of cases seen per clinical hour across the 15 UCCs was between 1.5 and 3. ‘Most clinicians with whom we discussed these findings, knowing the case mix that is seen in the centres, felt that this level was low,’ the report said.
In contrast, GP out-of-hours services saw between 1.5 and just over 5 cases per clinician hour, the report said.
Primary Care Foundation director Henry Clay said GP commissioners should review the role of UCCs as a matter of urgency. He said: ‘The public are confused about the range of terms we use and the lack of consistency across services.
'This report demonstrates the importance of fully joined-up commissioning of urgent care rather than commissioning services separately as has sometimes happened in response to centrally driven innovations.
‘There is a need for local commissioners to take a clear strategic view of all their urgent care services and develop an integrated approach that includes primary care.’