A review by competition regulator Monitor published on Monday found that 53 walk-in centres have closed in England since 2010 and a further 23 have had their services reduced.
Walk-in centre review: preliminary report found most of the remaining 185 walk-in centre contracts expire next year and ‘require immediate attention’.
But the division of commissioning responsibilities between NHS England’s area teams and CCGs is causing confusion over who should take charge of walk-in centres, it warned.
‘Commissioning of walk-in centres may work better for patients if one body is responsible,’ the report said.
'Providers consistently raised concerns that some CCG members have conflicts of interest when taking decisions about walk-in centres,' it said.
The review found that some centres were axed over fears that commissioners were paying twice for patients using them.
The GPC has said that there is a ‘perverse incentive’ for walk in-centres to drive up demand because they are largely paid by activity, unlike GP practices.
GPC deputy chairman Dr Richard Vautrey said that the remaining walk-in centres should be axed, and their funding diverted into GP practices. England's 8,000 practices could receive around £25,000 each from the move.
He called on Monitor, NHS England and the DH to launch a ‘public relations exercise’ to enable this to happen because walk-in centres are ‘unaffordable’.
‘The best solution is to use the resource in existing practices,’ he said. ‘There is no reason why it couldn’t happen.
‘We also need a very strong steer from the centre to support self-care.’
Demand for walk-in centres is rising and some GP practices direct patients to them because they offer same-day appointments, the review said.
‘GP practices have little incentive to improve their services so that their patients will choose to see them instead of attending the walk-in centre,’ it said.
The report calls for suggestions on ‘how payment mechanisms should be adjusted to increase patient benefits within the limits of NHS funding’.
Monitor is due to produce a final report on walk-in centres by early next year, ahead of a report on its wide-ranging review of general practice.
The review surveyed around 2,000 walk-in centre patients. It found that 69% of patients had not tried to contact their own GP before attending the walk-in centre. A total of 20% said they would go to A&E if the walk-in centre wasn’t there and 20% said they would go to their own GP practice.
But when provided with a full range of available options, 77% said they would visit their GP and 16% said they would go to another walk-in centre.
A total of 95% of walk-in centre patients were registered with another GP practice, it found.
