The quality of care at the different walk-in centres varied from one centre to another

Which? report

The centres, set up a year ago by the government at the cost of �32m, use trained nurses to offer health advice.

They add to the service already performed by the NHS Direct phoneline.

The magazine claims that on several occasions, staff did not spot potentially dangerous underlying conditions which might need urgent treatment.

One volunteer pretended to be a 55-year-old with increasingly frequent angina attacks - a possible precursor of a heart attack.

But at five centres, he did not even make it past reception - these simply suggested visiting a local GP, or other ways in which he could get more supplies of a pain-relief spray to take during the attacks.

In another case, the undercover researcher pretended to be a 35-year-old with a wheezy cough.

A proper medical history would have revealed that this could be a side-effect of beta-blocker medication he was taking.

However, at Leigh and Parson's Green, staff did not even ask what medication he was taking.

Only one centre, Wakefield, managed to link the pills with the cough.

Although in most instances, walk-in centres should with permission send a letter back to the patient's own GP, this rarely happened.

The report concluded: "It's clear there are issues that the Department of Health will need to address as the centres evolve.

Gatekeeper errors

"The quality of care at the different walk-in centres varied from one centre to another.

"It was partly dependent on whether the gatekeeper staff on reception screened the patient properly."

However, the Department of Health hit back, saying it had "substantial reservations" about the way the survey had been conducted - with Which? refusing to allow the department to check their own version of events as recorded in the walk-in centre notes.

A spokesman added: "All the new centres are being evaluated independently to ensure that high clinical standards are achieved.

"This will include a large-scale mystery shopper survey of walk-in centres which will also allow comparisons to be made with GPs and NHS Direct.

"Nonetheless, since the Consumer Association report was carried out in July last year - just after many centres opened - we have continued to introduce a common system of computer supported triage, based on NHS Direct, to ensure a consistent response to all patients at all walk-in centres."