The first evaluation of NHS walk-in centres has found they provide safe, high quality care to patients.

The independent study for the Department of Health goes as far as suggesting that in some cases the clinics may provide better care than general practice.

However, the study did not examine whether the centres provide value for money, and the authors said further research is needed to determine if they are cost effective.

Issues such as whether these services are cost effective are not examined

Dr Hamish Meldrum, BMA

Walk-in centres were launched amid great fanfare by Prime Minister Tony Blair in 1999. The clinics were seen as a way of providing faster, more convenient access to medical advice and treatment for minor ailments.

Critics, which included GPs and patient groups, said at the time the clinics were a gimmick and a waste of money.

The centres provide a free drop-in service to patients at busy locations in cities across England.

Comparison

Dr Chris Salisbury, and colleagues at the University of Bristol, assessed 20 walk-in centres in Birmingham, Bristol and London.

The performances of nurses at the clinics were compared with the treatment and advice provided by GPs and the national telephone helpline NHS Direct for five common conditions.

These included a request for the morning-after pill and patients presenting with headaches, sinusitis, chest pain and asthma.

Nurses in the centres performed as well if not better than GPs.

Writing in the British Medical Journal, Dr Salisbury said: "Walk-in centres provided equivalent if not better quality of care than general practice, with the exception of advice and treatment of sinusitis and examination of chest pain."

He added: "Walk in centres provide adequate, safe clinical care to a range of patients compared with general practice and NHS Direct."

However, Dr Salisbury said that because the study was limited to assessing just five common conditions "the findings that walk-in centres offer safe care cannot necessarily be extrapolated to all clinical conditions".

Helpline criticism

Nevertheless, the study makes further poor reading for the much criticised NHS Direct telephone advice line.

Dr Salisbury concluded that walk-in centres perform "significantly better" than the helpline.

"Contacting NHS Direct was sometimes time consuming and unsatisfactory," he said.

But Dr Salisbury acknowledged more research was needed to determine whether the centres were a cost-effective way of delivering care to NHS patients.

"The cost effectiveness of walk-in centres and their impact on workload of other healthcare providers requires further assessment," he said.

Dr Hamish Meldrum, of the BMA's general practitioners committee, said the study left many unanswered questions.

"Issues such as whether these services are cost effective are not examined," he said.

"The referral rates from NHS Direct and walk-in centres were higher than from general practice and the impact on the workload of other healthcare providers needs to be assessed."

He added: "All this paper shows is that for these limited conditions, NHS Direct and walk-in centres seem to be safe."