Almost a quarter of NHS walk-in centres have closed in just three years, making it harder for vulnerable and poorer people to access health services, a regulator warns.
Monitor, which regulates health services in England, said that 53 of England’s 238 walk-in centres have closed since 2010.
Walk-in centres, most of which were opened in the decade from 2000 to 2010, were set up to improve patients’ access to primary care and gave patients access to GP or nursing care without booking an appointment.
While the early centres were popular with younger, more affluent people, they have become increasingly used by people from lower socio-economic groups.
However, the closures could place added pressure on already overstretched A&E services. One in five walk-in centre users polled by the group said they would go to A&E were the centre to close.
“We found that walk-in centre closures can risk increasing health inequality if suitable alternatives are not put in place,” Monitor’s report concluded.
Shadow health secretary Andy Burnham said: “NHS walk-in centres are popular with patients and an important means of relieving pressure on A&E. When hospitals are under so much pressure, it makes no sense to close so many walk-in centres.
“People need services and support seven days a week and that is why the last Government introduced NHS Direct and walk-in centres. The decision to dismantle them is one of this Government’s worst acts of vandalism and patients are paying the price.”
Katherine Murphy, chief executive of the Patients’ Association, said: “Walk in centres have served a very useful purpose for a lot of people.
“Before closing them, we must make sure that the neccessary services are in the community for our patients.
“It’s all about looking to see what’s there to keep people safe and help them to live independently in the community.”
The extent of the pressure already facing A&E was also laid bare after figures emerged showing that half of all senior doctors’ posts at accident and emergency units across England are unfilled.
The College of Emergency Medicine said that 383 of the 699 specialist registrar posts in A&E have been vacant over the last three years.
It also revealed that the majority – 61 per cent – of training posts in A&E departments have not been filled in the first 10 months of this year.
The figures will add to fears that accident and emergency services are at serious risk. Health experts fear that services will seriously struggle with an ageing population facing complex health care needs. Senior doctors would be required to deal with such cases.
“Doctors in the NHS face increasingly challenging, high pressured and stressful work environments, often with limited resources and gruelling workloads.” Dr Mark Porter, BMA
Earlier this year, the college told the health select committee: “Workforce recruitment is in crisis. Three successive years of only 50 per cent fill rates for emergency medicine trainees has resulted in a ‘lost cohort’ of over 200 potential consultants.
“This loss is permanent and irredeemable….This shortfall affects service delivery and patient safety on a daily basis.”
Rising numbers of emergency admissions have also placed greater pressure on departments.
The rise has been partly attributed to a “four-hour standard” in which all patients arriving at A&E are supposed to have been dealt with.
During the first two years of the standard’s enforcement, from 2002-3 to 2005-6, admissions into units rocketed by 67 per cent year-on-year, according to the National Audit Office.
Responding to the latest figures, the British Medical Association (BMA) said that high-pressured and stressful work environments were driving doctors abroad.
Dr Mark Porter, chair of the BMA Council, said: “Doctors in the NHS face increasingly challenging, high pressured and stressful work environments, often with limited resources and gruelling workloads.
“Unsurprisingly, the result has been more doctors choosing to leave the UK to work abroad. In some specialties, such as emergency medicine, this has contributed to a recruitment crisis and means existing doctors who have to work are working flat out to meet rising demand.
“To stem this problem, we urgently need to address issues around workload pressures, resourcing and work-life balance. Only by making working practices and environments safe and sustainable will the NHS be able to attract and retain the best and brightest.”
Health Education England, the organisation responsible for education and training among health professionals, has said that it is “urgently reviewing” workforce issues in emergency medicine.
The organisation is due to publish a report from its taskforce in the next few weeks, and is expected to make a number of recommendations.