Do walk-in centres for commuters work? A mixed methods evaluation.

BACKGROUND Between 2005 and 2007, six pilot walk-in centres were opened in or near train stations, to provide health care to commuters. They are run by independent providers on behalf of the NHS, providing access to doctors and nurses. AIM To evaluate the policy of commuter walk-in centres. DESIGN OF STUDY Mixed methods evaluation. SETTING Six centres in England. METHOD Site visits, interviews with 28 users, survey of 1828 users, economic estimates, and interviews with six commissioning managers. RESULTS Each centre was located near a train station, although two were not within the main commuter flow. The average number of patients attending each centre on days when the user survey was undertaken was between 33 and 101 per day, considerably lower than the planned capacity of 150-180. Sixty-two per cent (1004/1627) of users identified themselves as commuters within the user survey, and 38% (95% confidence interval = 13% to 62%) had travelled to work by train that day. A large proportion of users worked in the local area (61%). The estimated cost per attendance, based on limited activity and price data, was between £52 and £150 for different centres at estimated current activity levels. Primary care trust managers' plans for the future of the centres involved changing the focus of the service to fit their local health economy. CONCLUSION Pilot walk-in centres placed near train stations for commuters had low activity levels and high costs. A policy of placing healthcare centres in areas of high worker density may be more successful.