Nurses will run drop-in health clinics

A NETWORK of 19 "halfway" clinics offering patients immediate treatment for minor conditions were named by the government yesterday as the forerunners of a new style of medical care.

The walk-in centres, led by nurses, will offer treatment half-way between hospital and GP care and are intended to end the waiting for patients and take pressure off accident and emergency departments and family doctors.

The move indicates ministers' growing confidence in the capacity of nurses to provide first-line care but was criticised by doctors' leaders who said the centres were "untried and untested".

Frank Dobson, the Health Secretary, said the new centres would offer a service "when the public need it and where the public need it". About half of the first 19 announced yesterday will be in high streets, shopping centres and railway stations, others will be bolt-on clinics at hospitals and health centres. They will cost pounds 15.4m in the first year, an average of pounds 800,000 each, and will have access to doctors. In what appeared to be a deliberate snub to the British Medical Association, Mr Dobson said further centres would be announced in the autumn, all with the backing of local GPs. The department had received 99 applications from primary care groups of GPs and nurses to run them, he said.

The BMA at its annual conference last week attacked the way the centres were being introduced and called on the Government to evaluate them before spending more NHS money on expanding the scheme.

John Chisholm, chairman of the GPs' committee, said yesterday: "Doctors are worried walk-in centres may increase unnecessary demand rather than meeting appropriate need. It is absolutely vital there is a thorough evaluation of their effects on the wider NHS."

Ministers believe providing a health service with "accessibility to match modern lifestyles", as Mr Dobson put it yesterday, is a vote-winner and that nurses are the key. The walk-in centres and the nurse-run telephone advice service, NHS Direct, which is being rolled out across the country by next April, will together receive funds of up to pounds 280m over the next three years.

A Department of Health spokeswoman said: "Some of the things that people visit their GP for could very well be dealt with by nurses. General practice is becoming more flexible, using teams of people - not just doctors and nurses but opticians and health visitors and chiropodists."

But experts have warned that the development of a parallel service of walk-in centres alongside the GP service could damage continuity of care and undermine one of the pillars of the NHS.

The GP's role as gatekeeper to the NHS is widely seen as providing protection to patients from overtreatment and a means of curbing costs.

The Royal College of Nursing said the development of the centres "shows tremendous confidence in nurses". A spokeswoman said it was important that record-keeping linked with the patient's own practice was "very thorough".

The New Walk-in Centres

THE 19 chosen centres will be in:

A shop-front site in Bath, close to the railway and bus station

A Boots shop in New Street, Birmingham

A city centre shop in Exeter

The Old Swan shopping centre in Liverpool

Terminal 1 of Manchester airport

Next to the railway and bus stations in Swindon, Wiltshire

West End of London

Sainsbury's supermarket in Dussindale, Norwich

The High Street in Peterborough, Cambs

The Royal London Hospital, Whitechapel, east London

The Edgware Community Hospital, north London

Parsons Green Health Centre, west London

Charing Cross Hospital, Fulham, west London

St George's Hospital, Tooting, south London

Newcastle General Hospital

Sheffield Hallamshire Hospital

Haywood Hospital, Stoke-on-Trent

A health centre by The Ridings Shopping Centre, Wakefield, West Yorks

York city centre