Darzi centre closures: patient choice must be upheld
Elliot Bidgood, 4 June 2013
Late last week it was revealed that health regulator Monitor is taking action over the mass-closure of NHS walk-in and urgent care centres, or ‘Darzi centres’ as they are sometimes known after their creator, surgeon and former Labour health minister Lord Darzi. These GP-led centres were originally set up to expand accessibility and patient choice and ease the burden on other parts of the health service. The 369 centres are open 8am to 8pm (sometimes longer) and have proven very popular, in at least some areas. Some are polyclinics, offering a wide range of services. However, it has been telegraphed for some time that budget constraints were putting their continued role in the NHS at risk, as localities in the NHS seek to find savings. Concerns are being raised that if the centres continue to close, patient choice will be constrained and the pressure on A&E services, which the NHS Confederation has warned are facing a “cliff edge”, could grow further in some areas. Given this morning’s revelation by The King’s Fund that the NHS missed the A&E waiting times target in the first quarter of the year, this is not a concern to be taken lightly. The centres can also help supplement out-of-hours services, another problem area in the news recently.
Walk-in centres have not been without their problems; in some areas very few local residents registered, something the BBC’s Nick Triggle has attributed to variance in the types of services available in different centres. For some time, this has led to GPs calling for centres to close. But while in some areas this may present a valid financial case for the service to be closed in order for resources to moved elsewhere if the walk-in centre is truly surplus to requirements, in others there may still be a case for the centres to be promoted and maintained as an alternative to A&E, especially if the latter turns out to be a false economy in light of the A&E crisis. At times Darzi centres effectively compete with other local services for patients, potentially creating positive incentives – NHS competition watchdogs have intervened to prevent closures before on this precise basis.
What is important and encouraging is that Monitor has done its duty and stepped in investigate, showing its willingness to ensure that patient choice is upheld in the NHS and is not undercut unnecessarily by fiscal retrenchment. Their report will be published later in the year. If Darzi centres still have a valid role in the NHS, they should be kept open where possible.