GP walk in centres will address missingness in healthcare? – not likely, here’s why
Published: 30 October 2025
30 October 2025: Professor Andrea Williamson writes about the reality of establishing GP walk in centres in Scotland and the role proper resourcing could play in addressing missingness in healthcare services to improving health equity.
Blog by Professor Andrea Williamson, Professor of General Practice and Inclusion Health.
The announcement at the recent SNP conference of planned new GP walk in centres across Scotland was a shock. GP walk in centres were tried before in the UK - so called ‘Darzi centres’ in the first two decades of the 2000’s; a key English policy at the time. They were closed because they were expensive, duplicated GP work and there was wide variation in what they offered(1).
I lead research about missingness in healthcare – defined as ‘the repeated tendency not to take up offers of care such that it has a negative impact on the person and their life chances’ (2). Applying a missingness lens is a tangible way to achieve equity in healthcare and part of the new Population Health Framework for Scotland.
It may seem plausible that a service where patients can walk into GP care would reduce missingness. However the causes of missingness are complex - patients have competing demands often with limited resources to manage them(3), and the transactional nature of these proposed centres; not close to where patient’s live; without knowledge of the patients history and complexities; will not meet missing patients’ needs; even if they manage to reach the service safely in the first place.
An overemphasis on reactive care attending to single conditions and demand, has not served the NHS well in the past couple of decades. GP Walk in Centres would simply amplify this state.
Our research found that applying a missingness lens to healthcare means we move away from a simplistic ‘one size fits all’ way of thinking about solutions. The suite of interventions to address missingness are grounded in relational trauma informed care, prioritising patients at risk of missingness and provide holistic continuity of care to address unmet need proactively, including attending to the wider social determinants of heath.
The way to stop the so-called ‘8am rush’ AND meet the needs of missing patients who have been invisible for so long is to properly resource GP practices to increase their capacity and change the way they work from the inside. With a small amount of Scottish Government extra resource some Deep End practices have demonstrated this is possible already, and new funding announcements and new funding announcements appear to follow through with what is needed to deliver high quality equitable General Practice care in Scotland.
References
- Monitor. Walk-in centre review: final report and recommendations. England, UK: Monitor, health service regulator for England; 2014.
- Lindsay C, Baruffati D, Mackenzie M, Ellis D, Major M, O'Donnell K, et al. A realist review of the causes of, and current interventions to address missingness in health care.Protocol. NIHR Open Research. 2023;3(33).
- Lindsay C, Baruffati D, Mackenzie M, Ellis DA, Major M, O’Donnell CA, et al. Understanding the causes of missingness in primary care: a realist review. BMC Medicine. 2024;22(1):235.
Image reference (1): Taken from Andrea Williamson, General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow
Image reference (2): https://eprints.gla.ac.uk/366491/1/366491.pdf
Author
Andrea Williamson is a Professor of General Practice and Inclusion Health in the School of Health and Wellbeing. She leads on research about "missingness" in healthcare and is involved in wider research and policy work to improve care for people experiencing severe and multiple disadvantage. Policy work includes being a founding member of GPs at the Deep End, deputy chair of the Health Equity Special Interest Group, RCGP; on the Scottish Government National Suicide Prevention Advisory Group; and was the Primary Care member of the NICE Guideline Committee for integrated health and social care for people experiencing homelessness. She is also a Research Affiliate of the Centre for Public Policy, University of Glasgow.
First published: 30 October 2025