Improving access to primary care - Walk-in GP clinics to open - A closer Look at a new pressure

14th October 2025

A network of walk-in GP clinics will open as part of work to improve access to primary care.

The clinics, which would be staffed by GPs, nurses and support staff, will be open seven days a week, 12:00-20:00, in addition to existing primary care services. They will provide a range of same-day assessments, diagnostics and treatment.

Fifteen clinics in sites across Scotland will proceed initially to test the benefits for patients.

Health Secretary Neil Gray said, "Improving access to primary care and shifting more care into the community is central for this Government

"As part of this, we are taking forward new and innovative ways to improve access to primary care, including the benefits of local walk-in GP clinics.

"These will be in addition to core GP services and will offer additional flexibility for patients. These will be designed in collaboration with NHS Boards, GPs and other partners to ensure they strengthen existing services."

Current staffing / GP shortage situation

What we know about the existing shortages:

Scotland has fewer GPs now (in whole‑time equivalent terms) than it did a decade ago.

Workload pressures are high; GPs have said they are already stretched, with concerns about unmanageable workloads.

Some previous promises (e.g. in the 2018 GMS contract) to increase numbers of GPs, expand supporting staff (nurses, other allied health professionals) etc., have not fully delivered yet.
Audit Scotland

How might they staff the new walk‑in centres?

The proposal says they will be staffed by GPs, nurses, and support staff. But given the shortages, how might that happen in practice?

Some possibilities:

Reallocating existing staff

Some GPs / nurses may be shifted from other practices or services to staff the walk‑in centres. This could relieve demand in some areas, but risks weakening other GP services if not well managed.

Support staff (reception, admin) may similarly be reassigned.

Hiring new staff

Recruiting more GPs (full‑time, part‑time) specifically for these centres. Could include international recruitment.

Increasing the number of nurses and possibly other healthcare professionals (e.g. physician associates, advanced nurse practitioners) to deliver care for cases that do not require a GP.

Extended hours / flexible scheduling

GPs and nurses may be asked to work more evenings/weekends. That may involve change in contracts, or use of locums, or extra pay.

Perhaps part of the staffing will be by people who work flexible hours, or part‑time staff working specifically shifts covering the noon‑to‑8pm period.

Use of multi‑disciplinary teams, more roles that can shift nonurgent tasks away from GPs

Some of the "walk‑in" demand may be manageable by nurses or nurse practitioners or paramedic practitioners, reducing GP burden.

Incorporating more diagnostic facilities / support so that some work doesn't require a GP's time directly.

Pilot / phased approach

Since only 15 sites initially are proposed, the government will likely test out what staffing levels are needed, what patterns of demand are, and adjust accordingly.

The first centre is intended to open "within a year" as a trial to understand how feasible this is.

Risks, concerns and uncertainties

While the idea is popular in terms of improving access, there are several key challenges:

Recruitment may be difficult: With existing shortages, it may be hard to find enough GPs and nurses willing to work the extended hours required, especially evenings/weekends.

Cost vs value trade‑off: £30m for 15 sites is substantial, but whether that covers staffing, premises, diagnostics, support depends on the full cost. Some worry that it may divert resources from supporting existing GP practices.
LBC
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Quality and continuity of care: If patients use walk‑in centres, could this fragment care (seeing different GPs) versus seeing one’s regular GP who knows their history? Maintaining quality, records, integration will be important.

Sustainability of staffing: Evening and weekend hours are less popular; burnout risk is higher. Also, if staffing is stretched, risk of high turnover or use of locums (which may cost more and be less stable).

What has not (yet) been clarified

Some things the government has not yet clearly set out (as of current public info):

Exactly how many GPs/nurses per centre will be needed, or what the staffing model will look like in detail. (E.g. shift patterns, full‑time vs part‑time, reliance on overtime/locum).

How they will recruit or retain enough staff to meet this demand, especially in areas with existing shortages.

What incentives (financial or otherwise) there will be for staff to take up evening/weekend work, or to locate to these centres.

Detailed costing beyond the initial set‑up for 15 centres — what the recurrent costs are, and how they will sustain that once initial funds are used.

How the walk‑in service will integrate with existing GP practices: e.g. patient records, referrals, follow‑ups, ensuring continuity.

Likely scenarios & what will determine success

What will influence whether this works or ends up stretched / delayed:

Effective workforce planning: Scotland will need to scale up GP / nurse training, improve retention, potentially recruit from abroad, make attractive terms (hours, pay, conditions).

Collaboration with existing GP practices and boards: To avoid duplication, to distribute workload sensibly, and ensure that regular GP services are not eroded.

Testing & iteration: Using the pilot phase of initial centres to see demand patterns, staffing requirements, patient mix, operating costs and adjusting plans accordingly.

Support systems: Good IT systems, diagnostics on site or nearby, good referral pathways, and ensuring patient data is shared so care is continuous.

Funding and remuneration models: Ensuring the centres are properly funded, paying staff appropriately for out‑of‑hours work, possibly offering bonuses or flexible working conditions to attract staff.

Will the new service prove to be expensive?
the proposed walk-in GP centres in Scotland are likely to be more expensive per consultation than traditional GP services.

Here’s why, broken down simply:

New infrastructure & overheads

Premises: New walk-in centres will need to be built, rented, or refitted. This is a capital cost on top of existing GP surgeries.

Staffing: You’re duplicating staff for extended hours — that’s extra cost, not redistribution.

Non-clinical staff: Reception, admin, cleaning, IT — all needed separately at each new site.

IT & equipment: Centres need their own systems, records access, diagnostic equipment, etc.

Existing GP surgeries already have this — it’s more efficient to expand them than to create parallel infrastructure.

Higher staffing costs due to unsocial hours

Walk-in centres are proposed to be open 12pm-8pm, 7 days a week, meaning:

Evenings and weekends = higher pay rates (unsocial hours)

Potential reliance on locums (temporary doctors), who are more expensive

Overtime or bonuses may be needed to entice staff

Regular GPs mostly work Mon–Fri, 8am–6pm — cheaper to staff.

Lower efficiency / throughput risk

Walk-in centres see unknown patients — consultations may take longer due to lack of history.

GPs in walk-ins may repeat tests, request referrals, or lack continuity — reducing efficiency.

Some patients may attend with non-urgent or inappropriate issues that could be handled by self-care, pharmacies, or telephone triage.

Continuity in traditional GP settings improves efficiency and care quality over time.

The numbers: early cost indicators

The government has budgeted £30 million for 15 centres = £2 million per centre to set up and run.

Each centre aims to deliver ~66,000 additional appointments per year (based on 1 million total).

That’s roughly £30–£35 per consultation in setup/running costs alone — before factoring in longer-term staffing, pensions, inflation.

Compare to:

A typical NHS GP appointment in a traditional surgery costs £25–£35 (average).

But walk-in models tend to cost more due to the factors above — sometimes up to £45–£60 per consult in other regions/countries, depending on staffing and usage.

What health professionals are saying

The Royal College of GPs in Scotland has warned that this plan risks being costly and inefficient, especially if it diverts money from improving existing practices or hiring more staff.

Audit Scotland and BMA Scotland have repeatedly said that efforts to expand GP capacity should focus on supporting current services rather than creating new “bolt-on” clinics.

Great headlines BUT can it be afforded and how will it hit existing GP services already facing severe pressure. Many questions need answering.