Walk this way: estimating impacts of Walk in Centres at hospital emergency departments in the English National Health Service

In publicly funded health care systems policy-makers face a dilemma: placing low acuity emergency care services outside hospitals may widen access to care and divert patients from making costly hospital visits, but may also attract new patients that have little need for medical care. Using detailed information contained in hospital records, I evaluate the impacts of one type of low acuity service - Walk in Centres (WiCs) in the English National Health Service (NHS) - relying on timing differences in the deployment of a single wave of services and restricting attention to places where new facilities opened to mitigate endogeneity concerns. Results indicate that WiCs have significantly reduced attendances at hospital Emergency Departments in places close by, but suggest that only between 10-20% of patients seen at hospital-based WiCs and between 5-10% patients seen at other WiCs were diverted from the more costly high acuity facilities at hospitals.