title: An analysis of the skin care patient mix attending a primary care-based nurse-led NHS Walk-in Centre.
abstract: BACKGROUND
  NHS Walk-in Centres (WiCs) are a new and expanding point of nurse-led primary care access for patients requiring skin care. Little is known about the dermatology case profile of such patients.
  
  
  OBJECTIVE
  To investigate the skin care patient mix attending a WiC and the feasibility and usefulness of retrieving data from the NHS Clinical Assessment System (CAS), as used by NHS Direct.
  
  
  METHODS
  Patients over 2 years of age presenting to a WiC in southern England with a nurse-assessed skin condition were recruited over a 12-week period (n = 233). A data set was extracted from CAS and analysed using Excel.
  
  
  RESULTS
  Of the total 31 591 patients attending the WiC in the first 2 years, 21% had a skin-related problem. During the 12-week study period, 88 of 233 eligible patients (38%) consented to participate. The typical patient profile was of female patients, 17-35 years (27%) attending during the week before 9 a.m. (35%) or after 5 p.m. (27%) from the locality (72%). CAS employs generic algorithms to specify clinical problems (e.g. rash) rather than medical diagnoses. Most patients presented with a rash (89%). No physical treatment was required in 77% of patients, although this was advised for 46%; 49% were advised to seek help but not return to the WiC; 16% were recommended to contact their general practitioner. There were practical difficulties accessing data from CAS software for research due to research governance requirements.
  
  
  CONCLUSIONS
  A significant number of patients with dermatological conditions could be seeking primary care through new NHS WiCs. Detailed dermatological appraisal of the patient mix is difficult due to the system of clinical categorization. There is scope to investigate further the nature of dermatological need and the patient education given. CAS is a cumbersome data extraction tool for research.
authors.affiliation: School of Nursing and Midwifery, Faculty of Medicine, Health and Life Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK. sje1@soton.ac.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: Ersser
authors.forename: V
authors.initials: V
authors.lastname: Lattimer
authors.forename: H
authors.initials: H
authors.lastname: Surridge
authors.forename: S
authors.initials: S
authors.lastname: Brooke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D015400:Clinical Nursing Research; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D017592:Skin Care / Q000451:nursing* / Q000706:statistics & numerical data; D012871:Skin Diseases / Q000175:diagnosis / Q000451:nursing*; D013222:State Medicine / Q000458:organization & administration