The analysis concludes that collaboration between nursing staff and doctors improves the management, monitoring, and resolution of this type of consultation. Likewise, 8 out of 10 patients who attend the health centre without a prior appointment due to a health problem receive an effective response on the first contact, without any need for consultation again in the following days.
The study, published in the International Journal of Nursing Studies, was led by Lluís González, researcher at IDIBAPS and CAPSBE, Clara Monfil and Alicia Alcaraz, CAPSBE nurses, and Sílvia Roura, IDIBAPS researcher and management assistant at CAPSBE. The research team analysed 2,624 unscheduled visits attended at three primary healthcare centres on the Clínic-CAPSBE Campus in Barcelona between April and July 2025.
The model analysed is the one that is progressively being rolled out to all communities in Spain: when a person arrives at the primary healthcare centre without an appointment due to a health problem, they are initially assessed by the nurse who follows a protocolised procedure. Depending on the clinical situation, the nurse can resolve the case or refer it to the general practitioner. The study has evaluated how this healthcare model works in real practice and what path patients subsequently follow.
The results show that 82.7% of the visits did not require any new contact with the centre in the following eight days. Only 8.9% of patients consulted again for the same problem and 8.4% received a scheduled follow-up visit. In addition, 54.2% of the consultations were managed entirely by nursing staff without the need for a medical referral during that visit.
“The results indicate that the current model makes it possible to provide an effective response to most of the health problems that motivate a walk-in visit. Rather than replacing other professionals, the value of the system is to organise healthcare in a coordinated way and adapt it to the needs of each patient", explains Lluís González.
The work also helps to identify which patients may need further follow-up. The results show that second consultations do not depend on whether or not the patient was referred to the doctor during the first visit, but above all on the type of health problem concerned. Consultations related to mental health and emotional distress were those that were associated with a higher probability of patients repeating a walk-in consultation, 4.5 times higher than people who consulted for other health problems.
According to Clara Monfil, "these results help us to better understand what people who come to the healthcare centre without a prior appointment need and to continue improving the circuits so that healthcare is accessible, safe, and focused on the needs of each patient".
Study of reference
Patient pathways and short-term outcomes following nurse-led first-contact unscheduled visits in primary care: A multicentre cohort study. Clara Monfil et al. International Journal of Nursing Studies. 2026. 10.1016/j.ijnurstu.2026.105628
