Deprived areas need urgent boost in GP numbers, RCGP warns

Practices in the most deprived parts of the UK cannot tackle health inequalities effectively because they have similar or worse numbers of GPs than wealthy areas, a landmark RCGP report has warned.

General practitioners at the deep end, due to be published later today by the RCGP, is a report based on the experience of GPs working in the 100 most severely deprived areas of Glasgow City, Inverclyde, Edinburgh, Ayrshire and Dundee.

It shows that in Scotland’s most deprived areas, GP numbers per head of population are no better than in the wealthiest parts of the country.

In England, the report points out, poor areas have fewer GPs per head than well-off areas.

The report calls for a ‘sustained and integrated package of measures’ to empower GP practices in deprived areas to do their utmost to tackle health inequalities.

It demands:

  • More time and capacity for Deep End practices to address unmet need.
  • Longer consultations between patient and GP over longer periods of time.
  • Better connections between GP practices and other professions and services.
  • Better connections between practices across the front line, building on the example  of the Deep End Project.
  • Better support for the front line from NHS organisations.
  • Support for leadership at practice and area levels.

Professor Graham Watt, professor of general practice at University of Glasgow and lead author of the report said: ‘Since 1948, the NHS has supplied GPs in the same way that bread, butter and eggs were rationed in World War II – everybody gets the same.

‘In severely deprived areas this results in a mismatch of need and resource, with insufficient time to get to the bottom of patients’ problems, hence the swimming pool analogy in which GPs at the "deep end" are treading water.

‘This does not imply that GPs at the "shallow end"  are not busy or that they do not have demanding patients, but their patients generally live much longer and most present less complex burdens of need.

‘Deep end practices cannot solve the inverse care law on their own. We need political commitment to addressing inequalities in the NHS and realignment of local NHS resources, services and structures to support general practices in the front line.’

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