GPs in Scotland must tackle health inequalities, says Audit Scotland

The GP contract in Scotland must help to tackle health inequalities and GPs in the most deprived areas should be given 'incentives' to improve access, an Audit Scotland report has concluded.

Dr Alan McDevitt: ‘The QOF helps to manage patients with long-term conditions where health needs can be greater in poorest areas.'
Dr Alan McDevitt: ‘The QOF helps to manage patients with long-term conditions where health needs can be greater in poorest areas.'

An Audit Scotland report, Health inequalities in Scotland, found that although overall health in Scotland had improved in the past 50 years, inequalities still remained.

Deprivation was the key determinant of health inequalities; the report found that men in the most deprived areas of Scotland died 11 years earlier than those in the most affluent, and the gap was 7.5 years for women.

One of the report's key recommendations for reducing deprivation was for the Scottish government and NHS boards to include deprivation monitoring in the GP contract.

The report said the contract should include ‘measurable outcomes’ to ‘monitor progress towards tackling health inequalities, and ensure that the QOF is specifically designed to help reduce health inequalities.’

The report also called for a review of the distribution of primary care services ‘to ensure that needs associated with higher levels of deprivation are adequately resourced’.

One further recommendation made by the report was for the Scottish government to ‘consider introducing incentives for GPs in the most deprived areas to help increase access to GPs in these areas.’

Commenting on the report’s recommendations for GPs, GPC Scotland chairman Dr Alan McDevitt said: ‘The BMA has recently reached an agreement with the Scottish government on changes to the GP contract for 2013/14 which include measures to enable practices to identify vulnerable patients who are at risk of avoidable hospital admission.

‘The QOF also helps to manage patients with long-term conditions where the health needs can be greater in the poorest areas.

‘However, it is important to leave enough time in the 10-minute consultation to deal with the problems that the patient wants to deal with and not just to deal with the reminders on the computer screen.

He added: ‘The solution to health inequalities is not necessarily simply a case of contractual change, but also providing the resources required to help practices meet the complex care needs of patients.'

Caroline Gardner, auditor general for Scotland, said: ‘Across the country, there are particular areas of poverty where people have higher healthcare needs. Resources should be better targeted at those who require them most.’

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