Supporting Welsh GPs at the Deep End

50 years on from GP legend Dr Julian Tudor Hart’s seminal 1971 article on ‘the Inverse Care Law’ about health inequalities, his premise that “the availability of good medical care tends to vary inversely with the need for it in the population served” remains pertinent.

And RCGP Wales are now following RCGP Scotland in initiating the ‘Deep End’ model of general practice.

In 2009, Professor Graham Watt and colleagues from Glasgow University joined with GPs in many of Scotland’s most economically deprived areas to tackle the underlying reasons for discrepancies in health outcomes, with general practice core to the project.

The model has been replicated internationally, but not yet in Wales, until now. A project proposed by RCGP Cymru Wales and spearheaded by immediate past joint- Chairs Dr Mair Hopkin and Professor Peter Saul has been granted initial funding for 18 months by the Welsh Government.

The 'Deep End' describes the additional needs for populations living in the most deprived areas and the impact this has on workload for the GP practices that support these communities.

Evidence shows that deprivation means people get sicker younger and are far more likely to have multiple physical and mental health co-morbidities. Difficulties with health literacy compound these challenges as many patients require additional support to benefit from healthcare advice.

In turn, the need for primary healthcare increases in both volume and complexity, meaning that 'deep end’ GPs and their teams are struggling.

“We were delighted to receive the go-ahead from Welsh Government for this pilot project,” says Mair Hopkin, “the College has played a key role in the development of ‘Deep End’ in Scotland and I’m pleased the College is leading the way in Wales”.

Peter Saul added: “This will provide a framework for tackling entrenched structural inequalities.”

Current Chair of RCGP Cymru Wales, Dr Rowena Christmas, said “I want to thank Mair, Peter and everyone else who have worked so hard to make this proposal a reality.” •