Assura : Levelling up access to general practice

New research by the BJGP Open has highlighted how people living in poorer areas can find it more difficult to see a GP or other primary care professional - in places where health inequalities are most acute.

The study found that workforce shortage for GPs, paramedics and other NHS roles are disproportionately affecting more deprived areas, where people are more likely to experience poor health driven by living, employment, education and financial circumstances.

The researchers conclude: 'In England, PCNs are to be tasked with reducing health inequalities. To do this, practices and PCNs in the poorest areas with need relatively more GPs and allied health professionals to respond to the demand for primary care services. The finding - that in general there remains a pro-rich inequality in recruitment of staff in primary care - should be of significant concern to policymakers. They will need to consider why practices and networks in deprived areas are relatively understaffed, and how this can be reversed.'

One contributing factor is a pretty basic one: that of the space and premises which GP practices have at their disposal. With many still working from unfit premises including portacabins and converted former homes, infrastructure continues to be one of the biggest investment ask from general practice. As RCGP Chair Dr Martin Marshall put it: 'We need an expanded workforce with the appropriate support and premises if we are to improve access, reduce health inequalities, ensure patient safety, and give GPs more time to care for and build trusting relationships with their patients.' It's an issue which GP and BMJ columnist Dr Helen Salisbury also blogged about recently - highlighting that there is 'No room for growth at general practices.'

Last year, a number of our new buildings were constructed to serve communities which are among the most deprived in England, including in Newtown in Birmingham, and Netherfield in Nottingham. We're on site right now in Wallsend, another community which sits high on the Index of Multiple Deprivation and where there's no doubt that creating more space is an urgent need for the practices serving thousands of local patients. One of the most common things we hear from primary care teams asking us to help them build a new space is that it will help them with recruitment: more modern space and facilities to expand and support their team are one of the tools in the box to attract, retain and train more of the professionals needed in primary care.

Care closer to home and a growing primary care workforce has long been a focus of the NHS to ease pressure on acute services - never more so than in dealing with the COVID crisis and the subsequent backlogs of care. The right infrastructure for the task will play a critical part in ensuring access to care for everyone, particularly in the places where health needs are greatest.

 

Claire Rick is our Head of Public Affairs