Abstract
Background & PurposeGPs in socioeconomically deprived ‘Deep End’ areas face additional challenges. While ‘Deep End’ projects have emerged to tackle health inequalities, Northern Ireland (NI) lags despite being the UK’s most socioeconomically deprived nation.
This work aims to explore:
1)How a ‘Deep End’ General Practice group can be effectively established to support GPs working in socioeconomically deprived areas of NI,
2)How well GP specialty training and undergraduate education reflect the socioeconomic deprivation experienced in primary care settings,
3)What the key challenges, motivations, and potential solutions for General Practitioners working in Deep End practices in NI.
Methodology
A mixed-methods approach was used: a narrative review, a scoping review on establishing ‘Deep End’ projects, two quantitative studies on GP training in deprived areas, and qualitative research (interpretative phenomenological analysis) exploring GPs’ experiences.
Results
Key steps to starting a ‘Deep End’ group included quantifying deprived patients/practices, setting GP-led objectives, regular steering meetings, and multidisciplinary collaboration. Studies 2 and 3 revealed underrepresentation of socioeconomic deprivation in NI’s GP training and undergraduate education. Study 4 found GPs face systemic challenges (excessive workload, issues accessing secondary care, complex patient needs) but are motivated by job satisfaction and community connection. Solutions require policy focus on social determinants, better mental health services, and tailored primary care initiatives.
Discussion & Conclusions
Improving health in socioeconomically deprived areas requires improving the environmental conditions, empowerment, and community investment. GPs report providing reactionary care, leading to feelings of helplessness. Funding alone won’t solve these issues—a holistic approach addressing living and working conditions is needed. Encouragingly, GPs remain motivated by personal connections or social responsibility. Recruitment, teaching, and training reforms could help close the gap on health inequalities, and within NI, there are opportunities to build on this and establish an equitable ‘Deep End’ GP workforce.
| Date of Award | Jul 2025 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Sponsors | General Practice Academic Research Training Scheme (GPARTS) |
| Supervisor | Nigel Hart (Supervisor), Diarmuid O'Donovan (Supervisor) & Jenny Johnston (Supervisor) |
Keywords
- Health Inequalities
- General Practice
- Socioeconomic Deprivation
- Primary Healthcare