Background From their Scottish origins in 2009, Deep End GP networks are being established all over the UK and further afield in Ireland and Australia. Formed of primary care practitioners in areas of high blanket socioecocomic deprivation, their common goal it to mitigate health inequalities and champion the cause of primary care. As the North East is the most deprived region in England, it was important to set up a network that was sustainable and reflected the priorities of those who worked in it. The network currently consists of the 34 most deprived practices in the region. Deep End NENC is affiliated with the Newcastle University Applied Research Collaboration’s (ARC) ‘inequalities and marginalised communities’ strand and this work will also be used to direct the ARC research priorities. This project aims to use co-design methodology to gather information from practitioners in the region that could be used to guide the initial steps of the Deep End NENC network. Co-design interviews would also serve to improve engagement and disseminate information about the network.
Methods Participants were recruited using purposive and snowball sampling, as well as a blanket communication to all Deep End practices. Fifteen semi-structured interviews were carried out with health professionals (11 GPs, 2 social prescribing link workers, 1 nurse practitioner and 1 district nurse) from Deep End practices in the NENC. Due to Covid-19 these were carried out over Zoom before transcription and thematic analysis. Findings from the interviews were communicated to the members of Deep End NENC via webinars and they also formed the part of the Deep End Steering Group spending prioritisation protocol.
Results A coding framework was used to consider findings at patient level, practice/network level and ‘upstream’ political level. Themes identified were the specific clinical and social challenges in the Deep End; barriers to patient care and access to services; training and recruitment; the need to connect with others who worked in these communities to share best practice; and the need to advocate for the Deep End. The COVID-19 pandemic itself brought challenges that were felt more acutely by Deep End patients and those who cared for them.
Discussion These interviews were successful at identifying priority areas that will form the basis of the work that Deep End NENC will focus on over the coming years. They also add to the literature around challenges facing staff who work in deprived communities.
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