Background The Deep End project in the North East and North Cumbria (NENC) was set up in 2020 to tackle health inequalities in general practice in the most deprived areas of the North East of England. One aim of the project is to improve recruitment of general practitioners to practices in areas of socio-economic deprivation. Previous studies have confirmed it is difficult to attract general practitioners to work in these areas. This study aimed to explore the experiences and perceptions of GP trainees working in such Deep End or Deprived Area Practices (DE/DAP) with a focus on improving recruitment.

Methods The study recruited 13 GP trainees at all stages of training from the Northumbria general practice training programme. Two focus groups and seven one to one interviews were undertaken using Microsoft Teams. A semi-structured interview approach was used. NVivo software was used to organise and code the data. Thematic analysis of the data was carried out focusing on recruitment.

Results Six main themes were identified: lack of knowledge of the Deep End concept; experiences of working in DE/DAPs; perceptions of working in DE/DAPs with no previous experience; factors influencing choice to work in a DE/DAP after training; how recruitment can be improved; the role of training. The main challenges of working in DE/DAPs included managing complex patients in short consultations. Benefits included rewarding work through helping those most in need. In those participants who had never experienced work in a DE/DAP the fear of the unknown was the main barrier to working in such a practice in the future. However, generally, the level of deprivation of a practice population was not a deterring factor. The most important factor was working in a practice the participant had trained in. This confirms the importance of DE/DAPs offering training to GP trainees. The most important factors to attract GP trainees to work in a DE/DAP post training were longer appointment times, allocated clinical professional development time and clinical supervision.

Conclusion This study explored how acknowledgement of the challenges and benefits of working in a DE/DAP can be used to improve working conditions and incentivise new GPs to join. It is clear non pecuniary measures implemented by practices to improve the working conditions should be the focus to improve recruitment of new GPs. Practices should also be encouraged to offer training as many trainees want to work where they are trained. Training in a DE/DAP also gives trainees the confidence to work in a similar setting when they finish training.