Addressing the inverse care law: how can we increase GP recruitment in areas of socioeconomic deprivation? A qualitative study of GP trainee views and experiences in the UK

Abstract

BackgroundThe Deep End network in the North East and North Cumbria (NENC) was set up to tackle health inequalities in general practice. One aim is to address the inverse care law and improve recruitment of general practitioners (GPs) which is known to be especially challenging in areas of socioeconomic deprivation.AimTo explore the experiences and perceptions of GP trainees of working in Deep End or Deprived Area Practices (DE/DAPs) to identify how recruitment can be improved.Design & settingQualitative study recruiting 13 doctors training to be GPs from the Northumbria training programme.MethodsAudio-recorded online semi-structured interviews and discussion groups were undertaken, transcribed verbatim, and analysed with a grounded theory approach using a process of thematic analysis.ResultsSeven interviews and two discussion groups (13 participants in total) were conducted. The challenges of working in DE/DAPs were not deterring factors for GPs in training wanting to work in areas of socioeconomic deprivation. However, gaining clinical experience during training in such practices was essential. Training in DE/DAPs gives trainees the confidence to work in areas of deprivation. Familiarity with a practice also makes them more likely to stay post training. Non pecuniary measures such as clinical support and protected time for professional development were also important.ConclusionTo improve recruitment to DE/DAPs investments should be made to increase the opportunities to train in these environments. This can be achieved by supporting more DE/DAPs to become training practices and providing clinical support and protected time for professional development.