At the deep end of Northern Ireland's health inequalities: the role of general practice in socioeconomically deprived areas

While ‘Deep End’ projects have emerged to tackle health inequalities, Northern Ireland (NI) lags despite being the UK’s most socioeconomically deprived nation. <br>This work aims to explore:<br>1)How a ‘Deep End’ General Practice group can be effectively established to support GPs working in socioeconomically deprived areas of NI, <br>2)How well GP specialty training and undergraduate education reflect the socioeconomic deprivation experienced in primary care settings,<br>3)What the key challenges, motivations, and potential solutions for General Practitioners working in Deep End practices in NI.<br>Methodology <br>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.<br>Results<br>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. <br>Discussion & Conclusions <br>Improving health in socioeconomically deprived areas requires improving the environmental conditions, empowerment, and community investment.