Thread by @BecksFisher

General practice in areas of high deprivation is under-funded and under-doctored relative to need.

Paper out today on why Govt needs to ‘level-up’ general practice & where they should focus.

🧵👇🏻 on evidence for #inversecarelaw in #generalpractice.

health.org.uk/publications/l…

Ppl who live in more deprived areas have greater health need.

-They are more likely to have multiple health conditions

-And they accumulate those conditions at an earlier age.

health.org.uk/sites/default/…

Need is 🔼, so you'd expect there to be🔼supply of health care. BUT.....

💰💰💰

- General practices serving more deprived populations receive less funding than practices serving more affluent ones.

- Once you adjust for need, practices serving the most deprived areas get around 7% less funding than practices in the most affluent areas

You’d expect practices in poorer areas, where health needs are greater to have more doctors. But no.

Once you account for need, a GP working in a practice the most deprived areas will have almost 10% more patients than a GP in the most affluent areas.

So. More health need, but less money and fewer doctors.

How does that translate to quality of care offered?

Disclaimer here is that the quality metrics available aren’t perfect, and may themselves be affected by factors related to deprivation. But….

Practices in more deprived areas earn fewer QoF points.

Which might partly nod to quality (depends on your view on how much QoF reflects quality of care), and definitely affects practice payments.

There’s a clear and persistent trend r.e patient satisfaction.

Patients in more deprived neighbourhoods report lower overall satisfaction with their #generalpractice

For more analysis of how pt satisfaction varies with deprivation/age/ethnicity:

health.org.uk/news-and-comme…

And practices in areas of high deprivation are more likely to be rated ‘inadequate’ or ‘requires improvement’ by the CQC and less likely to be ‘outstanding’.

For more detail on the above check out:

health.org.uk/publications/r…

For thoughts on what needs to be done: health.org.uk/publications/l…

& watch this space for big old piece of policy analysis of attempts to tackle the #inversecarelaw in #generalpractice

All of the above co-produced with my excellent @HealthFdn colleagues, including @cfraserepi @hughalderwick @RThorlby @pstilwell @CreinaLilburne @SeanAgass

Poss of interest @deependgp @CdsPcn @NextGGP @KirenCollison @doctor_oxford @rmsteen (apols if not)!