Primary care strategies to address health inequalities?

Strengths of general practice? Contact Coverage Continuity Co-ordination Flexibility Relationships Trust The challenge is for this to be delivered in a way that is: Effective Equitable Sustainable

Primary care strategies to address health inequalities? Consultation times – longer times – 15-20mins Networking – community groups, secondary care, social work, within practice (HV, HCA, PN, GPs), Patient lists – vulnerable adults, asylum/ refugee Service user involvement (patient groups) Clarity in communication with vulnerable groups/ asylum/ refugee Posters about difficult topics to prompt discussion – FGM, HIV Recognise differences between practices of different groups in need What are the issues in your community Health promotion – opportunistic Action plans for high service users

Primary care strategies to address health inequalities? Differentiated consultation times – 5, 10, 15, 20… ?Reception/Nurse/Patient triage – “simple vs. complex” More resources? Anticipatory Care plans Health promotion Technology – mobile apps, etc Trust – engagement, confidence Funding structures and recruitment Advocacy & Lobbyism? Better relationships with other services, esp. secondary care Access to advice Use of knowledge within practice(s) Robust systems/safeguards, e.g. polypharmacy reviews Multidisciplinary appointments – e.g. physio, dietician at health centre level Making best use of serial encounters Leadership roles with practices/group of practices “One size does not fit all” ideas from last year’s group

Advocacy Social prescribing – increase volume and quality of care in deprived areas. – importance of continuity and good relationships “all that GPs can do to reduce health inequalities is via the sum of care they provide for all their patients” Not just GPs at the Deep End?

Advocacy Supporting, speaking/writing on behalf of patients Patient welfare and benefits advice Referrals – Discuss challenges to access/attending appointments Lower uptake of screening/opt-ins – DNA Letters discussed, not just filed?

Social prescribing Use of non-medical community resources Availability of resources (housing, benefits) often rationed by medical need – Aim to move from dependency to self-efficacy Information Leaflets, Websites Voluntary services Exercise, Art, Books, Learning-on prescription?

Social prescribing Community Health Shop Womens’ Aid Cash for Kids Quarriers Community Addiction Team Maggie Centre Weight loss groups CRUSE Narcotics Anonymous AA/ Al Anon Stress Centre Council on Alcohol Community Law Centre Princess Trust for Carers Counselling services eg COPE Citizens advice School nurse Welfare Rights Parent and Child Team Breathing Space Relate Scotland Volunteer Scotland Victim Support

Useful resources GPs at the Deep End - Understanding Glasgow Poverty Truth Commission ScotPHO profiles - Scottish Neighbourhood Statistics – PBSGL modules Find your practice… – SIMD data - Practice/Practices-and-Their-Populations/ Practice/Practices-and-Their-Populations/ – Prevalence data -

Resilience?