In September 2009, RCGP Scotland held an unprecedented meeting involving GPs from the 100 most deprived general practices in Scotland. It was the first time in the history of the NHS that this group had been convened or consulted.
The College had set up a working group to produce a report on what general practices in Scotland could do to address inequalities in health. The group made three early decisions. First, it would not replicate the many previous and largely ineffective reports on inequalities in health, reviewing the partial literature and drawing partial conclusions. Second, it would not issue GPs with a ‘toolkit’, the approach of technocrats, which assumes that GPs only need to be told what to do. Third, it would listen to what GPs from the front line had to say.
The College established a budget which would allow locum fees to be paid. After some hesitation, the Scottish Government Health Department agreed to match the College's funding. On the day, GPs from 63 of the 100 most deprived general practices attended, along with four GPs from homeless practices in Glasgow and Edinburgh, four GPs from rural practices including small areas of deprivation, and two civil servant observers. The day was spent talking, in groups and open forums, to capture the experience and views of GPs from the Deep End.
THE DEEP END
Practices had been ranked according to the proportion of the patients on their lists living in the …