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Independents' Day

Patient wealth status 'impacts GP access more than other NHS services'

People living in deprived areas of England face greater health inequalities in relation to GP services than other NHS services, new research suggests.

The analysis by the Nuffield Trust found that patients in poor areas found it harder to get a GP appointment than their counterparts in the wealthiest places and that the number of patients per GP was higher.

In contrast, this access gap between the richest and poorest areas did not apply to hospital services, the think-tank said.

The Nuffield Trust analysis compared patients at CCGs in the fifth most deprived areas against CCGs in the fifth most prosperous.

It found that:

  • Average GP lists for each doctor in the most deprived areas had 2,125 patients, compared to 1,869 in the most affluent areas;
  • one in seven people in the poorest areas was unable to get a GP appointment, compared with one in 10 in the richest areas;
  • people in the most deprived areas saw the GP they wanted 52% of the time compared to 59% in wealthy areas;
  • people in the poorest areas were slightly less likely to report a good experience of visiting their GP, 83% against 87% in wealthy parts of the country.

It follows research by the RCGP in May 2018 suggesting that 'under-doctored areas' were more likely to be found in deprived parts of the country.

The Nuffield Trust report said that overall the NHS does ‘quite well’ in delivering equal services to rich and poor. For example researchers found no link between deprivation and the proportion of patients waiting more than 18 weeks to be referred, or more than fours hours waiting in A&E.

However, ‘a somewhat different picture emerges when you look at general practice,’ it added.

‘Across many measures, a gap emerges between the most and least deprived areas. The difference is typically not all that large…However, it is consistent, running across many measures of both how easy it is to get an appointment, and how satisfied people are when they do get one.’

‘Especially when it comes to how GPs behaved towards them, people in deprived areas still report a good experience. But their wealthier counterparts report a slightly better one.’

One of the starkest differences was in relation to GP staffing levels.

‘Even though you would expect them to have higher needs, practices that reported data in more deprived areas have fewer GPs per person on their list than those in less deprived areas.’ The same pattern does not exist in relation to nurses in general practice,' the report said.

Readers' comments (3)

  • The Swedish model would solve this - funding that follows the individual patient’s risk score.
    (Acg risk of hospital admission and co-morbidities)

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  • And this is news why? I seemed to remember something called the 'inverse care law' which has existed for decades and which succesive governments have done nothing to address - in fact Mr Hancock's obsession with digital media and apps will only make it worse.

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  • |Big and Small | GP Partner/Principal|03 Jan 2019 6:59pm - and you think that would solve all problems? Its still the same state-regulated coverage. Some pen-pusher deciding how much value you're supposedly worth/ how much to spend of others'/taxpayers' funds. Swedish model - doomed to failure. Not least that they don't restrict it to their own citizens only either.

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