Co-designing a Deep End network for the North East and North Cumbria (NENC)

Problem

From their Scottish origins in 2009, Deep End GP networks are being established all over the UK and further afield in Ireland and Australia. Their common goal it to mitigate health inequalities and champion the cause of primary care in these communities. As the North East is the most deprived region in England, we wanted to establish a network that was sustainable and reflected the priorities of primary care staff who worked in it. The network currently consists of the 34 most deprived practices in the region. Deep End NENC is affiliated with the Newcastle University Applied Research Collaboration’s ‘Inequalities and marginalised communities’ strand.

Approach

We used co-design methodology to gather information from stakeholders in the region that could be used to guide the initial steps of the growing Deep End NENC network. Interviews also served to improve engagement and disseminate information about the network. Participants were recruited using purposive and snowball sampling, as well as a blanket communication to all Deep End practices. A geography-based recruitment framework was used to ensure coverage from across the region – all but one Clinical Commissioning Group was represented. Thirteen semi-structured interviews were carried out with health professionals (11 GPs, 1 nurse practitioner and 1 district nurse) from Deep End practices in the NENC between October-December 2020. Due to Covid-19 these were carried out over Zoom before transcription and thematic analysis.

Findings

Themes identified were the specific clinical and social challenges that were common in the Deep End; barriers to patient care and supporting equitable access; training and recruitment; and the need to connect with others who worked in these communities. Caring for patients with mental health problems was the most frequently cited area of need for enhanced support. The Covid-19 pandemic also brought challenges that were felt more acutely by Deep End patients and those who cared for them.

Consequences

These interviews were successful at identifying areas to prioritise and form the basis of the work that Deep End NENC will focus on over the coming years. They also add to the literature around challenges facing staff who work in deprived communities and could be used as research priorities by other networks with similar population demographics.