Are we adequately preparing our GP trainees in Wessex to understand Health Inequalities and to work in areas of deprivation?

Problem

Health inequalities in England are worsening. Health inequalities forms part of the Royal College of General Practitioners’ curriculum but is often not taught. Exposure of GP specialty trainees (GPSTs) to deprivation is highly variable. Training practices are less likely to be situated in areas of deprivation. GPs tend to work in areas like those in which they trained so this may perpetuate the already unequal distribution of GPs. Too many lives are being cut short in the UK due to inequalities and I want to tackle this through improving knowledge and experience of our future GP workforce.

Approach

I analysed what education and exposure to health inequalities GPSTs across Wessex are experiencing through surveys of GPSTs and GP trainers. I developed and delivered interactive education sessions for GPSTs and GP trainers and gathered feedback data through surveys. I also analysed the distribution of training practices across Wessex based on the level of deprivation and created an interactive map with this data.

Findings

I found a paucity of health inequalities education with <10% of respondents having had any during their GP training. 63.5% hadn't worked in an area of deprivation but 80.1% would like this opportunity. 75% rated their understanding of health inequalities as fair or poor. After my education session, 100% rated their understanding as good, very good or excellent and 100% said they would engage in further learning and placements. 47% of 136 GP Trainers didn’t know that health inequalities forms part of the curriculum. Only 13.2% had facilitated a tutorial on this topic despite 89.7% believing it to be very or extremely important. Only 35.3% had had a trainee do a practice swap. Following my education session, 94% reported their educational practice would change, 100% reported they would use the resources and 91.4% reported they would encourage a practice swap. Training practices in areas of deprivation are, in fact, represented in Wessex. Only two of the seven practices in the most deprived 20% based on the Index of Multiple Deprivation are not training practices. However, GPSTs’ exposure to these varies hugely with some GPSTs only being exposed to one practice in their entire training.

Consequences

Health inequalities is an important topic for GPSTs to be exposed to through placements in practices in deprived areas and through targeted education.GPSTs are keen to engage in, and benefit from, learning about health inequalities. There is a need to embed this in GP training across Wessex.Raising awareness of health inequalities amongst GP trainers is likely to improve the exposure of GPSTs to the topic.Routine practice swaps and placements should be implemented to improve wider exposure of trainees to deprivation.