Inclusion health action in general practice: equality impact assessment

Background

The IHAGP programme was developed to address a foundational recommendation from the Primary Care Health Inequalities Short Life Working Group report for increased resources targeted at deprivation through ‘an enhanced service’ in General Practice which would start to address a mismatch between national funding formulae and population health need that perpetuates ‘an inverse care law’. The intent of that recommendation is twofold:

1. to address a gap between existing demand-led funding allocation processes and real and pressing needs of people; and

2. to act as a bridging mechanism between the current funding allocation to general practice in poorer areas – recognised by stakeholders, academics and others as being insufficient in accounting for deprivation and an example of the ‘inverse care law in action’ – and any future funding formula for general practice monies.

The 2018 GP contract, which drives much activity in primary care, and current reforms in primary care do not specifically tackle health inequalities.

The IHAGP programme, which launched in 2023, enables ‘Deep End’ practices in NHS Greater Glasgow and Clyde’s GGC’s most deprived areas to take modest, practical actions to tackle health inequalities within their patient populations and inequity of access, under specific themes:

• proactive outreach and longer appointments for patients at high risk of poor health, who often miss appointments (including screening) or do not seek healthcare when they need to;
• ensuring staff are skilled and knowledgeable about health inequalities;
• and practice engagement with their community and patient groups.

IHAGP is based on existing evidence from previous localised initiatives (including the evaluation of GovanSHIP and the Chance 2 Change project) which have demonstrated positive outcomes for both patients, staff and the wider healthcare system.