Inclusion health action in general practice: equality impact assessment

Key Findings

Scotland currently has the widest health inequalities in Western Europe and those living in the most deprived areas are being left even further behind across a wide range of health outcomes, but this is particularly striking in relation to mortality rates and healthy life expectancy. Since the early 2010s the trend for improving population health has stalled. Two recent reports by the Health Foundation concluded there is still a major implementation gap between policy ambitions to address health inequalities and sustainable delivery of related interventions in Scotland.

It is well documented that health tends to be poorer in Glasgow than much of the rest of the country – even after controlling for socioeconomic deprivation – and this has been studied extensively. For instance, 30% of children in Glasgow are living in poverty, and Glasgow has below average life expectancy and above average absolute inequality in life expectancy compared to the rest of Scotland. This is why IHAGP investment is targeted in the NHS Greater Glasgow & Clyde health board area, where there is the deep, blanket deprivation and has the majority of Scotland’s 100 most deprived practices or ‘Deep End’ practices. The 100 Deep End practices are defined on the basis of the percentage of the practice’s patients living in the 15% most deprived datazones. IHAGP practice payments are based on a practice’s overall patient list size and on SIMD to account for deprivation variability.

Although IHAGP is targeted by socio-economic status we found that it is likely to improve access to Primary Care services for some protected groups. Disabled people and ethnic minorities are more likely to experience health inequalities and barriers to healthcare access, and to be living in poverty and therefore reside in the areas of deprivation.

These findings will help officials to shape and refine the IHAGP programme moving forward. They will influence work to improve our logic model and identify sub-themes within the programme.