TRAINDEEP (TRaining Assistance INitiative in DEep End Practices) pilot evaluation: transforming GP practices into training practices in deprived areas of the North East and North Cumbria region of England

Problem

The Deep End Network was set up to address challenges posed by the inverse care law and to help deliver high quality to patients with the greatest need. It enables local GPs working within the most deprived communities to share ideas and develop interventions to positively change primary care delivery for patients, practices, and communities. Research shows that there is an uneven distribution of GPs, with there being low numbers in the most socioeconomically deprived areas, highlighting that the inverse care law applies to GP training practices. GP training disproportionately occurs in affluent areas; therefore, by increasing the number of training practices, it is hoped that this will increase GP recruitment and expand services. This is a pilot intervention whereby an experienced external GP trainer goes to a non-training DeepEnd practice twice weekly for 12 months to transform the practice into a training practice. The external trainer will also provide clinical supervision while a DeepEnd GP partner goes on an intending trainer’s course. On completion of the pilot, the DeepEnd practice will take on trainees regularly. Aims to evaluate the implementation by: Qualitatively exploring the feasibility and acceptability of transforming non-training practices to training practices Understanding the views and experiences (including opportunities and challenges) of delivering this pilot in the context of high deprivation.

Approach

Semi-structured in-depth interviews with staff involved will be done at three points during the pilot, to capture their insights at various stages. Thematic analysis is in-progress, to generate insights and perspectives from the interviewees. Once the pilot has ended, the findings will be written up into a manuscript.

Findings

The first round of interviews has been completed, with several key points have been drawn thus far; Providing time and knowledge is preferred when establishing a training practice, as practices struggle to have the time and expertise to utilise funding. The nature of the work in the DeepEnd is challenging, as patients have complex histories with social issues, and there is a high workload. However, the work is rewarding, and trainees will learn a lot. Some potential challenges of the intervention have arisen, including providing space for trainees, and appreciating that trainees may be of different abilities and therefore require varying levels of supervision. Success of the pilot can be measured in several ways, notably the practice becoming a training practice and taking on trainees regularly.

Consequences

On completion of the pilot and evaluation, it is hoped that the pilot can be rolled out across the DeepEnd network regionally and nationally, to increase training opportunities and reduce health inequalities.