Some doctors are testing new approaches, seeing if tweaking the way NHS works can deliver better health. Dr David Blane is a GP in Glasgow’s Possilpark, and academic lead for GPs at the Deep End, an organisation led by doctors in Scotland’s most deprived communities.
He says patients in these neighbourhoods typically develop multiple long‑term conditions 10 to 15 years earlier than those in wealthier areas.
“Not only is there a good chance that you’ve got more long‑term health problems, but there’s also other things going on in your life impacting on your mental health – lots of low mood, depression, chronic pain… These things have a big impact on your quality of life, your sense of self, your sense of purpose.”
Part of GPs at the Deep End’s role is to pilot new strategies to try to reduce healthcare inequalities.
One strategy has been to extend all appointments to 15 minutes. “That certainly helps with empathy. It helps with managing potentially more than one problem in a consultation and GP stress as well,” Blane says.
But the most important factor, he argues, is continuity of care – seeing the same clinician each time. “Continuity of care saves lives, and it can also help to facilitate better access, better follow ups, and just better health outcomes,” he says. “Over the last 10-15 years, the political emphasis has been much more on rapid access [to treatment], which is important for some things, but not for everything”.
Blane is also helping evaluate new family wellbeing support workers in Glasgow. These staff link patients to money advice, housing help, trauma counselling, language support and physical activity programmes. The model, he says, creates “sticky” engagement with those who might otherwise drop out of the system and could, he adds, be replicated with families across the country.