Attitudes towards health inequalities amongst GP trainers in Glasgow, and their ideas for changes in training

Blane, D.N. , Hesselgreaves, H., McLean, G., Lough, M. and Watt, G.C.M. (2013) Attitudes towards health inequalities amongst GP trainers in Glasgow, and their ideas for changes in training. Education for Primary Care, 24(2), pp. 97-104.

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Abstract

Background Health inequalities are a UK-wide health priority. Recent policy has suggested that primary care should be at the frontline of addressing health inequalities, but has not highlighted how. The RCGP curriculum states that 'Gaining a better understanding about inequalities in health and strategies to address inequalities in health are important aspects of training to be a general practitioner'. There have been no previous studies exploring GP trainers' attitudes towards health inequalities. The 1980 Black Report provides a potential framework for analysing competing explanations of health inequalities.

Aim The aim of this study was to explore attitudes towards health inequalities amongst GP trainers, and their ideas for changes in training that could contribute to tackling health inequalities.

Design This was a qualitative study using focus groups.

Setting This involved four GP trainers' meetings in Glasgow, covering North, East, South-East, and West trainers' groups.

Method Focus groups were audio-recorded and transcribed verbatim. Transcripts were coded and analysed using thematic analysis.

Results There was a range of views on the determinants of health inequalities, and the role of primary care in addressing them. GP trainers in more affluent areas were more likely to cite individual lifestyles as being the main cause of health inequalities, less likely to regard GPs as having a role to play in reducing health inequalities, and less likely to discuss health inequalities with their trainees. GP trainers in deprived areas felt that their trainees saw a greater proportion of patients with more complex problems related to deprivation and that this was not reflected in current RCGP assessments. Participants suggested practice rotations as a small step to allow trainees exposure to general practice in different settings.

Conclusion The theoretical framework of the Black Report was found to be useful in this analysis, with GP trainers in predominantly deprived areas favouring a materialist/structural explanation, and those in more affluent areas espousing cultural/behavioural explanations. Practice rotations for GP trainees may encourage more GPs to work (and become trainers) in deprived practices in the future - a small step towards addressing the inverse care law.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hesselgreaves, Dr Hannah and Blane, Dr David and McLean, Dr Gary and Watt, Professor Graham
Authors: Blane, D.N., Hesselgreaves, H., McLean, G., Lough, M., and Watt, G.C.M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Education for Primary Care
Publisher:Radcliffe Publishing Ltd.
ISSN:1473-9879
ISSN (Online):1475-990X

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