Health inequalities, multimorbidity, and primary care in Scotland

Mercer, S. W. , Blane, D. , Donaghy, E., Henderson, D., Lunan, C. and Sweeney, K. (2023) Health inequalities, multimorbidity, and primary care in Scotland. Future Healthcare Journal, 10(3), pp. 219-225. (doi: 10.7861/fhj.2023-0069) (PMID:38162206) (PMCID:PMC10753226)

Abstract

Scotland has an ageing population and the widest health inequalities in Western Europe. Multiple health conditions develop ∼10–15 years earlier in deprived areas than in affluent areas. General practice is central to the effective and safe management of such complex multiple health conditions, but the inverse care law has permeated deprived communities (‘Deep End’ general practices) for the past 50 years. A new, radical, Scottish GP contract was introduced in April 2018, which has a vision to improve quality of care through cluster working and expansion of the multidisciplinary team (MDT), enabling GPs to deliver ‘expert generalism’ to patients with complex needs. It states a specific intention to address health inequalities and also to support the integration of health and social care. Here, we discuss recent evidence for whether the ambition of the new GP contract, to reduce health inequalities, is being achieved.

• Item Type: Articles
• Additional Information: The recent work on the inverse care law reported in this paper is part of a study funded by the Health Foundation held by DB, SM, and DH. The evaluation of the new GP contract in Scotland is funded by the Economic and Social Research Council (ES/T014164/1) led by SWM with ED, DH, and others.
• Keywords: Scottish GP contract, Integration, multimorbidity, health inequalities.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Blane, Dr David and Mercer, Professor Stewart
• Authors: Mercer, S. W., Blane, D., Donaghy, E., Henderson, D., Lunan, C., and Sweeney, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Future Healthcare Journal
• Publisher: Royal College of Physicians
• ISSN: 2514-6645
• ISSN (Online): 2514-6653
• Copyright Holders: Copyright: © Royal College of Physicians 2023
• First Published: First published in Future Healthcare Journal 10(3): 219-225
• Publisher Policy: Reproduced in accordance with the publisher copyright policy