The Deep End GP Pioneer Scheme: a qualitative evaluation.

Background: The Scottish Deep End Project is a collaboration between academic GPs and GPs in practices serving the most socio-economically disadvantaged populations in Scotland. The Deep End GP Pioneer Scheme was established in 2016 to improve GP recruitment and retention in these areas. The aim of this study was to qualitatively evaluate the experiences of participating lead GPs and GP fellows.

Methods: Semi-structured interviews were conducted with nine lead GPs and 10 GP fellows, representing 12 of the 14 practices involved. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.

Results: Five main themes are presented: Recruitment to the Pioneer Scheme; Work motivation and satisfaction; Mitigating health inequalities; Retention and changes in work pattern; and Suggestions for the future. Key ingredients of the scheme were the additional clinical capacity (addressing the inverse care law), protected time for both GP fellows and experienced GPs to lead on service development initiatives and to share learning within and between practices, and the shared ethos and values of the Scheme.

Conclusions: There was strong support for the Scheme as a mechanism to improve GP recruitment and retention in areas of high socio-economic disadvantage, and to improve quality of care in these areas. As similar schemes are rolled out across the UK, there is a need for further research to evaluate their impact on workforce and patient outcomes in deprived areas.