Tackling health inequalities at the forefront

When Kamila Hawthorne became Chair of the RCGP in November last year, she knew that one priority would be addressing the long-standing workload and workforce pressures GPs and their teams are working under, which is impacting both on their ability to deliver safe care for their patients, and their own health and wellbeing.

But she also had another priority: she wanted to address health inequalities. It's an ambition that is no small feat. The concept that those who most need medical care are least likely to receive it first came to prominence in 1971 when Welsh GP Dr Julian Tudor Hart theorised the inverse care law of health inequalities in The Lancet – and the issue prevails today. Indeed, Michael Marmot’s ‘Marmot Review 10 Years On’, published in 2020 found that the health gap has grown between wealthy and deprived areas.

It's fitting then that another GP working in a deprived area of the Welsh valleys - Mountain Ash - wanted to take it on, and this became the topic of Kamila’s inaugural national media interview in the Guardian. It made the front page.

It also kickstarted a body of work for the College on addressing the stark health inequalities that exist in the UK – something that has become a key priority area in the RCGP’s 2023-26 strategy.

A snapshot survey of around 200 members conducted in November last year found that more than 85% of respondents had seen an increase in presentations that could be linked to poverty or lack of funds for daily living; and more than 70% were concerned both about the impact of rising cost of living on their patients’ health, and general practice workload.

In February, a well-received discussion paper went to the College’s governing UK Council. Council members were asked to consider and discuss the impact of health inequalities on patients and general practice, and what the role of GPs and their teams in addressing them should – and shouldn’t - be. They were also asked to share their knowledge of what is already being done to tackle health inequalities at a local and national level, and what support would be needed to do more – as well as their thoughts on what the College should be doing in this space.

Council members shared their own rich experiences, not just of the current cost of living crisis and how it is impacting their patients, but long-standing observations and concerns – and also potential solutions. The full discussion is available for members to watch back.

Next steps include further discussion within the College and with stakeholders about what can and needs to be done at a practice, system and national level to address health inequalities. This will be followed by a stakeholder summit this Summer, and the publication of a policy advocacy report later in the year.

Kamila is also providing guidance to GPs working at practice and system (be it ICB, federation or cluster) level on what they can do to reduce health inequalities, as well as lobbying politicians and decision makers to focus on reducing health and social inequalities by developing more equitable health and social national policies.