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NHS 'failing to provide needs-based care' in Scotland's poorest areas

Doctors are expected to warn that the health service's approach is a 'recipe for widening health inequality'.

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The NHS is failing to provide needs-based care in areas of blanket deprivation, GPs working in Scotland's poorest areas will tell MSPs on Wednesday.

The doctors are expected to warn that the health service's approach is a "recipe for widening health inequality" when they appear before the Public Audit Committee.

The GPs from The Deep End group, which represents 100 practices in the poorest parts of the country, are giving evidence for the committee's scrutiny of the Auditor General's report on health inequalities in Scotland.

The report warned that the distribution of GPs in Scotland does not reflect the higher levels of poor health and greater need in poorer areas and that "deep-seated inequalities remain between the least and most deprived communities".

In a written submission, The Deep End GPs said there is a "flat distribution of GPs in Scotland, in contrast to the steep social gradient in health needs", despite research showing higher rates of multimorbidity (more than one chronic medical condition) in patients from the most deprived areas.

This, combined with "dysfunctional links between general practice and other parts of the NHS", is "a partial explanation of 20 years of failure in addressing inequalities in health, and a major obstacle as NHS Scotland searches for effective, affordable ways of delivering integrated care for the increasing numbers of people with multiple health and health-related problems".

The submission warns: "The status quo is a recipe for widening health inequality, as the NHS fails to deliver needs-based care, especially in areas of blanket deprivation."

The GPs called for more time for doctors seeing patients in deprived communities, as well as better integration with other services such as social work and addiction services.

"Providing integrated care for patients with multimorbidity should be supported as a core practice activity, and not as a bolted-on additional activity," the submission states.

"The focus should be on sustainable development, with an emphasis on continuity and the productive power of long-term relationships.

New initiatives should be funded for at least three years, with ongoing evaluation and protected time to allow shared learning."

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