2024 PhD Project
About The Project
Access to primary care services is crucial in addressing health inequalities across communities. However, primary care in the UK is currently facing critical threats to sustainability, including extreme difficulties in recruiting and retaining clinical staff. Vacancies are at historically high levels and there is growing use of expensive locums, bank staff and trainees.
This problem is particularly acute within areas of high socio-economic deprivation. This compounds disadvantage as a lack of established care teams and services in these areas can lead to reduced quality of health and care as well as inconsistent uptake of new clinical evidence. Across Nottingham and Nottinghamshire, there are significant avoidable and unfair differences in the health and well-being of groups and different areas of the city.
However, within Nottingham, an innovative model of primary care is being developed to address these challenges. Elements of this model include direct employment of general practitioners at the area level, developing new career pathways for clinicians that reward working in more socio-economically deprived areas, new approaches to building the multidisciplinary primary care team, implementing evidence around severe and multiple disadvantages, and tying primary care closer to the research and knowledge infrastructure. While teaching hospitals have often had close relationships with universities, with benefits for staff and patients, this has traditionally not been the case in primary care.
This project will take an action research approach, working with Notts GP Alliance to address the challenge of health inequalities in Nottinghamshire by investigating the innovative approaches to primary care development emerging in the region. This research looks to engage with primary care stakeholders to evaluate the emerging Nottingham model of primary care. In doing so, it is intended to support general practice and primary health care in underserved communities within the region. This project is also intended to bring attention to this work at the national level acting as a catalyst for wider change.
Project Aims
The broad aims of this study are:
- To identify current challenges to the viability of general practice in socio-economically disadvantaged areas, examining how these challenges are shaped by the regional circumstances of Nottinghamshire and the broader region.
- To develop an understanding of the innovations of primary care organisations that are being adopted in Nottingham and Nottinghamshire to address these challenges.
- To analyse the impact of these innovations on improving the viability of general practice in disadvantaged areas, and identify routes for the wider implementation of successful innovations
The Project Team
- PhD Candidate: Krista Blair, UoN
- Lead Academic Supervisor: Dr Simon Bishop, UoN
- Academic Co-Supervisor: Professor Jayne Brown, NTU
- Community Supervisor: Dr Adele Cresswell, Nottingham City GP Alliance