What interventions have addressed the inverse care law in general practice in Scotland over the last 20 years? A systematic scoping review.

Background: Recent evidence demonstrates persistence of the inverse care law (ICL), with fewer GPs and less funding in more deprived areas.

Aim: To map out interventions that aimed to address the ICL and the rationale behind them, and to review the impact and sustainability of these interventions - what has worked, for whom, and why?

Method: The authors searched Embase, Web of Science, MEDLINE, CINAHL, Cochrane, and BASE from 2000 to 2022 for articles describing interventions or policies that aimed to address the ICL in general practice in Scotland. A systematic grey literature search of government, NHS, and third-sector websites was also performed.

Health inequalities, multimorbidity and primary care in Scotland.

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.

Is Scotland's new GP contract addressing the inverse care law?

Scotland, like many countries around the world, has wide health inequalities resulting, in part, from the longstanding 'inverse care law', in which a mismatch between patient needs and provision of care in general practice in deprived areas results in poorer care and worse patient outcomes compared with affluent areas. In early 2018, Scotland embarked on a new GP contract, a stated aim of which was to reduce healthcare inequalities. National data on avoidable mortality showed a 4.

Looking back to look forward: Surviving COVID-19 and the future of the NHS.

The COVID-19 pandemic affected healthcare systems worldwide, including the National Health Service (NHS). It drastically changed the practice and delivery of healthcare and laid bare longstanding structural flaws. It also brought a time of innovation and digitalisation and renewed appreciation of the role of public health.

Half a century of the inverse care law: A comparison of general practitioner job satisfaction and patient satisfaction in deprived and affluent areas of Scotland.

Background And Aims: The 'inverse care law', first described in 1971, results from a mismatch of healthcare need and healthcare supply in deprived areas. GPs in such areas struggle to cope with the high levels of demand resulting in shorter consultations and poorer patient outcomes. We compare recent national GP and patient satisfaction data to investigate the ongoing existence of this disparity in Scotland.

Inside general practice ethics: guidelines 'and' 'of' or 'for' good clinical practice.

The RCGP conference, like other annual healthcare conferences offers a protected space for reflection on ethical aspects of practice. This paper presents a summary and discussion of a fringe session led by the RCGP Committee On Medical Ethics at the 2017 RCGP annual conference in Liverpool. Well thought-out rules offer a potential solution to the burden of responsibility for making every single decision from first principles.

Improving access to the KIS in secondary care.

Effective communication of anticipatory care planning (ACP) discussions between patients and general practitioners across different healthcare settings is vital. In Scotland, the Key Information Summary (KIS) is a new piece of software that allows clinical data for selected patients to be shared electronically across the wider National Health Service from the primary care record. This can include details of ACP discussions and decisions.

Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners.

Background: Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care.

Aims: We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs' views on using KIS.

Methods: We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices.