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BackgroundFrom their Scottish origins in 2009, Deep End GP networks are being established all over the UK and further afield in Ireland and Australia. Formed of primary care practitioners in areas of high blanket socioecocomic deprivation, their common goal it to mitigate health inequalities and champion the cause of primary care. As the North East is the most deprived region in England, it was important to set up a network that was sustainable and reflected the priorities of those who worked in it. The network currently consists of the 34 most deprived practices in the region. Deep End NENC is affiliated with the Newcastle University Applied Research Collaboration’s (ARC) ‘inequalities and marginalised communities’ strand and this work will also be used to direct the ARC research priorities. This project aims to use co-design methodology to gather information from practitioners in the region that could be used to guide the initial steps of the Deep End NENC network. Co-design interviews would also serve to improve engagement and disseminate information about the network.MethodsParticipants were recruited using purposive and snowball sampling, as well as a blanket communication to all Deep End practices. Fifteen semi-structured interviews were carried out with health professionals (11 GPs, 2 social prescribing link workers, 1 nurse practitioner and 1 district nurse) from Deep End practices in the NENC. Due to Covid-19 these were carried out over Zoom before transcription and thematic analysis. Findings from the interviews were communicated to the members of Deep End NENC via webinars and they also formed the part of the Deep End Steering Group spending prioritisation protocol.ResultsA coding framework was used to consider findings at patient level, practice/network level and ‘upstream’ political level. Themes identified were the specific clinical and social challenges in the Deep End;barriers to patient care and access to services;training and recruitment;the need to connect with others who worked in these communities to share best practice;and the need to advocate for the Deep End. The COVID-19 pandemic itself brought challenges that were felt more acutely by Deep End patients and those who cared for them.DiscussionThese interviews were successful at identifying priority areas that will form the basis of the work that Deep End NENC will focus on over the coming years. They also add to the literature around challenges facing staff who work in deprived communities.

Background COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in areas of high blanket deprivation (also known as the ‘Deep End’) have unique insights into the challenges posed by the pandemic. We aim to explore the impact of the COVID-19 pandemic from the perspective of Deep End primary care practitioners in North East England, the most deprived region of the country. Methods Semi-structured interviews followed by thematic analysis. 13 participants were interviewed (11 GPs, 1 nurse practitioner and 1 district nurse) with Deep End careers ranging from 3 months to 31 years. Participants were recruited via purposive and snowball sampling. Semi-structured interviews were conducted using video-conferencing software. Data were analysed using thematic content analysis. Participants were interviewed between September-December 2020, at the start of the UK second wave of the COVID-19 pandemic. Results Our results can be categorised into three broad themes: the immediate health risks of COVID-19 on Deep End general practices and patients; factors likely to exacerbate the effects of existing socioeconomic deprivation; and wider implications for remote consulting. Discussion Deep End practitioners have valuable insights into the impact of social distancing restrictions and remote consulting on patients‘ health and wellbeing and on the delivery of primary care in areas of deep deprivation. Their experiences should guide future pandemic response measures and any move to ‘digital first’ primary care to ensure that existing inequalities are not worsened.