Health Equity GP Curriculum
In 2017 we conducted a Delphi survey of experts, frontline GPs, and patients to identify the knowledge skills and attitudes required to work in areas of socio-economic deprivation (the deep end).
This is presented below. We aim to refresh this soon, with a focus on all healthcare professionals and settings.
This is presented below. We aim to refresh this soon, with a focus on all healthcare professionals and settings.
Core knowledge
Background to health inequalities
Understanding patient groups
- Discuss the social determinants of health
- Explain the principle concepts of health inequalities, including the inverse care law and inequity vs. inequality
- Summarise the history and principles of the NHS and demonstrate an awareness of current national and local healthcare structures and politics
- Discuss differing social norms across populations
Understanding patient groups
- Describe the challenges and effects of living in poverty
- Give examples of the common barriers to accessing healthcare for marginalised groups
- Discuss the impact of adverse childhood events and experiences
- Describe the prevalent health problems of marginalised groups
Tackling inequality
- Apply the concepts of health inequalities and social determinants to a local and/or practice population, identifying features and demographics of local community that might impact on health and lead to adverse outcomes
- Demonstrate awareness of the local health support landscape, including community services to address the needs of patients e.g. health, social, voluntary and third sector
- Demonstrate competence in the identification and primary care management of mental health problems, including: complex trauma, depression, anxiety, personality disorder and post-traumatic stress disorder
- Offer primary care management of drug and alcohol problems
Extended knowledge
Extended background knowledge
Tackling inequality
- Broadly outline the social/benefits system and what support is available to help patients navigate its systems
- Outline local and national measures to influence the social determinants of health, including social prescribing schemes
- Describe the concept of health literacy and its impact on promoting health and delivering care
- Outline the rights to healthcare of migrants, refugees and asylum seekers
Tackling inequality
- Identify the unique needs of marginalised groups including ethnic minorities, homeless patients, gypsies/Roma/travellers, offenders, those seeking asylum, vulnerable migrants, those with a learning disability, patients who identify as LGBTQIA, and sex workers
- Debate the role that health advocacy and activism can play in improving the health outcomes of individuals and populations
- Identify, support, and direct to help those patients who are suffering social crises e.g. housing or finances
- Demonstrate competence in the holistic assessment and management of medically unexplained / persistent physical symptoms
- Discuss the features and usage of common psychotherapeutic interventions, including cognitive therapies, trauma therapy and motivational interviewing
Core skills
- Adaptable and flexible communication skills
- Team working
- Empathy
- The ability to take a thorough social history
- Critical thinking
- Time management
- Personal resilience
- Ability to identify and establish boundaries
- Identifying characteristics of patient populations
- Flexibility and creative thinking
- Ability to manage risk
- Promotion of patient self-care where appropriate
- Skills to overcome language barriers, including the use of interpreters
Extended skills
- Leadership
- Advocacy - both at individual patient level and by influencing systems and organisations
- Networking
- Collaboration e.g. with other practices, local services, academic institutions
- Education e.g. patients and colleagues
- Basic primary care cognitive therapy
- Motivational interviewing
- Prescribing in substance misuse
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