People with three or four long-term health conditions who are living in Scotland's most deprived communities are getting significantly less time with GPs compared to equivalent patients in more affluent areas.

The findings have emerged in a study led by Glasgow University, which tracked patient contacts at 150 GP surgeries in Scotland over a three year period, between 2013 and 2016.

Around half - 80 - of the GP practices were located in postcodes ranked one to five on the Scottish Index of Multiple Deprivation (SIMD) spectrum, indicating that they had higher levels of deprivation.

The remaining 70 practices were found in the less deprived areas with SIMD ratings of six to 10.

The Herald: Lead researcher, Dr Andrea WilliamsonLead researcher, Dr Andrea Williamson (Image: University of Glasgow)

Researchers from the universities of Glasgow, Aberdeen, and Bath compared the total number and duration of consultations patients had with their GP surgery.

This included contact with a GP as well as other healthcare professionals, such as a practice nurse, and included only face-to-face appointments - although these made up the the vast majority of consultations before the pandemic.

READ MORE: Two thirds of Scotland GP appointments now done face to face 

On average, patients in more deprived areas had slightly more contacts with their GP practice compared to those in less deprived areas, but the average length of each consultation was marginally shorter at around 12 minutes versus 13 minutes.

There was also no significant gap once the researchers adjusted for differences the age and sex of the two population groups.

However, when the comparison was repeated by matching patients based on their number of long-term conditions, a clear disparity emerged.

The Herald: Affluent patients with multiple health conditions get much more time with their GP and other practice staff Affluent patients with multiple health conditions get much more time with their GP and other practice staff (Image: BMJ Open)

This was most striking for patients with three or four long-term conditions who, on average, had been seen for 28 minutes less at their GP surgery over the three year period if they lived in the more deprived areas compared to patients with the same health needs in wealthier areas.

Dr Andrea Williamson, a GP and professor of general practice who led the research, said: "What this paper shows is that when you look at socioeconomic deprivation and you split it by age and by sex, it doesn't actually make much difference.

"Where it's really important is on long term conditions."

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She said there is a "flat distribution of GP resource across Scotland" whereas the study demonstrates that practices in more deprived areas require targeted, extra funding.

Dr Williamson, who worked at the Glasgow Homeless GP practice until its closure earlier this year, said: "We are trying our hardest to keep going when the unmet need sitting within our practices is a lot higher.

"We have the same workforce to deal with a lot more morbidity: people living with long term conditions, more of them, at a younger age, and having to deal with social complexity, but it's the same number of GPs and teams in the practices as it is in places with a lot more affluence and fewer health conditions.

"It's a mismatch."

The Herald: Previous research, published in 2015, illustrated how funding was distributed for general practice in Scotland and compared that against the level of premature mortality and morbidity in areas of lowest and highest deprivationPrevious research, published in 2015, illustrated how funding was distributed for general practice in Scotland and compared that against the level of premature mortality and morbidity in areas of lowest and highest deprivation (Image: British Journal General Practice)

The period covered by the research predates the Covid pandemic and the cost of living crisis, both of which are have hit poorer areas hardest.

It also predates the 2018 Scottish GP contract, which was criticised by doctors working in 'Deep End' practices for failing to divert additional income into deprived areas, as well as a 5% decline in the size of Scotland's GP workforce between 2013 and 2022.

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Dr Williamson said she hoped that the findings would encourage a change in approach.

She said: "There is this Holy Grail of trying to quantify unmet need. It's really difficult to know what's not being done for a person - it's easier to quantify what is being done.

"What I think this paper does is shed a wee bit of light on what that unmet need looks like in general practice.

"The problem so far is that all the discussions about more resource being needed in Deep End communities has been about 'well, if we're going to give you more resource we'll need to take it away from another part of the system'. That becomes really tricky.

"What we need to be saying is that we recognise there's a major problem and we need to find additional resource to put into these communities who most need it."