Last update March 2025
The Deep End ethos is that of an inclusive, grassroots movement and so whilst we welcome interest from many stakeholders. We wish to keep the focus on supporting those who most need the network, and not inadvertently worsen inequities.
Background
Deep End Cymru launched in November 2022 by inviting the top 100 GP practices in Wales to join in the initial phase until March 2024. Eligibility criteria were simple and were based on the deprivation ranking of practices provided by Stats Wales for the first time in January 2022. This been updated every year in July, based on data in April.
Wales uses quintiles of deprivation (i.e.20%, not 15% as used in Scotland) in analyses of the Welsh Index of Multiple Deprivation; hence we invited the practices that have the highest proportion of their patients living in the 20% most deprived Lower Super Output Areas (LSOAs) in Wales.
Changes in deprivation rankings. As GP practices close, merge or their registered population change, the deprivation rankings will change. Since the original list from January 2022:
Pockets of deprivation in other practices: There are more than 653,000 people who live in the most deprived areas in Wales. Of these, over 218,000 (33.4%) are registered with non-Deep End practices. We have focussed on Deep End practices and not Deep End communities, so the emphasis has been on struggles the practices face in providing a quality service, rather than on struggles that communities face in getting a quality service.
Health Inclusion Services: It has become clear that there were common concerns and synergies with health inclusion services across Wales. Health Inclusion Services are designed for the needs of multiply excluded groups, for example: people seeking asylum and refugees; people experiencing homelessness; people engaged in sex work; prison leavers; Roma, Gypsy and travelling people. Many Deep End practices have a higher proportion of their patients from these groups. Some do not have any other health inclusion service locally. There has already been engagement and mutual learning, and the intention to continue engagement in some form.
We are keen to reach all GP practices who serve the most disadvantaged communities and groups. So we welcome anyone working in any practice who aligns with our goals and values, who are welcome to join any of our events.
However, we have Welsh Government funding that is clearly for protected time for Deep End participants, and we will continue to offer this to those working in the original 90 Deep End practices, including those that have merged with other practices who may not have been Deep End. Anyone working in one of these practices will be eligible to claim reimbursement for their time and will be eligible to become members of the steering group.