“We’re all in the same boat… some of us just have more holes in their boat”: a qualitative interview study primary care staff views of Deep End Cymru

Background Socio-economic deprivation is associated with lower life expectancy and more complex health needs. General practices may mitigate some of these health impacts by providing holistic care to their patients. The Deep End Network was established in 2009 in Scotland to support practices working in the most socio-economically deprived communities, and the concept has since spread, with Deep End Wales (Cymru) launching in 2022.

Aim To explore experiences of staff working within Deep End practices in Wales and understand their motivations for choosing to work in challenging practices along with their needs from a Deep End network.

Design & setting Qualitative study with staff from Deep End eligible practices.

Method Seventeen semi-structured interviews were undertaken. Data were analysed using thematic analysis and interpreted with reference to self-determination theory.

Results Four main themes were identified: 1. Treading Water (experiences of providing care), 2. Diving into the Deep End (motivations for working in Deep End practices), 3. Providing a Life Jacket (support from the Deep End community), 4. Swimming to Shore (the search for work-based effectiveness).

Conclusion Deep End staff reported high workload, with limited resources and time to manage complex health needs. Most participants found working in Deep End practices rewarding. However, there was concern about staff burnout, recruitment, and retention of staff. Deep End Cymru is providing hope, validation, and a place to share ideas. Barriers to success were funding and time. Participants want Deep End Cymru to advocate for them, support recruitment, improve services for patients, and support research.