General Practice community engagement approaches to tackle health inequalities (HiQUALITY) study

We are pleased to share findings and insights from our collaborative HiQuality (Health Inequality) study. 

NHSE London, UKHSA London, the NHS Legacy and Health Equity Partnership, and Imperial College London collaborated to develop the HiQuality study. This regional study explored the different ways General Practices engage with communities to tackle health inequalities. We explored reasons behind variations in community engagement approaches, perceived outcomes, best practice and what support is needed to sustain community engagement to reduce health inequalities.

With thanks to colleagues and primary care professionals who were involved in our survey, interviews and focus group discussion between October 2023 and March 2024. Our findings highlight the exceptional commitment and good practice in General Practice for engaging communities in tackling health inequalities. The overriding theme emerging was the need to build trust with communities through creating a local enabling environment and culture that prioritises community engagement in General Practice, including through co-design and co-production. Four key guiding pillars identified as priorities for achieving this included:

• Fostering partnerships with communities
• Strengthening governance and leadership across the system
• Workforce development
• Bolstering data and evaluation

Given that asylum seekers were highlighted by 69% of survey participants as a key population that General Practice needs support engaging with, we further conducted a workshop exploring the challenges and solutions related to this group. Insights from this workshop are summarised in a BMJ letter, which can be accessed here:

“Mujong D, Harrod-Rothwell L, Nortley-Meshe A, Weil LG. Enhancing general practice care for asylum seekers and refugees in the community. BMJ. 2024 Dec 13;387. Available at: https://www.bmj.com/content/387/bmj.q2766”

The HiQuality study highlights that as we move forward towards a neighbourhood health service, embedding co-production and participatory methods into routine practice, supported by robust leadership, targeted funding, and workforce development, will be critical.

We hope that this report can support your engagement activities within General Practice. An academic publication which will provide further in-depth analysis of our findings will also become available soon.

Yours Sincerely, 

Dr Agatha Nortley-Meshe  

Regional Medical Director for Primary Care  

NHS WRES Expert  

NHS England – London Region