Scottish Deep End Project
Published: 21 March 2025
The Scottish Deep End Project is a collaboration between academics and frontline primary care practitioners working in the 100 most socioeconomically disadvantaged communities in Scotland. The project has driven change in primary care where it is needed most.
The Deep End project has created a body of evidence to show that the inverse care law i.e. the people who most need health care are least likely to receive it, is not an immutable fact of life, but a social challenge that can be overcome.
Their insights have provided important lessons for policymakers in Scotland, including the need to better match general practice funding and workforce to need.
Community Link Workers
Community Link Workers (CLWs) offer non-clinical support, signposting, and health promotion. They work with individuals to improve their health and wellbeing by offering help around issues such as poverty, loneliness and isolation, housing, and abuse.
Since a pilot project in seven Deep End GP practices in Glasgow in 2014, the Links Worker Programme has been rolled out nationally. The programme is now an established social prescribing force, with more than 300 Community Link Workers offering targeted support in practices.
Each referral made to a links worker helps reduce GP’s workload and supports people’s individual needs.
Welfare Advice and Health Partnerships
Following a successful demonstration project, dedicated Welfare Rights Advisors were rolled out nationally. These advisors are attached to practices to support patients who don’t engage with traditional advice services, offering help with financial issues such as debt, benefits, rent arrears, housing, and employability issues.
The advisors can help to alleviate financial stress and reduce pressure on primary care services, allowing GPs to focus on clinical care and treatment.
International reach
Although these initiatives have been based in Scottish GP practices, it is clear that the findings, and especially those concerning individual patient care, are relevant wherever people are living in deprived circumstances.
The Deep End network now spans 9 countries in 4 continents, including similar projects in England, Ireland, Denmark, Canada and Australia.
First published: 21 March 2025
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