UK primary care teams and social determinants of health intervention: a qualitative study

Background: Although inequalities in social determinants of health (SDOH) are
linked to poor health, they are often overlooked in healthcare. Primary care networks (PCNs) are an example of neighbourhood-level multidisciplinary teams (MDTs), established in part to address SDOH at locality. Further research is needed to understand how UK primary care health care practitioners (HCPs) understand and manage patient SDOH through these teams.
Aim: To explore how UK primary care HCPs view SDOH and how they perceive
working in PCN MDTs influences their ability to address them.
Design and Setting: A qualitative study undertaken in general practice in the UK.
Method: 25 primary care HCPs (GPs, GP trainees, nurses, pharmacists, care
coordinators and social prescribers) were recruited via purposive sampling
(males=10, females=15). One-to-one semi-structured interviews were conducted
between April 2023-May 2024.
Results: Thematic analysis revealed three key findings. First, participants described how primary care is uniquely positioned to address SDOH through community proximity and integrated MDT services. Second, they expressed helplessness to change SDOH, citing barriers outside their clinical sphere of influence. Finally, they raised concerns over tensions between rising expectations of primary care and insufficient structural resources, including staffing, estates and training, to tackle complex SDOH issues.
Conclusion: MDTs were widely viewed by HCPs to improve the ability of general
practice to address SDOH in community-based services due to the unique remit of multidisciplinary roles, and the extra time that some roles are allocated for patient consultation. However, further resources are crucial for these teams to achieve meaningful impact.
Keywords: Social determinants of health; primary health care, general practice,
multidisciplinary teams, health inequalities