Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part I: the GP perspective.
OBJECTIVE
This study aimed to describe social problems presented to general practitioners (GPs) in UK inner cities and GPs' responses; describe patients' help-seeking pathways; and consider how these pathways can be improved.


METHODS
The study involved a pilot survey and follow-up qualitative interviews with patients in two inner city areas in London and Salford in 2001-2. The pilot survey involved five practices in each locality. GPs completed questionnaires on 57 people presenting with social problems. A diversity sample of 12 patients were followed up for interview.


RESULTS
Study results are presented in two parts. This paper focuses on the GP survey results. People were presenting with a wide range of social problems, and multiple problems were also common. Problems with welfare benefits and housing were the most common, but GPs were most likely to refer to counselling services and to a lesser extent to generic advice services. Some GPs would have preferred to refer patients to more problem-specific services but did not believe these were available.


CONCLUSIONS
The study highlights the role GPs play in helping people deal with social problems but also identifies limitations in their response to these problems. It points to the need for more integrated pathways to help and advice for social problems. Primary care can make existing pathways more visible and accessible, and create new pathways through, for example, the new commissioning role and extending the scope of social prescribing.
Popay
Jennie
J
Institute for Health Research, Lancaster University, Alexandra Square, Lancaster LA1 4NT, UK. j.popay@lancaster.ac.uk
Kowarzik
Ute
U
Mallinson
Sara
S
Mackian
Sara
S
Barker
Jacqui
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D004739:England; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D054624:Health Status Disparities; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012940:Social Problems / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data