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 & 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.