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The power of research-practice collaboration: Co-designing a Deep End Network to support primary care in socioeconomically disadvantaged communities

The challenge

General Practices face increasing challenges, especially those which serve areas of blanket socioeconomic deprivation, where health needs are complex and demands on resources can be high.

In 2020, ARC NENC researchers partnered with primary care practitioners in our region to co-design the Deep End North East and North Cumbria (NENC) GP Network. This collaborative, research-led process ensured the Network was shaped by primary care professionals working in the most deprived areas.

The Network now includes 52 General Practices where half or more of their patients live in very disadvantaged circumstances.

Read more about the initial co-design of the Deep End NENC GP Network

Deep End programmes of work that have been developed with ARC NENC support

• Deep End Social Determinants of Health (SDoH) Pilot (Care DEEP)

Enables GP practices to provide support around the wider determinants of health. Provides flexibility to use financial support. 34 pilot practices have been allocated £38,000 per practice from the ICB NENC to implement initiatives focusing on non-medical needs of patients which impact on health outcomes, for example, screening uptake. Researchers from the ARC NENC are evaluating the impact.

• Minded Pilot

Explored the feasibility and acceptability of embedding clinical psychologists in general practice in areas of severe socioeconomic deprivation. ARC NENC supported an evaluation funded through the NIHR Three Schools Mental Health Practice Evaluation Scheme and NIHR RDN Targeting Health Needs fund. Further linked work has been funded via NIHR Three Schools Prevention Fund to explore a Community Research Link Worker Model for Deep End initiatives. Read more

• Train DEEP

Addresses the issue of how to increase GP recruitment in areas of socioeconomic deprivation to counteract the inverse care law, by supporting General Practices to become training practices. Funded as part of the ICB NENC support for Deep End programmes.

Read the latest research paper about this work.

• Taper – supporting opioid and gabapentinoid deprescribing

Taper began as a six-month pilot (in six Deep End practices) which aimed to reduce opioid and gabapentinoid prescription rates in patients identified as high risk – by implementing medication reviews and other linked work. An evaluation of the pilot was supported by ARC NENC and findings were fed back into our health and care system.

Taper is now part of our ICB’s Waiting Well programme, supporting patients waiting for routine surgery who have risk factors which may delay their eligibility.  A partnership between 40 Deep End practices and 7 Foundation Trusts is supporting deprescribing for over 400 patients on elective surgical waiting lists.

Targeted support is provided through the North East and North Cumbria Waiting Well programme. Initiatives include opioid deprescribing, as well as weight management, and intensive support for better diabetes management, alongside addressing wider determinants of health and well-being. These efforts significantly reduce the likelihood of surgery cancellations or postponements and improve the management of long-term health conditions. They also help ensure those with the most complex needs, including those who experience disadvantage – get more bespoke support, helping to ensure equity. Read more

This work was highlighted in the Government’s Fit for the future: 10 Year Health Plan for England

Learning is also being incorporated into non-Deep End practices as part of a wider transformation of General Practice.

• Deep End Childhood Immunisation catch-up (IMMS) – evaluation

IMMS was a pilot to increase childhood vaccination uptake in areas of deprivation (via flexible delivery mechanisms). An ARC NENC-funded PhD identified barriers, enablers and modifications to the pilot. Learning was shared with the NENC Immunisation Partnership Board for implementation across all NENC General Practices.

Find out more about the research that is supporting the Deep End GP Network

Supporting a case for investment in our region’s Deep End GP Network

Thanks to the ARC NENC’s evidence-based advocacy, the Deep End programme secured £1.6 million from our Integrated Care Board (NENC) to deliver work across 2024/25

A further £1.3 million has been secured for 2025/26.

This funding supports continued innovation and delivery in the region’s most underserved communities.

Community at the core

Public and patient involvement (PPI) is central to the Deep End NENC approach. A dedicated ARC fellow leads the public involvement element of the Deep End programme, ensuring community voices shape priorities and practice.

Read more about the ongoing work of the Deep End NENC GP Network

Expanding the Deep End concept into other areas of care

Building on the success of the Deep End GP Network, partners across our region are now exploring:

• Deep End Pharmacy – This began with NIHR Three Schools Prevention-funded activity developing the concept of Deep End pharmacy, followed by a further NIHR Three Schools Programme grant to co-develop a care pathway between community pharmacies and general practices in the Deep End.

Preventing chronic disease with community pharmacies at the deep end – NIHR School for Public Health Research

• Deep End Dentistry – A NIHR RDN Targeting Health Needs funded project to define and map Deep End dentistry across England. Findings were published in August 25 and discussions are now underway around how we might develop a Deep End dental group in the North East and North Cumbria.

Research highlights a new approach to tackle inequalities in dental care – ARC

• Deep End Emergency Department

The NENC Deep End network are also supporting the development of a ‘Deep End Emergency Department’ network this year (2025). This will explore how a Deep End network approach could support hospitals to better engage and support their communities with the highest health needs.

Lasting impact

• The Deep End NENC Network is transforming how primary care is delivered in areas of deprivation where patients have complex needs.
• Learning from pilots is being scaled across our region.
• The Network is a model for how research-practice collaboration can drive systemic change.

If you would like to talk to us about this work, we’d pleased to tell you more. Please email the team at [email protected]