{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:33:55Z","timestamp":1783654435347,"version":"3.55.0"},"reference-count":22,"publisher":"Royal College of General Practitioners","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2025,4,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Socioeconomic deprivation is associated with lower life expectancy and more complex health needs. General practices may mitigate some of these health impacts by providing holistic care to their patients. The Deep End network was established in 2009 in Scotland to support practices working in the most socioeconomically deprived communities, and the concept has since spread, with Deep End Wales (Cymru) launching in 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore experiences of staff working within Deep End practices in Wales and understand their motivations for choosing to work in challenging practices along with their needs from a Deep End network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>Qualitative study with staff from Deep End eligible practices in Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Seventeen semi-structured interviews were undertaken. Data were analysed using thematic analysis and interpreted with reference to self-determination theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The following four main themes were identified: (1) Treading water (experiences of providing care in Deep End practices); (2) Diving into the Deep End (motivations for working in a Deep End practice); (3) Providing a life jacket (support from the Deep End Cymru community); and (4) Swimming to shore (the search for work-based effectiveness).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Deep End staff reported high workload, with limited resources and time to manage complex health needs. Most participants found working in Deep End practices rewarding. However, there were concerns about staff burnout, recruitment, and retention of staff. Deep End Cymru is providing hope, validation, and a place to share ideas. Barriers to success were funding and time. Participants want Deep End Cymru to advocate for them, support recruitment, improve services for patients, and support research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2025.0019","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T10:35:11Z","timestamp":1749638111000},"page":"BJGPO.2025.0019","source":"Crossref","is-referenced-by-count":1,"title":["'We\u2019re all in the same boat \u2026 some of us just have more holes in their boat': a qualitative interview study of primary care staff views of Deep End Cymru"],"prefix":"10.3399","author":[{"given":"Louise","family":"Thompson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0634-8548","authenticated-orcid":false,"given":"Haroon","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7397-4074","authenticated-orcid":false,"given":"Fiona","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"2025111817501346000_BJGPO.2025.0019v2.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(21)00146-X"},{"key":"2025111817501346000_BJGPO.2025.0019v2.2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30248-8"},{"key":"2025111817501346000_BJGPO.2025.0019v2.3","unstructured":"World Health Organization (WHO) Social determinants of health. accessed. https:\/\/www.who.int\/health-topics\/social-determinants-of-health. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(71)92410-X"},{"key":"2025111817501346000_BJGPO.2025.0019v2.5","unstructured":"University of Glasgow The Scottish Deep End Project. accessed. .. https:\/\/www.gla.ac.uk\/schools\/healthwellbeing\/research\/generalpractice\/deepend\/. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.6","unstructured":"Norman C Wildman J Sowden S (2021) Co-designing the Deep End NENC: Initial report, March 2021. accessed. https:\/\/arc-nenc.nihr.ac.uk\/wp-content\/uploads\/2020\/12\/Deep-End-Co-design-Initial-Report-March-2021-v2-1.pdf. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.7","unstructured":"Peters M Thomas K (2024) Report of the First Phase 2022-2024. Cardiff. accessed. https:\/\/www.rcgp.org.uk\/getmedia\/ccfc4b02-48e2-497e-9333-42e9d0010202\/Deep-End-Cymru-Report-First-Phase-July-2024-FINAL.pdf. 30 Oct 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.8","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2024.0167"},{"key":"2025111817501346000_BJGPO.2025.0019v2.9","doi-asserted-by":"publisher","DOI":"10.1080\/09581596.2023.2205569"},{"key":"2025111817501346000_BJGPO.2025.0019v2.10","doi-asserted-by":"crossref","unstructured":"Deci EL Ryan RM (1985) Intrinsic motivation and self-determination in human behavior (Plenum Press, New York, NY).","DOI":"10.1007\/978-1-4899-2271-7"},{"key":"2025111817501346000_BJGPO.2025.0019v2.11","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"2025111817501346000_BJGPO.2025.0019v2.12","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"2025111817501346000_BJGPO.2025.0019v2.13","unstructured":"Primary Care One Primary Care Model For Wales, accessed. https:\/\/primarycareone.nhs.wales\/primary-care-model-for-wales\/. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.14","unstructured":"British Medical Association (BMA) (2024) Global sum allocation forumla, accessed. https:\/\/www.bma.org.uk\/advice-and-support\/gp-practices\/funding-and-contracts\/global-sum-allocation-formula. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.15","doi-asserted-by":"publisher","DOI":"10.1080\/09581596.2017.1418499"},{"issue":"89","key":"2025111817501346000_BJGPO.2025.0019v2.16","first-page":"i","article-title":"General practitioners at the Deep End: the experience and views of general practitioners working in the most severely deprived areas of Scotland","author":"Watt","year":"2012","journal-title":"Occas Pap R Coll Gen Pract"},{"key":"2025111817501346000_BJGPO.2025.0019v2.17","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp15X687829"},{"key":"2025111817501346000_BJGPO.2025.0019v2.18","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00093-2"},{"key":"2025111817501346000_BJGPO.2025.0019v2.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2024.10.009"},{"key":"2025111817501346000_BJGPO.2025.0019v2.20","unstructured":"Beaufort Research (2024) Stakeholders\u2019 views on Deep End Wales: qualitative findings, accessed. https:\/\/www.rcgp.org.uk\/getmedia\/cfe7ca2d-7bec-45c9-8f2c-12cc9f2b01c4\/Stakeholders%e2%80%99-views-on-Deep-End-Wales-Beaufort-Research-June-2024.pdf. 15 Sep 2025."},{"key":"2025111817501346000_BJGPO.2025.0019v2.21","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X708641"},{"key":"2025111817501346000_BJGPO.2025.0019v2.22","doi-asserted-by":"publisher","DOI":"10.1080\/14739879.2019.1670738"}],"container-title":["BJGP Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3399\/BJGPO.2025.0019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T01:50:25Z","timestamp":1763517025000},"score":1,"resource":{"primary":{"URL":"http:\/\/bjgpopen.org\/lookup\/doi\/10.3399\/BJGPO.2025.0019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":22,"alternative-id":["10.3399\/BJGPO.2025.0019"],"URL":"https:\/\/doi.org\/10.3399\/bjgpo.2025.0019","relation":{},"ISSN":["2398-3795"],"issn-type":[{"value":"2398-3795","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,11]]}}}