This analysis reviews attempts to tackle inequities in the supply of general practice services in England over the past 30 years. The report looks at policies on general practice funding, workforce, premises, contracts and commissioning.

In the first part, we summarise the problem – describing recent evidence on differences in the provision of GP services between more and less deprived areas of England. In the second, we assess past attempts to address the problem – reviewing national policies to reduce inequities in the supply of general practice services in England. In the final part, we discuss the implications of our analysis and set out policy recommendations for addressing the inverse care law in general practice.

We provide several recommendations for national policymakers, including: a new equity test for all new policies in general practice; an independent review of general practice funding allocations; and a long-term workforce strategy for general practice that should consider stronger central coordination and oversight of GP distribution.