Fairer Practice actions

Inclusive registration

Access and Flexibility

Follow NHS registration guidelines by removing documentation barriers. Ensure patients can register for care without the need for ID or proof of address.

Safe Surgeries Accreditation

Access and Flexibility

Implement the Doctors of the World Safe Surgeries Toolkit to create an environment where all patients, regardless of immigration status, feel safe accessing healthcare.

Flexible appointment booking

Access and Flexibility

Ensure multiple access routes for booking appointments, including walk-in, phone, and digital options.

Offer Face-to-Face Appointments Upon Request

Access and Flexibility

Provide in-person consultations for patients who request or would benefit from them.

Multi-lingual registration information

Access and Flexibility

Ensure signage, registration information and online details are accessible in multiple languages spoken by your practice population.

Staff training on access barriers

Access and Flexibility

Educate staff on the impact of digital exclusion, literacy issues, and cultural barriers.

Recording Language Needs and Interpreter Requirement

Access and Flexibility

Routinely code patients' preferred spoken language and interpreter requirements to ensure consistent communication support at every interaction.

Extended consultations for complex needs

Access and Flexibility

Offer longer appointments for Focus Patients who need or will benefit from this.

Flexible appointment structures

Access and Flexibility

Move away from rigid early-morning booking rushes and offer a mix of pre-bookable, on-the-day, and walk-in slots

Interpretation availability at reception

Access and Flexibility

Ensure access to interpreters at reception e.g. to support appointment bookings and information requests.

Care navigation training for reception teams

Access and Flexibility

Equip frontline staff to guide patients effectively to the right service.

Enable proxy addresses

Access and Flexibility

Allow patients with no fixed address to use the practice as their postal address for essential correspondence.

Named GP for Each Focus Patient

Access and Flexibility

Assign a GP to patients with complex needs to improve continuity of care. Where possible, care should be co-ordinated and delivered by that GP.

Review ‘One Appointment, One Problem’ Policies

Access and Flexibility

Facilitate a practice discussion on the impact of ‘one appointment, one problem’ policies and consider flexibility for patients with complex needs.

Neurodivergent-inclusive access and experience

Access and Flexibility

Proactively identify and address barriers to access for neurodivergent patients by creating practice environments and systems that are flexible, predictable, and accepting of different needs.

Embed Reasonable Adjustments for People with a Disability, including a Learning Disability

Access and Flexibility

Commit to making reasonable adjustments for people a disability and ensure staff receive training on practical implementation.

Proactively Flag Access Needs in the Clinical Record

Access and Flexibility

Identify and flag patients who need a different approach to access and care, ensuring adjustments are provided at every interaction.

Walk-in clinics for Focus Patient Groups

Access and Flexibility

Establish dedicated walk-in or outreach services in community hubs for those facing significant barriers.

Patient participation and co-design of access policies

Access and Flexibility

Develop and sustain engagement and co-production groups to ensure patient voices shape access policies.

Integrate Community Outreach into Routine Practice

Access and Flexibility

Develop structured outreach initiatives to engage underserved populations and improve service access.

Introduce peer navigators – Employ individuals with lived experience to support vulnerable patients in accessing care.

Access and Flexibility

Local Advocacy Networks

Advocacy and Policy

Facilitate networking opportunities, including Deep End GP groups, for GPs interested in advocacy for health equity to connect, share ideas, and collaborate.

Equip GPs with Practical Advocacy Skills

Advocacy and Policy

Provide training and resources to help GPs engage in effective advocacy at practice, local, and national levels.

Strengthen Partnerships with Third-Sector Organisations

Advocacy and Policy

Create and maintain mechanisms of partnership working between GP practices and third-sector organisations working on health inequalities.

Understand the Health and Care of Your Focus Patients

Care for Focus Patients

Use practice data to identify where your Focus Patient group is underrepresented in key clinical services or experiencing poorer outcomes.

Implement Targeted Blood Pressure and Cardiovascular Risk Checks

Care for Focus Patients

Offer opportunistic or outreach-based BP checks and CVD risk assessments to patients known to be under-screened or facing disadvantage.

Improve Equity in Vaccination Uptake Through Targeted Recall and Support

Care for Focus Patients

Identify patients from your Focus Patient group with missed vaccinations and offer accessible, supported options for catch-up.

Ensure Annual Physical Health Checks for patients with Severe Mental Illness (SMI)

Care for Focus Patients

Use proactive recall to ensure all Focus Patients with SMI are invited to annual health checks and supported to attend.

Identify and Proactively Support Patients with a Learning Disability

Care for Focus Patients

Ensure your practice has a robust process to identify, record, and maintain a register of patients with a learning disability, using appropriate clinical coding and enabling targeted support and reasonable adjustments.

Ensure Inclusive Screening for Trans Patients

Care for Focus Patients

Identify and invite all eligible trans and non-binary patients for appropriate cancer and health screening, regardless of gender marker.

Improve Access for Gypsy, Roma and Traveller Communities

Care for Focus Patients

Identify, record, and proactively address barriers to care for Gypsy, Roma and Traveller patients.

Assess the Needs of Vulnerable Migrants

Care for Focus Patients

Use NHS bilingual health needs questionnaires to assess the health and support needs of newly registered vulnerable migrants at or soon after registration.

Deliver culturally tailored smoking cessation support

Care for Focus Patients

Offer personalised, non-judgemental smoking cessation support targeted at Focus Patients from groups with higher smoking rates and lower quit rates.

Annual Health Checks for People with a Learning Disability

Care for Focus Patients

Deliver high-quality, person-centred annual health checks for all patients on the learning disability register, using a structured template, accessible communication, and a co-developed health action plan.

Recognise and Support Carers

Care for Focus Patients

Identify, record, and proactively support carers, including young carers, linking them to relevant information, services, and respite opportunities.

Veteran Friendly Practice Accreditation

Care for Focus Patients

Work towards and achieve RCGP Veteran Friendly Practice accreditation to improve care for patients who have served in the UK Armed Forces.

Inclusive, Stigma-Free Care for Sex Workers

Care for Focus Patients

Provide trauma-informed, non-judgemental, and accessible care for sex workers, ensuring services are flexible, inclusive, and supportive of holistic health needs.

Support Continuity of Maternity Care for Focus Patients

Care for Focus Patients

Collaborate with midwifery teams to ensure Focus Patients receive safe, continuous care during pregnancy.

Achieve Pride in Practice Accreditation

Care for Focus Patients

Work towards and achieve Pride in Practice accreditation to demonstrate commitment to LGBTQ+ inclusive care.

Run a targeted cancer screening improvement initiative

Care for Focus Patients

Design and deliver a short campaign to increase screening uptake (e.g. bowel, breast, cervical) among underrepresented groups.

Measure and Discuss Continuity of Care in the Practice Team

Continuity of Care

Track and review continuity of care metrics, particularly for Focus Patients, to identify and address fragmented care patterns.

Ensure Patients Can See Their Named GP When Possible

Continuity of Care

Enable patients to request and book appointments with their preferred GP to support continuity.

Facilitate Follow-Up Appointments for Patients and Clinicians

Continuity of Care

Ensure appointment systems allow follow-ups to be booked at the point of care, rather than requiring patients to call back later.

Make GP Working Patterns Transparent to Patients

Continuity of Care

Publish GP schedules online so patients can choose appointments with their preferred clinician.

Introduce Proportionate Continuity for High-Need Patients

Continuity of Care

Prioritise continuity for focus patients.

Introduce MDTs for Priority Continuity

Continuity of Care

Establish small, dedicated teams to proactively manage continuity for patients facing severe and multiple disadvantages.

Adjust Appointment Lengths to Support Continuity and Workforce Retention

Continuity of Care

Review appointment structures to ensure safe workloads, reducing GP burnout and improving continuity.

Proactively Identify Digitally Excluded Patients

Digital Inclusion

Use practice data to identify patients who are digitally excluded and ensure they have alternative access options clearly recorded.

Embed Digital Inclusion in Staff Training

Digital Inclusion

Incorporate digital inclusion awareness into staff training, helping teams recognise and support digitally excluded patients without assumptions.

Develop Digital Navigation Roles Within Practices

Digital Inclusion

Train or recruit trusted staff or volunteers to act as ‘digital navigators’ actively supporting patients to use digital healthcare tools effectively.

Deliver Community-Based Digital Literacy Support

Digital Inclusion

Build partnerships with local voluntary organisations to deliver community-based and outreach digital literacy support, including pop-up sessions in trusted community spaces.

Provide Accessible Digital Tools with Multilingual and Easy-Read Support

Digital Inclusion

Ensure practice websites, apps, and digital platforms include translation, easy-read formats, and accessibility options.

Establish Device Access Scheme for Digitally Excluded Patients

Digital Inclusion

Work with libraries, local VCSEs, or PCNs to create a device loan or donation scheme to support patients without access to smartphones or tablets for online care.

Provide Digital Access Points in Waiting Areas

Digital Inclusion

Install secure tablets or computer stands in waiting rooms to allow patients to access health information, book appointments, or complete forms with staff support if needed.

Regular Protected Team Health Equity Education Time

Team Education

Establish dedicated, protected time for regular team education sessions explicitly addressing health inequalities and related issues.

Neurodiversity awareness training

Team Education

Provide education and training for all staff on neurodiversity and neuroaffirmative approaches, co-designed with neurodivergent people.

Staff Training on Gypsy, Roma and Traveller Inclusion

Team Education

Provide training for all staff on understanding and addressing the needs of Gypsy, Roma and Traveller patients.

Innovative Empathy-Building Education

Team Education

Use creative and multimedia resources (films, documentaries, music, visual arts, podcasts, books, storytelling) within training sessions to explicitly build staff empathy towards diverse patient groups.

Provide Multilingual, Accessible NHS Navigation Guides at Registration

Health Literacy and Education

Ensure that practice websites, printed materials, and patient education tools are available in clear, simple formats and common community languages, helping all patients understand their rights and how to access care.

Integrate Health Literacy Training into Staff Development

Health Literacy and Education

Include health literacy training in induction and ongoing professional development for all practice staff to ensure effective communication strategies.

Regularly Update Staff Knowledge on Community Health Resources

Health Literacy and Education

Train reception and clinical staff to provide up-to-date information and signposting to local community health resources.

Provide Multilingual Self-Management Materials for Long-Term Conditions

Health Literacy and Education

Develop or signpost accessible self-management information for long-term conditions (e.g., asthma, diabetes, hypertension) in multiple languages and formats.

Embed Diverse Representation in Patient Education Resources

Health Literacy and Education

Ensure that educational materials and websites reflect the diversity of the community, using inclusive visuals, names, and real-life case studies from varied ethnic and cultural backgrounds.

Link Practices with Community-Based Health Education Initiatives

Health Literacy and Education

Partner with community organisations to deliver culturally relevant, community-led health education programmes.

Identify and Define a Focus Patient Group

Health Needs Assessment

Use local health needs data, deprivation data, and insights from patients and your team to identify and define your focus patient group (those most likely to experience poorer access, outcomes, or engagement).

Strengthen Links with Public Health Teams

Health Needs Assessment

Engage with local public health colleagues to share data, collaborate on population health priorities, and align general practice services with community needs.

Conduct a health needs assessment for your practice

Health Needs Assessment

Assess and document the demographic makeup, key health needs, and inequalities within your practice population. Create a report summarising this.

Use Lived Experience to Shape Health Needs Assessments

Health Needs Assessment

Engage patients with lived experience to help tailor how practices assess and respond to local population health needs.

Foster Collaboration Between Practices to Share Health Needs Assessment Work

Health Needs Assessment

Enable networks of practices (e.g., PCNs) to work together on health needs assessment and equity initiatives.

Develop Community-Based Approaches to Support Self-Care and Reduce Reactive Demand

Health Needs Assessment

Mobilise community assets and third-sector partnerships to create sustainable support models beyond traditional clinical care.

Proactively Identify High-Need Patients for MDT Care Planning

Multidisciplinary Team Approaches

Use structured methods (e.g., SNOMED coding, deprivation indexes) to proactively identify Focus Patients who would benefit most from multidisciplinary care planning and implement MDT-led interventions.

Structured MDT Meetings with Protected Time

Multidisciplinary Team Approaches

Establish regular, structured multidisciplinary team meetings with protected time to discuss and coordinate care for Focus Patients with complex needs.

Collaborate with Community and Welfare Services

Multidisciplinary Team Approaches

Formalise partnerships between practices and local welfare, housing, and community organisations to ensure integrated MDT responses for Focus Patients with complex social needs.

Embed Care Coordinators Within MDTs

Multidisciplinary Team Approaches

Integrate dedicated care coordinators into multidisciplinary teams to ensure personalised, proactive support for marginalised Focus Patients.

Identify Ethnic Minority Patients in the Practice Population

Minoritised Ethnic Communities

Use practice systems and coding to identify patients from ethnically and racially minoritised groups to support equity-focused service planning and care delivery.

Use Ethnicity Data to Identify and Respond to Disparities in Access, Experience and Outcomes

Minoritised Ethnic Communities

Review ethnicity-coded data to identify disparities and design specific actions to reduce inequities in access, experience, and health outcomes.

Introduce Basic Race and Health Awareness Training

Minoritised Ethnic Communities

Provide foundational training to ensure all practice staff understand race, racism, anti-racism and racial and ethnic disparities in primary care experience and health outcomes.

Promote Inclusive Social Prescribing and Signposting

Minoritised Ethnic Communities

Develop a robust, culturally relevant mapping of local social prescribing and community referral options, community services, and wellbeing groups tailored to the needs of ethnic minority populations.

Embed Patient Experience Feedback Loops for Ethnic Minorities

Minoritised Ethnic Communities

Establish robust feedback mechanisms specifically designed to understand the experiences and improve trust of patients from ethnic minority backgrounds.

Proactive Identification and Support for Ethnic Minority Patients Facing Disadvantage

Minoritised Ethnic Communities

Proactively identify patients from an ethnic minority background experiencing structural disadvantage and offer tailored support pathways, ensuring their care needs are appropriately prioritised and managed.

Cultural Safety and Anti-Racism Training

Minoritised Ethnic Communities

Deliver structured training on cultural safety, power dynamics, and anti-racist practice to create environments where patients from all backgrounds feel respected and heard.

Implement Inclusive Remote Consultation Practices

Minoritised Ethnic Communities

Ensure remote consultation approaches are culturally sensitive, inclusive, and supported by appropriate interpretation and communication tools.

Use Cultural Events to Promote Preventive Health

Minoritised Ethnic Communities

Recognise and incorporate relevant cultural events into practice activities to promote preventive healthcare messages such as screening, vaccination, or health checks.

Encourage Inclusive Participation in Patient Groups

Minoritised Ethnic Communities

Review and adapt communications about patient participation groups (PPGs) to ensure inclusivity, particularly for minoritised ethnic communities (e.g., inclusive language and visuals in flyers, text messages, and outreach).

Collaborate Across the Local System to Tackle Ethnic Health Inequalities

Minoritised Ethnic Communities

Use ethnicity-related insights from your practice to inform neighbourhood or locality-level initiatives aimed at reducing racial health inequalities.

Identify patients at high risk of missingness and explore barriers

Addressing Missingness

Track local patterns of missed care and use this information to explore root causes and inform tailored support.

Introduce a 'Missingness Coordinator' function

Addressing Missingness

Designate a staff member or role to lead missingness work, coordinate support, and advocate for patients experiencing repeated disengagement.

Develop Individual Needs Profiles (e.g. PIN documents) for at-risk patients

Addressing Missingness

Use structured documents to record how specific patients prefer to be contacted and supported around care engagement.

Address transport and logistical barriers to care

Addressing Missingness

Use a stepped approach to remove transport barriers—ranging from travel vouchers to direct accompaniment, depending on need.

Develop Practice-Level Community Resource Lists

Networks of Support

Develop and maintain comprehensive lists of local community, welfare and voluntary services to enable effective signposting for Focus Patients.

Establish Locality-Based Practice Collaboration Networks

Networks of Support

Actively collaborate with other local GP practices to share expertise, resources, and jointly address local health equity challenges.

Become 'Research Ready' Through RCGP Accreditation

Research

Achieve RCGP Research Ready accreditation, equipping them with foundational skills and confidence to participate in primary care research.

Actively Participate in Research Studies Focused on Health Equity

Research

Collaborate proactively with academic and research institutions to engage in or host research studies explicitly targeting health inequalities and inclusion health populations.

Foster Welcoming Practice Environments

Addressing Stigma and Discrimination

Create visibly inclusive environments through welcoming messaging, accessible resources, and staff training that signals all patients are valued and safe.

Increase Staff Awareness of Stigma and Bias

Addressing Stigma and Discrimination

Provide team-wide training on stigma, discrimination, and unconscious bias, particularly for frontline staff.

Tackle Stigma within the Workforce

Addressing Stigma and Discrimination

Support an internal culture shift by addressing discrimination and stigma within staff teams.

Neuroaffirmative care

Addressing Stigma and Discrimination

Adopt a neuroaffirmative approach that recognises neurodiversity as natural variation, focusing on environmental adaptations to improve care for neurodivergent patients and staff.

Proactively Identify and Address Candidacy Barriers

Addressing Stigma and Discrimination

Review practice systems to ensure that all patients feel entitled to and welcomed in primary care.

Develop Patient-Led Approaches to Combat Stigma

Addressing Stigma and Discrimination

Engage patients with lived experience to shape inclusive policies and reduce stigma.

Introduce Basic Structural Competence Training

Structural Competence

Provide simple, accessible training sessions or briefings to enhance all practice staff’s understanding of how social structures affect patient health and interactions.

Regular Practice-Based Structural Competence Discussions

Structural Competence

Incorporate regular structured conversations about structural competence into existing team meetings or protected learning time.

Co-located welfare and health services – Integrate services such as Citizen’s Advice or housing support within GP practices.

Structural Competence

Basic Trauma-Informed Care Awareness Training

Trauma-Informed and Enabled Care

Provide foundational training for all practice staff (clinical and non-clinical) to develop an understanding of trauma-informed principles and approaches.

Implement Trauma-Informed Care into Routine Practice

Trauma-Informed and Enabled Care

Embed trauma-informed principles into everyday interactions and systems within the practice, making it a routine aspect of patient and staff experiences.

Develop Trauma-Enabled Practice Infrastructure

Trauma-Informed and Enabled Care

Create the necessary infrastructure and resources, such as accessible psychological support, to sustain trauma-informed care effectively across the practice.

Identify a Fairer Practice Lead

Values and Behaviours

Designate a named member of the practice team as the Fairer Practice Lead to serve as a point of contact for the Fairer Practice team, champion health equity work and coordinate actions.

Promote Shared Discussion of Team Values

Values and Behaviours

Use regular team spaces to explore and reflect on the values that underpin how you work with each other and your patients.

Develop and Display a Team Charter or Code of Conduct

Values and Behaviours

Co-create and display a short statement of your practice’s agreed values and behaviours.

Use Reflective Tools to Explore Bias and Assumptions

Values and Behaviours

Facilitate structured reflection on values, assumptions and decision-making using stories, debriefs, or simulation.

Embed Equity-Related Values into Recruitment, Appraisal and Leadership

Values and Behaviours

Align recruitment, supervision and leadership development with your practice’s values and equity goals.

Regular Staff Wellbeing Check-Ins

Team Wellbeing

Implement regular, structured check-ins within teams to discuss workload pressures, emotional challenges, and identify support needs early.

Access to Occupational Health and Psychological Support

Team Wellbeing

Ensure equitable access for all practice staff (clinical and non-clinical) to occupational health and psychological support services.

Introduce Anonymous Staff Feedback Mechanisms

Team Wellbeing

Establish a double anonymous feedback system (e.g. digital form, secure comment box) to allow team members to voice concerns or improvement ideas without fear of retribution.

Establish Structured Reflective Practice Sessions

Team Wellbeing

Provide regular reflective practice opportunities, such as Balint groups or facilitated reflective sessions, supporting staff wellbeing and effective trauma-informed care.

Facilitate Trauma-Informed Debrief Sessions

Team Wellbeing

Provide protected, structured debrief sessions following critical or emotionally challenging incidents, ensuring they are trauma-informed and inclusive of all team members.