A cost-benefit analysis of an intervention to increase the number of deep end GP training practices in the North East of England

Background There are a lack of general practitioner (GP) training practices (TPs) in socioeconomically disadvantaged areas, where recruitment and retention are challenging. The North East and North Cumbria Deep End Network (NENC DEN) supports practices serving socioeconomically disadvantaged communities, where health needs are greatest. The TrainDEEP intervention aims to increase the number of Deep End TPs by embedding an experienced trainer within practices, providing clinical capacity and supporting a GP (general practitioner) to complete the Intending Trainers Course, to improve recruitment and access to care in underserved areas. Aim To evaluate whether TrainDEEP provides sufficient economic and operational value to warrant investment by health systems and participation from GP practices. Design & setting A cost–benefit analysis comparing an NENC DEN practice supported by TrainDEEP with a practice becoming a TP independently. Method Using data from NENC DEN practices and NHS England, practice-level costs and benefits of becoming a TP are estimated at a micro-cost level. Sensitivity analysis varied the benefits of hosting registrars and the cost of locum cover. Results Over 24 months, TrainDEEP generated benefits of £139,628 and costs of £24,024, yielding a net-benefit of £115,604. Over the same time-horizon, the net-benefit for unsupported practices was just £36,650 due to fewer benefits and greater costs. Overall, TrainDEEP produced a higher benefit–cost ratio than independent TP development, which was robust to sensitivity analyses. Conclusions TrainDEEP offers substantially greater net-benefits by reducing the time required to achieve TP accreditation and enabling earlier training-related benefits. Health systems should consider adopting this model to increase capacity and reduce inequalities.