Evaluation of a London-wide intervention targeted at tackling educational and workforce inequity in primary care workforce across London

The Inverse Care Law continues to define inequity in health systems, with those communities experiencing the greatest burden of ill-health often receiving the least medical resource. Alongside this, two further dynamics reinforce inequity: the inverse distribution of education, and the inverse distribution of the permanent workforce. This article reports the findings of an independent evaluation of a five-year, London-wide intervention led by the Primary Care School London (PCSL). The programme sought to address these barriers by targeting educational placements, educator development, and retention support to boroughs with the greatest population health need. The evaluation drew on a mixed-methods design, combining surveys, focus groups, independent observation of decision-making, and analysis of workforce data. It found that clinical placement capacity, educator numbers, and early-career retention all increased over the period studied. Between 2018 and 2023, the number of GP educational supervisors rose by 49%, while GP trainee numbers increased by 24%, with a substantial proportion placed in boroughs of high deprivation. General practice nursing training also expanded, while the SPIN retention scheme supported more than 500 doctors and multi-professional fellows into permanent posts, many in high-need areas. Although downstream population health outcomes were not yet measurable, the programme demonstrated that education and workforce policy can be deliberately re-aligned with deprivation and health need. These findings complement the conceptual argument set out in our linked leading article and underline the role of education and retention strategies as structural levers for health equity.