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Disparities in the quality of primary healthcare for socially deprived children
  1. Philippa Rees1,
  2. Adrian Edwards1,
  3. Colin Powell2,
  4. Huw Evans1,
  5. Sukhmeet Panesar3,
  6. Andrew Carson-Stevens1
  1. 1Healthcare Quality and Communication Research Group, Cochrane Institute for Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
  2. 2Institute of Molecular & Experimental Medicine, School of Medicine, Cardiff University, Cardiff, UK
  3. 3Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Andrew Carson-Stevens, Cochrane Institute of Primary Care and Public Health, 3rd Floor, Neuadd Meirionnydd, School of Medicine, Cardiff University, Cardiff CF14 4YS, UK; Carson-StevensAP{at}

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Mbeledogu et al1 demonstrate a reduction in unintentional poisonings in children in England, yet highlight the protracted social disparities among these children. This resonates with our exploration of over 20 000 paediatric safety incidents from primary care in England and Wales where the ‘Inverse Care Law’ features prominently.2 These reports include: looked-after children, immigrants, travellers, parents with addiction problems and those belonging to other disadvantaged groups. Data mining identified over 500 reports involving these groups and 33 reports involving homeless children or families. Such a reporting system has not previously been used to assess unsafe care in socially deprived groups.

Thematic analysis of free-text in reports involving homeless children was undertaken and five overarching failures were identified (see table 1). Some disclosure failures resulted in …

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  • Competing interests AC-S and AE are co-chief investigators of a NIHR HS&DR grant to characterise patient safety incident reports in primary care. PR is a research assistant employed to work on the study. HE and CP have no conflicts of interest. SP is a former clinical adviser at the NPSA (2008–2010) and an Academic Clinical Fellow at Imperial College London working for the NRLS research programme.

  • Funding This project was funded by the National Institute for Health Research HS&DR (project number 12/64/118). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR, NIHR, NHS or the Department of Health.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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