Table 1 Study setting

The Partnership for Health Equity (PHE) is an innovative collaboration which engages medical educators, researchers, clinicians and health service planners from across Ireland in collaboration to work on projects seeking to improve healthcare for marginalised groups. The current partners are the University of Limerick Graduate Entry Medical School, the North Dublin City General Practice Training programme and the Health Service Executive (HSE) Social Inclusion Division. The aim of the partnership is to improve healthcare for marginalised groups by conducting relevant research, by educating future healthcare professionals and by directly providing primary care to marginalised groups. A key feature of the PHE is that research is planned with all partners and research findings are used to inform the development of services, with a focus on priorities for action by the HSE – thereby making real differences in the day-to-day healthcare experiences of patients from marginalised groups across the country.

Limerick City was recognised as the most deprived local authority area in the country in 2014, with 28% unemployment and above average rates for all major causes of mortality (cardiovascular and respiratory disease, cancer, injury) [85]. Groups identified as ‘marginalised’ by the PHE in this setting included migrants, homeless, Irish Travellers, young mothers living in deprived areas, sex workers and drug users.

The Primary Care Team of interest was being established by the HSE and local general practitioners (GPs) in a one of the most deprived areas in the city, with a number of homeless hostels and a high migrant population. The PCT was to consist primarily of a physiotherapist, an occupational therapist, public health nurse (PHN), GPs and allied health professionals.