Research findings help guide clinical practice with reliable evidence derived from a primary care setting. 90% of NHS contacts take place in primary care. This equates to 340 million consultations a year. An average person sees the GP six times a year.
“Research has revolutionised my practice as a GP. Patients are offered management options not otherwise available to them. One patient quote I have never forgotten is ‘Is it fair that my GP practice does not offer me research opportunities when I know other practices do?'"
Dr Robin Fox, GP at Bicester Health Centre
"Research helps us improve the standard of care we provide as well as allowing our patients to be more involved and better understand their illnesses."
Dr Shamila Wanninayake, GP at The Manor Surgery
Why Should GP Practices Support Research?
It's good for career development for you, your multidisciplinary team and all trainees
Many healthcare professionals say they find the experience of being involved in research studies positive and rewarding. Any member of the practice team can get involved. The experience of staff involved in running research studies is very encouraging, with many reporting an increase in job satisfaction, improved training and career development opportunities. All members of the practice team can benefit from being involved in research. Research is fun, interesting and can feel positive; it enables you to build connections with new people and develop your knowledge in your areas of professional interest. It can also allow the opportunity for you to give something additional to your patients and allow them the opportunity to ‘give back’ to the NHS by supporting research and quality improvement.
Doctors supporting research in their practice are able to acquire Continuous Professional Development (CPD) hours for their annual appraisals, contributing to revalidation requirements. Research can stimulate future doctors and energise training GPs.
GP trainees: GP trainees now have a quality improvement mandatory requirement as part of their training. This could be completed by being a Principal Investigator/Sub Principal Investigator on a research study within their practice. This not only engages potential new researchers allowing them to undertake other responsibilities and have ‘portfolio’ careers, but also supports research in the practice and provides further opportunities for patients
The GMC position statement underpins the importance of research for patient care, wellbeing and the benefits for staff who deliver research. Research is recognised by the CQC as a marker of quality and excellence and many research studies align with NHS England long term plans for primary care
An NIHR case study demonstrates four key ways research can benefit your career, featuring testimonies from healthcare professionals who encourage others to follow in their footsteps and take their next step in their research career.
It's good for your practice
It can be empowering for GPs and patients alike to be helping to answer important research questions that are relevant to UK general practice. Practices have found that developing a research interest and participating in the Research Site Initiative Scheme can lead to a novel aspect of staff development and portfolio careers. Hosting research offers more variety to clinical roles and further opportunities to build networks.
The agile research delivery team (ARDT) provides extra workforce depending on the RSI level that your practice is working at. The agile research delivery team can provide support to help deliver research studies. Practices that receive a higher level of funding will be expected to independently support a proportion of their research activity. The ARDT supports study set up, patient screening and recruitment activities, providing patient care and support for the life cycle of the study. They also enter additional clinical codes to support QOF and clinical care. Feedback from practice teams is that they enjoy working with the ARDT.
The practice is paid for research activity. The work done is costed and paid appropriately and brings income into the practice for reinvestment into clinical services or to provide infrastructure for future research projects.
It's valued by the CQC
The NHS Constitution states that "research is a core NHS business and every patient should be offered the opportunity to engage with research activities".
The Care Quality Commission (CQC) has already identified research activity as a quality marker in secondary care, and some primary care CQC reports highlight the value of research to patients as a demonstrable commitment to quality improvement. The CQC now has a remit to assess how NHS organisations are supporting the delivery of research and embedding research outcomes to improve clinical outcomes for patients.
It's part of the NHS long term plan
A key focus is 'research and innovation to drive future outcomes and improvement'. This acknowledges that patients benefit enormously from research and innovation, with breakthroughs enabling prevention of ill-health, earlier diagnosis, more effective treatments, better outcomes and faster recovery. The NHS Long Term Plan includes the commitment to increase the number of people registering to participate in health research to one million by 2023/24.
It's good for your patients
Primary Care Research covers many disease areas creating many opportunities for patients. GP’s see patients with common and rare conditions. Research has proven that patients that receive care from a research active organisation have better outcomes.
Most people love taking part in research and feedback how positive the experience has been for them. Participating in primary care research is good for the patients as it is 'on their doorstep' and delivered by staff that they know well.
Patient testimonials underpin how our population benefits from being able to take part in primary care research and why we must continue to ensure our patients continue to have opportunities to participate.
Primary Care Research Sustainability
A lot of the research that takes place in the practice does not need to be done by the GP.
In most cases the actual time required of a GP is fairly minimal e.g. screening patient lists for eligibility and / or acting as a Principal Investigator for safety screening/reporting at the practice.
A lot of the day to day research activity can be managed by other skilled team members such as administrators, health care assistants, paramedics, trainees and practice nurses.
Primary care research contribution to the Quality and Outcomes Framework (QOF)
Site based studies, where the research activity is based at the practice (patient assessments/tests) either with a practice nurse / health care assistant or clinical research nurse delegated to deliver these tasks can boost prevalence scores. This work is often done by an embedded CRN nurse who can do this work for the practice.
Research assessments often involve obtaining data such as:
Height
Weight
BMI
Smoking status
Alcohol status
Blood Pressure
COPD annual review information
When entering patient data to the online case report forms required for the research study, the health care professional can simultaneously update the patients’ medical records. Our research nurses are trained to enter codes.
Acting as a Patient Identification Centre for studies that are not blinded to results can also contribute. Some research sites will send a copy of any assessment results to the named GP; any new diagnoses or results are then entered onto the patient system.
The NIHR offers a wide variety of studies covering multiple clinical areas such as COPD, atrial fibrillation, hypertension, obesity, mental health, osteoporosis and dementia etc.
Further reading and interesting podcasts
Dr Lisa Gibbons (NIHR SWP RRDN Primary Care Research Lead) blog about clinical research: https://spark.adobe.com/page/NztXokPBHlH43/
Professor Phil Evans podcast: https://ockham.healthcare/episode-82-phil-evans-research-in-general-practice/
Read about Dr Chris Keast's experience of how research has benefited his practice
Listen to Dr Simon Cartwright's podcast about Research at a GP Practice Level
NHS Long Term Plan - Chapter 3: Further progress on care quality and outcomes