Primary care: the sleeping giant of research delivery

Jon M Dickson; Andy Hilton; Catherine Kelsall; Lucy Cormack

doi:10.3399/bjgp23X732573

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Primary care: the sleeping giant of research delivery
Philip Evans, Morag Burton, Emma Tonner, Julie Solomon, Simon Royal and Sarah Crawshaw

Published on: 08 June 2023
Primary care: the sleeping giant of research delivery
Jane Wilcock

Published on: 01 May 2023

Published on: (8 June 2023)
Page navigation anchor for Primary care: the sleeping giant of research delivery
Primary care: the sleeping giant of research delivery
Philip Evans, Deputy Medical Director and SRO, Primary Care Strategy, NINR CRN
Other Contributors:
Morag Burton, Chief Operating Officer, CRN NENC and Business Lead CRN Primary Care Strategy, NIHR CRN

Emma Tonner, National Medical Director's Clinical Fellow, NIHR CRN

Julie Solomon, Head of Cluster C, NIHR CRN

Simon Royal, Primary Care National Specialty Lead, NIHR CRN

Sarah Crawshaw, Head of Research Delivery, NIHR CRN
We write in response to the recent editorial by Dickson and colleagues¹ advocating the expansion of research in primary care.

We agree that the increasing transfer of clinical care from secondary into primary care, the frequency of consultation, and the increasing care of chronic disease by primary care mean that primary care should be the ‘go to’ setting for research studies. This is underpinned by the extensive clinical data held by GPs, which we are only just beginning to fully use for identification of potential participants.

The authors refer to operationalisation of the 2021 NIHR Clinical Research Network research strategy.² The strategy was set up to address a number of the issues highlighted by the authors, including funding to primary care from the 15 Local Clinical Research Networks (LCRNs), more sophisticated Participant Identification Centre (PIC) models, and formally involving primary care organisations in the strategic delivery of research locally.

In 2021/22 we were pleased to see 51% of GP practices in England participated in CRN research, excluding those practices that only undertook PIC activity. We have successfully revised and implemented the PIC model for commercial research to make it more attractive to GP practices. In addition, all LCRNs now have primary care represented on their Partnership Groups.

It is also promising to see that initial data from the first six months of the N...
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We write in response to the recent editorial by Dickson and colleagues¹ advocating the expansion of research in primary care.

We agree that the increasing transfer of clinical care from secondary into primary care, the frequency of consultation, and the increasing care of chronic disease by primary care mean that primary care should be the ‘go to’ setting for research studies. This is underpinned by the extensive clinical data held by GPs, which we are only just beginning to fully use for identification of potential participants.

The authors refer to operationalisation of the 2021 NIHR Clinical Research Network research strategy.² The strategy was set up to address a number of the issues highlighted by the authors, including funding to primary care from the 15 Local Clinical Research Networks (LCRNs), more sophisticated Participant Identification Centre (PIC) models, and formally involving primary care organisations in the strategic delivery of research locally.

In 2021/22 we were pleased to see 51% of GP practices in England participated in CRN research, excluding those practices that only undertook PIC activity. We have successfully revised and implemented the PIC model for commercial research to make it more attractive to GP practices. In addition, all LCRNs now have primary care represented on their Partnership Groups.

It is also promising to see that initial data from the first six months of the National Contract Value Review process shows that, on average, commercial studies are achieving study set-up milestones 95 days quicker, which we plan to expand into primary care.

There is more still to do and we agree that there is an urgent need for research governance support for primary care, which has been reduced in the move from CCGs to ICBs.
We strongly believe that a greater collective focus between all the research infrastructure to expand primary care research is urgently needed, with the ultimate aim, as described by the authors, of making research business as usual.

References
1. J. M. Dickson, A. Hilton, C. Kelsall and L. Cormack. Primary care: the sleeping giant of research delivery. Br J Gen Pract 2023; 73(730): 198-199. DOI: 10.3399/bjgp23X732573.
2. NIHR. NIHR Clinical Research Network research strategy. 2022. www.nihr.ac.uk/documents/nihr-clinical-research-network-primary-care-strategy/29999.

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Competing Interests: None declared.
Published on: (1 May 2023)
Page navigation anchor for Primary care: the sleeping giant of research delivery
Primary care: the sleeping giant of research delivery
Jane Wilcock, GP, Silverdale Medical Practice, Salford
I absolutely agree that a shift to primary care research is required, there is a paucity of evidence for many conditions in general practices. However, as an independent GP with no university connection CRPD and MHRA (re CRPD contacted after a research webinar) have both refused me access to their data resource.

GPs are therefore denied access to data even though their data protection in practices rivals that of universities and secondary care. Costs of publishing are not available to GP practices either and journals will not publish small research data sets.

The conversation for the future must move into interested primary care clinicians and facilitating research access, not keeping a defensive institutional hold.

Competing Interests: None declared.