The goal of the Primary Care Unit is to reduce the burden of ill health by identifying and targeting behaviours that lead to chronic disease, by improving early detection of illness, and by improving the delivery of health services in community settings.
Our research is multidisciplinary, drawing in particular on clinical epidemiology and social and behavioural science, and ranges from qualitative interviews to meta-analyses of randomised trials and clinical trials set in primary care.
Particular strengths at the Unit include:
- our ability to develop interventions based on expertise in behavioural techniques and the determinants of patient and practitioner behaviour;
- we pay attention to both physical and psychosocial factors in patient health;
- access to well-characterised cohorts;
- evaluation of interventions using both precise objective measures of behaviour and exploration of people’s experiences;
- our capacity to conduct randomised trials in primary care;
- our ability to enable assessment of important clinical endpoints through extended follow-up;
- a focus on quality improvement in health care;
- using innovative approaches to strengthen the evidence base for improving healthcare;
- our focus on addressing real concerns of patients and staff;
- a commitment to discovering what doesn’t work, as well as what does.
Delivering results for patients and service users
We deliver major impact on both primary care practice and on health policy through our research and our teaching. We recognise that a very wide range of stakeholders influence the translation of our research into benefit for patients and have established strong, multi-dimensional links with stakeholders and decision-makers.
Recent research highlights
- Jonathan Mant and colleagues have demonstrated that, in most circumstances, using fixed dose combination pills is likely to offer better value for money than adhering to current guidelines for the prevention of cardiovascular disease (see PLOS One Sept 2017)
- Fiona Walter co-leads the international CanTest collaborative, Cancer Research UK’s most significant investment in primary care cancer research to date, setting out to deliver an annual International School in Early Detection Research in primary care, and to evaluate existing and emerging diagnostic technologies such as apps and biomarkers.
- The Palliative Care Group’s work on cancer-related fatigue (led by Anna Spathis) has been taken up in training materials being widely disseminated by Macmillan Cancer Support;
- The assumption that most people would prefer to die at home has been challenged by Sarah Hoare and Stephen Barclay ’s work from the End of Life Care Group in a systematic literature review endorsed and widely disseminated by the National Clinical Director for End of Life Care, Prof Bee Wee;
- Theresa Marteau and colleagues in Cambridge (Gareth Hollands and Paul Fletcher) and Bristol (Marcus Munafo) have been awarded a Wellcome Trust Collaborator Award in Science to develop their field and laboratory studies on changing behaviour by changing cues in the environment (“nudging”);
- Our previous Professor of Health Services Research, Martin Roland, carried out research on measures of quality that underpinned the NHS Quality and Outcomes Framework and the development of national patient surveys with online patient experience data now available on all GP practices in the country;
- Mary Dixon-Woods led the successful bid for £40 million from The Health Foundation to establish THIS Institute (The Healthcare Improvement Studies Institute), which aims to create a world-leading asset for the NHS and for science by strengthening the evidence base for improving healthcare.
Our research questions
The types of research question that we plan to emphasise over the coming five year period include:
Can we provide better ways to help people stop smoking, become more physically active, and take their tablets as prescribed?
Can we prevent type 2 diabetes developing in people who are at high risk?
What is the best way to detect type 2 diabetes in the early stages?
What is the best way to identify people who are at increased risk of developing colorectal cancer and melanoma?
Which diagnostic approaches will enable doctors to make more timely diagnoses of common and more difficult-to-diagnose cancers?
Does screening for atrial fibrillation prevent strokes and save lives, and is it cost effective?
What is the best way to provide services in primary care for people who have had a stroke?
What is the best way to help people at the end of life make decisions about what treatments they wish to receive?
How can palliative care services be redesigned to meet the needs of an ageing population, often with several co-morbid conditions?
What is the best way to improve the interaction between patients and general practitioners and does this lead to better health outcomes?
How can we provide a stronger evidence base for assessments of children’s mental health in primary care?
Can we prevent mental health problems developing in young people who are at high risk?
What is the best way to improve the quality of care the NHS provides in primary care?
How can we provide better evidence base for healthcare improvement?
What works in healthcare improvement, what doesn’t, and why?
How can we address the need for high quality, safe healthcare?