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.
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;
- access to well-characterised cohorts;
- evaluation of interventions using precise objective measures of behaviour;
- 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.
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 clinical research highlights
Our clinical research is led by Jonathan Mant, Fiona Walter, Simon Griffin, Stephen Barclay, Christi Deaton and Stephen Sutton. We aim to influence national and international clinical practice guidelines to impact on treatment and interventions.
- the efficacy and safety of anticoagulation in older people with atrial fibrillation, as demonstrated through research led by Jonathan Mant, is a key part of evidence quoted in the 2014 NICE guideline on atrial fibrillation;
- NICE guidelines in 2010 and 2012 on chronic heart failure and hypertension draw heavily on Jonathan Mant’s research on this topic;
- The majority of original data referred to by international recommendations concerning screening for type 2 diabetes (e.g. US Preventive Services Task Force and the UK’s National Screening Committee) is based on work in Cambridge by Simon Griffin and his research is quoted in NICE Public Health Guidance 35 and 38 on diabetes;
- Christi Deaton’s work on cardiovascular disease prevention has informed guidelines drawn up by the European Society of Cardiology;
- Fiona Walter’s work on skin cancer and the palliative care group’s work on breathlessness (led by Morag Farquhar) have both been taken up in training materials being widely disseminated by MacMillan Cancer Support;
- Stephen Barclay’s work on End of Life Care was influential in ensuring that NICE Quality Standards for End of Life Care (NICE 2012) included a separate Standard for Bereavement Care.
Recent health services research highlights
- Theresa Marteau’s research on the wider determinants of health has been important in informing government policy – for example, our evaluation showed that the Scottish ban on multi-buys of alcohol was ineffective in reducing alcohol purchasing;
- 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.
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, oesophageal cancer and melanoma?
Can we reduce the risk of a further stroke in people who have had a stroke by using polypills?
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?
What is the best way to improve the interaction between patients and general practitioners and does this lead to better health outcomes?
What is the best way to improve the quality of care the NHS provides in primary care?