The goal of the Cambridge Primary Care Unit (PCU) is to reduce the burden of ill health by identifying and targeting the behaviours that lead to chronic disease, by improving early detection of illness, and by improving the delivery of health services in community settings.
We aim to achieve this by delivering research and education at the highest international standards of excellence.
The Unit was established in 1997 under the directorship of the Foundation Professor of General Practice, Ann Louise Kinmonth. It now encompasses a multidisciplinary research group and those responsible for undergraduate teaching in general practice and primary care. We are part of the Department of Public Health and Primary Care, and a member of the Cambridge Institute of Public Health.
The PCU has doubled in size in the last five years, with the appointment of five new professors and the acquisition of over £42m of research funds. We are one of the most productive primary care units in the UK, with a high volume of publications in peer reviewed scientific journals and a high level of impact on clinicians, NICE guidelines, central and local government health policies and the work of charities and NGOs plus a wide range of activities to inform the public and patients and carers.
Introducing our research
The Unit has established itself as one of the UK’s strongest research groupings in behavioural science and primary care, and has built an international reputation for its work on the development and trial evaluation of theory-based preventive interventions, particularly in the areas of diabetes and cardiovascular disease.
The research strategy of the Primary Care Unit is core to that of the overall Department of Public Health and Primary Care. We focus on understanding the determinants of behaviour, translating knowledge about risk factors and mechanisms into preventative and management strategies for chronic diseases, and testing these strategies in populations and settings representative of primary care. Particular areas of interest are risk communication, behaviour change, and randomised controlled trials of interventions in primary care settings.
Our research is organised into five research areas: Behaviour and Health,Cardiovascular Disease and Diabetes, Cancer, Health Services Research and End of Life Care.
Our research has had a major impact on primary care practice and health policy. It has influenced national and international guidelines on atrial fibrillation, heart failure, hypertension, diabetes, and end of life care. It has informed government policy (e.g. on alcohol use) and underpinned the way in which quality of care in general practice is now measured. Examples of key studies include MoleMate, which was a randomised trial of different ways for primary care to diagnose melanoma, and ADDITION-Cambridge, which was the first randomised trial of screening for type 2 diabetes.
Our training and teaching
The Primary Care Unit plays a major role in organising, delivering and quality assuring teaching for student doctors at the University of Cambridge. This is coordinated by the General Practice Education Group within the Unit. The integration of research and teaching adds value to the research through testing in the applied world.
Undergraduate Teaching
The Primary Care Unit contributes to a range of programmes in the Department and Clinical School. The University of Cambridge admits about 280 students a year to read Medicine. The Clinical School also runs MB/PhD programmes and a 4-year Graduate entry programme. The PCU makes a substantial ongoing contribution through members of its General Practice Education Group (GPEG), working with approximately 100 general practices around the Eastern region, who deliver practice-based teaching.
Postgraduate Teaching
Over this time period, there has been a parallel expansion of our research training: We have trained, or are training, 17 junior academic general practitioners through the NIHR Academic Clinical Fellowship (ACF) Scheme; notably they have published over 30 papers from their ACF research.
The Primary Care Unit has developed a bespoke Masters in Primary Care Research and contributes to two Departmental Masters Courses (the MPhil in Epidemiology and the MPhil in Public Health). We are a site for Academic Clinical Training Fellows at both pre and post doctorate levels. There is an integrated education programme for doctoral and pre-doctoral postgraduate students – 19 PhDs were awarded during 2008-13 in primary care, and we currently have 15 further students registered for PhDs.
Our strategic partnerships
We benefit from strategic partnerships within Cambridge, nationally, and internationally. Within Cambridge, we work with other units and departments across the University that have complementary skills to our own, for example in conducting trials, measuring behaviour, statistics, development of innovative diagnostic tests and neuroscience. Nationally; we collaborate with other Universities including Bristol, Durham, Exeter, Oxford, Leicester, Nottingham, Edinburgh and KCL. We have published 135 papers with international co-authors, and hold research grants with overseas co-applicants that total over £32m.
The voices of patients and service users
The voices of patients and service users are central in shaping our research at all stages: deciding the research questions, developing research proposals (including study design), phrasing of documents, monitoring research progress, supporting data analysis and interpretation and joint authorship of papers and conference presentations.
We actively engage with the wider public through open meetings, presentations to support groups and engagement with the media.
Looking ahead
Our goal for the next five years is to continue to undertake multidisciplinary, collaborative, patient-centred research addressing NHS priorities, using the wide range of research expertise within Cambridge, nationally and internationally. Through our teaching and training programmes, we will increase the critical mass of high quality well-trained primary care scientists, including general practitioners, maintain an attractive and effective training environment and recruit strong candidates to study with us.