According to the RCGP, 5 to 10 per cent of GPs are involved in leading a primary care research project and a further 15 to 20 per cent collaborate on research.
There is no requirement for GPs to be accredited before they undertake research. However, a voluntary scheme to be launched by the RCGP late this year or early in 2007 should help ensure that you have everything in place before you start.
‘Research Ready’, a self-assessment accreditation scheme, is described on the RCGP’s website as ‘a low-level entry guideline to primary care research in England’. It will indicate a practice’s up-to-date knowledge of the standards and physical facilities needed to undertake research.
Currently being piloted in the East Midlands and in Essex, Research Ready is based around five core competencies practices should meet if they want to do research. The first is that all the partners at the practice should be in favour of research activity.
The other four are: having space and facilities to host research including secure storage for records and files; the practice database must be searchable; the GP researchers must be aware of what is required of the practice and its staff in relation to research governance; and lastly, researchers should be aware of their responsibilities to patients and staff.
Define your subject
If the question your study seeks to answer is not precisely defined, the results will not be meaningful, so defining the research is essential.
‘It is difficult to define a question that can be answered,’ says Professor Nigel Mathers, chairman of the RCGP research group. He recommends speaking to doctors and others who have done research, such as through the RCGP’s Scientific Foundation Board or the UK Federation of Primary Care Research Organisations. Other sources of help are the local department of general practice and the local NHS research and development support unit (RDSU).
Professor Mathers says that analysing qualitative data is difficult to do well, so going on a basic statistical training course is a good move. The local RDSU should be able to provide training and there is normally no fee.
The RCGP supports GPs and nurses to do research, and there are funding rounds twice a year. Its Scientific Foundation Board is a charitable funding body of the college. It awards grants for research projects of direct relevance to the care of patients in the general practice setting. The maximum award is £10,000. Your local NHS research consortium may also provide funding.
As a principal investigator, the GP researcher will need about a year between coming up with an idea and finishing the research.
Professor Mathers advises spending a third of that time on identifying the research question, developing a protocol, undergoing some training and nailing down the funding.
The next third should be spent collecting data, and the final third on analysing the results and writing up the research.
Professor Mathers says that the secret of getting published is to persist in submitting research results. The clarity of your write-up is also important. Medical journals will favour research studies that are clinically relevant. He advises approaching the British Journal of General Practice first. ‘You receive really good feedback on your paper, even if it doesn’t get published,’ he says. Other journals to try, depending on the topic, include BMC Family Practice, Education for Primary Care and Medical Education.
Case study: ‘Research keeps us up to date’
Albany House Medical Centre in Northamptonshire has participated in research for more than eight years. The GPs’ research activities have covered aspects of dermatology, cardiology, diabetes, asthma, gastrointestinal issues and osteoarthritis.
The bulk of the practice’s research work comes via the pharmaceutical industry, the Medical Research Council and universities.
Four of the nine GPs at the practice are principal investigators. One of them,
Dr Stephen Kownacki, says: ‘Research is not a moneymaking concern. We do it out of interest, to keep up to date and as a way of being a learning practice.’ He adds that the practice does make a small profit but the outgoings for staff and facilities are quite high.
The practice is paid a fee per patient. The amount depends on how much GP and nursing time is required and the number of tests carried out. All expenses are reimbursed. The GPs employ research and development nurse Kate O’Brien part-time to run the research work.
The practice was a pilot site for the RCGP’s Research Ready research accreditation scheme. This involved collating evidence around the scheme’s five core competencies and a visit from the RCGP.
- UK Federation of Primary Care Research Organisations
- Local research and development support units