What are the characteristics of effective ‘research active’ general practices from the perspective of staff, patients and stakeholders?

Problem

Research is fundamental to improving quality of care and is part of the NHS constitution. Recent policy has highlighted the need to expand participation in research, and to ensure that research is conducted in an inclusive fashion aligned with population burden. Greater participation has the potential to increase the amount, scope and quality of research and reduce ‘research waste’. Whilst participation is increasing, only around half of GP practices in the UK have recruited participants to NIHR CRN supported studies. We aimed to explore what factors were thought to be important for general practices to do research well and to sustain it over time.

Approach

General practices in Greater Manchester, Morecambe, Cambridge, Peterborough and London were recruited to a qualitative study between December 2021-September 2022. A total of ninety interviews were conducted with: clinical and administrative staff (n=41); patients either with or without direct experience of research at their general practice (n=28); and other stakeholders in primary care research such as NIHR Local Clinical Research Networks (LCRNs), local Clinical Commissioning Groups (CCGs), Primary Care Networks (PCNs) and other supporting bodies (n=21). Interviews were audio recorded, transcribed and coded by three researchers across the sites. Interviews were coded independently by researchers to an agreed coding frame. Analysis was inductive and themes were discussed regularly with the wider team to reach consensus.

Findings

Respondents reported a number of characteristics of effective ‘research active’ practices. These included those related to: practice structure and organisation, in particular the existence of a research champion, practice size and full complements of staff; ways of working, including effective time management and teamworking with a culture of valuing research; availability of wider support including an engaged patient group and external support from the Clinical Research Network and other professional groups such as academic and commercial research teams. However, there remained a lack of stability for research participation. Whilst some practices had a dedicated research team, if they were not well integrated with the main practice team this negatively impacted research activity. The variable levels of research activity (available studies) year on year and the reliance on a champion to drive research within the practices, worked to make the whole system fragile.

Consequences

We identified a number of characteristics for effective ‘research active’ practices from the perspective of patients and professionals. Understanding the characteristics may help assess practice suitability for research prior to a practice becoming research active, gage what support would be required to help practices become effective research practices, and help us to better communicate research activity in general practice to patients and the public.

This is a secondary complementary piece, the main results from the ARAPAHO study have also been submitted for presentation.