General Practice research
The Royal College of General Practitioners (RCGP) has long recognised the importance of primary care research – primarily because of the commitment of great primary care leaders over the last 60 years.
The RCGP was formed before any of the departments of general practice and was an early advocate for general practice research. The founders of the college, in 1952, embedded the research ethos within core RCGP principles, recognising that longitudinal and patient morbidity data, collected through the registered list, was a key opportunity for general practitioners to learn more about the natural history of a range of illnesses.
The formation of the RCGP Research Committee in 1953 by Dr Robin Pinsent led to 300 member names being put onto the RCGP’s research register within a year, generating a number of collaborative research projects. The central committee also encouraged faculties to set up their own research committees. The interest that was generated was also responsible for the setting up of the Journal of the College of General Practitioners (now the British Journal of General Practice) in 1958. The BJGP is an international journal of high quality primary care focused research.
It became clear during the 1960s that various different strands of research were being carried out in general practice, including single practice-based research studies (John Fry 1922-1995), John Howie and Will Pickles (1865 -1944]) as well as multi-practice research such as the Manchester Research Unit, led by Clifford Kay, which undertook the largest survey in the world of women on the contraceptive pill. This landmark study, the RCGP Oral Contraception Study, started in 1968, when 1,400 general practitioners throughout the United Kingdom recruited approximately 23,000 women who were using oral contraceptives, and a similar number of women who had never used this method of birth control. The study stopped general practice follow-up at the end of 1996 (26%).
Early RCGP-based GP researchers also developed the key tools of clinical research in primary care, such as the age–sex register and the disease register surveys in general practice.
The RCGP Research and Surveillance Centre (RCGP RSC) was established in 1957 as the Records and Statistical Unit and then latterly known as the Birmingham Research Unit. Dr Douglas Fleming took over as Director of the unit in 1988 from its founder Dr Donald Crombie, and the RCGP research adviser Dr Robin Pinsent.
Since then, the unit has been particularly concerned with the surveillance of diseases as they present to general practitioners. It collects and monitors data from a network of approximately 100 sentinel practices distributed throughout England and Wales. It is best known for its twice weekly reporting and surveillance of influenza-like illness and other respiratory diseases, and for its involvement in national morbidity surveys which it has conducted in co-operation with the Office of National Statistics.
In 1971, the Scottish Council of the RCGP and the Scottish Home and Health Department set up the Scottish General Practitioner Research Support Unit, directed by Professor Knox of the University of Dundee. In 1978, The Leigh Clinical Research Unit became an RCGP unit in 1978, based at the practice of Maurice Stone; Stone showed that fibrogen was a major risk factor for heart disease.
1994 saw the establishment of Research General Practices. In 1997, the Primary Care Research and Development Review led to new pump priming monies to expand university-based academic primary care. There are now over 30 primary care groups across the UK, with over 700 active primary care-based researchers carrying out multidisciplinary research that improves the illness experience and care delivered to patients in primary care.
The RCGP continues to recognise great practice-based researchers and the inaugural 2006 RCGP Discovery Prize went to Dr Julian Tudor-Hart, who is famously recognised for many achievements, including for his Inverse Care Law, published in The Lancet in 1971.
Professor Helen Lester exemplifies the RCGP commitment to research in her position as the Chair of the RCGP Clinical Innovation and Research Centre (CIRC, established in 2007). CIRC helps the RCGP to support and promote research activities in primary care, particularly supporting young GP researchers through initiatives such as the ‘Research Ready’ scheme, Research Paper of the Year, and the Scientific Foundation Board.
Many academic departments of general practice are led by eminent researchers who have, or who do, devote their time to the RCGP and are testament to the early research pioneers. From the time in 1963 when an RCGP member, Richard Scott, took the first Chair in General Practice in the world, academics and researchers have continued to support the RCGP. Present RCGP Council members include key researchers such as Professor Helen Lester, Professor Trisha Greenhalgh, Professor Mike Pringle (President-elect), and Professor Amanda Howe (current Honorary Secretary), each of whom ha also led on developing and nurturing young talented researchers for the future.