RESEARCH IN PRIMARY CARE NETWORKS: HOW GP SURGERIES ARE MAKING ACCESS TO RESEARCH EASIER FOR PATIENTS

Research across Primary Care Networks (PCNs) has been going from strength-to-strength with many sharing resources and knowledge to improve patient access to research. We caught up with the Abbeywell Surgery, part of Romsey & North Baddesley PCN, to see how their approach is improving patient access to research within Primary Care.

INTERVIEWEES:

NICOLA LESTER, Research Clinical Lead, Abbeywell Surgery

LIANE ARMSTRONG, Senior Research Nurse, Abbeywell Surgery

TRACY WHITFIELD, Administration Research

Facilitator, Abbeywell Surgery

NICOLA: We began looking at research across the Primary Care Network (PCN) as part of the PCN Incentivisation Scheme where additional funding is given to help networks improve their services to patients. We were already research active at Abbeywell but the Alma Road and North Baddesley Surgeries weren’t. I wanted to increase opportunities for the community to be involved in research, so I approached the practices and asked if they wanted to be part of the scheme.

LIANE: Research in any setting is really important but in my view it’s especially important in Primary Care and GP surgeries. We’re the first port of call for most patients so it's a great way of embedding research somewhere familiar with people they already trust. It’s also important to provide them with the opportunity that lots of hospitals have, offering research locally so that patients don’t have to go to a specialist centre.

A Personal Approach To Research

LIANE: One study that we’re working on at the moment is the HARMONIE study, which is the first commercial study within the PCN and our surgeries. The study is aimed at immunising babies against RSV through an antibody injection. Respiratory Syncytial Virus (RSV) has high hospitalisation rates, babies can get really poorly and there’s currently no treatment for it – just best supportive care.

Our recruitment began in October and we’re currently the third top recruiter in Wessex – we’re a small team of three, so we’re doing really well. We have 64 babies signed up and it’s a great study to offer parents here at the surgery. They’re already coming in for immunisations and eight week checks, so they know our team and trust us.

NICOLA: Liane calls all the patients personally before she sends out information on the study, then carries out follow up calls which help with recruitment. Having someone like Liane that they can contact directly for questions and queries gives much more direct support compared with bigger study models. It’s much more personalised and helps recruitment numbers. We operate on a hub & spoke model for our trials, which means that the team is based at Abbeywell and if required, patients attend clinics there, but patients from any of our PCN surgeries can take part. It makes it easier to run studies and opens the door for lots of opportunities because we have a larger recruitment pool of patients across the three surgeries. We can offer studies to another potential 25,000 patients.

LIANE: I’ve had patients specifically say they prefer being involved in research at the GP surgery rather than going to hospital, for practical reasons and also emotionally. It feels safer for them.

TRACY: As a small team, we work well together and good communication is essential for this work.

Overcoming Challenges

NICOLA: We found our learning around the finances quite a challenge – Tracy has been instrumental in helping us establish how the money is coming in and working with the Clinical Research Network (CRN) and the trials’ office so that we have a clear picture. Research finance can be tricky to understand but we needed to know how it worked so that we could plan effectively.

TRACY: Research is full of abbreviations and acronyms which can also be a challenge. The CRN team is really helpful in clarifying what certain terms were as this can be time consuming for a small or inexperienced team.

NICOLA: Negotiating how studies work across the three practices has taken time. Things like using different computer systems has been a challenge, when you’re used to a certain system it can be difficult to use another.

When we first started as a PCN, we found communicating between the three surgeries challenging. To overcome this, we now have a nominated colleague in each of our spoke sites that can raise awareness of research in their own surgery and be approached to signpost any questions to us as the hub team. We also send a quarterly PCN newsletter to staff members across the three surgeries to keep everyone up to date with current research. Making use of poster boards at the surgeries to promote active studies has also been useful, so that the patients know what they can access.

TRACY: It can be such a minefield. There’s a lot to pick up and learn, so to be able to offer our expertise across three sites is really good and helps hugely. As we grow, hopefully we will take on more staff and share our expertise which will enable research involvement to expand.

NICOLA: Research can be difficult, possibly even off-putting, so it would be nice to inspire and motivate other practices to do it too.

TRACY: The CRN has been really supportive; providing a bank of research nurses and clinical trials assistants when needed. They have been extremely helpful in answering any questions and finding solutions to any problems we have had

The Opportunities For Pcn Research

NICOLA: The great thing about PCN research is that we can pick studies that are directly relevant to our local community.

So far, we’ve been involved in the initial arm of the PANORAMIC study where we recruited 114 patients that would otherwise not have had the opportunity to receive COVID-19 treatment.

Other studies include WAVE, which looks to see if vocational interventions for people off on long-term sick leave might help them get back to work quickly and Active Brains, which looks at the use of computer-based activities to see if they can prevent dementia in the long-term.

Alongside these, there is STATIC, which looks at different options for Crohn’s medication. We’re also currently getting set up for Treat to Target gout which will look at the recurrence of gout if you can get uric acid levels to a certain level and maintain it.

LIANE: With PCN research, we have an increased recruitment pool of patients and we also have an increased awareness of research. Word of mouth between patients is powerful in PCN research.

I think that PCN research could pave the way for all GP surgeries to have access to research opportunities because this model allows access at other sites when it’s not possible to have an in-house research team.

Useful Links To Studies

HARMONIE: https://www.nihr.ac.uk/news/research-begins-totackle-rsv-infections-in-infants/31312

PANORAMIC: https://www.panoramictrial.org

STATIC: https://www.bsg.org.uk/clinical-resource/static-clinicaltrial/

Active Brains: https://www.hra.nhs.uk/planning-and-improvingresearch/application-summaries/research-summaries/activebrains-study/

WAVE: https://www.hra.nhs.uk/planning-and-improvingresearch/application-summaries/research-summaries/wave-trial

Treat to Target: https://academic.oup.com/rheumatology/ article/57/suppl_1/i20/4762109