Research
The following list outlines the Covid-19 research carried out by SSPC members so far:
SSPC Covid-19 Research Information
SSPC has been responsible for much high quality research and for bringing new research funding into Scottish universities. By facilitating collaborative and capacity-building activities, together with the ground-breaking work by Universities affiliated with SSPC, the School has contributed to Scotland’s current position as a world-leader in primary care research.
Research includes the Scotland-wide RCT led by Frank Sullivan on the treatment of Bell's Palsy, published in the New England Journal of Medicine and receiving Paper of the Year Award from the BMA in 2009.
SSPC has also supported career capacity building for cancer research in both Aberdeen and Edinburgh Universities. At Glasgow University, career capacity building for multimorbidity was aided by funding the establishment of a new Chair in Primary Care Research in 2008.
The multimorbidity programme was further developed through an Applied Research Programme; ‘Living Well with Multimorbidity’ led by Professor Stewart Mercer and funded through a successful competitive bid to the Chief-Scientist Office (CSO). The work was published in the Lancet in 2012 and won Best Paper of the Year Award from the RCGP in 2013.
Other SSPC-affiliated research programmes established as result of successful applications for CSO programme funding in 2008 include:
- Data-driven quality improvement in primary care led by Prof Bruce Guthrie (University of Dundee)
- Telemetric supported self-monitoring of long-term conditions led by Prof Brian McKinstry (University of Edinburgh)
- Pharmacovigilance for children: Signal generation from linked NHS administrative data co-investigator Prof Christine Bond (University of Aberdeen)
These CSO funded programmes of research have resulted in major outputs; to date eleven papers in the top-10 general medical journals in the world including the New England Journal of Medicine, the Lancet and the BMJ, as well as 47 other peer-reviewed papers and editorials and significant impact on practice in relation to multimorbidity, telehealth and prescribing safety.
Primary Care research priorities in Scotland after the coronovirus
The SSPC project involves health and social care professionals in Scotland completing a short survey that will ultimately lead to a Top Ten list of priorities for primary care research in Scotland. The goal of the project is to provide clear direction for future primary care research so that it benefits the lives of individuals and families, and increases the amount of funding for the most important primary care research. The project is designed to reach a concensus for primary care research priorities in Scotland where uncertanties remain and set a research direction that will be relevant for patients, carers and generalist healthcare professionals for the next 5 years.
Protocol Primary Care Research Priorities can be viewed here.
SSPC Evaluation of the Primary Care Transformation Fund and Primary Care Fund for Mental Health
In 2015, the Scottish Government established a Primary Care Development Fund which included £30 million to test new models of care through the Primary Care Transformation Fund (PCTF) and the Primary Care Fund for Mental Health (PCFMH). Tests of change began in every territorial health board in April 2016, funded until March 2018. The Scottish School of Primary Care was commissioned to evaluate the progress of these tests of change funded by the PCTF and PCFMH, plus any other innovative primary care projects identified that had the potential to be transformative. The overall aim was to 'tell the story of primary care transformation in Scotland' in terms of the tests of change that were being piloted over the period funded. The specific objectives of the evaluation were to;
Identify the location and types of tests of change carried out across Scotland and their progress during the funding period (national scoping).
Using a case study approach, conduct in-depth investigation (deep dives) of what was working well and why, in selected case sites (Health Boards) and across Scotland in two professional groups - Advanced Nurse Practitioners (ANPs) and Musculoskeletal (MSK) Physiotherapy.
Integrate the findings from the case studies to inform the key overall learning relating to successful implementation.
There were 204 tests of change. It was striking that despite explicit direction to focus on health inequalities, only 10% did so, suggesting this is a challenge for primary care. Evaluation, key learning and recommendations are summarised on the SSPC website and can be viewed by clicking the link below.
www.sspc.ac.uk/media/media_645963_en.pdf
There are also detailed reports on each case study: Inverclyde, Advanced Nurse Practitioners, MSK Physiotherapy, NHS Lanarkshire, NHS Ayrshire and Arran, NHS Tayside and NHS Highland, Orkney, Shetland and Western Isles. We are very grateful to our members for the substantial amount of high quality work that has gone into these reports.
From the key learning, the SSPC core team has also produced an SSPC Implementation Framework to provide support and guidance for those tasked with moving forward change in primary care in the future (Page 28 on full report). This has the potential to be further developed into an interactive online tool.
Recommendations:
- Recommendation 1: Primary care transformation should focus on a smaller number of larger projects, conducted over a longer period of time, with agreed goals and outcomes and sufficient support for robust evaluation.
- Recommendation 2: Role clarity, role support, governance, and clear communication channels are required as the primary care landscape becomes more complex. Strengthened support for collaborative leadership and multidisciplinary team working is required at all levels.
- Recommendation 3: Patient, carer, and community involvement is essential in the co-design of projects and service developments, rather than 'information compaigns' after the changes have been made.
- Recommendation 4: Further work is required on how primary care can best address, or mitigate the effects of, health inequalities. This should build on learning from the 'GPs at the Deep End', but include vulnerable groups living in less deprived areas.
- Recommendation 5: Rural proofing of health services should be considered as a systematic approach to ensure the needs of rural populations are considered in the planning and delivery of health services.
- Recommendation 6: The success of primary care transformation requires a step change in workforce planning, capacity, capability and leadership to address workforce and capability challenges across all clinical disciplines.
- Recommendation 7: A strategic, integrated approach to the evidence required to guide the ongoing transformation of primary care is required. Monitoring and evaluation should be accompanied by dedicated funding for high priority applied research in primary care in Scotland to fill the many evidence-gaps.
- Recommendation 8: Consideration should be given to a large-scale demonstrator digital primary care transformation project with clear co-designed and co-produced outcomes and rigorous evaluation.
- The full details of the reports can be found by following this link below;
