Research

The University of Leicester and Division of Primary Care has an outstanding record of producing world-leading applied primary care research for patient and public benefit. The Division has led a large number of research projects achieving international impact, and a wealth of publications in peer reviewed journals, and supervision of 70 research students. This volume and broad range of high quality research has been supported by external funding detailed in this application, and match. For example, research groups within the division have won a number of large awards from NIHR, such as funding three ARC’s (formerly CLAHRCs), a Biomedical Research Centre as well as significant funding from the MRC and national and EU health research charities.

Work funded by these grants has been of sufficient quality to influence national and international policy, including being used as best practice examples by NICE, the Department of Health, the Health and Social Care Information Centre, the NHS Health Checks Programme and the regional Primary Care Research Network.

The research expertise within the division covers the identification and prevention of chronic conditions such as diabetes and cardiovascular disease; adult mental health; assessing and improving care quality; healthcare management and policy; service design, delivery and improvement and innovation, and research methodology. These expertise cover the full breadth of levels of influence on primary care services including the individual (e.g. Clinician and patient), organisational (e.g. GP Practice, CCG), and policy level (e.g. NICE guidance).

The quality of primary care research delivered by the Division is strengthened by researchers based in the Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre (LDC), as well as strong working relations with local CCG’s, the University Hospitals of Leicester NHS Trust, local authorities, the NIHR Research and Design Service East Midlands, the East Midlands Centre for BME Health, and the National Centre for Sport and Exercise Medicine (NCSEM).

The University of Leicester and Division of Primary Care has built an outstanding track record of translating primary care research into practice to benefit patient care, both within and beyond the East Midlands. This has included influencing national and international policy, and local, national and regional practice. For example, we have led a number of studies on the impact of lifestyle behaviour change (Khunti, Yates) on the risk of type-2 diabetes mellitus (T2DM) which have generated new prevention pathways that have been adopted by primary care organisations locally, nationally and internationally. For example, the Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) programme for people with type-2 diabetes is used widely in Primary care internationally – it has been delivered in 107 UK sites as well as in Ireland, Australia and other countries.

The research evidence generated by ARC-EM, its members and Leicester Diabetes Centre, has been implemented at pace, and this rapid translation has resulted from detailed planning for implementation, co-production of research projects and systematic support for the dissemination and implementation of evidence. Findings arising from the ARC-EM and Leicester Diabetes Centre have been well adopted within primary care and have delivered benefits to patients with chronic kidney disease, mood disorders and other mental health conditions, and those at risk of or with type-2 diabetes.

For example the Improving Patient care and Awareness of Kidney disease progression Together (IMPAKT) tool. The IMPAKT tool is used by over 200 GP practices across the UK, including in the Midlands, North Wales, West Yorkshire and Greater Manchester. The tool identifies patients at risk of developing chronic kidney disease (CKD), enabling GP’s to provide support to manage risk factors and prevent the onset or worsening of CKD.

The Quality and Service Delivery Group has contributed to developing new primary care policy and service configuration. Some of this work has sought to understand the mechanisms of primary care that influence outcomes, and has had high level impact, with the paper entitled ‘Characteristics of general practices associated with emergency admission rates to hospital: a cross-sectional study’ being referenced by the former Health Secretary Jeremy Hunt when announcing that every General Practice patient over 75 would be allocated a named GP in INSERT YEAR.

Further work from this group has covered a wide range of issues related to practice and policy in primary care such as consultation length (influenced RCGP and QOF policy) and reducing admission rates (implemented in the local health economy) in the elderly.

For example ongoing work in the area of multimorbidity is focused on a range of issues such as cardio-metabolic multimorbidity; safe patient prescribing; supporting patient self-management, and reducing unplanned hospital admissions. Similarly, through the East Midlands Centre for BME Health, our work on ethnicity and health inequalities covers access to primary care services and health innovations; the implications of cultural traditions on health; and applied health care research participation, engagement and involvement by people from underrepresented communities. This work is supported by, ARC-EM who are the national lead for multimorbidity and ethnicity and health inequalities across all ARC’s.

In particular we have world leading expertise and a strong focus on type-2 diabetes prevention and management. For example, our DESMOND education programme of self-management for those newly diagnosed with diabetes is being used by 60% of all CCGs/practice areas in England, Scotland and Wales. Other work in this area focuses on effective methods for diabetes screening and prevention, understanding the links between sedentary behaviour and diabetes and cardiovascular disease, and evaluating lifestyle interventions for preventing progression from pre-diabetes.

Further, through ARC-EM, the resultant research activities and outputs are aligned with the needs of local services and Sustainability and Transformation Partnership Plans. This includes working with organisations such as Clinical Commissioning Groups, EMAHSN, local NHS service providers, local authorities, local providers of care services, NHS England, NHS Improvement, NIHR funded infrastructure groups, Public Health England, health and care charities and commercial organisations.

The University of Leicester and Division of Primary Care has strong and wide-ranging links with academic, clinical and industry partners at a local, regional, national and international levels. UK university links include Glasgow, Warwick, Imperial College, Southampton and Nottingham. International university partners include Melbourne University Primary Care Research Group, Brisbane Clinical Trials Unit, Department of Family Medicine University of Western Ontario, All India Institute of Medical Sciences, International Diabetes Federation, Department of Family Medicine University of South Carolina, and Department of Primary Care University of Barcelona.

There are excellent working relationships with a wide range of CCG’s from across the East Midlands and England such as NHS East Leicestershire and Rutland CCG and NHS Leicester CCG. We also have strong NHS collaborative partners such as Leicestershire Partnership NHS Trust, Northampton General NHS Trust, and East Midlands Ambulance Service NHS Trust. These partnerships have been leveraged to implement evidence from a range of our work such as DESMOND and IMPAKT, as well as targeting and reducing unplanned hospital admissions.

Industry and commercial links for the delivery of research studies are wide ranging and include internationally visible organisations such as Boots, NOVO, Lilly, Sanofi, Merck and Roche and Baxter Healthcare.