Case study: Developing Research Models across Primary Care Networks - East Staffordshire
Primary Care Research
The East Staffordshire Primary Care Network is made up of 18 practices with circa 150,000 population and covers an area from Uttoxeter in the West across to Burton on Trent in the East. There is a mixture of urban and rural practices, affluent and more deprived areas. Peel Croft Surgery in Burton and Mill View Surgery in Rocester are the hub practices for the PCN and 15/18 of the remaining practices are willing to be part of research delivery meaning 17 of 18 practices is involved in research. This was easily facilitated as the PCN team is keen to carry out as much of the delivery centrally as possible.
The PCN has a supportive Clinical Director and an executive leadership and management team provided by Howbeck Healthcare.
Key members of the team include the two GP Leads at the hub practices - Dr Ashok Kulambi and Dr Satveer Poonian together with Dr Baljinder Sidhu, an Associate Principal Investigator (PI) who came on board whilst we were delivering the PANORAMIC Covid-19 study.
Debbie Melling, who was Practice Manager at Peel Croft, is now the PCN Community Manager and enables Network wide working looking at health inequalities across the locality. Joanne Beanland is PCN Director and Practice Manager at Mill View Surgery.
Rachael Brown was employed by the PCN as Research Manager in September 2022 as part of the NIHR Improvement & Innovation Strategic Funding bid. Rachael works half her time as Research Manager and is also employed as Practice Manager at the Tutbury Practice. She is embedded into the PCN team so is in a perfect place for engaging with research, whilst appreciating the day job of those she is working with. Tracey Norton is also part of the team and is the Digital Transformation Lead for the PCN. Tracey has been successful in arranging the EMIS Searches and Reporting platform and has provided solutions to creating clinics and booking in participants onto the EMIS hub originally used for extended access.
The main aims of the Innovation & Improvement funding were to enable efficient regional level participant identification for research using EMIS Recruit and to employ a Research Manager to set up structures within the PCN.
The CRN and the PCN have worked together with EMIS Recruit to promote their platform across the Network and to help EMIS Recruit understand how research in Primary Care works, so that the platform can be fit for purpose and can be used at a PCN level, not just at individual practices. It is also now also possible to enable mass searching using EMIS Hub Search and Reporting, which has been purchased to streamline feasibility and participant recruitment making the process a lot more efficient.
The appointment of a PCN Research Manager has reaped many rewards for the PCN as a whole. It has allowed dedicated time towards meeting PCN research objectives and improved communications of research opportunities. The hub and spoke model has been further strengthened by more practices being willing to participate in future studies, firmly establishing a commitment to the provision and delivery of research within the PCN.
East Staffs has delivered manyresearch studies over the years. Initially studies were delivered practice by practice, with research naïve practices being introduced and supported with the delivery of more simple research studies. The NCMH study was one such example, where CRN WM Research Nurse Richard Hibell supported and facilitated delivery demonstrating great care and commitment to their patients. CHESS and iwotch were also interesting simpler studies to deliver looking at chronic headaches and opioid usage.
East Staffs was accepted on to the Group Practice Scheme, which was designed to incentivise practices to work more closely together. GPs and Practice Managers attended a research launch meeting to discuss how research could be delivered more efficiently and talk about research ideas. Unfortunately, COVID-19 hit almost immediately after that, but this offered more opportunities. The PCN gave two laptops to the CRN Facilitator and Nurse so that we could work remotely, running searches, carrying out online mailings etc,allowing us to deliver studies entirely remotely.
With Active Brains (involving 14 practices), searches were run, screening completed and docmail invites were processed without the need to go into the practice. For the PANORAMIC Trial, Peel Croft and Mill View were hub sites for participants to be referred into for Covid-19 antiviral treatments. Tracey Norton, Digital Transformation Lead, enabled a time saving way of adding patients onto the EMIS Hub clinics so the PIs could easily check for eligibility without having to log in and out of each clinical system.
East Staffs PCN is still working hard and forging ahead, seeking out new research opportunities. The team is exploring commercial research studies and has created Expression of Interest templates submitted in response to commercial research opportunities. East Staffs is already working closely with Mercian PCN and intends to collaborate with them on future studies. There will be further collaboration with Burton Albion Community Trust to deliver studies such as the UK EDI Pancreatic Cancer study and ELSA, (EarLy Surveillance for Autoimmune) diabetes in children study at research clinics held at the Pirelli Stadium.
Communication, teamwork, use of technologies, enthusiasm, engagement and collaboration are the key words we would use to describe how the PCN has got to where it is and the CRN team is seen as an extension of the PCN team. Research is part of their agenda.
If any other PCNs are thinking about getting involved with research, contact the study support team via firstname.lastname@example.org and they will be able to forward you details to the relevant team member.
Pictured: Richard Hibell, Gerri Mulcahy Joanne Beanland, Debbie Melling