Research capacity in UK primary care

Background. Moves towards a 'primary care-led' National Health Service (NHS ) and towards evidence-based care have focused attention upon the need for evaluative research relating to the structure, delivery, and outcome of pri mary health care in the United Kingdom (UK). This paper describes work carr ied out to inform the Department of Health Committee on Research and Develo pment (R&D) in Primary Care (Mant Committee). Aim. To describe the extent and nature of current research capacity in prim ary care in the UK and to identify future needs and priorities. Method. Funding data were requested from NHS National Programmes, NHS Execu tive Regional Offices, the Department of Health (DoH), Scottish Office, Med ical Research Council, and some charities. A postal survey was sent to rele vant academic departments, and appropriate academic journals were reviewed from 1992 to 1996. In addition, interviews were conducted with academic and professional leaders in primary care. Results. Overall, total annual primary care R&D spend by the NHS and the Do H was found to be 7% of the Total spend, although annual primary care R&D s pend differs according to funding source. Journals relating to primary care do not, with some notable exceptions (e.g. British Journal of General Prac tice, Family Practice), have high academic status, and research into primar y care by academic departments is, with perhaps the exception of general pr actice, on a small scale. The research base of most primary care profession s is minimal, and significant barriers were identified that will need addre ssing if research capacity is to be expanded. Conclusion. There are strong arguments for the development of primary care research in a 'primary care-led' NHS in the UK. However, dashes for growth or attempts to expand capacity from the present infrastructure must be avoi ded in favour of endeavours to foster a sustainable, long-term research inf rastructure capable of responding meaningfully to identified needs.