Practice and patient case study
Queen Square Medical Practice are winners of the Royal College of General Practitioners/Clinical Research Network Practice Award and were shortlisted for the Health Service Journal Clinical Research Impact Award in 2016. We asked the practice and one of their patients about the importance of research and what they’re doing to raise the profile and delivery of research in their local community.
Queen Square Medical Practice has come a long way since carrying out its first commercial research study looking at swine flu in 2009/10, with over 100 patients recruited onto the study. This year the practice has recruited 179 patients to 10 research studies so far. So what’s the secret to their success?
Nicky Harding is a research nurse, who in addition to her work supporting studies at Queen Square, encourages other practices in the region to become research active by sharing the benefits of doing so: “Research helps to raise the standards within the practice. Research shows that care is better in practices that are research active. In fact, patients tell us that’s why they registered with us.”
One patient who has benefitted from research is 70 year old Hazel Blackburn, a retired nurse who specialised in mental health care and carried out research herself. This is something that Hazel says helped her to make the decision about taking part in a study herself, soon after she was diagnosed with Chronic Obstructive Pulmonary Disease (COPD): “After my husband died, I must admit the cigarette consumption went up. I noticed I was finding it hard to breathe, walking the dogs was a nightmare, walking up hills was just desperate.”
Soon after Hazel found out she had the lung condition she approached her GP about taking part in a study which she saw advertised on the practice notice board.
The PACE study is looking at whether a quick and safe finger prick blood test, measuring C-reactive protein (CRP) levels, can help guide better antibiotic use in patients suffering from an acute exacerbation of their Chronic Obstructive Pulmonary Disease (COPD).
Hazel said the study was very easy to take part in, something she feels a lot of people don’t realise and stops them from seeking out research opportunities: “They think it’s going to be extra work, it’s going to put them out, but that’s not the case!”
Hazel has since become a patient ambassador for research at Queen Square and hopes to change people’s perceptions and help them see the benefits of research: “I think it increases their awareness of what’s being done, what can help and what part they can play. That gives people a sense of ownership so that they feel they contributed and that it mattered.”
Hazel says she doesn’t feel her own health has changed much after taking part in the study, but that she hopes to have helped others. Nicky says this is the main reason her patients tell her they are taking part in research: “They say they may not benefit directly but want to help the next generation and give something back as they are grateful for the care they are receiving from the practice and the NHS.”
Despite the benefits to the practice and the patients, convincing surgeries to take up research can be challenging, says practice director Jonathan Whitford-Bartle. “There is so much pressure on doctors and nurses time. It’s often hard to persuade them to take the risk, as it feels like a leap into the unknown. But with the support and funding from the NIHR Clinical Research Network it takes some of the risk away.” says Jonathan.
Queen Square is part of a local federation with 11 other general practices in Garstang, Lancaster, Morecambe and Carnforth. There are around 120 GPs working in the area with 160,000 registered patients. Jonathan continues: “We worked with the Federation and the Network to get funding to put some research nurse time into all of these practices. We employed some of the nurses to work across several practices using this funding. We coordinated the research activity and recommended studies to practices and research nurses in them.”
In turn this is part of a wider collaboration, Better Care Together, where universities, NHS trusts and councils have come together to make sure the local population is getting the best care possible. All of them are research active. “In addition we are part of the Lancaster University Health Hub which identifies academic collaborators within Lancaster University who wish to support research activity in the NHS and also NHS collaborators for academic researchers.
“We also have links with secondary care already in place - the research staff from University Hospitals of Morecambe Bay NHS Foundation Trust attend the regular research meetings that we hold for all the local practices. It’s of benefit to both of us - when we heard they were having trouble recruiting to a rheumatology study our nurses immediately pointed out that we could find patients in primary care.” says Jonathan.
The future for research in general practices of Lancashire is bright, says Nicky: “We will be using research capability funding to help GPs develop their own local research to benefit their communities.
“We want to carry on increasing the amount of academic and commercial research taking place, but would also like to develop further links with universities and secondary care and work together with them on studies.”
Jonathan also sees more potential: “Our practice cares for patients from cradle to the grave. We computerised back in the 1990s, so we have a great database, which I think is a fantastic resource for research which we should make better use of.”