Growing Primary Care scholarship

Primary care is the workhorse of the NHS. 90% of healthcare work is done in Primary Care. “If primary care fails then the NHS fails.”

But all too often, people mistake the job of the primary care workforce as something simple. Primary healthcare roles are viewed as simply a ‘factory production line’ job, If you want to do interesting, exciting, stimulating medicine then you need to go into hospital medicine. If you want to have the best cutting edge care, then you need to be referred to a hospital service.

Both views completely misunderstand/misrepresent the task of general practice and primary healthcare. Primary care delivers some of the most complex healthcare in the country, indeed the world. Because primary care is the centre for delivery of whole person medicine - healthcare which is uniquely tailored to the needs, expectations and circumstances of the individual.

This advanced generalist medical practice can also be found in the hospital setting, but less frequently and consistently. Because central to the sustained and successful delivering of whole person medicine is the capacity to continuously review and revise care – the continuity of care that is built into primary healthcare but not secondary care models.

International research has shown that strong primary healthcare – continuous, comprehensive, coordinated, accessible, person-centred care – delivers efficient, effective and equitable health care. It is the strongest model of healthcare we have for managing the coplexities of modern healthcare needs – multimortbidity, problematic polypharmacy, persistent physical symptoms etc.

But optimising primary healthcare delivery needs recognition understanding and resourcing of this distinct model. It requires a distinct workforce trained in the critical understanding, delivery and evaluation of this model of healthcare. And it needs a distinct data/evidence base to support this unique work.

At the heart of strong primary healthcare is robust primary care scholarship. The distinct model of practice that enables us to Discover, Intergate, Apply and Inspire (The Society for Academic Primary Care) for the basis of primary care practice.

We cannot just assume we can take research from other settings and apply it in primary care. We need to generate a distinct knowledge base.

We cannot assume that people trained in healthcare practice within hospital setting are able to automatically work in the community context of primary care. We need to train a distinct workforce.

We cannot assume that healthcare policy developed to support specialist (condition focused_ health care will cover person centred primary care. We need distinct evidence-informed primary care policy.

All of which needs a distinct academic discipline – that of Academic Primary Care.

Without Academic Primary Care we risk a domino effect of primary care fails, and so the NHS fails.

See: Unlocking the potential of academic primary care - The Society for Academic Primary Care

The Academy of Primary Care is a lead partner in a UK and international collaboration to promote, support and sustain the distinct discipline of academic primary care.

We are a partner in the UK wide network that is The Society for Academic Primary Care (SAPC) – in turn embedded within an international community including the Australasian Association for Academic Primary Care Inc (AAAPC) and the North American Primary Care Research Group (NAPCRG)

Professor Joanne Reeve has been past Chair of SAPC, past Chair of Heads of Department group, past Chair of Annual Conference (2017). The Academy of Primary Care hosted the northern SAPC conference in November 2020 and we co-lead the Northern SAPC collaborative.

We work closely with Health Education England and Royal College of General Practitioners (RCGP) to make visible and promote academic career pathways, recognising three paths for GP scholarship:

• Every GP a scholar: Using the distinct wisdom of primary healthcare within every day practice, supported by work/resources in WiseGP and our work on Advanced Generalist Medicine.
  
  
• GPs with extended role in research teaching and scholarship: The growing proportion of GPs with extended professional roles that include scholarship activities including GP Vocational Trainers, tutors working with medical schools; local research leads in practices, including members of PACT (Professor Joanne Reeve is on the Senior Advisory Board); and those working with the RCGP Research Engagement Hub.
  
  
• Academic GPs: GPs who undertake specific academic training to take up formal university posts. We have hosted Foundation Year fellows, Academic Clinical Fellows, Doctoral Fellows, In Practice Fellows here at the Academy of Primary Care.

You can find out more about each of these roles on this video prepared in conjunction with RCGP and Health Education England (see link at end under videos)

Our work continues to highlight that there is much still to do. To make visible the distinct role of Primary Care, and the role of a distinct Academic Primary Care workforce within that

But our work continues to recognise that Academic Primary Care matters – for example see this summary of primary care key literature from the University of Exeter APeX team.

Professor Reeve's book: Medical Generalism, Now!

Review of 'Medical Generalism, Now!' - BJGP Life

Evidence to Health Select Committee (PDF)

WONCA Asia invited speaker 2019 and presentation information