The relationship between research activity and quality of care in English general practice: a mixed methods study.

Abstract

There is evidence showing that healthcare organisations that take part in research demonstrate better performance. However, most evidence derives from hospital settings and these findings may not extend to general practice. The relationships between research activity and outcomes across general practices in England were explored. To assess whether levels of research activity in general practice are associated with a range of organisational and patient-reported outcomes, and to explore possible mechanisms that might explain those associations. Analysis of national data on research activity and outcomes (including QoF, GPPS, prescribing, GP retention, and hospital utilisation) between 2008 and 2019 from practices in England, combined with qualitative interviews with general practice staff, patients, and wider stakeholders. In cross-sectional analyses, research activity was associated with a number of outcomes, including clinical quality of care, patient-reported experience, and hospital use. The associations were generally modest in magnitude. However, longitudinal analyses did not generally support a causal relationship. Practice staff reported that the most likely benefits of research activity would be on professional wellbeing. Similar to hospital settings, general practice research activity is associated with a range of positive outcomes, although it is difficult to claim that research is causing those improvements. This study identified no negative impacts, suggesting that research activity is something that high-quality practices are able to deliver alongside their core responsibilities. There is a need to explore ways by which additional impacts of research can be maximised.