The GPART scheme, which is jointly-funded by NIMDTA and R&D of the PHA, gives participants an extra year and in the current GP Training scheme the ST3 year (the final year of GP training) then runs over two years with each trainee receiving clinical training in preparation for the MRCGP assessment and training and experience in research. Most participants have completed an MPhil as part of the scheme, some have gone on to complete MDs and PhDs.

Mission, Vision & Values (Agreed at the GPARTS ‘Away day’ 1st May 2018)

Thinking on these reflections then and looking toward the future we set ourselves the task of agreeing a statement of Mission, Vision and Values of GPARTS.

Here is a summary of the outcomes of our discussions:

General Practice Academic Research Training Scheme (GPARTS)

Mission: Nurturing capability, fostering critical thinking and inspiring leadership in research among future General Practitioners.

Vision: To be a thriving centre for research expertise supporting a network of primary care communities conducting high-quality healthcare and educational research of relevance to general practice and of benefit of all.

Values: Community-focussed, Patient-centred, Clinically relevant, Scholarly, Mutually-supportive, Collaborative, Open, Inclusive

FAQ FOR GPARTS

Q. Can I work part time?

A. Yes. Normal provisions apply in accommodating trainees with LTFT training possibility at 80%. Given that this job already reduces the amount of clinical time spent per week, should a trainee wish to consider LTFT at less than 80%, this would need to be approved by RCGP to ensure adequate clinical training requirements are being met for CCT.

Q. What research experience do I need?

A. There is no prerequisite for research experience in applying for this job and the prospective GPARTS trainee can expect to learn and apply a lot of new skills throughout the two year programme. An ability to demonstrate a keen interest in this area is desirable however and previous involvement with audit, quality improvement projects, poster presentations etc. are looked upon favourably.

Q. What are the RCGP/NIMDTA requirements during GPARTS?

A. Aim is to pass the AKT and CSA in year 1. You also have to complete:

A QI project (EQUIP programme) is also carried out in 1st year
2 learning logs per week

Rest of normal requirements for standard ST3 year are split over two years:

3 COTs / 3 CBDs for each review period (12 of each over the two years)
1 PSQ over the two years
2 MSFs over the two years
CEPS all to be completed by end of training
72 hours OOH to be completed over the two years

Q. What are the pros and cons of doing ST3 over 2 years?

A. In the first year of GPARTS, 60% of time is spent in clinical practice and 40% doing research and vice versa in year two. Less concentrated clinical time can mean a slower integration into a new practice, but an extra year in the training environment is beneficial as it allows more time to absorb knowledge and refine skills. Research not only provides an opportunity to become an expert on an important topic relating to primary care but also enhances development of skills transferable to the clinical environment, such as critical thinking and leadership. Benefits result from remaining within the trust area with the opportunity to attend locality training days whilst also learning from a group of supportive trainees and mentors in GPARTS. With the combination of clinical and research, trainees are refreshed upon returning to clinical practice.

Q. Who will be supervising my research?

A. Research will be supervised by a primary supervisor and a secondary supervisor approved by QUB. Supervisors will usually be allocated and determined based on areas of interest of relevant academics. Meetings with supervisors are required on a minimum of a bimonthly basis.

Q. Who will be supervising my clinical work?

A. Clinical supervisors will be designated GPST3 trainers in approved training practices within the relevant locality area. They will be aware of the GPARTS job role and the division of time between clinical and research commitments.

Q. What are the assessments and deadlines expected for GPARTs?

A. There are a few assessments that need completed over the 2 years. Throughout the 2 years, you will have several meetings with your supervisors. QUB requires 12 meetings to be recorded over the course of the 2 years (1 report every 2 months). These are fairly straight forward and just a documentation as to what was discussed.

You also need to record 10 training days/year which again is completed on the same platform as supervisor reports.

Year 1 (August 2020-August 2021)

January 2021: Completion of literature review/background

May 2021: Annual Progress Review including training record

Year 2 (August 2021-August 2022)

February 2022 : Intention to submit thesis

Annual Progress Review

April 2022: Hard bound thesis deadline for summer graduation

June 2022: Viva

Q. What is an MPhil degree?

A. Many people setting out to train in research set out to complete a PhD over 3-4 years. An MPhil is the equivalent of year 1 of a PhD. An MPhil is a therefore a 1 year Masters degree achieved by completion of a thesis and examined by a Viva.

Q. Is there any change in your pay?

A. Your pay moves along the pay scales as it normally would in keeping with your stage of training. Your banding remains the same.

Q. What is the structure of a typical week in the GPARTs programme?

A. The first year of MPhil is 60% clinical, comprising of two days in practice, Thursday tutorial group as well as two days at QUB. The second year is 40% clinical, the Thursday tutorial day is replaced by a day at QUB. There will be a number of QUB induction days at the start of the academic year.

Every Wednesday there is a GPARTS meeting, this includes trainees and clinical academic lecturers. During these sessions we can present research updates, there may be presentations from outside speakers on topics such as infographics, PPI and literature searches. There is also teaching on research approaches, problemitisation and other topics from our trainers.

Each month there is a postgraduate teaching session within the centre of medical education at QUB. This is where a number of PHD students from a variety of specialties such as paediatrics, psychology as well as senior lecturers and GPART trainees attend. A number of topics may be presented and discussed including thesis writing, phenomenology and data handling.

As well as this you will have regular meetings with you supervisors and complete independent work on literature review and various projects. Over time you will be able to arrange interviews and data gathering as well as the opportunity to attend conferences.

GPARTS 2022 START

Pursuing flourishing General Practice: understanding the pressures affecting Practices at the ‘coal face’

Dr Richard Dillon

Academic Supervisors: Dr Grainne Kearney & Prof Michael Donnelly

Clinical Supervisor: Neil Stockman at Regency Medical Practice, Newtownards

Summary of Project

My project aims to look at the current pressures within general practice. There has been unprecedented demand in Primary Care in recent times. Over the last 4years, there has been a reduction in the number of GP surgeries. This is either through closures or mergers. A BMA report identified several different factors that may play a part. Since then a number of things have changed (MDT involvement with Physios, Social workers etc and the increased use of telephone triage). My research is focused on reviewing the survey previously carried and trying to identify what factors would help to generate flourishing primary care.

In situ simulation for Paediatric Emergencies in Primary Care

Dr Sarah O’Hare

Academic Supervisors: Professor Gerry Gormley

Clinical Supervisor: Dr Paul Carlisle, Hillhead Family Practice, Belfast

Summary of Project

I am completing a project on the use of in situ simulation training in managing paediatric emergencies in general practice. A wide range of emergencies may present including anaphylaxis, and meningitis. Paediatric emergencies pose a particular challenge, as treating children requires specific knowledge, skills and equipment.

Existing evidence shows that in-situ simulation training is an acceptable and feasible way of developing interprofessional skills in primary care settings. The aim of this research is to investigate the use of simulation to improve preparedness to manage paediatric emergencies in primary care.

I am currently completing a literature review, to establish what is known about how in-situ simulation achieves its outcomes. I will develop and implement a programme of in-situ simulation relating to primary care paediatric emergencies. Using participatory research methodology, supported by multimodal evaluation using video, field notes and interview data, I will explore its effects on learning and organisational change.

Moving More: How can we reduce sedentary behaviour in Primary Care?

Dr Richard Mayne

Academic Supervisors: Dr Neil Heron & Dr Nigel Hart

Clinical Supervisor: Dr David Moore at Struell Surgery in Downpatrick

Summary of Project

Sedentary time (assessed as either daily overall sedentary time, sitting time, television or screen time, or leisure time spent sitting) is independently associated with a greater risk for all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or mortality (breast, colon, colorectal, endometrial, and epithelial ovarian), and type 2 diabetes in adults.

Reducing sedentary behaviour and increasing physical activity in the Primary Care setting could lead to extensive benefits at an individual and population level. Potential individual-level benefits include improved physical and mental health (reducing workplace absenteeism and early retirement) and improved workplace satisfaction. This could lead to population level benefits, whereby General Practitioners subsequently encourage patients, colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity. Doctors who follow healthier lifestyles are more likely to advise patients on improving their own health behaviours. Patients are also more likely to act on health behaviour guidance if the doctor giving the guidance is seen to follow the guidance within their own life. Patients who act on guidance to reduce sedentary behaviour and increase physical activity will gain improved physical and mental health, making them more likely to advise their colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity.

Social Prescribing in Primary Care

Dr Katherine McCracken

Academic Supervisors: Dr Diarmuid O’Donovan & Dr Helen Reid

Clinical Supervisor: Dr Adrian Johnston, Toome Surgery, Toome

Summary of Project

Social prescribing is being widely advocated as a tool to help address patients’ complex health and social care needs. Social prescribing refers to linking patients with sources of support in the community. It seeks to address patients’ needs in a holistic way and empower individuals to take greater control of their health. Social prescribing is a key component of the NHS Long Term Plan and one of the ten high impact actions to release time for care in the NHS General Practice Forward View. A stronger evidence base is required to support continued interest and innovation in social prescribing. I will start with a scoping review which will guide my empirical work. I will potentially use qualitative interview approaches to examine the perceptions of healthcare professionals regarding social prescribing.

GPARTS 2021 START

Diving into the ‘Deep End’ of General Practice in Northern Ireland

Dr Daniel Butler

Academic Supervisors: Prof Nigel Hart, Prof Diarmuid O’Donovan & Dr Jenny Johnston

Clinical Supervisor:

Summary of Project

Those living in socio-economic deprivation live sicker and shorter lives. General Practice in these high-need areas has more demand, less funding and fewer GPs (General Practitioners). The ‘Deep End’ is a network for GPs and other primary care staff who work in practices in the most socioeconomically deprived areas who are passionate about tackling health inequity.

This project explores the Northern Ireland context, identifying the key issues and workable solutions at the Deep End of Northern Ireland General Practice. Investigating the steps in establishing a Northern Ireland ‘Deep End’ initiative aiming to;

advocate for vulnerable patient groups and their healthcare providers
research and recording the experiences of Deep End GPs
research education and training opportunities in high need areas

Addressing the low uptake of pertussis and flu vaccine during pregnancy: what is happening and what can be done about it in primary care

Dr Stephanie McCarron

Academic Supervisors: Dr. Declan Bradley and Prof. Nigel Hart

Clinical Supervisor: Dr. Eddie Santin, Campbell Surgery Dungannon, Co. Tyrone

Summary of Project

GPARTS has provided me with an opportunity to pursue my research interests in womens health, particularly during pregnancy. My current research is addressing the significant morbidity and mortality that is caused by pertussis and influenza infections during pregnancy and in the neonatal period. Maternal vaccination in pregnancy would significantly reduce this but vaccine uptake rates have shown regional variation in NI, UK, and Ireland, with there being much scope for improvement. As yet, it is not clear what approaches are effective and used to promote uptake of pertussis and influenza vaccines in pregnant women in the UK and Ireland. I am anticipating that the results of a scoping review in this area of research will inform future research and methods of improving uptake of maternal vaccinations in the UK and Ireland.

Exploring GPs' Experiences of Assessing And Referring Young Adults With Lower GI Symptoms Suspicious For Cancer

Dr Orla O'Neill

Academic supervisors: Professor Helen Coleman, Dr Helen Reid

Clinical supervisor: Dr Darragh Lewis

Summary of project:

My research is looking into the increasing incidence of bowel cancer in young adults, those under the age of 50. Data from cancer research UK has shown that the incidence has increased by 41%(1993-2017) in this age group. This increasing trend has been replicated on a global scale, illustrating a shift in disease burden for future generations. These younger patients tend to present later with more aggressive disease, with 1 in 4 being diagnosed at the latest stage. Bowel cancer UK’s ‘Never too young report’ investigated the experiences of young bowel cancer patients. The report highlighted significant barriers for patients accessing timely care, including 43% visiting their GP at least 3 times prior to referral, with resultant delays in diagnosis. The report also highlighted the lack of awareness of early onset bowel cancer within the public and health professionals.

My qualitative study will take the form of semi-structured interviews with GPs' throughout Northern Ireland. By gaining a better understanding of the difficulties and barriers faced by GPs in assessing and referring this group of patients, I hope to identify ways to improve the diagnostic pathway and experience for young bowel cancer patients

Making the GP Contact Count

Dr Alex Huey

Academic Supervisors: Professor Nigel Hart and Dr Grainne Kearney

Clinical Supervisor: Dr James Crothers, Knock Medical Centre

Summary of Project:

Homelessness is experienced by individuals and families worldwide and we are not immune to its reach in the UK and Ireland. The statistics show that between January and March 2021 over 60,000 households in England and 2700 households in Northern Ireland received government support for housing issues.

Homelessness results in grave social and health costs, with the health outcomes of those experiencing homeless being significantly worse even in comparison to the most socially deprived housed groups.

Existing research shows that 50% of health outcomes are a result of social determinants of health and an individual’s physical environment, with the remainder attributable to health behaviours and the medical care received. This tells us that the health service is managing health outcomes where social issues are a significant causative factor. It is therefore in the best interests of clinicians and patients to play our part in prevention of these issues.

In North America there has been growth in the development of screening tools to screen for social determinants of health, including housing, in primary and secondary health care settings, with onward referral to available support services. Acceptability studies have shown that both patients and clinicians agree that screening is valuable for understanding patient context and enabling patient access to services. As a public facing service with high levels patient contact daily, we feel that GP is a great setting to opportunistically pick up housing concerns.

This research will trial housing screening questions from a pre-existing tool in a UK and Ireland GP setting for the first time. There is no gold standard screening tool, therefore the first step will be choosing a tool using a consensus method known as a Delphi process. Following that we will trial the tool in GP practices, and the final set will be an acceptability study with the GP participants

Domestic abuse in general practice: we could have done more?

Dr Claire McPeake

Academic Supervisors: Gerry Gormley, Helen Reid

Clinical Supervisor: Chris Murray

Summary of Project:

Rates of domestic violence and abuse (DVA) have soared during the covid-19 pandemic. The World Health Organization considers violence against women an “urgent public health priority.” GPs are often trusted by survivors; they are well placed to listen, and offer practical support. However, evidence would suggest that GPs, and staff in GP practices, could do more in helping victims of DVA to disclose about their violence. In partnership with Womens’ aid – we are developing an innovate intervention (in situ simulation by means of forum theatre) to help transform GP practices preparedness in recognising, and helping produce the conditions, for victims of DA to disclose and be offered appropriate care. Research would help shape this intervention.

Fibromyalgia in Primary Care

Dr Kerrie McConnell

Academic Supervisors: Dr Neil Heron & Prof Nigel Hart

Clinical Supervisor: Dr Paula Davidson, Glengormley Practice

Summary of Project

Chronic pain and fibromyalgia are extremely prevalent in General Practice, with a huge individual and societal impact. Indeed, Fibromyalgia has an estimated prevalence of 2.1% in the general population. Despite this, it remains difficult to diagnose and treat in Primary Care. As a General Practice trainee, I felt compelled to gain a better understanding of this condition, in order to improve my own knowledge and my ability to help my patients.

I started by completing a literature review on Fibromyalgia, focusing on the epidemiology, diagnostic criteria, current treatment guidance and patient and physicians' perspectives on the condition.

From my research, it became clear that Fibromyalgia remains a very frustrating condition for both patients and health-care professionals, with physicians uncertain regarding the diagnosis, feeling powerless to provide adequate treatment. Patients can become indignant that their symptoms are not getting better. In addition, patients can often struggle with the concept that there may not be a specific reversible cause for their pain, and that other factors, such as their lifestyle and psychology, may be having the greatest impact. This can result in difficult therapeutic relationships between patients and their healthcare providers.

Following on from my literature review, I am currently completing a scoping review, focusing on the question, “What does the literature tell us about providing an explanation of a fibromyalgia diagnosis in primary care?”. The overall aim is to identify areas of best practice regarding the communication of a fibromyalgia diagnosis, to provide better outcomes for both patients and clinicians. I hope to achieve this through further qualitative research with relevant stakeholder groups.

GPARTS 2020 START

Set up for Success? How do we best implement Near Peer Teaching within the General Practice workplace?

Dr Kelly Doherty

Academic Supervisors: Dr Jenny Johnston & Dr Davina Carr

Clinical Supervisor: Dr Siobhan Harkin at Salisbury Medical Centre, Belfast

Summary of Project

Medical education is undergoing significant changes across the UK. Generalist skills are increasingly important and of a greater focus in the undergraduate curriculum. Whilst this change is welcome, it presents further pressure on struggling general practices to provide the teaching required to students. Near peer teaching (NPT) (teaching between a GP trainee and undergraduate student) presents an effective strategy to this challenge and has benefits for both teacher and learner. Existing literature, however, lacks information on formal integration of such programs. To optimise conditions for NPT, it is important to understand the processes of this type of learning within the workplace, and the influence of different contexts on those processes. My research seeks to add to the literature by doing a formal realist synthesis with the following review question; how can we best implement NPT in general practice? Realist synthesis is a theory-driven summary of the literature and can help us understand why educational interventions work. Three main concepts central to this philosophy are context, mechanism, and outcomes; only in a particular context will mechanisms within an educational intervention operate to generate an outcome.

This research will translate the findings of empirical studies into context, mechanism and outcome configurations and identify those causal relationships that allow for effective NPT implementation in the general practice workplace. This work aims to provide a deeper understanding of how we can best implement NPT within general practice. The results of this synthesis will be useful to policymakers and practitioners in NPT, who will be able to apply the findings within their own contexts and thus design a clinical learning environment that is more effective for learning.

Pursuing flourishing General Practice: understanding the pressures affecting Practices at the ‘coal face’

Dr Richard Dillon

Academic Supervisors: Dr Grainne Kearney & Prof Michael Donnelly

Clinical Supervisor: Neil Stockman at Regency Medical Practice, Newtownards

Summary of Project

My project aims to look at the current pressures within general practice. There has been unprecedented demand in Primary Care in recent times. Over the last 4years, there has been a reduction in the number of GP surgeries. This is either through closures or mergers. A BMA report identified several different factors that may play a part. Since then a number of things have changed (MDT involvement with Physios, Social workers etc and the increased use of telephone triage). My research is focused on reviewing the survey previously carried and trying to identify what factors would help to generate flourishing primary care.

In situ simulation for Paediatric Emergencies in Primary Care

Dr Sarah O’Hare

Academic Supervisors: Professor Gerry Gormley

Clinical Supervisor: Dr Paul Carlisle, Hillhead Family Practice, Belfast

Summary of Project

I am completing a project on the use of in situ simulation training in managing paediatric emergencies in general practice. A wide range of emergencies may present including anaphylaxis, and meningitis. Paediatric emergencies pose a particular challenge, as treating children requires specific knowledge, skills and equipment.

Existing evidence shows that in-situ simulation training is an acceptable and feasible way of developing interprofessional skills in primary care settings. The aim of this research is to investigate the use of simulation to improve preparedness to manage paediatric emergencies in primary care.

I am currently completing a literature review, to establish what is known about how in-situ simulation achieves its outcomes. I will develop and implement a programme of in-situ simulation relating to primary care paediatric emergencies. Using participatory research methodology, supported by multimodal evaluation using video, field notes and interview data, I will explore its effects on learning and organisational change.

Moving More: How can we reduce sedentary behaviour in Primary Care?

Dr Richard Mayne

Academic Supervisors: Dr Neil Heron & Dr Nigel Hart

Clinical Supervisor: Dr David Moore at Struell Surgery in Downpatrick

Summary of Project

Sedentary time (assessed as either daily overall sedentary time, sitting time, television or screen time, or leisure time spent sitting) is independently associated with a greater risk for all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or mortality (breast, colon, colorectal, endometrial, and epithelial ovarian), and type 2 diabetes in adults.

Reducing sedentary behaviour and increasing physical activity in the Primary Care setting could lead to extensive benefits at an individual and population level. Potential individual-level benefits include improved physical and mental health (reducing workplace absenteeism and early retirement) and improved workplace satisfaction. This could lead to population level benefits, whereby General Practitioners subsequently encourage patients, colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity. Doctors who follow healthier lifestyles are more likely to advise patients on improving their own health behaviours. Patients are also more likely to act on health behaviour guidance if the doctor giving the guidance is seen to follow the guidance within their own life. Patients who act on guidance to reduce sedentary behaviour and increase physical activity will gain improved physical and mental health, making them more likely to advise their colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity.

Social Prescribing in Primary Care

Dr Katherine McCracken

Academic Supervisors: Dr Diarmuid O’Donovan & Dr Helen Reid

Clinical Supervisor: Dr Adrian Johnston, Toome Surgery, Toome

Summary of Project

Social prescribing is being widely advocated as a tool to help address patients’ complex health and social care needs. Social prescribing refers to linking patients with sources of support in the community. It seeks to address patients’ needs in a holistic way and empower individuals to take greater control of their health. Social prescribing is a key component of the NHS Long Term Plan and one of the ten high impact actions to release time for care in the NHS General Practice Forward View. A stronger evidence base is required to support continued interest and innovation in social prescribing. I will start with a scoping review which will guide my empirical work. I will potentially use qualitative interview approaches to examine the perceptions of healthcare professionals regarding social prescribing.

‘Gut feeling, gestalt or guesswork?’ The lived experiences of GP trainees managing uncertainty in remote consulting

Jill Christy

Academic Supervisors: Prof. Gerry Gormley, Dr. Grainne Kearney, Dr. Richard Conn; Centre for Medical Education

Clinical Supervisor: Dr. Daniel Hayes, Redwood Surgery, Bangor Health Centre

Summary of Project

Remote consultation has been increasingly promoted as the NHS pursues its Long Term Plan with aims to offer digital first primary care by 2023-24, and the COVID-19 pandemic has expedited this with a switch to a telephone first system being strongly encouraged. It is likely going forward that an increasing proportion of primary care consultations will take place remotely, by telephone or video consultations. Literature to date has focussed on the acceptability and functionality of these more varied consultation forms and whilst there are benefits and drawbacks to moving away from face-to-face consultations as standard, little is known about how these changes are impacting certain aspects of GP consulting. Of note little research has focussed on the educational impact of these changes and how clinical decision making is experienced within telephone or video consultations.

The aim of my research is to better understand how clinicians experience remote consultations particularly General Practice trainees. The overall objective is to better understand uncertainty and decision-making within remote consulting amongst trainees. A narrative literature review has been undertaken and to continue our research we hope to undertake qualitative, semi-structured interviews to explore the experiences of this group of GPs in training with a view to expanding our knowledge in this area so that we can better inform educational and training facilities.

GPARTS 2019 START

Pursuing flourishing General Practice: understanding the pressures affecting Practices at the ‘coal face’

Dr Richard Dillon

Academic Supervisors: Dr Grainne Kearney & Prof Michael Donnelly

Clinical Supervisor: Neil Stockman at Regency Medical Practice, Newtownards

Summary of Project

My project aims to look at the current pressures within general practice. There has been unprecedented demand in Primary Care in recent times. Over the last 4years, there has been a reduction in the number of GP surgeries. This is either through closures or mergers. A BMA report identified several different factors that may play a part. Since then a number of things have changed (MDT involvement with Physios, Social workers etc and the increased use of telephone triage). My research is focused on reviewing the survey previously carried and trying to identify what factors would help to generate flourishing primary care.

In situ simulation for Paediatric Emergencies in Primary Care

Dr Sarah O’Hare

Academic Supervisors: Professor Gerry Gormley

Clinical Supervisor: Dr Paul Carlisle, Hillhead Family Practice, Belfast

Summary of Project

I am completing a project on the use of in situ simulation training in managing paediatric emergencies in general practice. A wide range of emergencies may present including anaphylaxis, and meningitis. Paediatric emergencies pose a particular challenge, as treating children requires specific knowledge, skills and equipment.

Existing evidence shows that in-situ simulation training is an acceptable and feasible way of developing interprofessional skills in primary care settings. The aim of this research is to investigate the use of simulation to improve preparedness to manage paediatric emergencies in primary care.

I am currently completing a literature review, to establish what is known about how in-situ simulation achieves its outcomes. I will develop and implement a programme of in-situ simulation relating to primary care paediatric emergencies. Using participatory research methodology, supported by multimodal evaluation using video, field notes and interview data, I will explore its effects on learning and organisational change.

Moving More: How can we reduce sedentary behaviour in Primary Care?

Dr Richard Mayne

Academic Supervisors: Dr Neil Heron & Dr Nigel Hart

Clinical Supervisor: Dr David Moore at Struell Surgery in Downpatrick

Summary of Project

Sedentary time (assessed as either daily overall sedentary time, sitting time, television or screen time, or leisure time spent sitting) is independently associated with a greater risk for all-cause mortality, cardiovascular disease incidence or mortality, cancer incidence or mortality (breast, colon, colorectal, endometrial, and epithelial ovarian), and type 2 diabetes in adults.

Reducing sedentary behaviour and increasing physical activity in the Primary Care setting could lead to extensive benefits at an individual and population level. Potential individual-level benefits include improved physical and mental health (reducing workplace absenteeism and early retirement) and improved workplace satisfaction. This could lead to population level benefits, whereby General Practitioners subsequently encourage patients, colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity. Doctors who follow healthier lifestyles are more likely to advise patients on improving their own health behaviours. Patients are also more likely to act on health behaviour guidance if the doctor giving the guidance is seen to follow the guidance within their own life. Patients who act on guidance to reduce sedentary behaviour and increase physical activity will gain improved physical and mental health, making them more likely to advise their colleagues, relatives, friends and family to reduce their sedentary behaviour and increase their levels of physical activity.

Social Prescribing in Primary Care

Dr Katherine McCracken

Academic Supervisors: Dr Diarmuid O’Donovan & Dr Helen Reid

Clinical Supervisor: Dr Adrian Johnston, Toome Surgery, Toome

Summary of Project

Social prescribing is being widely advocated as a tool to help address patients’ complex health and social care needs. Social prescribing refers to linking patients with sources of support in the community. It seeks to address patients’ needs in a holistic way and empower individuals to take greater control of their health. Social prescribing is a key component of the NHS Long Term Plan and one of the ten high impact actions to release time for care in the NHS General Practice Forward View. A stronger evidence base is required to support continued interest and innovation in social prescribing. I will start with a scoping review which will guide my empirical work. I will potentially use qualitative interview approaches to examine the perceptions of healthcare professionals regarding social prescribing.

GPARTS 2018 START

The Mental Health Detention Process in the Community

Dr Paula Houton

Academic Supervisors: Professor Gerry Gormley & Dr Helen Reid

Clinical Supervisor: Dr Paul Carlisle, Hillhead Family Practice, Belfast

Summary of Project

One of the most challenging tasks a doctor can be faced with is deciding whether or not an unwell patient requires detention for assessment under relevant mental health legislation. This can be a highly emotional and difficult process for all involved. General Practitioners (GPs) are faced with this medical emergency but despite this – they get limited training in this area. Literature review indicates that there is very limited formal training in this area for any of the professionals involved. However, there is widespread acknowledgment of the challenges associated with these situations in the community and of the potential benefits of interdisciplinary training. There is therefore a need to develop clinical education in this area to bridge this knowledge gap. By means of a scoping literature review, we aim to address the following research question; what is known about how to best train health and social care professionals in the process of mental health detention in the community? This may potentially lead on to empirical work in this area. It is anticipated that this research will help develop training delivery which would be beneficial to all stakeholders involved in this complex clinical encounter.

The challenges for Primary Healthcare teams of managing people with dementia

Dr Lucy Hodkinson

Academic Supervisors: Dr Bernie McGuinness & Dr Nigel Hart

Clinical Supervisor: Dr Miriam Dolan, Maple Healthcare, Lisnaskea

Summary of Project

My name is Lucy Hodkinson and I am second year of the GPARTs programme. My work is looking at dementia care in rural settings.

As we live in an aging population, long term conditions such as dementia are increasing. Older people are more frequently moving out of urban areas into rural areas particularly when they reach the age of 65 and older. This means that there will be more older people living in rural areas. I am interested in finding out how the rural primary care team look after these patients and what challenges they face. I plan to interview members of the rural multidisciplinary primary care team to find out more about this and ultimately hope to improve care for patients with dementia in the future.

Can routinely collected primary care data help us better understand Severe Asthma?

Dr Johnny Stewart

Academic Supervisors: Prof Frank Kee & Dr Nigel Hart

Clinical Supervisor: Dr Caren Walsh, Grosvenor Road Surgery, Belfast

Summary of Project

My research interest is Severe Asthma. In the majority of cases asthma can be treated effectively with currently available medications in primary care. However, a proportion of patients with asthma have a severe variant that does not respond effectively to these therapies. This group of patients with treatment resistant disease, known as Severe Asthma, pose a significant challenge for clinicians and patients.

The majority of asthma care takes place in primary care. Yet research into this condition takes place almost exclusively in secondary and tertiary care. I am interested in the untapped potential of the data we routinely collect in primary care every day to better understand this high risk disease.

Records for individual patients are usually held in various disconnected databases throughout our health and social care system. I am investigating if linkage of primary care data to other health and administrative records to create a single unique dataset can improve our understanding of Severe Asthma.

GPARTS 2017 START

Understanding how knowledge is shared and how people learn through Project ECHO

Dr Catherine Hanna

Academic Supervisors: Dr Jenny Johnston & Dr Nigel Hart

Clinical Supervisor: Dr Naoimh White, Rowan Tree Medical Practice, Belfast

Summary of Project

My research project involves looking at Project ECHO and how we learn in this environment. Project ECHO is a teleconferencing network used mainly by healthcare professionals to share knowledge and ideas through case based discussions and presentations from expert speakers. I am interested in how we are learning in this way currently and using a theory based approach I am exploring how we learn together in ECHO as a team. Going forward, I hope this work can be used to better understand what is happening within ECHO and afford useful insights for the planning and setting up of new networks.

Queen's University Belfast

GPARTS

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Queen's University Belfast