After years in the doldrums, primary care research is on the national agenda

For the first time, key RACGP goals such as boosting primary care research and stronger pathways for clinician researchers have been recognised as national priorities in the 2018–2020 Priorities for the Medical Research Future Fund (MRFF).
 
To address the ‘capacity and production gap’ in primary care research, the MRFF will now support the establishment of practice-based research networks (PBRNs) to advance primary care research, and work to boost scholarships for GPs considering doing a PhD.
 
‘[The MRFF will] develop a grant opportunity to support PBRNs and other collaborations to conduct prioritised primary care research that is led by clinicians, can permeate daily practice and has potential for scalability,’ the document states.
 
The RACGP has long called for an end to the neglect of primary care research, which receives only a tiny fraction of current medical research grants.
 
The college’s submission to the MRFF priority consultation process states that primary care research has ‘the greatest potential reach and population impact compared to research in other health sectors’.
 
‘There is the opportunity for the MRFF to make a significant difference to primary healthcare, and for Australia to become uniquely placed to lead in this area,’ the RACGP submission states.
 
‘Developing high-quality, evidence-based care will lead to more efficient and effective primary care and produce a more affordable health system.’
 
University of Tasmania primary care researcher Professor Tania Winzenberg welcomed the news that primary care is one of the MRFF’s 12 national priorities.
 
‘This is great news for general practice but also, I believe, for the Australian community, who will in the long-term benefit from improved care based on quality general practice research,’ she told newsGP.
 
Professor Winzenberg said the RACGP Expert Committee – Research (REC–R) has been highly engaged with the MRFF over the last few years regarding the importance of general practice research.
 
‘The priorities acknowledge and focus on many of the key areas we have put forward, including capacity-building the general practice research workforce, supporting GP-led practice-based research and the networks to make this happen, and the need for the evidence base for clinical care to include research that is generalisable to complex general practice patients,’ Professor Winzenberg, former Chair of the REC–R, said.

Primary care researcher Professor Tania Winzenberg believes a focus on primary care research is great news for the Australian community, as well as general practice.

Current Chair of the REC–R, Professor Clare Heal, said the news is extremely positive.
 
‘Establishing a clear career pathway for GP academics is high priority, and PhD scholarships for GPs will help ensure the viability of the next generation of researchers. I would like to see the [RACGP] explore combining PhDs with GP registrar training,’ she told newsGP.
 
Professor Heal cautioned that PBRN research should be led by primary care researchers, rather than used by hospital clinician researchers to recruit patients.
 
The MRFF is on track to reach $20 billion in funding by 2020–21, after which it will disburse around $1 billion a year in funding. When it reaches fully funded status, the MRFF will almost double the Federal Government’s investment in health and medical research.
 
The fund is designed to address emerging health concerns through strategic investment in research, and to complement – not duplicate – the work done by the Australia’s top medical research funding body, the National Health and Medical Research Council (NHMRC).
 
Emerging academic GPs have also welcomed the news.
 
Dr Jo-Anne Manski-Nankervis of the University of Melbourne said general practice research had long been under-recognised and under-funded.
 
‘The renewed focus on primary care in the MRFF priorities is exciting and we need to make sure we make the most of the opportunities which will be coming online,’ she told newsGP.
 
‘There are opportunities for research in key areas that affect primary healthcare such as digital health and antimicrobial resistance, and to utilise [PBRNs] for primary care research.’
 
Dr Manski-Nankervis said investment in financial support for GPs to undertake their PhDs would help develop the academic GP workforce.
 
‘A lack of financial support makes it very difficult for GPs to undertake higher degree research training,’ she said. ‘An investment from MRFF will help to develop the academic workforce that will work with clinical colleagues to undertake high-quality research to inform the work that we as a profession perform into the future.’
 
The MRFF’s new Priority for clinical researcher capacity states that clinically active researchers ‘bring a practice perspective that aids research translation’.
 
‘Sufficient and sustained investment is required to ensure Australia maintains its reputation for research excellence. This attention must traverse career stages with a focus on early and mid-career to ensure the viability of the next generation of researchers,’ it states.
 
The RACGP submission to the MRFF states that while most healthcare occurs in the community, most medical research takes place in hospitals or specialist settings.
 
‘There is currently a significant gap in the funding of general practice research compared to its importance to healthcare in Australia. Between 2000 and 2008, fewer than 2% of NHMRC grants awarded were for primary care research,’ it states. ‘General practice makes up an even smaller proportion of this funding. Instead, most medical research continues to be conducted in the hospital sector.
 
‘The growth in chronic and complex diseases, particularly in cohorts with low socioeconomic status, calls for a more concerted effort in primary care research that is geographically relevant and where possible scalable nationally to maximise impact.’
 
The MRFF priorities call for the rollout of PBRNs to advance primary healthcare research. These networks are well established in the US, Canada and the Netherlands, but efforts to roll them out in Australia have suffered from funding uncertainty.
 
The MRFF’s other priorities include tackling antimicrobial resistance, global health challenges, Aboriginal and Torres Strait Islander health and ageing research.

general practice research Medical Research Future Fund primary care research