A coalition of the UK's leading primary care academics has outlined urgent actions needed to protect the country's world-leading position in general practice research, following concerns raised by the Medical Research Council report about the collapsing clinical academic workforce.
The timing is particularly critical given the government's Spending Review commitments to "bring back the family doctor" by training thousands more GPs and delivering millions more appointments. The recommendations, published today in the British Journal of General Practice, come as the government commits £29 billion to transform NHS care "from hospital to community" - a shift the authors warn cannot succeed without the research workforce to guide it.
Without academic GPs to research what works, test new models of care, and train the next generation, we're essentially flying blind. You cannot transform healthcare without evidence, and the workforce that provides it is in crisis."
- Professor Sir Aziz Sheikh
Lord Darzi's review, which informed this strategy, identified the shift from hospital to community care as essential for creating "an NHS fit for the future."
The paper, co-authored by academics from the Universities across the UK including Birmingham and Oxford, reveals that academic GPs, who provide the evidence base for effective community healthcare, now represent just 0.05% of the GP workforce, compared to 3% of hospital doctors in academic roles.
The research crisis comes as demand for community-based evidence has never been higher. With over a million GP consultations occurring each working day, the need for evidence-based community care is urgent. Yet without this research, patients may receive treatments that work in hospitals but haven't been tested in community settings.
The paper proposes five key recommendations to address the crisis:
- Create structured, academic career pathways with secure funding to attract and retain talent
- Reinforce university infrastructure for academic general practice
- Build a stronger research culture within general practice
- Provide practical support and mentorship for clinical academics
- Champion the contribution of general practice research
Professor Clare Taylor, Professor of General Practice at the University of Birmingham, and lead author of the study commented: "We need to make academic general practice a visible and valued career path for the next generation of GPs, to combat this clear decline within the current workforce. Funders and academic institutions need to work together to provide stable routes for career progression, without the threat of gaps in funding, to recruit and retain talent.
"Academic GPs are uniquely positioned to ask the right questions, collect real-world evidence, and translate these findings into clinical practice. However, without investment in people, infrastructure and culture to build a strong academic GP workforce for the future, we risk undermining the very foundation of evidence-based primary care."
Professor Patrick Maxwell CBE, Regius Professor of Medicine at the University of Cambridge and Chair of the Medical Schools Council said: "The Medical Schools Council became increasingly concerned that just as the NHS needs to pivot towards community-based care, we're losing the very researchers who can show us how to do it effectively.
We asked the country's most senior primary care academics to come together and identify practical solutions. Their analysis confirms our fears: without urgent action, the UK risks losing decades of global leadership in primary care research at precisely the moment we need it most."
The UK has historically led the world in academic general practice, with research from UK GPs developing internationally renowned and widely used tools like QRISK, establishing new standards for blood pressure monitoring as well as rapidly identifying effective COVID-19 treatments during the pandemic. However, this leadership is now under threat.
Professor Michael Kidd AO, Professor of Global Primary Care at the University of Oxford and Chief Medical Officer of Australia added: "Having worked in primary care systems across the world, I've seen firsthand how UK research has shaped global healthcare. From Australia to Canada, we've relied on evidence generated by British academic GPs to transform our health systems.
It's deeply ironic that as other nations invest heavily to build their academic primary care capacity – often by recruiting UK talent – Britain is allowing this world-leading resource to wither. The brain drain is real, and it's accelerating."
Professor Sir Aziz Sheikh, Head of the Nuffield Department of Primary Care Health Sciences at the University of Oxford and a co-author of the paper said: "The government has committed significant funding to move care into the community and train thousands more GPs, which is very welcome. But without academic GPs to research what works, test new models of care, and train the next generation, we're essentially flying blind. You cannot transform healthcare without evidence, and the workforce that provides it is in crisis."
Co-author Professor Richard Hobbs CBE, Mercian Professor of Primary Care at the University of Oxford added: "The Spending Review demonstrates the government's commitment to community-based care, but money alone won't deliver transformation and some elements of the strategy not specified, such as the right numbers of generalist medical practitioners, especially GPs, practice nurses and pharmacists, to meet the needs of the population. This workforce also needs reliable evidence base and for decades, UK GP research has shown the world how to deliver effective primary care. Without urgent action to rebuild our academic GP workforce, we risk squandering the world-class academic legacy we have built and the billions being invested in more community care."