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Shaping the future: a Primary Care research and Development Strategy for Scotland  
 

The CPHVA in Scotland acknowledges the need to develop the research agenda within primary care and welcomes the consideration your working party is giving this matter. We would endorse the general theme of the document.

However, there must be seen to be a positive commitment to embrace ALL professionals who work within the primary care/ community settings. There is some concern that this may become purely medically driven. It is accepted that the medical profession has a ‘head start’ on nursing and PAM’s in terms of research activity therefore there is a danger that the medical agendas may be overwhelming. Therefore, in order to subscribe to this, and I believe to capture universal commitment to the strategy, the multidiciplinary ‘ethos’ must be demonstrated.

Given the geographical spread within Scotland the principle of a virtual school is appealing. However, how this would be managed overall may present a challenge. In an attempt to ensure equitable access and SUPPORT this approach should include innovative methods of teaching/links, e.g. To include open leaning, information technology, teleconferecing, as integral features (not add-on extras). Also how would the quality of services offered by the virtual school be monitored?

Given also, some of the constraints that may face clinical personnel in small or very rural practices how best can these be included or given a chance to participate in the emerging research agenda if desired? Is there any way that a CAT type scheme may be developed within this strategy so that individuals may accrue ACADEMIC knowledge incrementally over a specified period of time. I am thinking particularly of practice nurses, who within Grampian may welcome alternate methods of building up academic credibility to augment their broad clinical skills, but equally this may apply to other disciplines

I believe that it is also vital to consider how students will be supported or mentored throughout their research experience. Different professions may be starting off at varying levels of knowledge and academic expertise. Mentoring must be developed as a feature of the infrastructure from the start as often the support mechanisms in place can positively affect the outcome, both in learning experience and research rigour.

There is a need for greater transparency between organisations and general practices in order to achieve the much of the aims of your Strategy. Given the emerging access of information technology within primary care would this medium not be a useful tool through which to share information broadly, to be used in conjunction with the co-ordinators?

The use of coordinators is useful, as individuals who can view the ‘smaller pieces’ and how they fit within the context of the broader picture: in order that personal efforts are maximised to benefit patient care and also so that we are doing the right things in the right way. Although not wishing to constrict innovative thought it would be useful if individual research activity was viewed within the strategic frameworks from government, PCTs & LHCC’s. Also consideration may be afforded to patient total care pathways. It may be useful to examine in partnership with the PCT’s, what the current level of knowledge & skills are and to identify where obvious gaps exist.

The CSO has invested in research training fellowships in the past. Having been successful in obtaining and completing one of these I feel happy to discuss areas where the process may have been improved. One of my primary concerns, which were highlighted to the CSO, was the lack of support or infrastructure Another, perhaps surprising outcome, was how clinical managers viewed this episode. Rather than seeing this as ‘adding value’ to existing clinical skills, to be rewarded, there was a sense that research skills had been achieved to the detriment of clinical skill. This was not a situation encountered only by myself but was also identified by others colleagues in similar positions. This reflects, perhaps, a need for a broad change of attitudes towards research and development within the service (which may be assisted with the emerging clinical governance agenda).

Suggested amendment pg. 3, point 2: "a comprehensive system of funding for training and career development which will ensure access to a range of research raining to secure effective multidisciplinary leadership for primary care R & D in Scotland"

Community Practitioners and Health Visitors Association
69 Countesswells Road
Aberdeen AB15 7Y
Scotland

26.02.99

 
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