Introduction
Research activity usually improves outcomes by being translated into practice. However, there is developing evidence that research activity itself may improve the overall performance of health care organisations. However, evidence that these relationships represent a causal impact of research activity is less clear. Additionally, the bulk of the existing evidence relates to hospital settings, and it is not known if those relationships would also be found in general practice, where most patient contacts occur. We sought to (a) test whether there were significant relationships between research activity in general practice and organisational performance (b) test whether those relationships were plausibly causal.
Methods
We analysed national data between 2008 and 2019 using cross sectional and longitudinal analyses, on 7921 general practices in England. Research activity included measures from the NIHR Clinical Research Network and the Royal College of General Practitioners. Measures of practice performance included clinical quality of care, patient reported experience of care, prescribing quality and hospital admissions.
Results
In cross-sectional analyses, research activity was positively associated with a number of measures of practice performance, including clinical quality of care, patient reported experience of care, and hospital admissions. The associations were generally modest in magnitude. However, longitudinal analyses did not support a reliable causal relationship.
Conclusions
Similar to findings from hospital settings, research activity in general practice is associated with practice performance. There is less evidence that research is causing those improvements, although this may reflect the limited level of research activity in most practices. We identified no negative impacts, suggesting that research activity is something that high quality practices are able to deliver alongside their core responsibilities and a potential marker of quality.