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Exeter Collaboration for Academic Primary Care (APEx)

About APEx

Our mission 

  • Establish a research focus on the development and delivery of holistic, person-centred care that builds on existing expertise.
  • Understanding, researching, and exploring new, integrated models of care which cross traditional boundaries of primary, secondary, mental health and social care.
  • Look at innovative ways of delivering high-quality integrated care that exploit the potential of technology.
  • Establish a continuum of education in primary care from the undergraduate to the postgraduate and the established professional, placing research and evidence at the heart of primary care education.

Our Team 

Member of staff Position
Professor John Campbell Professor of General Practice and Primary Care, Director Exeter SPCR. @profjcampbell
Professor Richard Neal Professor of Primary Care and Director of APEx. @richarddneal

 

Member of staff Position
Professor John Campbell Professor of General Practice and Primary Care,  Director Exeter SPCR
Professor Richard Neal Professor of Primary Care and Director of APEx
Associate Professor Gary Abel Senior Lecturer & Statistician
Dr Nur Akter Statistician/ Data Analyst (Di-Facto Project, National Cancer Diagnosis Audit)
Kasim Allel Henriquez Research Fellow (Antimicrobial Resistance)
Jenny Amesbury

Project Administrator (REACH-HF Project) 

(Rehabilitation Enablement in Chronic Heart Failure)

Dima Arafah PhD Student
Associate Professor Sarah Bailey Associate Professor of Primary Care Diagnostics
Mrs Melissa Barlow

Graduate Research Assistant - (EPIC Project)

(Evaluating ethnic differences in blood markers of cancer in primary care)

Dr Jess Bollen Postdoctoral Research Fellow
Dr Jo Butterworth NIHR Academic Clinical Lecturer in General Practice / Medical Education
Dr Raff Calitri Trial Manager/Research Fellow

Dr Mary Carter

Research Fellow 

Miss Wawa Chen

Graduate Research Assistant (DISCO Team)

Amy Chinner

Graduate Research Assistant

Dr Chris Clark

Clinical Senior Lecturer in General Practice and Primary Care

Dr Emma Cockcroft

Research Fellow and NIHR SPCR Postdoctoral Research Fellow

Louise Cooper

Graduate Research Assistant (CARPE Umbrella Review)

Dr Rosina Cross

Postdoctoral Research Fellow 

Associate Professor Hasnain (Hayes) Dalal 

Clinical Associate Professor & Senior Clinical Research Fellow (REACH-HF Project)

(Rehabilitation Enablement in Chronic Heart Failure)

Dr Gianni Dongo NIHR Academic Clinical Fellow 
Ms Elizabeth Down

Graduate Research Assistant (EPIC Project)

(Evaluating ethnic differences in blood markers of cancer in primary care)

Professor Barney Dunn Professor of Psychology
Marilyn Evans APEx Administrator
Professor Philip Evans Professor of Primary Care Research
Emily Fletcher Research Fellow and PhD Student
Charlotte Forbes Academic Clinical Fellow
Laura Gill

Graduate Research Assistant

Becky Gudka

Graduate Research Assistant

Dr Abi Hall

Postdoctoral Research Fellow

Rebekah Hall

Graduate Trainee Assistant in Health Economics and PhD Student

Professor David Halpin Consultant Physician and Honorary Professor
Professor Willie Hamilton  Professor of Primary Care Diagnostics
Professor Alex Harding Sub Dean, Course Director M.Clin.Ed

Dr Sara Hayes

NIHR SPCR Manager and SPOCC (SPotting Cancer among Comorbidities) Research Manager

Kate Jardine-Brown

APEx Administrator

Professor Umesh Kadam

Professor of Primary Care and Public Health Research

Tomazo Kallis

Senior Research Fellow

Adnan Khan

Academic Clinical Fellow

Dr Nada Khan

NIHR Academic Clinical Fellow

Taha Khan

Academic Clinical Fellow
Eve Kingstone Professional Training Year Student
Ellie Kingsland  PA to John Campbell and Richard Neal, and Senior Administrator to APEx
Lucy Kirkland Graduate Research Assistant (DISCO team)
Judit Konya Academic Clnical Lecturer
Stella Kozmer SPCR PhD Student

Professor Sallie Lamb

Mireille Gillings Professor of Health Innovation

Dr Deepthi Lavu

Academic Clinical Fellow

Hassanat Lawal

SPCR PhD Student

Dr Tani Martins

Research Fellow (DISCO Group)

Dr Sinead McDonagh

NIHR SPCR Postdoctoral Research Fellow

Rosie Mew

Academic Clinical Fellow 

Kinan Mokbel 

Post Doc Research Fellow
Dr Sarah Moore NIHR SPCR GP Career Progression Fellow

Dr Luke Mounce

Research Fellow (DISCO Group)

Abdullah Mubarky

MPhil/PhD PGR Student

Benjamin Atta Owusu

Research Fellow in Statistics/Data Science

Professor Rupert Payne

Senior Academic GP and Clinical Pharmacologist

Associate Professor Emma Pitchforth

Associate Professor in Primary Care

Dr Ian Porter

Associate Research Fellow

Dr Anna Price

Research Fellow (Three Schools Mental Health)

Dr Sarah Price

Research Fellow

Charlotte Reburn

SPCR MRes Student

Dr Elizabeth Shephard

Research Fellow  

Mr David Shotter 

Graduate Research Assistant (SPOCC Project)

(SPotting Cancer among Comorbidities)

Dr Jane Smith

Senior Lecturer in Primary Care
Beccy Summers Research Associate (PPI)
Dr Bethan Treadgold

Postdoctoral Research Fellow 

Dr Maria Valasaki Postdoctoral Qualitative Researcher (SPOCC Project)

Dr Sam van Beurden

Senior Research Fellow in Complex Interventions

Dr Fiona Warren

Senior Lecturer in Medical Statistics  

Dr Bianca Wiering

Postdoctoral Research Fellow

Rachel Winder

Research Fellow 

 

  

Member of staff Position
Christine Addington Postdoctoral Research Associate (Pflexi Study)
Professor Louise Allan Professor of Geriatric Medicine
Professor Rob Anderson Associate Professor of Health Services and Implementation Research, Director of Research Impact (Institute of Health Research), Director of ESMI
Professor Clive Ballard Professor of Age Related Diseases
Professor Vashti Berry NIHR South West Peninsula Applied Research Collaboration Senior Research Fellow
Dr Alex Burns GP and PhD Student
Professor Linda Clare Professor of Clinical Psychology and Ageing and Dementia
Dr Anne Corbett Senior Lecturer in Dementia Research
Dr Antoinette Davey Postdoctoral Research Fellow
Professor Helen Dawes Professor of Clinical Rehabilitation
Professor Sarah Dean Professor of Psychology Applied to Rehabilitation and Health
Dr Ndubuisi Egwim Honorary Associate
Professor Chris Dickens Professor of Psychological Medicine
Professor Andrew Eynon-Lewis Honorary Clinical Professor in General Practice and Primary Care
Dr Lisa Gibbons  Honorary Clinical Associate Research Fellow and Clinical Research Specialty Lead for the NIHR
Professor Vicky Goodwin Associate Professor of Ageing and Rehabilitation
Professor William Henley

Professor of Medical Statistics

Professor Alexandra Hillman

Associate Professor in Sociology

Professor Clare Hulme Professor of Health Economics
Professor Chris Hyde Professor of Public Health and Clinical Epidemiology
Professor David Keene Associate Professor 
Professor Dawn Lee Associate Professor of Health Economics and Health Policy
Dr Kristin Liabo Senior Research Fellow
Dr David Llywelyn Senior Research Fellow

Dr Mae Mansoubi

Research Fellow

Dr Jane Masoli

Senior Clinical Research Fellow & Honorary Consultant Geriatrician 

Dr Matthew Masoli

Honorary Senior Clinical Researcher

Dr Andrew Mcgovern 

Academic Clinical Fellow

Professor Antonietta Medina-Lara

Associate Professor in Health Economics (E&R)

Dr Sam Merriel

Honorary Senior Clinical Researcher

Sarah Morgan-Trimmer

Senior Research Fellow

Dr Tamsin Newlove-Delgado

Senior Clinical Lecturer and Honorary Consultant in Public Health

Professor Heather O'Mahen

Professor in Perinatal Clinical Psychology

Dr Martin Pitt

Associate Professor of Healthcare Modelling and Simulation

Dr Janice Ranson

Senior Research Fellow

Dr Beverley Shields

Senior Lecturer in Medical Statistics

Professor Anne Spencer

Associate Professor

Professor Rod Taylor

Professor of Health Services Research

Dr Rohini Terry

Research Fellow

Professor Krasimira Tsaneva

Professor of Mathematics for Healthcare

Professor Jose Valderas

Honoary Professor

Laura Warbrick

Research Fellow (Three Schools Mental Health)

Ed Watkins

Professor of Experimental and Applied Clinical Psychology

Dr Esther Williamson

Senior Research Fellow

Dr Lianne Wood

Senior Research Fellow

Dr Kim Wright

Associate Professor in Clinical Psychology

 

Bringing together research groups across Health and Community Sciences

  • Ageing and Frailty (website under construction)

APEx has key partnerships with individuals and local, regional, national and international organisations, some of which are highlighted below.

Region Partner Detail
Local
Dr Lisa Gibbons An Honorary Research Fellow of the University of Exeter Medical School, is the Clinical Research Specialty Lead for Primary Care within the CRN: SWP, based in Exeter.
Associate Professor Philip Evans

The National Specialty Lead for Primary Care for the CRN covers the whole of England, and is also one of the two Cluster C Leads based within King's College London with specific responsibility for Dermatology, Mental Health, Primary Care and Public Health. 

Regional

Devon NHS Clinical Commissioning Group (CCG)

 

NHS England and NHS Improvement South West

 

 

NIHR Clinical Research Network (CRN): South West Peninsula

 

Royal College of General Practitioners (Tamar Faculty)

 

National

 

NIHR Clinical Research Network (CRN): National Lead

 

Research Impact

The NHS needs clear, detailed feedback from patients to monitor the performance of primary care clinical teams. Research from the University of Exeter directly informed the creation and use of the national GP Patient Survey (GPPS) – one of the world’s largest annual patient surveys, covering all 6,900 practices, and over 14 million patients in England since 2014. 

The resulting impact has been:

(i) GPPS is routinely used to measure and monitor the quality of GP services

(ii) GPPS data has informed new national policies that have been introduced changing service provision

(iii) the public, regulators/inspection agencies, and service providers have been better informed about patient experience of general practice.

Professor John Campbell Professor of Primary Care 2002 to date
Dr Gary Abel Senior Lecturer in Primary Care (Medical Statistics) 2016 to date
Dr Ruben Mujica Mota Senior Lecturer in Health Economics 2003-2019

 

1. Campbell J, Smith P, Nissen S, Bower P, Elliott M, Roland M. The GP Patient Survey for use in primary care in the National Health Service in the UK–development and psychometric characteristics. BMC Family Practice. 2009 Dec;10(1):57.

2. Burt J, Campbell J, Abel G, et al. (+12 other University of Exeter co-authors). Improving patient experience in primary care: a multi-method programme of research on the measurement and improvement of patient experience. Programme Grants for Applied Research (NIHR Journals Library). 2017. No. 5(9).

3. Roberts MJ; Campbell JL; Abel GA; Davey AF; Elmore NL; Maramba I; Carter M; Elliott MN; Roland MO; Burt JA. Understanding high and low patient experience scores in primary care: Analysis of patients’ survey data for general practices and individual doctors. 2014. BMJ (Online) 349(nov11 3):g6034

4. Burt J; Newbould J; Abel G; Elliott MN; Beckwith J; LLanwarne N; Elmore N; Davey A; Gibbons C; Campbell J et al. Investigating the meaning of ‘good’ or ‘very good’ patient evaluations of care in English general practice: A mixed methods study. 2017. BMJ Open 7(3):e014718

5. Warren F, Abel G, Lyratzopoulos G, Richards S, Barry H, Elliott M, Roland M, Campbell J. Characteristics of service user and provider organisations associated with experience of out-of-hours general practitioner care in England: population based cross sectional postal questionnaire survey. BMJ 2015; 350: h2040.

6. Mujica-Mota RE; Roberts M; Abel G; Elliott M; Lyratzopoulos G; Roland M; Campbell J. Common patterns of morbidity and multi-morbidity and their impact on health-related quality of life: evidence from a national survey. 2015. Quality of Life Research 24(4):909-918.

In the UK, cancer will affect 1 in 2 people during their life. Delays in diagnosis are common, and shorten lives. This large programme of research by Hamilton and the DISCO team has developed risk assessment tools for 13 more cancer sites. The resulting impact has been:

(i) These risk algorithms have been incorporated into the three main UK GP software systems. It is available for use by over 90% of general practices in the UK, covering more than 50 million registered patients.

(ii) This research also underpinned 89 of the 210 recommendations in the 2015 NICE guidelines for recognition of suspected cancer, governing ~£1bn of annual NHS spending.

(iii) Implementation of this guideline has speeded up cancer diagnosis by on average a week, with improved cancer survival.

 

Professor Willie Hamilton Professor of Primary Care Diagnostics 2010–date

Dr Elizabeth Shephard

Research Fellow 2010–date

Dr Sarah Price

Research Fellow 2013–date

Dr Sarah Walker

Research Fellow  2013–date
Dr Sarah Bailey Research Fellow  2013–date 
Prof Anne Spencer Professor  2012-date

 

1.     Shephard EA, Neal RD, Rose P, Walter FM, Litt EJ, Hamilton WT. Quantifying the risk of multiple myeloma from symptoms reported in primary care patients: a large case–control study using electronic records. Br J Gen Pract. 2015;65(631):e106-e13.

2.     Stapley S, Peters TJ, Neal RD, Rose PW, Walter FM, Hamilton W. The risk of pancreatic cancer in symptomatic patients in primary care: a large case-control study using electronic records. British Journal of Cancer. 2012;106(12):1940-4.

3.    Walker S, Hyde C, Hamilton W. Risk of breast cancer in symptomatic women in primary care: a case-control study using electronic records. Br J Gen Pract. 2014;64(629):e788-e93.

4.    Hamilton W, Hajioff S, Graham J, Schmidt-Hansen M. Suspected cancer (part 2 – adults): reference tables from updated NICE guidance. Brit Med J. 2015;350:h3044.

5.    Banks J, Hollinghurst S, Bigwood L, Peters TJ, Walter FM, Hamilton W. Preferences for cancer investigation: a vignette based study of primary care attendees. The Lancet Oncology. 2014;15:232-40.

6.    Bailey SE, Ukoumunne OC, Shephard EA, Hamilton W. Clinical relevance of thromocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data. Br J Gen Pract. 2017;67:405-13

7.    Price S, Spencer A, Medina-Lara A, Hamilton W. Availability and use of cancer decision-support tools: a cross-sectional survey of UK primary care. British Journal of General Practice. 2019;69(684):e437

Type 2 diabetes affects around 4 million people in England, with around 200,000 new diagnoses every year. However, the disease can be prevented by identifying early signs of its development (so-called ‘pre-diabetes’) and supporting people to improve their diet, increase physical activity and reduce weight. Behaviour change research at Exeter since 2003 has directly informed the creation in 2015 and subsequent development of the NHS Diabetes Prevention Programme (NHS DPP) in England. Over 400,000 people have been referred to NHS DPP and in 2018 –19. It exceeded its policy goal of 100,000 people on the programme each year. Based on similar numbers, NHS England’s own impact analysis of the NHS DPP estimated net economic benefits of £1.2bn for 5 years’ of the programme from 2016 to 2021.

(i) Evidence from University of Exeter research led to the 2012 change in the recommendations of the NICE public health guidance PH38 on diabetes prevention

(ii) The NHS DPP has been a joint programme of NHS England, Public Health England and Diabetes UK, delivering at scale, evidence-based behavioural interventions for individuals identified as being at high risk of developing Type 2 diabetes

(iii) Based on similar participation assumptions, NHS England’s own impact analysis (in 2016) of the NHS DPP estimated that by the end of the fifth year of the programme (i.e. 2020) 18,000 cases of diabetes would have been prevented or delayed among 390,000 programme participants

Dr Jane Smith

Senior Lecturer in Primary Care

2012–date

Professor Colin Greaves

Associate Professor of Psychology Applied to Health

2003–2018

Dr Phil Evans

Associate Professor of General Practice and Primary Care 2012–date

1. Greaves CJ, Sheppard KE, Abraham C, et al. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health 2011;11(119):1–12. doi: 10.1186/1471-2458-11-119

2. Greaves CJ, Stead J, Hattersley A, et al. A simple pragmatic system for detecting new cases of type 2 diabetes in primary care. Family Practice 2004;21(1):57–62. doi: 10.1093/fampra/cmh113

3. Dunkley AJ, Bodicoat DH, Greaves CJ, et al. Diabetes Prevention in the Real World: Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes and of the Impact of Adherence to Guideline Recommendations: A Systematic Review and Meta-analysis. Diabetes Care2014;37(4):922–33. doi: 10.2337/dc13-2195

4. Evans PH, Greaves C, Winder R, et al. Development of an educational "toolkit" for health professionals and their patients with prediabetes: The WAKEUP study (Ways of Addressing Knowledge Education and Understanding in Pre-diabetes). Diabetic Medicine 2007;24(7):770–77. doi: 10.1111/j.1464-5491.2007.02130.x

5. Evans P, Greaves CJ. Helping people at high risk of type 2 diabetes: Using the WAKEUP materials. Diabetes and Primary Care 2015;17(4):175–79.

6.  Smith JR, Greaves CJ, Thompson JL, et al. The community-based prevention of diabetes (ComPoD) study: a randomised, waiting list controlled trial of a voluntary sector-led diabetes prevention programme. Int J Behav Nutr Phys Act. 2019;16(1):112. doi:10.1186/s12966-019-0877-3

Primary Care Key Literature

See Primary Care Key Literature