In British primary care, where 80% of National Health Service consultations take place, policy decisions often depend more on optimistic theory than on evidence.1 Conducting research has generally been a low priority for primary care clinicians in the United Kingdom. The ethos of independent small business in general practice tends more towards innovation than research, and scarce academic training opportunities are associated with a culture where research is not much expected, valued, or rewarded.2 Yet with leadership, resource, and good relationships between researchers and service providers, primary care research can underpin effective and efficient practice in ways that specialist perspectives alone cannot.3 4 5

Moreover, the UK has developed primary care research infrastructures that have been enabling and influential internationally.6 7 8 Most recently, the new national health research strategy aims to “re-engineer the environment in which clinical research is conducted” through the UK Clinical Research Network (UKCRN), which involves primary care centrally (figure⇓).9 This network is intended to offer a managed approach to …