Our early work focused on supporting general practitioners and primary care teams to engage with information technology (IT) to improve patient care, enhance clinical practice and streamline administrative processes. Much of this involved identifying the barriers and facilitators to IT and developing solutions that were easily adopted and replicated across the UK.

PRIMIS facilitators, employed locally but trained and supported by us, were our essential partners in this quest and were instrumental in helping GP practices to effectively utilise data and IT tools to enhance patient care, ensure data quality, and implement best practices.

Aside from our work with GP practices, PRIMIS experts also supported national data collection activities: we contributed to the design and production of code groups for the National Diabetes Audit and for many years we worked working closely with colleagues from the University of Birmingham on testing the feasibility and validity of proposed indicators for the Quality and Outcomes Framework (QOF).

By 2005 there was a network of over 400 PRIMIS facilitators. This network played a critical role in supporting GP practices to enhance patient care, optimise clinical operations, and maintain high standards of data quality. Through collaboration and continuous improvement, the PRIMIS Facilitator Network helped shape the future of primary care IT and data quality, supporting better outcomes for patients and communities.

We released CHART in 2005, an advanced suite of data extraction, analysis, and reporting tools designed to support GP practices in improving patient care, clinical performance, and operational efficiency. By leveraging data from electronic health records, the tools enabled healthcare providers to make informed, data-driven decisions that enhanced the quality of care and optimised practice management. The ability to compare practice performance against regional or national benchmarks was introduced soon thereafter.

In 2006, we had a pivotal role supporting the Information Management and Technology Directed Enhanced Service (IM&T DES) by designing and delivering an approach to primary care data accreditation. Over 500 GP assessors were trained by the PRIMIS Clinical Adviser team, and a set of indicators implemented across all 7,000 GP practices provided the most comprehensive measure of data quality in England ever undertaken. 

Our work on the national vaccination uptake surveys began in 2007. These surveys are crucial for assessing vaccination coverage, identifying gaps, and informing strategies to improve immunisation rates. We set the standards and requirements for collecting, recording, and managing vaccination data within primary care settings. We are very proud of our work with the UKHSA (and its predecessor Public Health England), a collaboration that continues still to this day.

In 2009, evidence for the underutilisation of oral anticoagulants led to national quality improvement initiatives to improve their uptake. One such example was the PRIMIS GRASP-AF quality improvement tool. Developed in collaboration with West Yorkshire Cardiovascular Network and NHS Improvement, GRASP-AF identified patients with atrial fibrillation (AF) at risk of stroke who might benefit from anticoagulation therapy. In 2013, data from GRASP-AF formed the basis of a landmark study which provided insights into the prevalence and contemporary management of AF in England.

GRASP-AF was the first of several tools developed by PRIMIS in collaboration with various healthcare partners designed to help GP practices identify and manage patients with long-term conditions. The GRASP suite of tools has played a crucial role in supporting primary care practitioners in risk assessment, preventive care, and disease management, ultimately contributing to better patient outcomes and healthcare delivery in the UK.

The PRIMIS Data Quality Award was introduced in 2011. It was an accredited programme for PRIMIS Facilitators designed to recognise their understanding of best practices in clinical data management and implementation within a primary care setting. Over 100 facilitators achieved the award which not only prepared them to undertake their valuable work with GP practices but helped to foster a culture of continuous improvement and professional development in the field of primary care health informatics.

The end of a national contract for PRIMIS in 2014 marked a significant transition for primary care data quality services in England. The national contract had funded the development and dissemination of data quality improvement tools and various training programs, ensuring wide accessibility and consistent support across the country. This shift brought challenges and opportunities for GP practices and stakeholders who had come to rely on PRIMIS’s tools and expertise. 

The end of the national contract necessitated a new strategic approach for PRIMIS too involving securing alternative funding, adopting new tools, developing in-house capabilities, and building of new collaborative networks. Despite the change, PRIMIS continued to promote best practices and contribute to NHS policy and strategic direction on the use of primary care data, whilst establishing ourselves as a major source of highly skilled and effective health informatics support and broadened our collaborations and partnerships with academia, industry, and charitable organisations.

The effectiveness of our approach was reinforced in 2015 when NHS Rightcare acknowledged the role PRIMIS played in providing expertise, tools and resources to GP practices to optimise healthcare delivery, improve patient outcomes and reduce unwarranted variation in care. 

2015 marked the start of our involvement in PINCER, an intervention developed by academics at the University of Nottingham designed to reduce medication errors in primary care. By leveraging information technology and providing targeted support to healthcare providers, the PINCER intervention reduces clinically significant medication errors and enhances patient safety. During 2015-2017, PRIMIS supported the scale and spread of PINCER across the East Midlands, including the introduction of new approaches to searching patient records. In 2016, a short life working group of the World Health Organization (WHO) recommended the national roll out of PINCER and in 2017, PRIMIS was selected by the Health Foundation to participate in its Exploring Social Franchising programme. Using social franchising as a mechanism for the replication, scale and spread of PINCER paved the way for national roll out.

The national rollout of PINCER, coordinated by PRIMIS in collaboration with the Academic Health Science Network (our franchisees), took place between 2018-2022. During this period, over 23 million patient records were searched using PRIMIS tools and over 1,500 health care professionals were trained by PRIMIS. Findings from the national roll out showed comparable reductions in medication errors to that observed in the original research, demonstrating the successful replication of the intervention at scale. 

The adoption of SNOMED CT by GP practices in England in 2020 marked a significant step toward achieving interoperability and standardization in primary care electronic health records. By offering training, technical assistance, tool development and through advocacy efforts, PRIMIS played a key role in promoting the adoption and integration of SNOMED CT.

PRIMIS celebrated its 20th anniversary in 2020, the same year that School of Medicine at the University of Nottingham celebrated its 50th anniversary. We are extremely proud of our long and thriving relationship.

The COVID-19 pandemic posed unprecedented challenges to healthcare systems worldwide, but it also spurred significant innovations and improvements in healthcare quality, patient safety, and the sharing of patient information. 

As part of our work with the UKHSA on vaccination uptake, PRIMIS produced a data specification for the COVID-19 vaccination and supported its implementation by GP IT system suppliers. The specification includes attributes necessary for tracking and monitoring vaccination efforts and remains the only specification approved for reporting as well as call and recall purposes.

Prior to the COVID-19 pandemic, PRIMIS experts had worked with the University of Liverpool on influenza preparedness, including the development of tooling to support GP practices in the event of a surge. During the COVID-19 pandemic, PRIMIS collaborated with EMIS Health on the deployment of the tooling, which helped GP practices to triage and manage hundreds of thousands of patients correctly, as well as generate consistent and standardised data on patients presenting to general practice with COVID-19.

PRIMIS continued to support the national roll out of PINCER during the pandemic. In 2023 investigative work in collaboration with the Bennett Institute for Applied Data Science, published in BMJ Medicine , looked at the impact of the COVID-19 pandemic on safe prescribing using the PINCER indicators as a marker. The study, based on 57 million primary care records, demonstrated that hazardous prescribing had been largely unaffected during the pandemic.

The impact of the PINCER intervention extends across multiple dimensions including patient outcomes, healthcare practices, policy development, and economic savings. The PRIMIS team led on the development of the 4* REF 2021 impact case study, which recognises the changes and benefits that research has had on society, economy, public policy and practice, environment, and quality of life. 

Throughout our long history, we have demonstrated our expertise in supporting the widespread scale and adoption of innovations, and our ability to bridge the gap between research discoveries and their application in clinical or real-world settings. FAMCAT2 is another such example. The algorithm helps to identify patients with familial hypercholesterolemia (FH); early detection and effective management of FH are crucial for reducing the risk of cardiovascular complications and improving long-term outcomes for affected individuals and their families. We had previously worked with academics at the University of Nottingham to help validate earlier iterations of the algorithm and were delighted to support its further scale and spread, which included translating the algorithm into a workable data model for use in primary care settings. PRIMIS continues to build partnerships to promote the use of the algorithm within population health management systems, and in 2023, registered FAMCAT2 as a medical device.

PRIMIS continues to work with the NHS, industry, academia and charities to identify and act on opportunities to make bigger and better data-driven healthcare improvements.