Primary Care & Health Sciences
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Following clinical training at Nottingham University I moved to North Staffordshire in 1999 to complete my general practice vocational training. In 2004 was awarded an Arthritis Research UK Fellowship to investigate the prognosis of older people with joint pain in primary care (the PROG-RES study) and in 2011 I was awarded an Arthritis Research UK Clinician Scientist Fellowship to research missed opportunities to improve the management of inflammatory arthropathy in general practice.
I am currently Professor and Director of Academic General Practice. I am also Director of Academic Clinical Training for the Faculty of Health.
My research interests focus on improving the management of common rheumatological complaints in primary care. In particular I am interested in diagnosis and prognosis of musculoskeletal disorders in a general practice setting.
Early work focussed on the association between painful exposures in childhood and common conditions experienced as a young adult. My Arthritis Research UK funded PhD investigated a generic approach to determining the prognosis of older adults with musculoskeletal pain in general practice (PROG-RES study).
My new programme of work focusses on 'missed opportunities' to improve the management of inflammatory conditions in primary care. Specific projects include using GP consultation to investigate the association between PMR and vascular disease, clinical comorbidity in patients with gout, and vascular screening in patient with rheumatoid arthritis. A new large inception cohort of patients with PMR is being established to establish the course and prognosis of this group in a primary care setting.
I am involved in two large randomised controlled trials. The TATE study is investigating the use of TENS for people with tennis elbow, whilst the POST study is a large cluster randomised trial looking at the effects of screening older consulters with joint pain for anxiety and depression symptoms in the consultation.
I have active research collaborations with the University of Birmingham (Dr Karim Raza - early diagnosis of rheumatoid arthritis) and University of Essex (Professor Dasgupta - polymyalgia rheumatica) and am a member of the Brisbane Initiative.
My work is funded by Arthritis Research UK, the National Institute for Health research (Research for Patient Benefit, Programme Grant, National School for Primary Care Research) and the North Staffordshire Medical Institute.
I have been awarded three Fellowships by Arthritis Research UK, an RCGP Great Expectations Award and a prize for best patient involvement in research.
Selected Publications
Full Publications List show
Journal Articles
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2013. Should there be a Quality and Outcomes Framework domain for osteoarthritis? A cross-sectional survey in general practice. Qual Prim Care, vol. 21(2), 97-103. link>
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2013. Transcutaneous electrical nerve stimulation as adjunct to primary care management for tennis elbow: pragmatic randomised controlled trial (TATE trial). BMJ, vol. 347, f5160. link>
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2012. The association between pain intensity and the prescription of analgesics and non-steroidal anti-inflammatory drugs. Eur J Pain, vol. 16(7), 1014-1020. link> doi> full text>
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2012. Patient related factors are also important in treating gout. BMJ, vol. 344, e191. link>
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2012. The association of anxiety and depression with future dementia diagnosis:a case control study in primary care. Family Practice. doi>
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2011. A Content Analysis of Environmental Sustainability Research In a Sport-Related Journal Sample. JOURNAL OF SPORT MANAGEMENT, vol. 25(3), 240-256. link>
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2011. Sickness certification for mental health problems: an analysis of a general practice consultation database. Prim Health Care Res Dev, vol. 12(2), 179-182. link> doi> full text>
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2010. An intercalated research Masters in primary care: a pilot programme. Educ Prim Care, vol. 21(3), 208-211. link>
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2010. Improving access to health care: is the investment in walk-in centres paying off?. Qual Prim Care, vol. 18(6), 405-406. link>
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2010. Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis. BMJ, vol. 340, c1269. link> doi> full text>
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2009. Discussing prognosis with older people with musculoskeletal pain: a cross-sectional study in general practice. BMC Fam Pract, vol. 10, 50. link> doi> full text>
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2009. Tennis elbow. BMJ, vol. 339, b3180. link>
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2009. Time to revisit Dr Finlay's casebook? The unique potential of the general practice case report. Cases J, vol. 2(1), 119. link> doi> full text>
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2009. Transcutaneous electrical nerve stimulation for the management of tennis elbow: a pragmatic randomized controlled trial: the TATE trial (ISRCTN 87141084). BMC Musculoskelet Disord, vol. 10, 156. link> doi> full text>
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2008. Predicting the course of functional limitation among older adults with knee pain: do local signs, symptoms and radiographs add anything to general indicators?. Ann Rheum Dis, vol. 67(10), 1390-1398. link> doi> full text>
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2008. Sickness certification in general practice: a comparison of electronic records with self-reported work absence. Primary Health Care Research & Development, vol. 9(2), 113-118. doi>
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2008. A woman living with osteoarthritis: A case report. Cases J, vol. 1(1), 153. link> doi> full text>
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2006. The assessment of the prognosis of musculoskeletal conditions in older adults presenting to general practice: a research protocol. BMC Musculoskelet Disord, vol. 7, 84. link> doi> full text>
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2006. Is chronic pain in adulthood related to childhood factors? A population-based case-control study of young adults. J Rheumatol, vol. 33(11), 2286-2290. link>
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2007. Prognostic factors for musculoskeletal pain in primary care: a systematic review. Br J Gen Pract, vol. 57(541), 655-661. link>
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2005. Severely disabling chronic pain in young adults: prevalence from a population-based postal survey in North Staffordshire. BMC Musculoskelet Disord, vol. 6, 42. link> doi> full text>
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2004. An academic vocational training scheme for general practice - a model for the future. Education for Primary Care, vol. 15, 67-573.
Other
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2013. GOUT IS AN INDEPENDENT RISK FACTOR FOR ALL TYPES OF VASCULAR DISEASE: A RETROSPECTIVE COHORT STUDY IN THE UK GENERAL PRACTICE RESEARCH DATABASE. RHEUMATOLOGY (vol. 52, pp. 38-39). link>
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2013. POLYMYALGIA RHEUMATICA: THE VIEW FROM PRIMARY CARE. RHEUMATOLOGY (vol. 52, p. 21). link>
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2013. THE RISK OF A SUBSEQUENT CANCER DIAGNOSIS AFTER PMR: A PRIMARY CARE DATABASE STUDY. RHEUMATOLOGY (vol. 52, p. 40). link>
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2013. TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION FOR THE MANAGEMENT OF TENNIS ELBOW: A PRAGMATIC RANDOMIZED CONTROLLED TRIAL. RHEUMATOLOGY (vol. 52, p. 38). link>
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2012. ARE RHEUMATOID ARTHRITIS PATIENTS SCREENED FOR CARDIOVASCULAR DISEASE IN PRIMARY CARE?. RHEUMATOLOGY (vol. 51, pp. 37-38). link>
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2012. FATIGUE AS A PRECURSOR TO POLYMYALGIA RHEUMATICA: A RETROSPECTIVE COHORT STUDY. RHEUMATOLOGY (vol. 51, p. 112). link>
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2012. POLYMYALGIA RHEUMATICA: MORE THAN JUST SHOULDER PAIN. RHEUMATOLOGY (vol. 51, p. 10). link>
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2012. THE ASSOCIATION OF GOUT WITH SLEEP DISORDERS AND SLEEP APNOEA: A CROSS-SECTIONAL EPIDEMIOLOGICAL STUDY IN PRIMARY CARE. RHEUMATOLOGY (vol. 51, p. 111). link>
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2012. THE COURSE OF COMORBID ANXIETY SYMPTOMS IN PATIENTS PRESENTING TO GENERAL PRACTICE WITH SYMPTOMATIC OSTEOARTHRITIS: LATENT CLASS GROWTH ANALYSIS. RHEUMATOLOGY (vol. 51, pp. 110-111). link>
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2011. POLYMYALGIA RHEUMATICA: DIAGNOSIS, PRESCRIBING AND MANAGEMENT IN PRIMARY CARE. RHEUMATOLOGY (vol. 50, p. 86). link>
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2009. HOW IS ACUTE GOUT MANAGED IN PRIMARY CARE?. RHEUMATOLOGY (vol. 48, pp. I101-I102). link>
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2009. LAY SYMPTOM ATTRIBUTIONS FOR KNEE PAIN AND HAND PAIN: A CROSS-SECTIONAL STUDY. RHEUMATOLOGY (vol. 48, p. I12). link>
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2008. Screening older people with musculoskeletal pain for depression during the general practice consultation. RHEUMATOLOGY (vol. 47, p. II179). link>
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1993. PROMOTING CONCEPTUAL CHANGE IN CHILDREN LEARNING MECHANICS. PROCEEDINGS OF THE FIFTEENTH ANNUAL CONFERENCE OF THE COGNITIVE SCIENCE SOCIETY (pp. 878-882). link>
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1990. A DIRECT MANIPULATION MICROWORLD FOR VERTICAL MOTION. COMPUTERS IN EDUCATION (pp. 375-382). link>
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1990. COMPLETE, CONSISTENT GOAL SETS - CONTROLLING THE SEARCH WITHIN NONLINEAR PLAN GENERATION. FIRST INTERNATIONAL CONFERENCE ON EXPERT PLANNING SYSTEMS (vol. 322, pp. 152-156). link>
With colleagues I have developed the Keele Medical Academic Pathway within the Faculty of Health bringing together the core components of undergraduate and postgraduate clinical academic training. I am lead for the medical student research group and research based intercalation within the Faculty of Health and am Director of the Keele Academic Foundation Programme. I lead the local NIHR Academic Clinical Fellowship and Clinical Lecturer schemes and take a national role with general practice recruitment to GP ACF posts.
I am a GP trainer in an advanced training practice, deliver sessions for the vocational training scheme and MMedSci course and am a past course organiser on the North Staffordshire VTS. I mentor undergraduate medical students and am the education link between the Medical School and the Research Institute.
I currently supervise 3 MMedSci dissertatons, 2 MPhil dissertations and 2 PhDs and I am deputy director of postgraduate research.
I am a GP partner at Kingsbridge Medical Practice, Newcastle under Lyme (1 day per week).
I am an editor of the European Journal of General Practice and review board member for Education for Primary Care.

