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Tony Avery

Professor of Primary Health Care, Faculty of Medicine & Health Sciences

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Biography

Tony Avery is a GP, Professor of Primary Health Care and an NIHR Senior Investigator. He is also National Clinical Director for Prescribing. He undertook his undergraduate medical degree at the University of Sheffield; completed GP training in Nottingham and has been a clinical academic at the University of Nottingham since 1992. He led a major expansion of the Division of Primary Care from 1998 - 2012, securing membership of the NIHR School for Primary Care Research in 2009. He was appointed as the Director of Research for the School of Medicine in 2013 and was Dean and Head of School 2015-2019.

Tony also works as a GP at the Valley Surgery, Chilwell, Nottingham, and he has introduced a large number of innovations since joining in 1992. He leads on patient safety and prescribing for the practice, and had an important role in the practice achieving an 'Outstanding' rating from the Care Quality Commission in 2015.

Expertise Summary

Keywords:

Primary care research, patient safety, prescribing errors, medication errors, medicines optimisation, polypharmacy, randomised trials in primary care, electronic prescribing systems.

Teaching Summary

Tony is an experienced, enthusiastic and effective teacher with excellent feedback on his teaching at undergraduate and postgraduate levels. He has led a number of educational initiatives that have… read more

Research Summary

Tony's research focuses on patient safety in primary care, and he has led major studies to identify the frequency, nature and causes of prescribing errors and avoidable patient harm in primary care.… read more

Selected Publications

  • John Fry Silver Medal (2008): awarded by the Royal College of General Practitioners to one GP each year in recognition of their research contribution.
  • Professor Tony Mitchell Memorial Medal (2009): presented annually at a lecture in Nottingham in memory of Professor Tony Mitchell, the Foundation Professor of Medicine at the University of Nottingham
  • James MacKenzie Lecturer Silver Medal: presented at the Royal College of General Practitioners Annual General Meeting (2016)
  • NIHR Senior Investigator Award (2018)

Tony is an experienced, enthusiastic and effective teacher with excellent feedback on his teaching at undergraduate and postgraduate levels. He has led a number of educational initiatives that have an impact on education and training for GPs. He has co-developed e-learning materials on prescribing safely, which have been accessed by over 3000 health professionals with significant improvement in knowledge demonstrated. He has also led a major project to develop, evaluate and disseminate a 'Patient Safety Toolkit' for general practices (2011-17), and this has been accessed over 10,000 times since 2017; the Patient Safety Toolkit is listed as one of the 'top 10 achievements of the NIHR School for Primary Care Research'.

Tony has taught on ethics, communication skills, clinical general practice and patient safety to undergraduate medical students. He supervises PhD students in topics relating to prescribing and patient safety.

Current Research

Tony's research focuses on patient safety in primary care, and he has led major studies to identify the frequency, nature and causes of prescribing errors and avoidable patient harm in primary care. He has also developed and evaluated interventions aimed at improving patient safety in primary care. In addition, he has led, and collaborated on, a large number of randomised trials in primary care.

Current research includes:

  • Avoiding patient harm through the application of prescribing safety indicators in English general practices (acronym: PRoTeCT); NIHR Programme Grants for Applied Research; £2.4m (Chief Investigator)
  • NIHR Greater Manchester Patient Safety Research Collaboration; £4.9m (Co-investigator)
  • Improving outcomes for patients with opioid-treated persistent non-cancer pain: a proactive clinical pharmacist-led primary care intervention (PROMPPT intervention); £2.5m (Co-investigator)
  • Social Prescribing for people to Live ENjoyably with Dementia/memory problems In Daily life (SPLENDID); £2.7m (Co-investigator)
  • Understanding the scale and nature of avoidable harm in prison healthcare; £0.85m (Co-investogator)

Past Research

Past research studies include:

  • Allopurinol and cardiovascular outcomes in patients with ischaemic heart disease (ALL-HEART); £2.7m (Co-investigator)
  • Helicobacter eradication to prevent ulcer bleeding in aspirin users: a large simple randomised controlled trial (HEAT); £2.5m (Co-investigator)
  • Understanding the frequency of avoidable significant harm in primary care; NIHR Policy Research Programme; £430,000 (Chief Investigator)
  • Improving prescribing safety in general practices in the East Midlands through the PINCER intervention; Health Foundation; £500,000; 2015-2017 (Chief investigator for the evaluation component of this intervention)
  • Greater Manchester Translational Research Centre for Primary Care Patient Safety; NIHR Patient Safety Translational Research Centre; £6.2m 2012-2017 and £6.7m 2017-23 (Co-investigator)
  • Investigating the implantation, adoption and effectiveness of ePrescribing systems in English hospitals: a mixed methods national evaluation; NIHR Programme Grant for Applied Research; £1,999,523; 2011-2017 (Co-investigator)
  • Characterising the nature of primary care patient safety incident reports in England and Wales and identifying feasible and priority interventions: mixed methods study; NIHR - HS&DR
  • Treating acute gout in primary care: A randomised equivalence trial comparing naproxen and low-dose Colchicine; NIHR School for Primary Care Research; £769,553; 2012-2015 (Co-investigator)
  • Understanding and appraising the New Medicines Service in the NHS in England; Department of Health CCF RMS; £720,908; 2012-2014 (Co-investigator)
  • The initiation of Advance Care Planning in community care settings and outcomes for End of Life Care; NIHR Health Services Research Programme; £315,853; 2012-2014 (Co-investigator)
  • Developing, testing and implementing the NSPCR Patient Safety Toolkit in general practices in England; NIHR School for Primary Care Research; £569,740; 2011-2014 (Co-investigator)
  • Preparatory work for an application for a Phase IV trial using methods developed in the PINCER trial; NIHR School for Primary Care Research; £119,909; 2010-2014 (Co-investigator)
  • Knowledge sharing across the boundaries between care processes, services and organisations: the contributions to 'safe' hospital discharge and reduced emergency readmission; NIHR SDO; £237,229; 2011-2013 (Co-investigator)
  • Randomised controlled trial of a cognitive therapy based practice intervention for frequent attenders with depression, anxiety or medically unexplained symptoms in primary care; Collaborations for Leadership in Applied Health Research and Care (CLAHRC); £353,417; 2008 - 2013 (Co-investigator)
  • Comprehensive geriatric assessment for medical crises in older people; NIHR Programme Grant for Applied Research; £1,995,813; 2008-2013 (Co-investigator)
  • Does the presence of Thrombophilia increase the risk of developing idiopathic pulmonary fibrosis? MRC; £479,000; 2009-2012 (Co-investigator)
  • Getting out of the House: A multi-centre randomised controlled trial of occupational therapy targeted at improving outdoor mobility for people who have had a stroke; NIHR Health Technology Assessment; £1,219,983; 2009-2012 (Co-investigator)
  • Investigating the prevalence and causes of prescribing errors in general practice; General Medical Council; £101,380; 2010-2011 (Chief investigator)
  • Evaluation of the adoption of the NHS Care Record Service in Secondary Care; NHS Connecting for Health Evaluation Program; £1,500,000; 2008-2010 (Co-investigator)
  • Evaluation of the Electronic Prescription Service in Primary Care; NHS Connecting for Health Evaluation Programme; £956,680; 2008-2010 (Co-investigator)
  • Partnerships with children and adolescents in medicine-taking: rights and responsibilities; NIHR SDO; £411,000; 2008-2010 (Co-investigator)
  • Evaluation of the Yellow Card reporting scheme for patients; Department of Health; £249,000; 2007-2010 (Co-investigator)
  • Virtual Organizations for Trials and Epidemiological Studies (VOTES); MRC; £597,244; 2006-2009 (Co-investigator)
  • Cluster randomised trial evaluating the effectiveness of a pharmacist-led intervention vs. simple feedback in reducing rates of hazardous prescribing in general practices (The PINCER Trial); Department of Health Patient Safety Research Portfolio; £643,690; 2006-2010 (Chief investigator)
  • Evaluation of supplementary prescribing by nurses and pharmacists; Department of Health; £249,000; 2005-2007 (Co-investigator)
  • RCT assessing weight loss and quadriceps strengthening exercises as interventions for reducing knee pain in the community of the overweight; Arthritis Research Council; £483,000; 2002-2007 (Co-investigator)
  • Programme for the Development of Capacity to Evaluate Information Technology (IT) Interventions to Reduce Risk; Department of Health Policy Research Programme; £140,000; 2003-2005 (Co-investigator)
  • Randomised controlled trial of community pharmacy intervention in patients with coronary heart disease; Department of Health; £479,982; 2001-2004 (Co-investigator)
  • An Evaluation of the use of PharmDIS (Pharmacodynamic Drug Information and Dosage Adjustment System); European Union (CRAFT (Biomed-2) programme; £333,000; 1998-2003 (Co-investigator)
  • Salaried general practitioner contracts: their impact on recruitment, retention, workload and quality of care; Department of Health; £258,777; 1998-2001 (Co-investigator)
  • Randomised controlled trial to assess the relative clinical efficacy, microbiological safety and cost of currently available oral and topical antimicrobial therapies for acne vulgaris; NHS R&D (Health Technology Assessment); £532,340; 1997-2001 (Co-investigator)
  • Audit of Child Health Surveillance in Nottingham Health Authority; Department of Health; £222,910; 1993-1998 (Co-investigator)
  • Identifying how general practices make savings on their prescribing costs; Department of Health; £104,666; 1996-1998 (Chief investigator)

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