Joe Kai has been an inner city general practitioner since 1991. He is Professor and Head of the Division of Primary Care at University of Nottingham. The Division is part of the National Institute of Health Research (NIHR) School of Primary Care, delivers internationally excellent research, and teaching and training of medical students across all five years of the BMBS course at Nottingham.
Joe trained at Newcastle University, became a GP principal at Adelaide Medical Centre in the city, and helped set up the West End Health Resource Centre. As a lecturer, he developed interests in medical education, responding to ethnic diversity, and qualitative research. He won the inaugural RCGP award for best research in primary care in 1997 for his doctoral work on parents dealing with acute illness in young children.
As a senior lecturer at Birmingham University (1999-2002) he helped establish the Midlands Research Practices Consortium (MidRec) as its clinical director, facilitating implementation of major MRC and HTA commissioned trials in primary care, and worked as a GP in Quinton.
In 2003 he became Foundation Chair and Head of Primary Care at University of Nottingham's new graduate entry medical school. He supported its innovative curriculum and GP led clinical course at Derby. Moving to Nottingham's main campus in 2010 to also develop applied research, he became Head of the Division of Primary Care in 2012, with over 100 academic, teaching and research staff, including 8 chairs.
Joe remains a part-time GP at Derby Family Medical Centre with 85% of his patients from minority ethnic inner city communities.
In addition to health research, Joe has on-going interests in health professional training and service improvement. He has developed and led national training to support genetic assessment and screening by health professionals in the NHS, using haemoglobin disorders as a model (www.pegasus.nhs.uk). His other work includes the BMA award winning Primary Care in Urban Disadvantaged Communities (Radcliffe); and interactive health professional training to reduce ethnic inequalities in health care. This includes PROCEED: Professionals responding to cancer and diversity (Cancer Research UK), the BUPA award-winning Valuing Diversity (2nd ed, Royal College of General Practitioners, 2006); and e-learning on health inequalities, language barriers and cross-cultural communication for the national GP curriculum (e-GP, RCGP). He led the primary care research programme of the NIHR CLAHRC for Notts-Derbys-Lincs till 2013, and public health programme on service improvement for obesity with East Midlands Academic Health Science Network (AHSN) till 2017.
Joe co-leads the Primary Care Stratified Medicine (PRISM) research group at Nottingham to improve effective and equitable health care and disease prevention. PRISM does this by developing and using advances in genomics and data science to better identify people's risk of disease and their response to interventions.
In 2015, Joe's research was named among the BMJ's top 20 outstanding papers of the past 20 years.
Expertise in clinical and applied health research, teaching and service development in relation to:
- Primary care stratified medicine
- Applied genetics in primary care - use of family history; common inherited problems such as haemoglobin disorders, familial hypercholesteroalemia
- Translational genomics
- Reducing inequality and responding to ethnic diversity in health and health care
- Women's health
- Qualitative and community participatory methods, and primary care based trials
Cross-cultural health care; ethnic diversity, inequality and health
Applied genetics; haemoglobin disorders (sickle cell & thalassaemia); women's health
Current undergraduate teaching includes clinical primary care/general practice, early clinical and professional development, community follow up courses
Current postgraduate teaching includes:
Masters in Public Health (Health Inequalities)
Masters in Clinical Genetics (Population Screening and Primary Care)
Health care research including qualitative and community participatory methods, and primary care based trials.
Women's health: Joe co-leads the world's largest trial of medical management of heavy menstrual bleeding in primary care (ECLIPSE trial with J Gupta and clinical trials unit at University of Birmingham). Commissioned by NIHR-HTA Programme, this £1.8m trial involves over 60 centres, with over 15% of participants from ethnic minorities. The first results provided the most robust evidence available for first line treatment of this common problem for women, published in the New England Journal of Medicine in 2013. See www.youtube.com/watch?v=IybneDeaXUA . Major long-term follow up of outcomes for women and health services is still ongoing in primary care.
Reducing inequality and responding to ethnic diversity in health care, and applied genetics:
While often focusing on diverse ethnic communities, the generic application and utility of this research across populations and care settings is sought and emphasised.
Current activity within the Primary Care Stratified Medicine (PRISM) research group includes:
- Intervention development to enhance health professional responses to ethnic diversity
- Developing community informed interventions to reduce disease risk in deprived South Asian communities
- Developing preconception health interventions in primary care, including among ethnic communities at high risk
- Universal screening for common inherited haemoglobin disorders (sickle cell and thalassaemia)
- Use and communication of genetic information in primary care
- Access to genetic health care in minority communities with familial cancer risk
- Use of family history in primary care (e.g. in cardiovascular assessment; and inherited predisposition to cancer)
- Earlier identification of women at risk of familial breast cancer
- Earlier detection and targeting of familial hypercholesterolaemia
ALLFORD, A., QURESHI, N., BARWELL, J.G., LEWIS, C. and KAI, J., 2014. What hinders minority ethnic access to cancer genetics services and what may help? European Journal of Human Genetics. 22(7), 866-874 (Epub 20 Nov 2013) GUPTA, J., KAI, J., MIDDLETON, L., PATTISON, H., GRAY, R. and DANIELS, J., 2013. Levonorgestrel intrauterine system versus medical therapy for menorrhagia New England Journal of Medicine. 368(2), 128-137
MCDONALD, R., CHERAGHI-SOHI, S., BAYES, S., MORRISS, R. and KAI, J., 2013. Competing and coexisting logics in the changing field of English general medical practice Social Science & Medicine. 93, 47-54
- Developing and implementing health professional training interventions to improve health care of ethnically diverse communities (Valuing Diversity, RCGP 2006; PROCEED, CRUK, 2005))
- Responding to cancer and ethnic diversity (e.g. Kai et al PLoSMed 2007; Kai et al BJC 2012)
- Community participatory methods to engage & train minority communities in research (Kai & Hedges, Health Expectations 1999; Bush et al, BMJ 2003)
- Influences on smoking and physical activity in South Asian communities
- Primary care of mental ill health
- Primary care of acutely ill children (e.g. Kai BMJ 1996)
Joe co-leads his Division's Primary Care Stratified Medicine (PRISM) research group with Nadeem Qureshi
His other ongoing applied research in primary care includes:
Leading long term follow up of women in the ECLIPSE trial of medical management of heavy menstrual bleeding in primary care (NIHR HTA Programme 2015-2019);
Developing and evaluating interventions to reduce disease in high risk deprived and minority ethnic communities;
Other commissioned work (from 2013/14, all NIHR) includes:
- Improving identification of women at risk of familial breast cancer in primary care (PRISM group)
- Detecting and targeting familial hypercholesterolaemia in primary care (PRISM group)
- Psychological intervention for health anxiety in persistent high users of unscheduled care (led by Prof Richard Morriss, Division of Psychiatry, Nottingham)
- Implementing diabetes prevention interventions in multi-ethnic communities (with Dr Tom Yates, University of Leicester)
- Understanding interactions in primary care consultations for acute cough in children (led by Dr Christie Cabral, University of Bristol)
New collaborative research (from 2016/17) includes:
- ROSHNI-D: multi-centre RCT of group psychological intervention for postnatal depression in British mothers of South Asian origin (NIHR HTA, led by Dr Nusrat Hussain, University of Manchester)
- VITA randomised controlled trial of oral metronidazole vs topical lactic acid gel for bacterial vagninosis (NIHR HTA, led by Prof Jonathan Ross, Birmingham)