UCLP-Primrose (2021-2026)

Severe Mental Illness (SMI) refers to people who have a debilitating psychological problem (for example: schizophrenia or bipolar disorder) that significantly impacts their daily activities. People with SMI are frequently managed in primary care and have a higher risk of problems linked to cardiovascular disease.

UCLP-Primrose brings together two innovations: Primrose-A and The UCLPartners Proactive Care Frameworks.

Primrose-A

Primrose-A is an evidence-based approach to delivering intensive tailored support for people with severe mental illness. It is a primary care service where individuals are supported to build behavioural strategies to prevent relapse and improve their cardiovascular health. The service includes up to eight 30-minute sessions with a nurse and four 60-minute sessions with a peer coach (individuals with lived experience of mental health problems) over six months.

Primrose-A was developed and delivered collaboratively with patient and public involvement throughout including the research design, intervention development and delivery, and interpretation of results with a Lived Experience Advisory Panel. Primrose-A has been shown to deliver improvements in mental health and reduce healthcare costs. Watch Population Health Nurse Anne-Marie Kay and Consultant Psychiatrist Dr Ian Prenelle introduce Primrose A below.

UCLPartners Proactive Care Frameworks

The UCLPartners Proactive Care Frameworks uses stratification to identify patients who need priority management and deploy the wider primary care workforce to provide structured support for patient education, self-management, and behaviour change. The framework is designed so that those patients with the greatest clinical risk from physical risk factors are prioritised so that their treatment can be optimised. Watch Programme Director and GP Dr Matt Kearney introduce UCLPartners Proactive Care Frameworks below.

UCLP-Primrose

Bringing them together: UCLP-Primrose has been developed to maximise the benefits of the SMI physical health check and to help people with SMI to receive the best care for their physical health as well as their mental health. Alongside this, patients receive structured support for education and self-management, and holistic support for wider health and social needs. 

UCLP-Primrose is being implemented nationally. This started with expansion of delivery in two existing London boroughs, followed by uptake in a third London borough, and parallel implementation in Bradford, Yorkshire.

For more about the UCLP-Primrose pathway see the UCLP-Primrose pathway tab and the UCLPartners website.

Implementation research

Research to update Primrose-A (becoming UCLP-Primrose) and evaluate this adapted service was funded by NIHR ARC East Midlands (November 2021 to August 2024) as part of the national Multiple Long-term Conditions Programme.

This research specifically looked at whether UCLP-Primrose could be set up and delivered, and what helped and challenged its implementation.

The team was subsequently awarded an extension to this research (October 2024 to March 2026) to explore sustainability and spread of UCLP-Primrose delivery in existing sites, as well as potential for spread elsewhere.

Chief investigator - Professor David Osborn.

For more information the research, see the UCLP-Primrose research tab and NIHR ARC North Thames website.

WHOLE-SMI:

Building on Primrose, Professor Emily Oliver and the team at Newcastle University, with Professors David Osborn and Kate Walters at UCL, are completing a project called WHOLE-SMI (wellbeing and holistic health for individuals living with severe mental illness). WHOLE-SMI is focused on holistic health promotion for people living with severe mental illness and explores the implementation and adaptation of PRIMROSE in the Northeast of England and North Cumbria. For more information on the status of this work, please see the WHOLE-SMI tab or contact Emily.oliver@newcastle.ac.uk.

UCLP-Primrose Team

UCL: Professor David Osborn, Dr Philippa Shaw, Dr Danielle Lamb 

UCLPartners: Dr Matt Kearney, Professor Peter Fonagy, Niran Rehill, Gemma Copsey, Dr Stephanie Peate, Dr Deep Shah, Dr Ed Beveridge, Mairead McErlean, Lucy Brock

Improvement Academy, Bradford Institute for Health Research: Dr Kristian Hudson, Dr Zuneera Khurshid, Dr Eloise Ryde, Beverley Slater, Dr Vishal Sharma

ARC North Thames: Professor Fiona Stevenson

Diamonds Voice: Angela Ross

ARC Yorkshire and Humber: Professor Simon Gilbody

Camden & Islington NHS Foundation Trust: Dr Ian Prenelle

Bradford District Care NHS Foundation Trust: Dr Gregor Russell

University of York: Professor Najma Siddiqi

Mind in Bradford: Masira Hans

News

UCLP-Primrose training is now recommended by NHS England! 

Pip, Zuneera, and Gemma have published a blog looking back at the history of Primrose.

Innovate Awards 2022: UCLPartners Proactive Care Frameworks were joint winners of the ‘Outstanding Contribution to Population Health Through Innovation’ award.

UCLPartners Proactive Care Frameworks were finalists in the HSJ primary and community innovation of the year award. 

UCLPartners Proactive Care Frameworks have been nominated for the HETT User-centered Design award and the General Practice Long Term condition award.

Watch Primrose features in national multimorbidity webinar with Professor Chris Whitty Managing Multimorbidity Seminar | 5th October 2021 | ARC East Midlands

Listen and watch more about Primrose:

• Watch the UCLP-PRMROSE team and WHOLE-SMI team talk about their research in the NIHR Three Research Schools Seminar Series. 
• The Research Sofa Season 2 Episode 8 feat. Professor David Osborn (UCL)
• Listen to Professor David Osborn on The Lancet podcast

Want to read more?

Navigating the UCLP-Primrose tabs:  

• The UCLP-Primrose (2021-2026) tab provides an overview of what UCLP-Primrose is, where this service is being delivered, research around UCLP-Primrose.  
• The UCLP-Primrose pathway tab introduces the UCLP-Primrose diagram of how support is offered to patients through the service.
• The UCLP-Primrose research tab collates the outputs from research investigating the implementation of UCLP-Primrose (2021-26).
• The WHOLE-SMI tab provides details of a sister project, based at Newcastle University.
• The Primrose-A (2019-2022) tab documents the co-produced adaption to Primrose (Primrose-A) which was delivered and evaluated in London.
• The Primrose (2010-2019) tab provides information about the research underpinning UCLP-Primrose, including the development of Primrose and the findings from the Primrose clinical trial.