Tackling Health Inequalities through Research Equity: A Case-study of the Greater Manchester Inclusive Research Network

Abstract

Background:

Health inequalities persist despite advances in healthcare. Research could ameliorate this, but populations experiencing the greatest burden of disease are often underrepresented in research. This mismatch limits the generalisability of evidence and risks reinforcing existing inequalities. Inclusive research is increasingly recognised as both an ethical imperative and a scientific necessity, yet participation in research remains unevenly distributed.

Objective:

To examine the distribution of research activity across general practice in Greater Manchester and to describe the development and early implementation of the Greater Manchester Inclusive Research Network (GM IRN) as a model to support more equitable, primary care-led research.

Methods:

A descriptive case study design was used, drawing on data including system-level research activity, practice characteristics, participation metrics, survey responses, and programme documentation. Quantitative data were analysed descriptively, and survey responses were analysed thematically to explore factors influencing engagement.

Results:

Research activity in general practices across Greater Manchester was concentrated in a subset of practices, with the highest recruiting practices being larger and serving less deprived and less ethnically diverse populations. The GM IRN engaged 80 practices, of which 70% were not currently research-active and 24% were research-naive. These practices served significantly more deprived and diverse populations, who are traditionally under-represented in research. Practices demonstrated strong motivation to engage in research, particularly where opportunities were perceived as relevant and co-designed. Early outputs included enhanced recruitment to studies, research consultancy, co-applications for funding, and system-wide collaborations. Relational factors, including collaboration, trust-building, and co-design, were key drivers of engagement.

Conclusions:

Low participation in research among general practices is driven less by lack of interest than by structural barriers and limited access to relevant opportunities. The GM IRN potentially provides a scalable model for embedding inclusive, primary care-led research by enabling frontline teams to shape research priorities. In doing so, it introduces a 'PPIE-equivalent' model for practice teams, extending principles of co-design to those delivering care in underserved settings. Addressing health inequalities requires both widening access to research and reconfiguring how evidence is generated to reflect populations with the greatest health need.