ABSTRACT
Health services research traditionally has focused on secondary and tertiary care, partly because of the concentration of resources in these services and partly because of the greater availability of routinely collected patient and process of care data. As the centre of gravity within the NHS moves towards primary care and chronic disease management shifts towards medical and nursing care into the community, research on the appropriateness and effectiveness of general practice is essential. The chapter describes personal perspectives and experiences gained from seven years of health services research in East London. During this period the authors have carried out studies on different clinical topics adapting methods from various disciplines. East London is an area of great richness and variety and there are many opportunities for research. The creativity of local communities in the face of severe socioeconomic pressures and the striving of many general practices to meet the demands of their patients creates exciting challenges for researchers.
