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Professor Paul Little MBBS, BA, MD, DLSHTM, MRCP, FRCGP, FMedSci

Professor of Primary Care Research

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Professor Paul Little is Professor of Primary Care Research within Medicine at the University of Southampton.

Professor Little was the first GP to be awarded a Wellcome HSR training fellowship (for research on health promotion), and the first to be awarded an MRC Clinician Scientist Fellowship (for research on common self-limiting illness), and in addition current major areas of research are in enabling behaviour change both for health professionals and also in empowering patients.


BA Physiology, Oxford (1981)
MBBS, London (1984)
MRCP, London (1989)
MD, London (1992)
MRCGP, London (1992)
DLSHTM, London (1995)
MSc, LSHTM (1995)
FRCGP, London (2000)
FMedSci, London (2010)

Appointments held

Wellcome HSR Fellow,
University of Southampton (1993-1997)

MRC Clinician Scientist,
University of Southampton (1998-2003)

Current Post: Professor of Primary Care Research.

Aldermoor Health Centre, Southampton University commenced 1/2/2003







Research interests

Two main areas of interest: health promotion and the management of common self-limiting illnesses. These topics link evidence about effectiveness with the effect of management of patient beliefs and behaviour, better understanding the importance of the patient centred approach to the consultation.

CANcer Diagnosis Decision rules (CANDID)

Health promotion

Back Pain
ATEAM trial

This was an MRC funded trial of the Alexander Technique (a technique to improve and modify poor postural and body ‘use’ habits) and exercise prescription by GPs for back pain (the ATEAM trial). It demonstrated significant benefits for pain and function in the longer term.

ASPEN trial

Following the ATEAM trial EME have now funded this study to investigate the mechanisms of Alexander Technique and the mechanism of recovery in back pain with both physiotherapy and the Alexander Technique.

ARC Fellowship (Lisa Roberts)

I am co-investigator and mentor for this project which aims to understand communication in physiotherapy consultations and will then develop and pilot and intervention to modify consultation behaviour.

Internet based behaviour support

A major focus of interest is in developing internet based behavioural support for a range of conditions:
Obesity (the HTA funded POWeR trial)
Hypertension (SMILE trial, funded by the National School for Primary Care Research)
Infection transmission (The MRC PRIMIT trial)
Irritable bowel syndrome (NIHR funded, lead by Hazel Everitt)
Eczema (NIHR funded, lead by Miriam Santer)

The management of common infections

UTIS study
Following our work in trialling antibiotic prescribing strategies in several respiratory infections we have also recently completed a study to develop clinical scoring algorithm for urinary tract infections leading to a trial of different management approaches.

We have just completed two major trials as part of a large European Union Network of Excellence project (GRACE) for Lower respiratory tract infection - which is the commonest acute condition managed in primary care.
RCT of amoxicillin: this trial which is coming to a close has randomized 2061 individuals in 12 Networks across Europe and the results are likely to dominate the management of lower respiratory tract infection (LRTI) in primary care for some time.

The second GRACE trial developed from another EU project we share (CHAMP), developed and tailored web based communication training packages for health professionals in 6 EU countries. We randomized 246 practices across Europe and recruited more than 4000 patients in this trial - which assessed whether an internet based behavioural intervention to modify communication in the consultation can modify health professional antibiotic prescribing for LRTI.

This is a large prognostic cohort study in acute sore throat (more than 13000 patients have been recruited) funded by the MRC.

This is an HTA funded study to develop and perform a randomized trial (which has recruited more than 1500 patients) of strategies for using rapid tests and clinical scores for sore throat.

The MRC have funded us to develop and trial an infection control website requiring complex intervention development.

Internet Dr
An MRC studentship was used to develop web based self help advice using the MRC Framework for the development of complex interventions.

NIHR PRIME Programme grant
This supports several studies on the management of acute and recurrent infections:
PIPS: steam, paracetamol and ibuprofen for acute respiratory infections.
SNIFS: nasal irrigation and steam for recurrent sinusitis.
TASTE: probiotics and xylitol for recurrent sore throat.
3C’s study (Cough Complication Cohort): a large prospective cohort similar to DESCARTE but for LRTI
Internet Dr trial (following the development referred to above).

Academic unit(s)

Primary Care & Population Sciences Academic Units

Affiliate academic unit(s)

Primary care Research group

Research project(s)

ARCHIE The early use of Antibiotics for at Risk CHildren with InfluEnza in primary care

BARACK-D Benefits of aldosterone receptor antagonism in chronic kidney disease

BATHE Bath additives in the treatment of childhood eczema

BREATHE (Breathing Retraining for Asthma Trial of Home Exercise)

Although effective medicinal treatment exists for asthma, many people continue to have distressing symptoms and impaired quality of life. People with asthma have expressed interest in non-drug asthma treatments, particularly in breathing exercises. Several recent studies have shown benefits from a short course of breathing exercises taught by a respiratory physiotherapist for people with asthma who remained symptomatic despite usual treatment. We believe that many NHS patients could potentially benefit from these exercises, but unfortunately, there is currently not enough access to suitable trained physiotherapists able to provide such a service. We propose to provide the same breathing training programme that we have previously shown to be effective when taught 'face-to-face' by a physiotherapist in the form of a DVD, or internet download. Patients will use this in their own home at times convenient to them, in addition to their standard treatment (e.g. with inhalers). We will find out whether this type of instruction is better than the 'usual care' that is currently provided, and whether it is as good as the 'face to face' physiotherapist instruction (which is more expensive and less convenient for patients).

CANDID Cancer Diagnosis Decision Rules

FAME Fatigue: acute Fatigue Assessment and Management in Everyday practice

UNderstanding medIcal and non-medical anTibiotic prescribing for rEspiratory tract infections in primary care out of hours services: a qualitative analysis (The UNITE Study)

Creating a taxonomy to harness the placebo effect in UK primary care

Acupuncture for Back Pain: Evaluating Patient Outcomes and Their Determinants

Treatment Beliefs in Back Pain

Benefits of the Alexander Technique for sufferers with low back pain

Positive Online Weight Reduction (POWeR)

Developing a nurse-delivered behavioural intervention to support weight loss in obese adults

Positive Online Weight Reduction Plus (POWeR+)

Assessing Cognitive behavioural Therapy in Irritable Bowel Syndrome (ACTIB)


The DIPSS (Integrating Digital Interventions into Patient Self-Management Support) project has received funding of £2 million from the NIHR to examine patient digital self-management with healthcare professional support in primary care. Our aim is to develop digital behaviour change interventions for asthma and hypertension self-management, which will be examined in feasibility studies and full RCT (hypertension only). Issues surrounding the feasibility, acceptability, effectiveness and cost-effectiveness of digital intervention delivery will be explored with patients and healthcare professionals for each condition.

Undergraduate teaching

Responsibility for critical appraisal paper in MBBS finals.
Clinical teaching for MBBS.

Postgraduate student and research fellow supervision

I supervise 3 PhD students, 3 Academic Clinical Fellows, and mentor 2 senior postdoctoral awards and a Clinical Research Fellow.
I also do regular teaching at GP workshops and clinical postgraduate meetings.

Divisional responsibilities

Member of Management team for Primary Care and Population Sciences Division.

National and International Responsibilities

Head of Southampton primary care group for National Primary Care HODs group and also for the National School for Primary Care Research.
Director of NIHR Programme Grants for Applied Research (PGfAR) Board
Member of REF panel for Public Health, Health services and Primary care.
Fellow of the Academy of Medical Sciences




Clinical Teaching in Primary care for undergraduates.

Lecturing on research methods (critical appraisal and the development of complex interventions).

Supervision of Post-graduates and research fellows.

Post-graduate teaching for clinicians.

19 Aug 2015
'Handwashing can stop viruses completely' interview with That's Solent TV.

7 Aug 2015
Internet programme to encourage hand washing reduces spread of cold and flu viruses, continue reading here

26 May 2015
Professor Paul Little has been quoted in the Telegraph about a new study published in the British Journal of General Practice. Paul and his team of researchers video-taped the consultations of 320 patients who visited 25 doctors in Southampton and found that, in contradiction to previous research, ‘patients actually preferred a traditional style of doctor, who knew them personally, but who was relatively distant and professional.’

8 December 2014
Paul Little was quoted in the Daily Mail about the University's earlier research on the best treatment for coughs, colds and sore throats.

8 November 2013
New test for patients with sore throats cuts antibiotic use by nearly a third. Please click here for full news item.

30 July 2013
Internet-based training could help in the fight against antibiotic resistance. Please click here for full news item.

14 December 2012
Commonly prescribed antibiotics ineffective for treating uncomplicated chest infections. Please click here for full news item.

Professor Paul Little
Primary Medical Care Aldermoor Health Centre Aldermoor Close Southampton SO16 5ST

Room Number: AHC/

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