Skip to main navigationSkip to main content
The University of Southampton
(023) 8059 1791

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

Professor of Primary Care Research

Professor Paul Little CBE's photo
Related links

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 in 1993 (for research on health promotion), and the first to be awarded an MRC Clinician Scientist Fellowship in 1998 (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.

Professor Little received recognition in the 2018 Queen’s Birthday Honours with the award of a CBE for services to General Practice Research, in June 2019 he was awarded the RCGP Discovery Prize in recognition of his outstanding research in general practice and in November 2020 Paul was awarded The Maurice Wood Award for Lifetime Contribution to Primary Care Research.


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.

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.

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.

Internet based behaviour support

A major focus of interest is in developing internet based behavioural support for a range of conditions:
RECON (PGfAR programme to limit cognitive decline)
CLASP (PGfAR programme to support cancer survivors)
Obesity (the HTA funded POWeR trial)
RECUR (PGfAR Programme for recurrent infections)
Hypertension (SMILE trial, funded by the National School for Primary Care Research)
Infection transmission (The MRC PRIMIT trial)
Irritable bowel syndrome (NIHR funded, led 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 completed a study to develop clinical scoring algorithm for urinary tract infections leading to a trial of different management approaches.

We 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 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 was a large prognostic cohort study in acute sore throat (more than 13000 patients were recruited) funded by the MRC.

This was 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 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 supported 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).

Please visit the Primary Care  website.


Primary Care, Population Sciences and Medical Education

Affiliate Department(s)

Research project(s)

4S Sore Throat Study (Scores and Swabs to Self-assess Sore Throats)

A digital behaviour change intervention to help reduce the spread of the COVID-19 outbreak: A rapid co-design, implementation and evaluation project. (GERMDEFENCE)

ACTIB - Assessing Cognitive behavioural Therapy in Irritable Bowel Syndrome

ALICE Antivirals for influenza like illness - an RCT of clinical and cost effectiveness in primary care

Infectious diseases are a major threat to human wellbeing and economic and social development. Influenza, a highly contagious virus, causes a common respiratory infection with local and systemic symptoms.

ANCAP - Antibiotic Negotiations Conversation Analytic Project

Many patients in primary care are being prescribed antibiotics to treat mild infections such as colds, earaches and sore throats. Many of these are viral rather than bacterial infections that get better on their own and which can be treated with self-care (such as rest, fluids and mild pain killers).  

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


We are looking to investigate the usefulness of antibiotics in this age group, it follows a European wide trial that was very similar for adults. Children will be provided antibiotic or placebo and keep a symptom diary for up to 28 days. They can opt to provide a throat swab, a blood sample and have a chest x-ray.

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

CEDAR the children's ear pain study

CERrnaTc-19 (Clinical Evaluation of Rapid RNA Test for Covid-19)

CERAbTc-19 (Clinical Evaluation of Rapid Antibody Test for Covid-19)

Chinese Herbal medicine to aid AnTibiotic use reduction in exacerbation of Chronic Obstructive Pulmonary Disease (CHAT COPD)

CLASP Cancer: Life Affirming Survivorship support in Primary care

DEFINE: Development and evaluation of a FeNO-guided asthma management intervention in primary care

ECO - Eczema Care Online

This programme of research aims to promote effective eczema self-care by improving individuals’ knowledge of eczema treatments and influencing attitudes, skills, and habits related to treatment use.   

Empathica: Expectation Management for Patients in Primary Care: Developing and Feasibility Testing a New Digital Intervention for Practitioners

FAME Fatigue: acute Fatigue Assessment and Management in Everyday practice

Healthy Paths - Exploring primary care patients’ experience of an internet intervention ‘Healthy Paths’ for emotional distress

OPEN: Out of Hours Prescribing: Enhancing Communication

The overuse and misuse of antibiotics in primary care is an increasing national and global concern due to the increasing risk of antimicrobial resistance (AMR) (when bacteria becomes resistant to treatments leading to increased risks of illness lasting longer, increased symptom severity and even death).

OPTIMISE - OPtimising Treatment for MIld Systolic hypertension in the Elderly

The population is getting older (over 3 million people [5%] in the UK are >80 years) and the number of people living with multiple long-term conditions taking multiple drugs is increasing. High blood pressure is one of the most common conditions in older patients and up to half of this population receive two or more drugs to treat it. However, recent evidence suggests that large reductions in blood pressure, and too many drug prescriptions may be associated with an increase in serious falls and death in the elderly.  

Patients’ experiences of self-management interventions for chronic widespread pain including fibromyalgia: A systematic review and thematic synthesis (CWP Qualitative Review)

PROBITY - Prolonged Antibiotic Use, Inflammation and Obesity - a retrospective cohort study

This is a retrospective cohort study to investigate the long-term effects of prolonged antibiotic consumption on health.

RECON - Reducing and preventing Cognitive impairment iN older age groups (the RECON programme)

Reducing common infections in usual practice for recurrent respiratory tract infections: The RECUR Programme

REDUCE (REviewing long term anti-Depressant Use by Careful monitoring in Everyday practice)

Retrospective Survey of Prevention, Treatment, Occurrence and Outcomes of Covid-19 in the community (RTO-Covid-19)

This is a survey about what people have done to try and prevent and treat Covid-19 since the start of the pandemic.

SNIFSII - Saline Nasal Irrigation For acute Sinusitis II

Acute sinus infections are one of the commonest infections managed in primary care, Currently GPs prescribe antibiotics to most  patients presenting with sinusitis, the highest of any of the common acute infections presenting in adults, at over 90%.

STREAM - Screen and TREAt for Malnutrition

Supporting self-management of low back pain with an internet intervention in primary care: A randomised controlled trial of clinical and cost-effectiveness (SupportBack 2)

In the SupportBack 2 trial we aim to find out if an internet intervention, with or without physiotherapist support, can be effective in helping primary care patients manage low back pain.

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

Pre-GRACE - GRoup Alexander lessons for Chronic musculoskeletal pain in Everyday practice (GRACE): preliminary development

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

Acupuncture for Back Pain: Evaluating Patient Outcomes and Their Determinants


A primary care trial of a website based infection control intervention to modify influenza-like illness and respiratory infection transmission.

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.

Telemedicine in cochlear implants

This project is exploring different ways of providing long term follow up to cochlear implant users.

Supporting Targeting Of antibiotics in Primary care to combat AMR using decision aids (STOP AMR – decision aids)

VENUS Study – Developing a new approach to managing care home residents with possible urinary tract infection 

Talking in Primary Care 2: Testing the effects of communication skills e-learning for practitioners on patients’ musculoskeletal pain and enablement (TIP2)

PANORAMIC - Platform Adaptive trial of NOvel antivRals for eArly treatMent of COVID-19 In the Community

AIM study - The development and validation of population clusters for integrating health and social care: A mixed-methods study on Multiple Long-Term Conditions (MLTC)

Supervision of 1 PhD student, mentors 2 NIHR Professors and 3 Clinical Research Fellows.
Regular teaching at GP workshops and clinical postgraduate meetings.

School Responsibilities
Member of Management team for The School of Primary Care, Population Sciences and Medical Education.

Divisional responsibilities

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

National and International Responsibilities

Represent Southampton on the School for Primary Care Research Board.
Member of REF panel for Public Health, Health services and Primary care.
Member of ARC panel.
Fellow of the Academy of Medical Sciences.
International Advisory Board for Asthma UK Centre for Applied Research.

Sort via:TypeorYear






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.

March 2020
Professor Paul Little has been quoted in outlets such as BBC News Online and The Guardian about whether people should take ibuprofen to treat Coronavirus.

June 2019
Professor Paul Little awarded RCGP Discovery Prize.

June 2018
Professor Paul Little receives CBE for services to General Practice Research.

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 CBE
School of Primary Care, Population Sciences and Medical Education
Aldermoor Health Centre
Aldermoor Close
SO16 5ST

Room Number: 9590 AHC/145/S2

Telephone:(023) 8059 1791
Facsimile:(023) 8070 1125

Share this profile Share this on Facebook Share this on Twitter Share this on Weibo
Privacy Settings