While the use of appropriate technologies, an opposition to medical elitism, and achieving health for social development have been repeatedly cited as ideas important to both the Declaration of Alma-Ata and primary health care more generally, we believe that key geographic concepts are equally as foundational. More specifically, notions of ‘community’, ‘equity’, and ‘access’ are consistent definitional elements of primary health care across systems; each of these possesses inherently geographic components and, thus, to truly effectuate the most relevant primary health care research and practice, we must think geographically about them. Our objective in this short paper is to introduce readers to the geographic nature of primary health care and to encourage researchers and clinicians alike to engage with applying a ‘geographic lens’ to relevant enquiry and practice. To achieve this, we overview the geographic nature of community, equity, and access as these concepts relate to primary health care and also outline the fundamental geographic concepts of scale, space, and place.

The implementation of a revised government strategy for UK health research led to a reorientation of primary care research, largely focused on recruitment to, and involvement in, clinical trials. This reorientation prompted consideration of new approaches to developing clinical research facilities able to deliver this agenda. The provision of local enhanced services (LES) allow primary care organizations to provide additional services and thereby offer potential for involving primary care staff in clinical research. This paper describes the development and evaluation of one such LES scheme in the East of England, and highlights potential barriers and facilitators to progress.