It is with a sense of honour but also deep sadness that I write this obituary of one of the iconic figures of academic general practice. How appropriate that only weeks before her death, Helen should have given the eponymous James Mackenzie lecture – in memory of another of the great names in our discipline. Her ability to deliver that lecture in the way she did while so unwell and knowing that her days were numbered typifies the manner in which Helen had always approached life. She loved her work, always wanting to do more and different things and the bigger the occasion, the better. She always rose to it.
After leaving the Kings High School for Girls in Warwick, Helen went to the University of Wales, College of Medicine in Cardiff and it was there that she met her much loved and loving husband Huw. It is not surprising, looking at her later career, that she received prizes in both psychiatry and general practice as a student – the stars were already aligned. A career in general practice was never in doubt and Helen completed her VTS in South Glamorgan with, of course, a distinction in the MRCGP. Along the way she was awarded the South Glamorgan Syntex prize for a research project on cholesterol testing in general practice – a sure sign of things to come.
Helen joined the Lee Bank Group Practice in 1991 where she played a major role in developing the practice as a base for both undergraduate and post-graduate teaching. She also developed a practice-based medical service for people with serious mental illness and depression – which would become the focus for her future research.
In 1995, she was awarded her first research fellowship by the RCGP Midland faculty, and in 1997 a Sheldon fellowship that enabled her to study for an MA at Warwick in Sociological Research Methods and to undertake the RCT that was to become the subject of her thesis, awarded as her MD in 2000. Thus began her academic career, and in 12 years Helen went on to achieve what most of us can only dream about.
A senior lecturer post in Birmingham was quickly followed by an NIHR career scientist award as Helen began to develop her research programme in primary care mental health, focussing on those with long-term enduring illness and its associated social disadvantage and built a devoted research team. She became nationally and internationally known and highly regarded for her work on quality improvement, health inequalities, the development of primary care mental health and the interactions between research, policy and clinical practice. She made important additions to the evidence base of primary care mental health through the completion of numerous high-quality multi-method research studies. She made major contributions to national policymaking bodies including the Royal College of General Practitioners and Department of Health with the hope of improving the structure, process and outcomes of mental health delivery in the United Kingdom. She was also interested in promoting and enabling user involvement in primary care and mental health, particularly for ‘hard to reach’ groups such as people with serious mental illness.
As time went on, Helen got itchy feet. She was promoted as a professor in Birmingham in 2006, but sought greater challenges where her leadership qualities would be put to good use and to dovetail her academic ability with her increasing interest in policy matters. In 2006, she moved to a Chair in Manchester to work in the National Centre for Primary Care Research and Development where she became Deputy Director of the Centre and Lead for the Quality group. It was her experiences there that gave her the confidence and competencies to apply for a number of national roles including standing for College Council, Chair of the Society for Academic Primary Care and Chair of the RCGP Clinical Innovation and Research Centre. This was a very productive time for Helen and she became increasingly sought after as an advisor to many national groups, as a speaker on the national and international stage and as a collaborator on many large and prestigious grants. Some of this work coincided with the setting up of the National School for Primary Care Research in which Helen played a leading role, especially in heading up the mental health theme.
Helen's interest in policy extended well beyond the academic, and perhaps for the majority of GPs she was best known for her work on the Quality and Outcomes Framework (QoF). This began in Birmingham in 2005 requiring Helen to supervise the reviewing of evidence and negotiate with the Department of Health, its health ‘Tsars’, Government ministers and the BMA. Her involvement with QoF continued in Manchester as external contractor for NICE, developing and piloting a range of clinical indicators and advising on cost-effectiveness, thresholds and points. Only weeks before she died, Helen was instrumental in ensuring that the team she had built would be able to continue this work as a result of another successful bid to NICE.
Helen was very loyal to the organisations she loved – in particular the Society for Academic Primary Care. She and I worked very closely together in the years that I was Chair and she was Secretary; together with Sue Stewart, we ran three very successful conferences and moved the society on in many directions. Helen was an assiduous colleague always encouraging us to be brave and look forward. She had already made her mark as Chair of SAPC by taking the major step for the joint conference with RCGP last October in Glasgow. She pulled out all the stops in her Stella McCartney dresses. Her other love was ‘the College’, and increasingly over the years she became a major figure, not only as an elected member of Council but especially as the chair of the Clinical Innovation and Research Centre. Leadership came naturally to Helen and with that leadership the enjoyment of helping others achieve their ambitions. The SAPC condolence book bears testimony to that special ability – to make people feel listened to and empowered.
In 2011, Helen moved back to a chair in Birmingham to further develop her mental health research portfolio but also to spend more time with friends and family. As she became more unwell she unfailingly tied up all the loose ends she possibly could, ensuring a seamless handover of her projects and responsibilities. She continued to write papers adding to what was already a prodigious bibliography. The acronyms EDEN, Befriending, CRIMSON and PARTNERS are synonymous with the name Helen Lester and papers were regularly published in all the leading journals – the British Medical Journal, the British Journal of General Practice, Family Practice, the British Journal of Psychiatry and many others.
We have to accept that Helen is with us no more. She leaves the most amazing legacy for academic general practice. We must live up to her expectations. She also leaves her lovely family – Huw, Ali, her sister, and her three children David, Emma and Elinor. Thank you all of you for letting Helen enrich our lives as she did yours.
