TWO of this year’s International Congress of Medical Libraries (ICML) Keynotes speak to Rob Green about what to expect from next month’s gathering in Glasgow. Lucy Aphamor will be looking at “healthy eating” and what that really means, while Professor Steven Buchanen will be looking at health inequalities from a human information behaviour perspective. You can read a full version of this article in the June/July issue of Information Professional.

Professor Steven Buchanen

Keynote speaker Steven Buchanen says: “I will be discussing health inequalities from a human information behaviour perspective (how people interact with and use (or not) health information), and with attention to current and emerging challenges, posing an important question: are we progressing or in danger of regressing?”

Steven’s research delves into information behaviour and the impact that has on health literacy levels. He points out that many countries are suffering with low health literacy, and highlights a number of factors for these low levels, saying: “Whilst health literacy is widely recognised as a key determinant of health and now enshrined in health policy worldwide, there appears to be a gulf between policy and practice.”

He adds that there are many local examples of good practice aimed at improving health literacy, but these have not been scaled meaning wider impact cannot be delivered.

Away from policy, personal motivation can have a huge impact on health literacy – revealing a split between those who do not recognise their need to be informed and those who recognise a need, but are not motivated to seek it out.

This is often where information professionals can have the biggest impact, as Steven says: “It is important to view health communication and education as a constructive incremental process that takes account of the variable cognitive and affective factors influencing people’s information behaviours and actions, not least when concerning sensitive and possibly complex issues of personal health. These are enduring challenges for health communication that I will be discussing in my talk including the impact of new technologies.”

Lucy Aphramor

Lucy is a radical dietician and EDI consultant who has worked across the NHS, third sector, academia, and independently, building knowledge from clinical and community dietetic posts, disability advocacy, work with LGBTQ+ groups, and co-founder of the World Critical Dietetics movement.

Lucy’s keynote, “Who Is Healthy Eating Advice for? Cultivating Equity by Reconsidering 'Neutral',” looks at mainstream public health nutrition messages and asks whether they are really truly equitable and effective. They say that their own journey of questioning the effectiveness and fairness of these messages grew from real world experience of working as a dietician.

“Once I realised the conventional approach caused harm and was therefore unethical I started to develop another approach that initially focused on self-care behaviours instead of the pursuit of weight loss, and later was also shaped by data that showed how non-nutrient social factors – stigma, racism, trauma for example – were implicated in pathways predisposing people to so-called diet-related disease,” says Lucy.

“If we promote the advice as universally appropriate we cause harm as we leave people behind and mobilise oppressive ideologies such as ableism and racism.

“When we uncritically accept popular nutrition messages as beyond scrutiny because they invoke ‘science’ as often happens with ‘healthy eating’, we can unintentionally contribute to personal suffering and embed structural violence.

“Healthy eating advice centres biomedicine as indisputably appropriate and incontestably robust, as if there are not other useful frameworks for exploring links between food and flourishing. In this it continues a colonial legacy, erasing Global Majority wisdom and sciences.”

Book your place at ICML.

In March 2026, the Knowledge for Healthcare Learning Academy short-course skills development programme was reaccredited by CILIP. In the five years since the initial accreditation, the Knowledge for Healthcare Learning Academy has gone from strength to strength and has now received accreditation for the short course programme from CILIP for 2026-29.

NHS England Knowledge and Library Services Senior Managers Alison Day, Clare Edwards, Library Services Manager Sarah Lewis, and Knowledge and Library Services Development Manager Gil Young look at how CILIP accreditation is helping to ensure training remains rigorous and relevant for staff.

Training provision for NHS England

Leading the provision of bespoke training to upskill and ensure the talent supply pipeline of highly qualified health knowledge and library services specialist staff for the NHS in England is a key part of the work of the national team. As part of this, we work in partnership with specialist NHS knowledge and library practitioners to maintain the employer-led centre of excellence for skills development for all health knowledge and library staff, The Knowledge for Healthcare Learning Academy.

The role of NHS knowledge and library staff in England is to ensure access to and use of the right evidence and knowledge at the right time and in the right place. They save NHS staff time by searching, appraising and presenting decision-ready evidence from data, published research and best practice. They bring the evidence to underpin research, policy, practice and drive innovation in the NHS. NHS knowledge and library specialists have a specific role enabling the NHS to maximise efficiencies through effective use of emerging digital technologies.

In the left shift from analogue to digital outlined in the 10-Year Health Plan, NHS staff and organisations require expertise from trusted professionals to ensure the quality of information to inform care. They are critical to managing an environment where tacit knowledge is effectively shared and used and where a culture of continual improvement and learning thrives. To do this effectively they need to maintain and develop their skills and knowledge by completing appropriate, accredited learning.

What is the Knowledge for Healthcare Learning Academy?

The Knowledge for Healthcare Learning Academy brings all nationally provided learning and training opportunities under a single umbrella. This is a unique offer of tailored learning opportunities that are highly relevant for the health knowledge and library services workforce not available elsewhere. There is a rolling annual programme of short courses and other learning opportunities which are free at the point of access for NHS library and knowledge staff in England. A biennial development needs analysis is used to inform the programme of development opportunities and informs annual events such as sessions for new starters and a celebration event to share good practice from across NHS knowledge and library services in England.

Our accreditation journey

The short course programme is one of the main elements of the Knowledge for Healthcare Learning Academy and it was first accredited by CILIP in 2021 (Gilroy, D. and Day, A. 2022). We were keen to retain this accreditation to ensure recognition for the quality of our short course programme, and relevance to the employment market.

All CILIP accredited short courses must meet the following criteria:

• The relevance of the course to CILIP’s Professional Knowledge and Skills Base (PKSB).
• The training provider provides a high-quality learning experience.
• The training provider engages with employers to ensure that courses are relevant.
• Trainers are up to date with current professional practice.
• Learners are encouraged to engage with CILIP

Benefits of accreditation

The accreditation process was rigorous and provided an opportunity to make further improvements to our short-course offer and reflect on how the Knowledge for Healthcare Learning Academy has evolved since it was first accredited.

Completing the accreditation process has improved the quality of our training offer. From our first accreditation we changed the way we collate information about our short-courses. This is now more consistent and has in turn made the accreditation process this time much simpler. This included introducing a single booking form to capture all the key information for accreditation such as learning outcomes, course details, trainer CVs, and mapping to relevant CILIP PKSB areas.

Read more about the benefits, the process of achieving accreditation, lessons learned and the next steps in the June-July issue of Information Professional.

The International Congress on Medical Librarianship will be taking place in Glasgow in July, bringing together health knowledge managers and librarians from around the world. Rob Green spoke to Imrana Ghumra, Conference Lead, and Elizabeth Ketterman Director, Health Sciences Library East Carolina University, to discuss why this is the must-attend event for the sector. Book your early bird tickets before 13 March to be sure of the best price.

This summer, the global health information community arrives in the UK for the 14th International Congress on Medical Librarianship (ICML). In a year where the profession is navigating the rapid ascent of AI, tackling misinformation, and championing equity, the Congress provides a vital space for knowledge exchange that transcends borders.

"The 14th International Congress on Medical Librarianship is a dynamic conference for health knowledge, library and information professionals that provides a global perspective on the challenges and opportunities facing our profession.” – Imrana Ghumra

With the theme Flourish: Growing Our Communities, this year’s ICML stands as the premier gathering for health library and information professionals. And with IFLA’s World Library and Information Congress coming to London in 2027, ICML will serve as a high-impact bridge to that event.

ICML is being hosted by CILIP’s Health Libraries Group and partners and Imrana says it provides a unique opportunity to develop knowledge at an international level.

She says: “The 14th International Congress on Medical Librarianship is a dynamic conference for health knowledge, library and information professionals that provides a global perspective on the challenges and opportunities facing our profession.

“The opportunity to connect with international colleagues affirms the common interests and priorities for health knowledge, library and information professionals and allows us to flourish, growing our communities by sharing globally diverse perspectives and experiences. Learning together with international colleagues connects us and enriches the professional development experience.”

Those opportunities to develop international connections and share knowledge beyond borders will help foster new networks and highlighting best practice. Elizabeth says that these connections can bring benefits for all delegates, and the wider teams they represent.

“The international nature of this congress gives us a powerful opportunity to learn across borders and contexts, recognising both our shared challenges and the unique strengths of our local communities,” she says. “By intentionally creating spaces for dialogue, collaboration, and knowledge exchange, we can build relationships that extend well beyond the conference itself. When health knowledge, library and information professionals work together globally – sharing practices, resources, and perspectives – we strengthen our collective capacity to support health, equity, and scholarship in our respective communities.”

This year’s theme, Flourish: Growing Our Communities, provides a platform for knowledge to spread, and the congress is also embracing an open and inclusive ethos. The call for papers set out to ensure be as welcoming as possible with Imrana noting: “Inclusivity is about ensuring that everyone involved in or interested in this sector of our profession had the opportunity to participate in the call for papers as we kept the sub-themes of the Congress quite broad.

“Interpretation of specific words and phrases may mean different things to different people, so we ensured our judging panel was internationally diverse. I approached colleagues whom I thought would strike the balance of academic excellence and ethnicity to represent this global event after volunteers had stepped up.”

She adds: “We had a diverse group of health knowledge, library and information professionals to put the expression of interest together to bid for the opportunity to hold the Congress in the UK. We then strengthened it with one of CILIP’s Disability Network leads, Morag Clarkson when we did site visits and interviewed for the conference organiser. Finally adding Kate Lomax from Artefacto as the technical advisor on the second site visit.”

Organisers have been keen to deliver a venue that meets everybody’s needs as well as pushing for sustainable options wherever possible, including a largely vegan/vegetarian menu.

Opportunities for the sector

Like many information and knowledge sectors, health librarianship is experiencing rapid change driven by technology. And while some of this change manifests as short-term challenges, there are opportunities running alongside. The congress will focus on key topics, helping delegates to navigate and thrive in changing circumstances.

Imrana says: “Health librarianship in 2026 is focused on navigating rapid change whilst remaining grounded in our core values of access, equity, and trust. Key issues include the ethical use of artificial intelligence, supporting evidence-based practice amid misinformation, and ensuring equitable access to health information across diverse populations and settings. At the same time, the profession is addressing workforce sustainability and wellness, evolving skill sets, and the need to demonstrate impact within increasingly complex health and research environments for public benefit.

The three-day event, taking place from 14-16 July, is CPD certified and features to confirmed keynote speeches so far, with CILIPS Chief Executive Sean McNamara opening the conference and Lucy Aphramor, UK Dietitian and EDI Consultant, speaking on day two.

Elizabeth points out: “Globally, health knowledge, library and information professionals align with CILIP’s ethical framework although the words we use may be slightly different. The sub-themes for ICML 2026 also align with this.”

With early bird rates available until Friday 13 March, there is still time to book your place at the best price.

Imrana said: “We look forward to welcoming you to #ICML2026 which is going to be the mega health libraries event of the year, and we encourage everyone to attend as it is only run every 4 to 5 years across the globe. We welcome first-timers and new professionals as well as regular congress attendees to the event which will help us to flourish and grow our communities.

“The early bird discount has been extended to 13 March 2026, and we have just added some discounted accommodation, courtesy of Glasgow Convention Bureau.”

For more details and to book your place visit www.hlg-conference.com/icml2026/accommodation.

Programme highlights

Day one

• Keynote: Connecting out communities for a Healthier Scotland – Sean McNamara, Director CILIP Scotland;
• AI indexing and government interference: measuring frequency changes in MeSH for “DEI” terms over the last 10 years – Isobel Eddyshaw, Academic Liaison Librarian, University of Exeter and Monica Casey, Senior Information Manager, NICE;
• Prompt Engineering for Systematic Reviews: Using AI for sensitivity improvements in LGBTQ+ and Ethnic Minority Search Strategies – John Barbrook, Faculty Librarian, Lancaster University;
• Tactical, Timely, and Impactful: How a Strategic Marketing Approach Has Enhanced Our Health Literacy Training Offer – Bethany Courtney, Assistant Librarian, Gloucestershire Hospitals NHS Foundation Trust;
• Demonstrating Value and Impact: The Knowledge for Healthcare Value and Impact toolkit – validation, collaboration and the benefits – Clare Edwards, Knowledge and Library Services Senior Manager, NHS England;
• Coffee across the pond: implementing a transatlantic randomised coffee trial for hospital nurses, Phillip Barlow, NHS Support Librarian, Imperial College London;
• Unbound: Letting go of the book as the library’s primary icon – Beth Jackson, Knowledge Skills Librarian, University Hospitals Coventry and Warwickshire;
• Bloody Brilliant Libraries: Tackling misogynistic misinformation through menstrual health literacy – Kirsten MacQuarrie, Sector Development Manager, CILIP Scotland;
• Workshop: The development and evaluation of an innovative online systematic review escape room for early career clinicians – Paul Cannon, College Librarian Medical, Veterinary and Life Sciences, University of Glasgow;
• The Conference Social – will take place at The Corinthian Club in Glasgow, beginning at 7:00 pm and continuing until late.

Day Two

• Keynote: Who Is Healthy Eating Advice for? Cultivating Equity by Reconsidering ‘Neutral’ – Lucy Aphramor, Radical Dietitian and EDI Consultant, Freelance;
• Getting the balance right: evidence and knowledge for national workforce policy and planning, and developing tools to measure impact – Emily Hopkins, Knowledge Management Service Senior Manager, NHS England;
• Collaborative Innovation: Integrating GenAI and Interactive Engagement Tools for Impactful Learning at an NHS Trust – Karen Poole, Clinical Support Librarian. Libraries & Collections at King’s College London;
• Reaching digitally-excluded communities with health information: a partnership between NHS England and public libraries – Ruth Carlyle, Co-Chair Health Libraries Group/Head of Knowledge and Library Services, NHS KLS Leadership, Health Libraries Group/NHS England;
• Living Partnership: Hinari and Research4Life after 25 Years – Kimberly Parker, Program Manager, Hinari, World Health Organisation;
• Think like a Teacher: Pedagogical Skills for Librarians – Neena Shukla Morris, Information Resources Librarian, University Hospitals Sussex;
• Flourishing or floundering services? The staffing gap and how to plug it whilst supporting staff development – Vicky Harrison, Library and Knowledge Services Manager;
• On a Roll: Tea Trolley Teaching as a Method of Delivering Library Outreach Services – Suzannah Bridge, Outreach Librarian, Bodleian Libraries, University of Oxford and Hannah McGivern, Outreach Librarian, Bodleian Libraries, University of Oxford;
• Workshop: How do I make my practice evidence based? – Alison Brettle, Professor Health Information and Evidence Based Practice, University of Salford;
• The Welcome Reception – official welcome to the city, hosted by the Lord Provost, and will provide attendees with an opportunity to gather in a prestigious setting at the start of the event.

Day Three

• “Remember the blank sheet of paper”. Reflections on setting up a service from scratch – Daniel Froste, Library Manager, Sheffield Teaching Hospitals;
• Adapting Pedagogy in Medical Librarianship: A Three-Year Case Study of Information Literacy Instruction for Physiotherapy Students – Chiara Cecchinelli, Teaching and Learning Librarian, Royal College of Surgeons in Ireland;
• Growing Medical Library Support for Health Innovation, Entrepreneurship, and Commercialization – Jeffrey Mason, Health Sciences Librarian: Innovation and Entrepreneurship, McMaster University;
• UnMASKing health misinformation and promoting better healthcare communication: a partnership approach – Joanne Naughton, Knowledge and Library Services Development Manager, NHS England;
• Print Medical Journals: do we still need them? – Erin Watson, Health Sciences Librarian, University of Saskatchewan;
• Defining and defending library spaces in smaller hospital facilities – Daniel Park, Library & Knowledge Service Manager, The Rotherham NHS Foundation Trust;
• Decision Support: app and web development and the role of the Librarian – Michelle Kirkwood, Knowledge Services Manager, NHS Greater Glasgow and Clyde;
• The Comeback Chapter: A New Page for NHS Library Engagement – Helen Stewart, Library Manager, NHS Ayrshire and Arran;
• Bridging the Divide: Enhancing Health Sciences Libraries’ Impact on Health Disparities through Academic Collaboration – Xiaolan Qiu, Research Data Librarian, East Carolina University;
• Growing Wellbeing in Medical Trainees with Medical Humanities Programming in the Library – Kathryn Houk, Associate Professor, UME Librarian, University of Nevada, Las Vegas.

• For full programme details and to book your place.

CILIP, the library and information association, is delighted to announce that the Health Education England Knowledge for Healthcare Learning Academy has been awarded accreditation under its Short Course Accreditation scheme.

CILIP Short Course Accreditation helps both Learning and Development providers and learners themselves by offering the same quality guarantee that full CILIP Accreditation offers to degree-level courses. Employers and individuals can book quality training to enhance skills with confidence.

The Knowledge for Healthcare Learning Academy offers a range of bespoke learning opportunities tailored to the needs of the specialist healthcare knowledge and library workforce in England. Informed by Health Education England’s strategy and a regular development needs analysis, the programme is commissioned and delivered in partnership with skilled and experienced facilitators.

Helen Berry, CILIP’s Workforce Development Manager explained “We know that CILIP accreditation stands for quality. By choosing a CILP accredited course, learners can feel confident that the content is high quality and has been tested against the professional standard by an independent assessor. The CILIP accreditation certifies quality learning and delivery as well as relevance to the employment market.

Our Short Course Accreditation offers the same quality guarantee to shorter courses which don’t lead to a formal qualification. This includes modular courses, day courses and online courses within the Library, Knowledge or Information field.”

Independent assessor, Dr Carolynn Rankin, commented that “The Knowledge for Healthcare Learning Academy short courses offer participants a high-quality experience delivered by experts in the subject content and by experts in methodology.”

Patrick Mitchell, Director of Innovation, Digital and Transformation at Health Education England said “Health Education England is ambitious for our new Learning Academy; it is a great basis for further developing the NHS knowledge specialist workforce. We look forward to continuing to work with CILIP and other partners in the future”.

Sue Lacey Bryant, National Lead for NHS Knowledge and Library Services in England, said “I am delighted to see the launch of our CILIP-accredited Knowledge for Healthcare Learning Academy. This is a crucial building block in strengthening the capability of health knowledge specialists to lead and deliver knowledge services in the digital age. We see skills in mobilising and using research evidence and lessons learned from experience to improve patient care are also of increasing relevance to the wider healthcare workforce.”

About CILIP Short Course Accreditation

CILIP Short course accreditation was launched in 2020.

Accredited Short Courses are recommend for L&D professionals booking training for their organisations and independent learners looking to enhance their skills. There is a full list of short courses which we accredit on the website.

All CILIP Accredited Short Courses are independently assessed every three years to ensure they meet the following criteria:

• Relevance of the course to the professional standard (CILIP’s Professional Knowledge and Skills Base)
• the learning provider is providing a high-quality learning experience
• the learning provider engages with employers to ensure that programmes are relevant
• Staff and trainers are up to date with current professional practice
• Learners are encouraged to engage with their professional body CILIP

Knowledge for Healthcare Learning Academy

Offers a range of learning opportunities to the specialist healthcare knowledge and library workforce in England.

Health Education England is part of the NHS. Their role is to work with partners to plan, recruit, educate and train the health workforce.

Health Education England is the strategic lead for NHS knowledge and library services in England.

This year more than most, the role of knowledge in the NHS has come to the fore. As the world has responded to the most significant health crisis of modern times, the dissemination, interpretation and application of evidence, knowledge and insight has led the fight against Covid-19. Sue Lacey Bryant, National Lead for NHS Knowledge and Library Services, talks to CILIP Chief Executive Nick Poole about how NHS Library information teams have supported services throughout the crisis.

It’s no surprise that the role that NHS knowledge and library services play in shaping the decisions of frontline teams is coming into sharp focus. (Celebrated between 14 and 18 June during the first ever NHS Knowledge and Library Services Awareness Week.) However, it isn’t just clinical responses for which England’s network of NHS library teams provide the evidence.

An information scientist and librarian by profession, Sue Lacey Bryant is a vocal champion of the role that knowledge plays in the success of the NHS – in every regard. As the national lead for NHS Knowledge and Library Services, Sue leads a pioneering strategy to deliver Knowledge for Healthcare, placing knowledge at the core of NHS decision-making, equipping colleagues with valuable evidence and enabling teams to share their learning from experience. Building on the first five years of work, Knowledge for Healthcare 2021-2026 was launched earlier this year.

Expertise in action

“Applying knowledge into action is the currency of a successful healthcare organisation. But we know that evidence does not speak for itself – it needs to be mobilised at the right time and through the right people to make a difference in decision-making,” explains Sue.

“Helping NHS bodies, staff, learners, patients and the public to access and use the right knowledge at the right time, in the right place to inform decision making and drive delivery of excellent healthcare and health improvement, is at the core of our work.

“It’s the expertise of our library teams that actively mobilises knowledge. Above and beyond enabling staff and trainees to pull down the evidence they need, and pushing out targeted and tailored information about research to health professionals, increasingly knowledge specialists are aligned to multidisciplinary teams. They enable NHS organisations to make an asset of the knowledge and experience of their staff. They find, synthesise and summarise evidence; saving staff time, placing evidence at the fingertips of health professionals, and at the heart of healthcare

“Knowledge services are an essential part of the decision-making infrastructure of the NHS, as well as of its education and training infrastructure. I am tremendously proud to work for the NHS and it’s a real privilege to be leading the work to ensure that the value that our incredible library services can bring to healthcare is fully realised.”

Equal benefit

The Knowledge for Healthcare strategy sets direction, providing a common development framework across the country.

“Knowledge for Healthcare is a change programme, at a really fundamental level. The ambition is to enable all NHS staff and learners to benefit equally from high-quality knowledge services, and to optimise the expertise of knowledge service teams to inform decision-making from board to bedside, and in community and primary care settings,” explains Sue.

The NHS employs 1,200 library staff across 183 services in England. And it is their work that has delivered the significant progress made through Knowledge for Healthcare. There is a raised profile and respect for these services across the NHS and this is absolutely at the door of the work that library teams do, day in day out, to support their colleagues on the frontline. “It is about taking library services that are highly respected and trusted by frontline teams, through decades of work focused on education and on clinicians, and moving that forward in a way that establishes knowledge services as a business-critical basis of decision making. It’s an evolution of our services, ensuring that we maximise the return on investment in knowledge.” Sue’s team recently developed a value proposition for NHS knowledge and library services – ‘The Gift of Time’ – work designed to help healthcare professionals understand the tangible impact the service can have on their practise.

Demonstrating value

Undertaken by an independent health economist, the study homes in on the real impact of knowledge and library services, producing a value proposition that captures the unique benefits of knowledge and library services to the NHS. The report focuses on two key strands: meeting the duty that the NHS has – under the Health and Social Care Act 2012 – to use evidence from research; and understanding how clinical librarian roles, and other embedded roles within clinical practise – impact on outcomes.

“Well, it’s the Holy Grail. Having a value proposition that really captures the difference we’re making to healthcare,” says Sue.

“We were able to see very clearly, the expert skills that knowledge specialists have in finding and presenting evidence and synthesised information and the real impact of this. The health economist reported that the service provides healthcare professional staff with time saving, accelerated access to better quality evidence which in turn allows the NHS to meet its statutory obligations to utilise evidence from research. There is, of course, enormous value in this.

“It found that our fantastic knowledge and library teams help healthcare professionals use their time more effectively to drive improvements against the quadruple aim of the health service - improving the health of populations, enhancing the experience of care for patients, reducing the per capita cost of healthcare and improving the staff experience of providing care. The study reported that NHS library services deliver a net economic benefit of £77m per annum, and were the staff ratio for qualified librarians improved in line with Health Education England’s recommendations, that number could be rather greater.

“It is an incredible demonstration of the value of the work of knowledge specialists, knowledge managers, everyone who works in our NHS libraries. I see their impact. I see the difference our service makes, but to have an objective view on that – and to see it played back so clearly through the ways in which these Services inform decisions – whether on clinical guidelines or treatment options for an individual patient, or service design, is really something. These are decisions that should be based on the very best evidence – and library services staff in Trusts can bring that together, taking a wealth of evidence from research and across a range of experience and specific insight - or ‘know-how’ for short – enabling NHS professionals to use that knowledge effectively.”

The right decisions

Under Sue’s watch, NHS knowledge and library services staff have been able to bring to life the diversity of their work and their real impact. Much of this is thanks to the #AMillionDecisions campaign, a partnership between Health Education England and CILIP Health Libraries Group. Recognising the enormous number of decisions taken across the NHS every single day, this initiative spotlights the significant role that knowledge and library specialists can play in ensuring these are evidence-informed.

“The #AMillionDecisions campaign really helps to shine a light on the importance of knowledge for decision-making and the valuable work of information professionals in nurturing the NHS as the learning organisation that the health service strives to be.

“It has given a platform to recruit wonderful champions to tell their story of working with librarians and for knowledge and library specialists to articulate the difference they make. #AMillionDecisions gives teams a stage on which to showcase the impact that evidence brings to bear, and how their skills in searching for evidence, and managing knowledge help health professionals improve patient safety, reduce costs, lead effective change management programmes, and redesign the workforce. Yes, the knowledge service helps clinicians keep up to date with key information in their world – but it is so much more than that, supporting roles in research, quality improvement, management, finance, procurement and more.”

Sue adds: “The ambition now is to continue to use our Knowledge for Healthcare framework as a change agent – a tool to drive innovation and improvement, to ensure that the work and expertise of library teams underpins decision-making across the system.”

And, as the first NHS Knowledge and Library Services Awareness Week rolls out, Sue expects that the enhancements that knowledge services are making to assist NHS staff and learners will come into sharper focus. There are five key themes driving the work.

“We’re looking at a new digital infrastructure to streamline access to knowledge and library resources. That’s a huge programme of work that will see us invest in a national resource discovery system that will connect in with local library systems and improve our digital offer to the workforce. Currently we have 91 library management systems across the 183 services operating in England. Working in partnership with local teams, we will be consolidating these to less than 10, simplifying access to knowledge resources.

“Mobilising evidence from research is not only about ensuring that it is discoverable but also about disseminating information effectively, and sharing it in formats that can be used easily. Equally, it is about us tapping into staff know-how, and promoting tools and techniques that help staff mobilise knowledge. We are here, in a digital age, and there is a tremendous need to accelerate the spread and adoption of innovation across the NHS. That’s one of the outcomes we’re aiming to achieve through Knowledge for Healthcare.” “Knowledge services are business critical. The national team in Health Education England assures the quality of health library services on behalf of the NHS, helping NHS organisations understand what good looks like, using a maturity framework. We help teams to refine their services to add even greater value.

“Health literacy is another vital aspect of the work. We know people face challenges as they connect to the health service, and look to find, interpret and respond to health information. We want to help people make better decisions about their health. We are working to ensure that staff, learners, patients and the public are all better equipped to use evidence-based patient, health and wellbeing information both for shared decision making and self-care. So, a priority for us is to work alongside other information providers on building the health literacy skills of the community.

“And, as a key pillar of work – Knowledge for Healthcare has a strong focus on workforce planning and development to support the transforming nature of knowledge and library services. Library teams contribute to everything from policy change, clinical protocols, cost savings, staffing and patient safety. Therefore, we are focused on ensuring that our knowledge and library services workforce has the capability, confidence and capacity to meet the evolving needs of the healthcare system.

“As the technology advances, and the needs of the NHS change, the healthcare workforce needs to gain new skills and adapt. And all of that, remembering that 50 per cent of today’s NHS workforce will still be in post in 10 years’ time. Keeping up to date and continuing to learn is really key for everyone. Libraries have an important part to play in that agenda, and indeed, our own specialist workforce must similarly continue to evolve and adapt to support that journey too.”

Visible, valued, embedded

Some of the projects the team has taken forward – particularly around digital resources – are designed to place knowledge at the fingertips of health professionals, and that’s a vital workstream, according to Sue. Purchasing BMJ Best Practice as a Clinical Decision Support tool for the NHS in England has been a major step forward in terms of provision. Knowing when our loved ones are in hospital, that the staff caring for them can go to this app and look up high-quality evidence at any time of day or night is something I am very proud we have been able to achieve in the last few years. This is an expensive piece of kit to purchase for a country and we need to make sure it is visible and promoted, and delivers value, but it’s hugely important and is helping to embed this evidence-led approach in practice. The BMJ Best Practice app is a hugely valuable resource.

“And of course, we have seen a huge driver for change during the pandemic too.

“Like our colleagues on the frontline, knowledge and library service teams have also adapted quickly to respond to the pandemic, something that has created a whole new appetite for skills around knowledge. The way in which local services have adapted their services, and their commitment to collaboration has been staggering. In turn, keen to avoid duplication of effort, the national team has mobilised to coordinate some of this work, for example initiating a shared Covid-19 Search Bank. And we have built a gateway to information about Covid for patient groups with specific information needs.

“As we come through the crisis, we’re seeing many changes in healthcare: the growth in virtual consultations, the way in which people can use wearables and sensors to gather clinical data – I think these are just some innovations that will be extraordinarily impactful over time. Knowledge specialists will be playing a role in helping healthcare professionals to draw on insights from the pandemic and gain new skills as services transform.”

“In essence, knowledge specialists have and will continue to make an extraordinary contribution to the health service that I believe the nation has never valued more,” Sue adds. “We are committed to ensuring the right knowledge is used at the right time, and in the right places – and in this way library and knowledge specialists effectively empower people to make the right decisions.”

Talk to your librarian

So what would Sue say to anyone seeing the NHS Knowledge and Library Services National Awareness Week campaign and wondering how it might assist them in their role?

“I would say ‘talk to your librarian. Invite them to be a part of your multidisciplinary team. The breadth of their work means that you can be absolutely certain that they offer services that can help you and your team. Knowledge and library specialists prepare evidence summaries, keep teams up to date, teach information skills, assist learners and researchers, and provide expertise in knowledge management. This pivotal service is absolutely shaping the work of the incredible NHS.”

Check out NHS Knowledge and Library Services's website for coverage of NHS Knowledge and Library Services Awareness Week and Twitter at #KLSNAW.

Read Knowledge for Healthcare: A strategic framework for NHS Knowledge and Library Services in England 2021-2026

Read NHS Library and Knowledge Services Value Proposition: The Gift of Time.

Read Recommendations to improve the staff ratio for the number of qualified library and knowledge specialists per member of NHS workforce (pdf).

Knowledge for Healthcare Covid-19 Search Bank.

It was back in December 2014 that the original Knowledge for Healthcare strategy was published and as we embark on the second phase, which will run until 2026, I feel it is important to look at how far we have come.

The central proposition of the first strategy was:

“Information will increasingly become the currency of healthcare in the future, and our ability to access, understand and interpret it at individual and population level will be a key determinant in the future success of our healthcare system."

Unsurprisingly to those in the Knowledge and Information field and increasingly in healthcare this premise endures.

A key insight, which in our view has made a considerable contribution to the ability of the NHS to leverage knowledge to deliver real improvements in health outcomes, is that technology on its own without the input of information professionals will not deliver improvement. With that in mind three things have taken place to realise the central vision of Knowledge for Healthcare, firstly building proactive and customer-focused services, secondly developing knowledge infrastructure across the healthcare ecosystem and finally creating a skilled and professional Library and Knowledge Service workforce.

A Million Decisions, a campaign, run in partnership between Health Education England and CILIP, has highlighted how Government and health service providers can make use of the skills of librarians and knowledge specialists to address the requirement in the 2012 Health and Social Care Act for decisions in the healthcare sector to be evidence-based. The campaign has highlighted the many ways in which librarians and knowledge specialists have facilitated evidence-informed decision-making by management and clinical staff, delivering real efficiency savings and improvements in health outcomes.

In our view, Knowledge for Healthcare has been a remarkable success through its first phase. We can now look ahead to the next 5 years in the knowledge that it has a track-record of proven impact to bring to bear in helping the NHS and healthcare community mitigate risks and maximise opportunities on behalf of patients, their families and carers and taxpayers. As we move into that second phase, we would encourage the leadership of Knowledge for Healthcare to maintain its focus on people over systems – it will be the continued focus on human infrastructure of skilled and ethical professionals that helps to deliver on the promise of evidence-informed decision-making across healthcare.

A recently published international literature review suggests the potential for significant savings of time for users and expenses for health organisations from using a Library and Knowledge Service - a median of $2.4 benefit for every $1 cost. Health Education England commissioned an independent study. Assuming the international findings are applicable to the NHS, this suggests that the service is potentially already generating an overall economic benefit of £132m per annum for the NHS, a net economic benefit of £77m per annum for the NHS. Furthermore, if the NHS were to achieve target staff ratios (1 librarian for every 1250 NHS staff), this net benefit could potentially increase from £77m to £106m per annum relieving pressure on an already over-burdened system and on hard-pressed clinical staff.

Most of all, we look forward to working with Health Education England to build on the insights and lessons learned from this successful first phase in order to shape not only our work together, but the future direction of the knowledge, information and library profession.

To read the full strategy, a summary or download and Easy Read version go to Knowledge for Healthcare.

Find out more about the national NHS Knowledge and Library Services team.

When in October this year, the BMA published its statistics on the impact of COVID-19 on the capacity of the NHS, they made for sobering reading.

The figures show a decline in outpatient attendances of nearly 13.4m for August and September as the NHS re-focused on critical care for people with coronavirus symptoms. The average waiting time for specialist referrals rose to 14.8 weeks.

In healthcare, time is arguably the most precious commodity there is. A 2016 study from the University of York found a significant correlation between longer waiting times and in-hospital mortality or emergency readmission for patients waiting for bypass surgery. The BMA found that 20% fewer patients started their cancer treatments in August 2020 than they had in the same month in 2019, largely as a result of reduced capacity and availability.

We have long known that efficient, expert and repeatable access to quality information and reliable evidence has a profound impact on both health outcomes and the efficiency of healthcare provision. The joint CILIP/HEE campaign #AMillionDecisions has provided dozens of examples of the impact of evidence-based clinical care and the cost-savings to the NHS.

But what we lacked was a truly rigorous econometric study that could put this impact into its proper context in a way that will resonate across both clinical and non-clinical specialists. Until now, that is.

The publication of the Health Education England report Value proposition for librarians and knowledge specialists in health – The gift of time at a Libraries All-Party Parliamentary Group meeting at the beginning of November marks something of a turning-point in making the case for librarians and knowledge specialist staff in the healthcare system.

The report, commissioned by HEE from health economist Jacque Mallender of Economics by Design, tells a powerful story of how librarians and knowledge specialists take the ‘heavy lifting’ out of evidence-based practice for clinicians, in turn giving them that most precious of all gifts – time.

As the report says, “The core Value Proposition is simple: the service provides healthcare professional staff with time-saving accelerated access to better quality evidence which, in turn, enables the NHS to meet its statutory obligations to utilise evidence from research, and, as importantly, for healthcare professionals to use their time more effectively to drive improvements against the quadruple aim” (a metric of the overall success of the NHS).

Perhaps most starkly of all, the report puts a financial value on the impact of library and knowledge services – an estimated net economic benefit to the NHS of £77m per year. If a proposed increased ratio of library and knowledge staff to clinical staff is achieved, this could rise to an annual saving of more than£106m. This is money that can be put to work for the benefit of patients and their carers across the healthcare ecosystem.

As we face a challenging winter, with pressure on NHS services predicted to increase and a potential surge in COVID-19 related admissions over Christmas, policymakers and NHS managers need to do everything in their power to relieve pressure on an already over-burdened system and on hard-pressed clinical staff.

Now, thanks to this report, we can demonstrate to Parliamentarians, NHS leaders and the people holding the purse strings that a small investment in professional librarians and knowledge specialists at this vital stage will give them in return the most important gift of all – the life-saving gift of time.

Download the report in full from the NHS Health Education England website

Banner image: Librarian and Knowledge specialist at Frimley Park Hospital

My transition into an apprenticeship and the start of my time in the NHS followed a long journey of higher education, part-time work and an ongoing unfulfillment with my professional progress. Initially pursuing an undergraduate degree was driven as the next logical step after my A-Levels, and my postgraduate degree seemed to temporarily fill a gap I thought needed filled. Alongside my educational career I worked in various administration roles in different sectors which made do at the time but never left me satisfied. Working in a library was always a goal of mine, but I was never quite sure how to get there. The librarian felt like a role you were born into, and the path towards it seemed almost hidden.

Getting into my apprenticeship with Southmead Library was a fruitful result of a vigilant library career quest, including countless job searches and CV tweaks. When I saw the opportunity to join the LKS team as an apprentice I was immediately excited – professional and educational development? That was the dream! I was lucky enough to be picked for interview and when I received the congratulations call I was overcome with happiness and relief. My time in my role has far exceeded my expectations thanks to the brilliant team I have come into and my ever-growing understanding of what the role can encompass. A most recent example of this is getting the opportunity to look into decolonising the library collection, looking into expanding the diversity of both authors and visual content alongside compiling lists of reading materials and resources to implement. Being able to take on this project was not only relevant to me from a racial perspective, but highlighted the constant development of healthcare library collections and the potential for building more representative resources. I would never have imagined getting to undertake this kind of work so early in my role, so it has been a fruitful endeavour. In just under a year I feel I have come such a long way in my role thanks to the professional guidance of my colleagues, getting to grips with the daily operations of a healthcare library and opportunities to take on new responsibilities.

Though my journey to my current role felt longer than expected I do not regret any of my experiences. Undertaking two degrees allowed me to hone my writing capabilities and the academic research has largely helped with searching for articles and navigating library classifications. Whilst administration was never my long term goal, it meant I developed a wide set of transferrable skills of working with different systems and responsibilities that are found across many office-based jobs. Doing an apprenticeship at this stage in my life has allowed me to put my goals into action and given me clear direction on how I want my career to progress. Assignments set by LMP and projects arising in the workplace equip me with both a broad and specialist insight into library provision.

As a young professional, I hope my apprenticeship experience so far can help inform and encourage others looking for focused development to look into apprenticeship opportunities – it can introduce you to a whole new world of possibilities!

Shakira Rawlins
Library Assistant
Library and Knowledge Service, North Bristol NHS Trust
Southmead Hospital
Bristol BS10 5NB

This article originally appeared in the Knowledge for Healthcare blog.

NHS Library and Knowledge Services are helping to deliver the best care and treatment possible to patients.

Making the gathering of information as easy as possible for healthcare professionals, getting the required evidence into practice and giving them the ‘gift of time’ which they can then spend with patients is where Library and Knowledge Services can have both a direct and indirect effect on the care patients receive and a positive impact on NHS services as a whole.

Health Education England (HEE) commissioned a report Library and Knowledge Services Value Proposition: The Gift of Time, identifying key benefits of a library and knowledge service within an NHS organisation and, specifically, the specialist roles embedded within NHS teams.

Findings in a recently published international literature review [see p21 of Report for list of referenced materials] showed that for every $1 of funding spent on library and knowledge services a return of $2.4 is received. If applicable to the NHS it suggests that library and knowledge services are already delivering a net economic benefit of £77m per annum. Were HEE’s recommended staff ratio for qualified librarians per member of the NHS workforce achieved, this could increase to £106m per annum.

Read the report and find out more about NHS Library and Knowledge Services.

Header image: photo of Walsall Healthcare NHS, provided by Health Education England.

Health librarians have been at the forefront of responding to the Covid-19 pandemic. Catherine McLaren, on behalf of the Health Education England (HEE) Library and Knowledge Services Team, looks at what that has meant over the last three months – and what it means for the sector as it moves forward.

Although we are all still amid change, the national Library and Knowledge Services team within Health Education England (HEE) has recently taken stock of our activities through the pandemic to date. We are keen to understand the learning that we can take from the experience and are sharing our reflections at this point in the hope that this may be helpful to others.

Implementing Knowledge for Healthcare, the team leads a strategic approach to the development of NHS library and knowledge services. Now, as in normal times, we provide professional advice to the system and to health librarians. The team procures and ensures that the NHS has 24/7 access to evidence and knowledge resources, supports the development and assures the quality of NHS library and knowledge services in England. During the Covid-19 pandemic we have also undertaken some direct service provision where we have identified a single, central approach as the most effective response to the need.

On 30 January 2020 the first laboratory confirmed case by specimen data of Covid-19 in England. The next day another one followed, and throughout February cases slowly picked up. At the same time people were placed in quarantine as they came back from Wuhan China. Information professionals were quickly on the case. On 18 February #ukmedlibs held a twitter chat on Questions for coronavirus, and other public health emergencies: the librarian’s role. The chat was hosted by Caroline De Brún of Public Health England (PHE) and highlighted the work of libraries during health emergencies. By the end of the chat5 that evening, a lot of material had been gathered and ideas on the best way forward had been shared. The HEE Library and Knowledge Services team immediately decided to create an online resource to bring information and ideas together in response to the developing crisis. We chose to host the new resources on the Knowledge for Healthcare blog, as a site with which NHS librarians were already familiar.

Scope of the response

By the beginning of March there were over 80 lab-confirmed cases and, on the 6 March, sadly the first death. It was clear that health services across the UK were going to be affected in an unprecedented way due to Covid-19.

We wanted to facilitate knowledge sharing by NHS library staff in England so that they could better support the wider health system. Information products needed to be quickly developed and shared. We committed to developing resources that would directly meet the needs of health librarians and save them time. Out of this came the Covid-19 blog site pages which went live on the 13 March 2020. We saw that work was being repeated across the system. Recognising that some knowledge services were under pressure, and that health librarians offer unique specialist skills into the system, we wanted to assist and encourage colleagues to share their work and avoid duplication, releasing their time to focus on priorities.

Evidence Sources

We wanted to bring all the evidence sources linked to Covid-19 into one place and highlight what information was freely available. Doing it in this way means that as things change, we update one national page rather than several regional or local pages. This applies both to sources in the wider system and to sources for library and knowledge specialists. HEE’s Knowledge Management team compiled and updates resources for the international Coronavirus section on e-Learning for Healthcare, notably compiling essential guidance.

Database and e-resource providers opened a lot of resources relevant to Covid-19 for free, in a short period of time. The HEE Library and Knowledge Services team saw the need to collate information into one place. Additionally, publishers have also opened e-resources that are not directly linked to Covid-19 for a limited time. We focused on selecting those resources that NHS librarians could make readily discoverable for healthcare staff via the discovery platforms they already use. In this way we can enable and disable access quickly and easily as publishers change their position.

Search Bank

The evidence sources page went live on the 24 March. By then it had already become clear, as NHS staff across the system began posing questions, that there was duplication of requests for literature searches and evidence summaries on different aspects of managing Covid-19. The HEE team responded by forming a working group of expert searchers from across England with members of the HEE Library and Knowledges Services team. They worked together to plan and deliver a service, inviting colleagues to share their work to assist library and knowledge services staff and better meet the needs of NHS staff in England.

Searches are received through a central email; they are then distributed to the expert group for assessment against the inclusion criteria before being added to the search bank [n=138 at 12 June 2020]. The page went live at the end of March, and continues to be refined. It also links users to several ready-made search strategies.

Naturally, other nations and organisations have similarly come together to streamline procedures around how their library and knowledge services teams are working to provide evidence and support librarians and knowledge specialists through the pandemic. We signpost work undertaken by Scotland and Ireland and other countries. At a strategic level, the national lead is in regular liaison with the NHS leads in the home countries, with Ireland, and across Europe through the European Association for Health Information and Libraries.

Current Awareness

One area where NHS library and knowledge service staff were struggling to support the healthcare workforce effectively at the start of the pandemic was information overload. In a time of pressure and change when getting the right information to the right people is even more important, we wanted to highlight to NHS library and knowledge service staff the work that had already been happening around current awareness.

Recognising that some services might be struggling to maintain current awareness services, or needing to set something up in a hurry, we signpost to Current Awareness Service for Health (CASH) and KnowledgeShare, the two dominant services in this field on a page on the Covid-19 blog.

We are encouraging a collaborative approach, linking to bulletins that library and knowledge services are happy to share, providing details on who to contact and when each is updated.

With an impressive track-record of cooperation and networking, the experience of working through Covid-19 has only strengthened the level of collaboration between NHS library and knowledge services. They are willing to share the work they are doing with other services in the NHS and recognising that in many cases this only needs to happen once.

Adapting the workplace

HEE has successfully ensured maintenance of 24/7 access to evidence-based digital knowledge resources for the whole NHS workforce throughout the pandemic and focused on business resilience to achieve this. Sixty per cent of NHS libraries remained physically open throughout the pandemic, most staffed but with reduced staffing and 21 per cent accessible to healthcare staff but not staffed. In a further five per cent of cases, service delivery has been virtual.

When needed we have highlighted information to library and knowledge services staff so they could make changes, which keeps themselves and their users safe. This included the guidance from the Covid-19 Guidance Cell of Public Health England’s National Infection Service, as advised to the Department of Digital, Culture, Media and Sport at the end of March:

• The risk from books covered in a plastic cover handled by someone who is a possible Covid-19 case is negligible after 72 hours.
• The risk from books with a cardboard/paper cover is negligible after 24 hours.

As services assess and plan the changes they need to make over the medium term the Adapting the Workplace pages enable library service managers to share information, including approved plans and resources, around what they are doing to fully reopen the physical space. We include some of the work that has happened elsewhere, including in this area from NHS Wales and it enables those libraries who have been continuing their physical services throughout the pandemic to share their learning.

Knowledge for Healthcare Blog Usage

Mostly the blog site is being accessed from the United Kingdom, but it has also been accessed from Australia, Canada, Finland, France, Germany, Ireland, Netherlands, Spain, and the United States. The three pages within the Covid-19 resources with the highest unique page views up until 7 June, are the evidence sources (4,450), literature searching (3,085) and adapting the workplace (983). Across all the Covid-19 pages there has been over 14,000-page views.

Patient and Public Information

Early on we started a Covid-19 page for patients and the public which signposted to the NHS coronavirus hub, NHS 111, the WHO information network and highlighted myth-busting links.

We were very aware that in many cases this was not enough. Lots of organisations and charities were providing information specific to their clients’ needs around Covid-19. Healthcare staff had no one place to go to find this information.

We wanted to assist NHS library and knowledge service colleagues bringing information together to save them time. At the same time, we wanted to support NHS and social care organisations to meet the Accessible Information Standard.

Liaising with NHS England, Public Health, NHS for Scotland and the Patient Information Forum, we confirmed that it would be helpful for the HEE national team to take on the role of curating this information and that other NHS organisations would then signpost to the pages we built. While the national Library and Knowledge Service team does not usually undertake direct service provision, we were delighted to capitalise on our own team’s expertise and experience to collate a central collection of Coronavirus Resources for the Public as part of HEE’s response to the pandemic.

Launched on 26 May 2020 the library. nhs.uk resource of Coronavirus Resources for the Public initially focused on three areas: Children and Young People, Older People, and Accessible Formats. The latter has attracted the most use to date. By 11 June there had been over 11,018 unique visits to the site. Further areas are in development; we are collating Corona- virus information resources on Cancer, Wellbeing, Long Term Conditions and Carers.

Nightingale Hospitals

Liaising with NHS library services that stepped up to support the information and evidence needs of staff at the new Nightingale hospitals has been an important area of work during the pandemic. The London site opened in early April. Barts Health NHS Trust Knowledge and Library Services were able to offer knowledge services and resources. The team was quickly able to promote resources that had already been gathered by HEE on the Covid-19 blog pages.

Nightingale Hospital London,

As other Nightingale hospitals were planned the HEE team set up a com- munity of practice for the library and knowledge services staff involved, so that they could collaborate, learn, and support each other. As part of this, clinical decision-making tools like BMJ Best Practice have been embedded into the patient record.

Representatives from the library and knowledge services supporting the seven Nightingale hospitals in Birmingham, Bristol, Exeter, Harrogate, London, Manchester and Washington participate in this community of practice which is facilitated by the HEE team. To begin with they met weekly and the learning from the London team was shared with the group.

Meeting training needs

NHS librarians have an impressive record of networking as a means of mutual support as well as knowledge exchange. The HEE regional teams have ensured regular contact with trust library service managers throughout. We moved fast to commission programmes to support virtual working – facilitating virtual meetings, developing skills to deliver training online. These were fully booked within 30 minutes of being advertised and are being repeated to enable maximum participation across the country. Equally we have been concerned to support individuals through a challenging time and have offered sessions on wellbeing and resilience.

Learning to date

We will continue to reflect on an ongoing basis, but there are some initial themes. Covid-19 has raised the profile of NHS library and knowledge services in many trusts. It has the potential to influence the design and delivery of services going forward. The delivery of health library and knowledge services through the pandemic reinforces guiding principles and values articulated in the Knowledge for Healthcare strategy, particularly regarding:

• Collaboration: we observe greater collaborative working between NHS library services
• Digital-by-default: accelerating approaches that optimise digital and virtual delivery
• Collective purchasing: centralised procurement to reduce inequities in access to evidence sources
• It also speaks to the importance of mobilising knowledge to support evidence usage from Board to bedside.

Teams are supporting each other not simply by knowledge sharing and through networks but by sharing and repurposing information outputs.

Looking ahead to the ‘new normal’ in which health and care staff will be working we see a greater role for health library and knowledge service teams in supporting digital skills, digital and health literacy and patient information.

At the same time, the pandemic experience has surfaced that health librarians will want to consider whether there are further areas where it is most productive to create a single resource, or lead delivery of a single service once, nationally.

All these themes will be reflected in the refresh of HEE’s strategic development framework, Knowledge for Healthcare. As a member of the HEE Library and Knowledge Service team this time has been equally challenging and rewarding. There have been the personal challenges faced by all of us of seeing society, work and family life change overnight. There has been the challenge and delight of virtual working, of virtual friends and virtual family. Gardens and public green spaces have become more important. It has been rewarding to engage my critical thinking and assessment skills of information while contributing to the direct service provision provided to the public through the Coronavirus resources on library.nhs.uk. Working as part of a diverse and skilled national team during this time has allowed me to develop my skills further in different areas including curating information, responding to training needs and web development all at speed.

The dedication of NHS librarians through these difficult times is striking. For our part, the HEE Library and Knowledge Services team is focused on understanding how we can assist and support our colleagues to deliver knowledge services to the NHS during the pandemic. We are committed to supporting library and knowledge services staff in the NHS, and to deliver what is of most help to them, as they continue their work to bring evidence to the ward and the Board, to underpin patient care.

Details of access to library and knowledge services for Health Education England staff can be found here.

 

KnowledgeShare: access to evidence for NHS staff

In 1999 Brighton and Sussex NHS Library’s KnowledgeShare project set out to support the library team’s ability to facilitate evidence-based practice (EBP) and knowledge management within the local healthcare population. It now serves over 200 health organisations across the country.

Eight years ago Bastian et al indicated the scale of the problem facing those who wish to practice evidence-based healthcare. They suggested that 75 randomised trials and 11 systematic reviews, the best evidence we have for therapeutic interventions, were being published every day of the year.¹ Policy documents, guidelines and case studies of innovative practice add to this plethora. For a clinician or manager to keep pace, services and tools that bring this new evidence to their attention in a timely, accessible way have become crucial to patient care and health service improvement.

Knowledge for healthcare

Health libraries address this need through the provision of in-depth evidence reports to answer uncertainties. They also provide information skills teaching so that healthcare staff can find the best evidence online. And in order to keep colleagues up-to-date, they provide current awareness services alerting them to new publications in their field. Traditionally, these current awareness services have taken a blanket approach, distributing relatively long, broad bulletins to large numbers of recipients. They have usually failed to match a member’s specific interests, and to “save the time of the reader”.² These bulletins, produced by individual health ­libraries across the country, draw from many of the same sources and therefore represent a significant duplication of work. For these reasons, the provision of individually tailored current awareness services was an important component of the Knowledge for Healthcare Development Framework for NHS library and knowledge services.³ The framework established that standards should be set for current awareness services and that provision should take a do-once-and share approach in order to extend reach to the whole of England.

Highly targeted evidence updates

The KnowledgeShare project began in 1999. Its aim was to increase our team’s ability to facilitate evidence-based practice (EBP) and knowledge management within the local healthcare population.We created a website signposting staff to EBP resources, increased evidence searches for management decision-making and started teaching staff to critique research papers. We also introduced highly targeted evidence updates informing colleagues about new research and government publications in their field.The system created to automate the production of these emails for thousands of local staff, with each email personalised and specific to the recipient, was unique.By 2005 it had grown to incorporate the management of our team’s evidence search requests and information skills teaching and had become a single portal to streamline and manage the three core services of health libraries.

Do once and share

For a number of years, KnowledgeShare remained an off-line system used only in Brighton and Sussex but there was growing interest from other health library teams in making use of it to enhance their own searching, teaching and current awareness. In 2012 we partnered with Maldaba, a software development company, who worked with us to rebuild KnowledgeShare as a web-based application. Moving KnowledgeShare online meant that we could support a collaborative approach to evidence updates and searching across NHS library teams, allowing them to save time and standardise their processes.

Connecting librarians with their members… and with each other

When members sign up to a library that uses KnowledgeShare they list their professional interests, being as broad or specific as they like. The evidence updates can encompass every aspect of clinical care, from emergency medicine to mental health. They can include public health content or focus on management topics such as patient experience, clinical risk, staff education, etc. Members are categorised according to their interests, publications are categorised according to their content, and KnowledgeShare matches the two together, sending personalised emails that tell library members what they need to know and no more. It was important to preserve the connection between an individual librarian and their members and so the evidence updates arrive directly from a local colleague. Members can also log into KnowledgeShare to update their professional interests, request a search for evidence or book onto teaching. Evidence search reports are collated within KnowledgeShare meaning that they can be easily shared with other librarians (for peer review) or shared with other NHS staff in order to widen the impact and reach of library work. Members can also evaluate the results of a search request, or a teaching session through the system, and KnowledgeShare will remind them if they forget.

Communities of practice

KnowledgeShare is still developing and will soon be expanding further into knowledge management through the creation of online communities of practice. NHS staff will be recommended by colleagues who share their interests and will be able to form groups through the system, from a virtual journal club in a single hospital to cross-organisational forums. Groups will request and share evidence searches to support their work and discuss the results through KnowledgeShare. The system will become an NHS-specific network, mediated by library and knowledge professionals.

KnowledgeShare continues to expand across the country, and there are now 82 services licensing KnowledgeShare.

Sharing knowledge across the country

In 2013, KnowledgeShare was made available beyond Brighton & Sussex, initially to other health libraries in the South and, over the next two years, 28 NHS LKS teams had signed up to use it. The system continues to expand across the country and there are currently 82 services licensing KnowledgeShare who between them serve over 200 health organisations. Most teams begin by using the updates function to provide current awareness to their members. Almost 250,000 ­tailored evidence updates were sent by the system in 2017, to around 21,000 individual members. The number of teams using KnowledgeShare to manage their teaching provision increased by 63 per cent this year. The number using it to record their evidence searches increased by 75 per cent.

User feedback informing development

KnowledgeShare was initially designed to meet the needs of the Brighton and ­Sussex NHS Library and Knowledge Service, however not all health libraries work in the same way. The system now supports a wide variety of teams and is constantly evolving to satisfy their needs. From the initial onsite training to answering support queries in established services, we maintain a conversation with health librarians to discover potential development opportunities and adaptations. The indexing that powers KnowledgeShare is also updated based on changing requirements, for example the introduction of a specialist orthopaedic trust has led us to refine the musculoskeletal categories to better meet the needs of their members. KnowledgeShare user communities of practice are a fertile area for exploring future directions for the platform and give librarians a chance to share ideas on promoting and evaluating the system.

Evaluations coming from library members in teams across the country include: “KnowledgeShare updates generate new ideas and initiate group discussion within the team thus introducing new changes in practice. The updates have the potential to initiate such a change!” (Heart of England NHS Trust) and “KnowledgeShare is very helpful and leads me to read things I wouldn’t normally – it expands our viewpoint on all kinds of commissioning work” (Whittington Health NHS Trust).

Case study: Tom Roper, Clinical Librarian, Brighton and Sussex Hospitals

CLINICAL librarians provide information at the time and place of need, on ward rounds and in departmental meetings. I work with the Abdominal Surgery and Medicine, Acute Floor and Musculoskeletal directorates. With access to KnowledgeShare on my iPad, it makes it easy for me to add new requests for evidence searches as they come up by the bedside or in a meeting. I can quickly find past evidence search reports, book people onto teaching sessions and set up or tweak their current awareness profiles. It makes it quick and simple to manage my workload, to share or reallocate searches to other members of the searching team. I don’t have to spend time worrying about formatting my search reports consistently. KnowledgeShare produces everything in a standard format, and even adds a model citation, if the search requester wishes to cite the search in published work. It allows me to add summaries and syntheses of search results, saving the time of the user. And I can share searches with colleagues, and, with permission, with any KnowledgeShare user anywhere in the NHS.

Case study: Stephen Ayre, Library Services Manager, George Eliot Hospital

THE William Harvey Library team at George Eliot Hospital is fairly small (3.8 whole time equivalents). Although we had a management bulletin and posted regularly to social media, we were aware that our current awareness offering could be improved. Licensing KnowledgeShare in February 2017 has allowed our users to receive current awareness personalised to their interests, which we would not have been able to provide in any other way. As of March 2018, 105 of our users are receiving alerts, and appreciate the service. One said “With so much information on the internet, using KnowledgeShare is a strategic way to work. It helps you establish what you are looking for, filter out irrelevant or bad content and helps you to explore information in a directed way”. Having introduced KnowledgeShare for current awareness, we also took advantage of its other features. The literature searching module allows us to assign search requests to a librarian, which is useful in ensuring searches are completed in a timely way, especially complex searches involving more than one librarian. Ensuring the output of search requests is professional and user-friendly is important but sometimes difficult when multiple sources are used. Therefore the ability to combine results into an attractive format is very useful. In addition, the training module allows us to see who has received what library training and manages their feedback.

References

1 Bastian H, Glasziou P, & Chalmers I. “Seventy-five trials and eleven systematic reviews a day: how will we ever keep up?” PLoS Med 2010;7:e1000326

2 Ranganathan, S. R. The Five Laws of Library Science. Bangalore: Sarada Ranganathan Endowment for Library Science; 1957.

3 Health Education England. Knowledge for Healthcare: a development framework for NHS library and knowledge services in England 2015–2020. London: HEE, 2014. https://bit.ly/2ljkNj0

 

 

 

Emily Hurt (@EmilyHHurt) is a clinical librarian at Lancashire Teaching Hospitals NHS Foundation Trust.

Emily says: “The mainstay of my role is undertaking literature searches and providing information skills training, but I get to do other things too, from shadowing ward rounds on Critical Care to sitting on the Patient ­Information Leaflet group. I’m currently trying to ­organise a story time in the children’s clinic. I love my job and the people I work with.”

Emily recently won the LILAC Information Literacy Award for an outstanding researcher or practitioner in Information Literacy.

What was your earliest ambition?

I wanted to be a vet, but then realised I wouldn’t be very good as I’d cry every time an animal died. I stumbled into librarianship – I had dropped out of a PhD in children’s literature and was doing admin jobs through a temping agency. I was placed as a library assistant at Worcestershire Royal Hospitals and found I really enjoyed working there. I was lucky enough to be given funding for a part-time PGDip, and took it from there.

Who has inspired you in your career?

I saw Victoria Treadway speak at the Manchester 2013 CILIP conference, and thought “I need to be back in the NHS”. I had lost my way somewhat – after qualifying I worked as a subject librarian, but after I left my job to move North and have my daughter, I struggled to find a part-time qualified post. I was working as a library assistant in a public library, and hearing Victoria talk gave me the impetus to sit down and plan how I could get back into health libraries. I took a band two (assistant library assistant!) maternity cover post at an NHS library and it gave me the experience I needed to get a qualified post.

Career advice – what’s your top tip?

You don’t always need to be moving up, sometimes moving sideways can be just as rewarding. Management and leadership aren’t for everybody – sometimes a good career can mean finding jobs that you’re happy with and that give you room to grow.

Best professional achievement?

In April this year I won the LILAC Information Literacy Award, which is for an outstanding researcher or practitioner in Information Literacy. My manager, Tracey Pratchett, nominated me and I was very proud to win – the first non-university librarian to have been given the award, and hopefully not the last from the NHS. I think we do a huge amount of work around IL in the health sector, but we don’t necessarily shout about it as much as we should do. My nomination was around the project I run with a research nurse colleague, the Research Engagement Programme.

Worst professional moment?

Not really a worst moment, but more of a professional confession – I am not chartered.

What CILIP member networks do you belong to?

Health Libraries Group, Information Literacy Group, Library and Information Research Group. I’m a member of the HLG CPD working group.

What drives you on?

I love my job, but I get itchy! So I start new things, and I am very fortunate to have a line manager who shares my enthusiasm. Since I’ve started shadowing ward rounds, I’ve started to think more about how information can help patients, and it’s something I’d like to develop. Providing something that can help a person better manage a condition, understand a procedure, or make a decision about which treatment to choose, that’s an amazingly powerful use of information.

A book you’ve enjoyed recently?

The Tiger’s Wife by Téa Obreht. A beautifully descriptive book, it made me want to visit Serbia. It slips backwards and forwards between the tales of a young doctor and the past of her grandfather. And there’s a tiger in it!

Have you got any hidden talents?

I started sewing clothes for my daughter when she was a toddler, then moved on to things for me, and more recently I’ve started making quilts. It keeps me sane, I find it very therapeutic, and the satisfaction of wearing something you’ve made yourself is immense.