Nature of future strategy for management of the knowledge base of

Draft

Discussion Paper:

The Nature of Future Strategy

Confidential

for

Management of the Knowledge Base of Healthcare for NHS Scotland

2003-2006

Knowledge Management to Support the Patient Journey:

National Support and Local Challenge

March 2003

The Nature of Future Strategy for Management of the Knowledge Base of Healthcare for NHS Scotland:

National Support and Local Challenge Draft 2.0 Confidential

1

Contents

1.

Introduction: an integrated local and national strategic framework

2.

Policy context

3.

Definition of Library and Knowledge Services

4.

Aim, Vision and Values

5.

The Patient Journey as the framework for NHS Scotland Library and

Knowledge Services

6.

Key result areas

7.

Development of the Information Practitioner workforce

8.

Funding

9.

Development milestones

10.

Monitoring and evaluation

11. Conclusion



2

1. Introduction: an integrated local and national strategic framework

1.1 This draft outline strategy has been produced for initial discussion with the

Communicators Group, representing Library Services for each Board within NHS Scotland.

Presentation to the NHS Scotland Library Services Steering Group, comprising senior management representatives for each NHS Board, and to the Senior Management Group within NHS Education is planned for February 2003. Broader consultation with stakeholders in the NHS and other sectors should take place during March 2003 with a view to submission to the Scottish Executive as a component of overarching NHS Education for Scotland strategy in April 2003.

1.2 Formulation of the outline strategy has been guided by:



The need to respond to the overarching strategic objectives for NHS Scotland

development as a whole.



Work on development of local strategies for NHS Grampian and NHS Glasgow



Informal consultation with the NHS Scotland library and information

community



Discussions with stakeholders



Reference to parallel developments in similar contexts elsewhere in the UK



Definition of the functions to be fulfilled by NHS Education



Policies promulgated by the Scottish Executive in establishing the aim and vision for

NHS Education



The strategy for NHS Education as a whole

1.3 The proposed strategy envisages the following key outcomes:

Delivery of Library and Knowledge Services that:



Support all stages of the patient journey



Are accessible on an equitable basis



Are accessible at point of need



Are fit for purpose for their fundamental aim of supporting the work of the NHS



Operate across geographical and sectoral boundaries in alignment with new workforce and service structures within NHS Scotland



Work in synergy with other information and learning services both within the NHS and with partners in other sectors



Are supported and funded by unified NHS Boards



Are believed in and owned by Board staff



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1.4

This outline strategy for NHS Scotland Library and Knowledge Services aims to define key responsibilities, relationships and objectives for the next three years.

1.5 It advocates an integrated approach to development of local, regional and national strategies, as essential to support equitable, widespread service development. This integrated model will operate by linking local access and support for library and knowledge services with national policies and priorities, in coordination with central provision of core information and learning resources.



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2. Policy context

2.1 Effective utilisation of the knowledge base of healthcare is an intrinsic requirement within core government policy on health service management. Library, Information and Knowledge

Services consequently need to be empowered and supported to realise their full potential in supporting delivery of patient care. Specifically, adequately resourced responses need to be made to the following core strategic imperatives:

2.2

Designed to Care and Our National Health: a plan for action, a plan for change primarily require the NHS to focus upon evidence-based healthcare and best practice to improve patient care. Clinical governance has emerged as a system to assure and assess quality in these areas.

These core NHS strategies initiate also the new concept of educational governance, addressing responsibilities for fostering a learning culture throughout the organisation so that the workforce is properly equipped to base decisions and actions on validated evidence and practice.

2.3 Clinical and educational governance both depend upon NHS staff having access to, and training in effective use of, the published knowledge base. In recognition of this need, the

Scottish Executive has specified high quality information and learning services as a means towards modernising the NHS and improving patient care. Two critical documents set out policy and call unequivocally for action:

2.4 Learning together (1999) requires that “……within five years all staff groups in the NHS in Scotland have ready access to comprehensive and improved library and information services designed and resourced to meet their needs”. It is emphasised that provision is to be made for all staff categories – not merely those in clinical areas.

2.5 HDL (2000) 01: Learning resources and the knowledge base of healthcare confirms that access to the knowledge base is essential, stating explicitly the need for national policy for

NHS Scotland Library Services. Furthermore, it calls for all Trusts and Boards to create local plans for library service development, reflecting the priorities established in national policy, and with clear links to strategies for Clinical Effectiveness, Information Technology and

Research and Development.

2.6 Other relevant policy documents which influence development of Library and Knowledge

Service strategy are:

 “Working for health: the workforce development action plan”.

This sets out a national, regional and local framework to enable a more strategic approach to workforce planning and development. It is particularly concerned with crossdisciplinary, cross-boundary approaches to working and learning in NHS Scotland.



The Joint Futures programme, fostering partnerships with the local authority sector in delivery of health services and shared learning.



Patient Focus and Public Involvement , which calls for greater empowerment of patients, carers and the general public through improved access to information about their own health and health care.



5



The Acute Services Review, which seeks to remove geographical and sectoral inequities in the way patient care is delivered, recommending a cross-boundary, crossdisciplinary model for delivery of acute services, in the form of Managed Clinical

Networks.



Towards a Healthier Scotland and Improving Health in Scotland: the Challenge, providing the strategic framework to support the processes required to deliver a more rapid rate of health improvement in Scotland.

2.7 The new white paper Partnership in Care further develops a number of themes which we aim to reflect in strategy for management of the knowledge base of health care by NHS

Library and Knowledge Services – namely:

 a greater emphasis on partnership between the NHS and Local Authority Services in delivery of care

 the NHS as a learning organisation

 the importance of patient involvement in decision-making

 an e-health programme, optimising the potential of health informatics to support delivery of care

 an integrated approach to service planning at local and national levels across NHS

Scotland

2.8 The development of the Knowledge Services Group within NHS Education for Scotland, and the creation of the post of Library Service Development Coordinator are direct responses at national level to these requirements. The Coordinator’s role is to guide development of a national framework for service provision, at the same time supporting efforts in each Board area to build from what is currently available towards an integrated service framework.

2.9 The ongoing expansion and development of the NHS Scotland e-Library is a symbol of this commitment to unified, equitable access to the knowledge base, making available to all staff a total of approximately 20 databases, 200 e-books, 4000 e-journals and a range of additional free health information websites covering the broad spectrum of health information, with further expansion planned for 2003.

2.10 The challenge for Trusts and Boards is to develop the local library and information practitioner workforce, together with local service management mechanisms - namely, access, training, outreach, and evaluation - to ensure that these valuable resources are effectively used to realise their full potential in supporting direct delivery of patient care.



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3. Definition: Library and Knowledge Services

3.1 The term “Library and Knowledge Services” is used throughout this document to represent the following dimensions of service management. Service delivery will generally involve partnership working by “traditional “ library services with Information Technology,

Research and Development, Medicines Information, Training and Education and other departments.

3.1.1 Services, skills and resources to support work, lifelong learning and professional development and research among the wider NHS workforce.

3.1.2 Retrieval and appraisal of evidence to support decision-making in clinical, managerial and social aspects of health management.

3.1.3 Retrieval, appraisal and dissemination of evidence to support setting of policy and formulation of guidelines for improvement of management and practice in delivery of care.

3.1.4 Support for health information needs of patients and the general public.

3.1.5 Keeping the health workforce up to date with developments in research, clinical evidence and policy changes.

3.1.6 Management of internal, organisational knowledge.

3.1.7 Facilitate the translation of evidence into practice.

3.2 Key mechanisms by which information and learning services are delivered to support these areas of work include:

3.2.1 A professionally led team of information practitioners with appropriate skill mix.

3.2.2

The physical library, including organised print resources, study and reading areas, and dedicated workstations for access to electronic information and learning resources.

3.2.3

Outreach services, including information support teams serving primary care and remote and rural areas, and likewise “clinical librarians” working closely with multidisciplinary teams in clinical settings.

3.2.4

Management, organisation and delivery to the desktop of electronic information and e-learning resources - via Intranet and Internet.

3.2.5

Delivery of information skills training programmes for the healthcare workforce.

This will range from basic I.T. skills to advanced information retrieval and evaluation skills.

3.2.6

Alerting services, e.g., current awareness bulletins, Selective Dissemination of

Information, print and electronic newsletters, contents page services.

3.2.7

Dissemination of evidence-based guidelines and policies.

3.2.8

Integration of evidence sources and “prompting” mechanisms underpinning care pathways, guidelines, protocols and standards.

3.2.9

Provision of patient information in partnership with clinicians, via validated leaflets and websites and, in some cases, direct access to NHS information and learning services.



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4. Aim, Vision and Values

- for NHS Scotland Library and Knowledge Services are as follows:

4.1 Aim

To contribute to the highest quality of health care in NHS Scotland by providing Library and

Knowledge Services to support all stages of the patient journey, including improvement of the health of the population.

4.2 Vision

The vision is of NHS Scotland Library and Knowledge Services transformed in the light of new technology, operating as a network of proactive, skilled information practitioners and managers, empowered to deliver centrally funded resources to point of need on an equitable, integrated, nationwide basis.

4.3 Values

The following values for NHS Library and Knowledge Services are shared with those of NHS

Education as a whole. The basic criterion must be that all activities of NHS Library and

Knowledge Services should contribute to improving health and patient care in Scotland.

NHS Library and Knowledge Services should:



Have credibility, authority, efficiency and effectiveness



Be accountable to patients and to stakeholders



Be wholly committed to equitable access to the knowledge base for all



Demonstrate professionalism, cross-sectoral working, continuous evaluation and improvement.



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5. The patient journey as the framework for NHS Scotland Library and Knowledge

Services

5.1 The basic aim of strategic planning and service redesign for NHS Scotland Library and

Knowledge Services is provision of information and learning support throughout all stages of the patient journey. By adopting this model as the unifying concept for service planning we aim to:



Ensure a consistent focus on patient need throughout the service development process



Foster a new way of looking at NHS Library and Knowledge Services, ready to embrace change positively, and unconstrained by traditional models of service delivery.

5.2

Reducing the patient journey model to its essentials, for the purpose of providing a high level overview of information and learning support needs, we have focused on five broadly defined stages within the patient journey:



Encounter with the NHS, via emergency services or primary care



The acute hospital stay



Discharge, follow-up and rehabilitation



Palliative care



The idea of health improvement, promoting well-being of the individual and the population is regarded as a fifth element in the picture, underpinning all stages of the patient journey.

5.3 Our objective for NHS Library Service development is to identify and respond at each stage of the patient journey to the information and learning needs of: a.) The wider NHS workforce; b.) Patients, carers and the general public. Figure 1 shows examples of key issues relevant to service planning arising from the patient journey model.

5.4 The following principles, which should govern NHS Library Service development throughout the timescale of this strategy, all arise directly from the patient journey model.



Equity of access to the knowledge base of health care and equity of accompanying support, independent of geography, sector, discipline, staff category



A unified, Scotland-wide approach to service provision



Access to support for information and learning at all times and at point of need , including the acute and community sectors, clinical and non-clinical settings.



Support for personal and professional development and lifelong learning to empower the wider NHS workforce to play their role in service delivery to optimal effect and to



9

empower patients, carers and the general public to play a role in making decisions about their own health and healthcare.



Recognition at NHS senior management level of the essential need to access and utilise the knowledge base as an integral part of the work of all staff who contribute to the work of the NHS.



Proactive outreach to community settings, peripatetic staff and remote and

rural areas



Recognition of the social as well as the medical model of care, and the redefining of the NHS as a public health organisation. Information support for the social, economic and environmental aspects of health care should receive attention equal at least to that given to treatment and diagnosis of disease.



Partnership working within the NHS to deliver information and learning support seamlessly across the boundaries between public health, health promotion, primary and secondary care. Contribution by NHS Library and Knowledge Services to other working agendas such as Health Informatics, Training, Education and Organizational

Development, Medicines Information, Research and Development, Clinical Governance,

Patient Focus and Public Involvement, and others.



Partnership working with Library and Knowledge Services from other sectors to achieve maximum synergy from complementary strengths.



Responsiveness to information and learning needs of the entire health care workforce , including the many sectors that partner with the NHS in delivery of care –

Local Authorities, Higher Education, Voluntary Sector, Royal Colleges and others.



Recognition by NHS Boards of their responsibility for direct provision and performance management of Library and Knowledge Services.



A multi-layered approach to service delivery, operating across geographical boundaries to ensure equity of service provision at local, regional and national levels.



Resourcing of NHS Library Information and Knowledge Services on a transparent business planning basis , reflecting the cross-sectoral and cross-geographical nature of service provision.



The patient journey model imposes an inescapable obligation on NHS Library and

Knowledge Services to delineate their role in support for patient and public health information within the wider spectrum of patient and public health information services provided by organisations within and outside the NHS.

5.5 The following strategic objectives constitute a national framework for development of

NHS Library and Knowledge Services. The unified, equitable approach to service delivery should be implemented through integrated service development plans, seeking “unity in diversity” by interpreting and realising national priorities in the local context. The Library



10

Coordinator and Knowledge Services Group will work closely with librarians and managers at Trust and Board level to ensure alignment of overall strategy with local need.



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6. Key result areas

Based on the patient journey model and the associated principles of service development, specific objectives have been defined as follows:

6.1 Analysis of user needs

A basic requirement to ensure an NHS Library and Knowledge Service fit for purpose is, first and foremost, a reliable definition of user needs. An analysis of information and learning requirements of the full range of NHS staff will be conducted during the latter half of 2003.

This analysis will form the basis of detailed service planning at all levels for the future.

6.2 Definition of service provision to the wider health care workforce

Closely allied to the analysis of NHS workforce needs is the requirement to define terms and conditions of service provision to the wider health care workforce. This broader workforce includes, for example, the Voluntary Sector, Higher Education, Local Authorities, Royal

Colleges and others. A basic definition of core service entitlements will be established at national level, with local variations to be agreed according to circumstances. As far as access to e-Library resources is concerned, the issue of entitlement will in part be resolved through terms and conditions established through negotiations with suppliers conducted as part of the tendering process for e-Library content from 2004 onwards. Suppliers will be specifically encouraged to propose creative solutions to facilitate cross-sectoral access.

6.3 Partnership framework

The partnership framework for NHS Library and Knowledge Services will encompass internal partnerships within the NHS as well as effective coordination with other sectors.

6.3.1 Multi-sectoral partnerships

6.3.1.1 The assessment of NHS user needs and the definition of services to the wider health care workforce will form the basis of a “whole systems” model of library and knowledge service provision to the NHS and the wider health care workforce. At the heart of this model is the need for NHS management at national and board level to assume primary responsibility for delivery of Library and Knowledge Services to NHS staff. This core provision needs of course to operate within the context of the complementary strengths unique to other health information sectors .

6.3.1.2 The NHS Scotland Library Service Development Coordinator will work with the

Scottish Library and Information Council in its multi-sectoral capacity to establish a forum for furthering cross-sectoral objectives and to develop partnership projects of mutual benefit.

6.3.1.3 In collaboration with Voluntary Health Scotland and with the support of the Scottish

Library and Information Council, we will aim to carry out a project to define a model for interaction and mutual support at the voluntary sector / NHS health information interface

6.3.1.4 We will seek to carry out pilot projects, again under the auspices of the Scottish

Library and Information Council, to explore use of public libraries, public library mobile



12

learning units and community centres as outlets for access to health information and health information skills training, both for health care staff and for the general public.

6.3.2 Local, regional and national service management systems.

To achieve alignment with workforce development strategy, plans for NHS Library and

Knowledge Services will need to reflect the three-level national, regional and local framework for workforce planning and development outlined in

“Working for health: the workforce development action plan”.

6.3.2.1 Local service planning

Within each NHS Board, coordination of Library and Knowledge services should aim to establish a seamless service operating across Primary and Secondary Care Trusts, Public

Health and Health Promotion boundaries Beyond this, there is a need to define specific areas for collaboration with other NHS partners in delivery of information and learning services – for example, Health Informatics, Training and Organisational Development, Research and

Development, Clinical Governance, Medicines Information and other clinical and non-clinical services committed to supporting information and learning for the wider NHS workforce.

6.3.2.2 National service planning

Three main lines of management operate at national level:

NHS Education

At national level, the NHS Scotland Library Service Coordinator role and the Knowledge

Services Group within NHS Education for Scotland have a remit for the following areas of work:



National strategy and service development



Supporting service development at local and regional level



Quality assurance and benchmarking



Centralised purchasing of information and learning resources, and provision of central support



Staff development and training for the NHS Library and Knowledge Service workforce



Advising on job definition and grading

Scottish Library and Information Council (SLIC) and Chartered Institute of Library and Information Professionals for Scotland (CILIPS)

The Knowledge Services Group and Library Coordinator will work closely with the Scottish

Library and Information Council and the Chartered Institute of Library and Information

Professionals in Scotland in the following areas:



Cross-sectoral working within the broader library and information sphere



Continuing professional development for the Library and Knowledge Service workforce



Development and implementation of quality standards



13

At national level, the Knowledge Services Group and Library Coordinator will also seek to define and promote strategic alliances between Library and Knowledge Services and key partners within the NHS:



With Health Informatics / Information Technology, stressing the need for improved connectivity and computer availability and integration of the knowledge base with electronic patient record developments if access to information as core support for day to day service delivery is to become practical reality.



With Research and Development, emphasising the importance of information access, information analysis and evaluation skills as an integral part of the research process.



With the Modernisation Agenda, highlighting the role of access to the knowledge base via information and learning services, including the e-Library and related e-Learning developments, as the primary foundation for development of a learning culture in the

NHS and for planned, effective development based on evidence and a workforce empowered to access information and learning to support ongoing service development.



With Medicines Information, exploring synergies with Library and Knowledge Services strategy to support the MI-led development of expert, clinical support for delivery of information about medicines to health care staff and patients. Areas of common interest include: information skills training for NHS staff, operation as specialist information networks and development of proactive specialist information services.



With Clinical Governance, based on the need to base managerial and clinical decision making on best evidence and best practice.

Special NHS Boards

Library and Knowledge Services for special NHS Boards have a national remit for specific areas of work within the NHS – for example, public health, health promotion, health care management, management information and statistics. The challenge is to ensure effective interfacing of these specialised remits with the new local, regional and national service frameworks so that duplication is minimised and best use is made of all available services and resources. We will work with librarians and senior managers in the Special NHS Boards in the second half of 2003 to develop integrated strategies which will define and develop their national roles in management of the knowledge base for NHS Scotland.

6.3.3 Regional service planning

6.3.3.1 In addition to the established local and national service planning frameworks, the

Health care workforce action plan responds to the vision of a new mechanism of delivery of care through the operation of extended multidisciplinary teams or networks. These proposals for workforce development mirror the service redesign process presaged by the Acute

Services Review in its recommendation for development of Managed Clinical Networks operating across geographical, sectoral and disciplinary boundaries. The Workforce action plan acknowledges the crucial importance of effective planning of education and training in close parallel with workforce management and service delivery needs to ensure that skilled



14

and educated staff are always available at point of patient need, in all geographic locations and at all times.

6.3.3.2 NHS Library and Knowledge Services need to respond to these service imperatives, by defining mechanisms of information and learning support which transcend geographic boundaries and correspond to these new frameworks for workforce planning and service delivery.

6.3.3.3 Definition of operational management, staff management, and service planning arrangements for these multiple management layers for NHS Library and Knowledge

Services is a significant challenge, to be met by closely aligning management approaches for

Library and Knowledge Services with the wider emerging systems for workforce planning, education and service delivery. A grant funded project “Managed Knowledge Networks for

Cancer, Coronary Heart Disease and Mental Health in the West of Scotland”

will conduct exploratory research with the aim of recommending and ratifying new operational and business models appropriate for this new system of service delivery. As with the developing strategy for NHS Education as a whole, the potential for joint NHS Education / NHS Board appointments to lead development of the new service model should be explored.

6.3.4 Information specialist networks

A key component of the new definition of Library and Knowledge Services on a regional basis will be the development of regional networks of information specialists with responsibility for expert information retrieval in selected health priority areas – for example, coronary heart disease, cancer, mental health. “Clinical Librarian” roles, working closely with multidisciplinary healthcare teams, will be key components of these networks. The aim of these networks is equity of information support across the entire geographic area. The

“Managed Knowledge Networks” project currently ongoing within the Knowledge Services

Group, exploring operational and business models to underpin multi-sectoral information support across the entire patient journey for cancer, coronary heart disease and mental health, should provide the evidence on which to base this area of development.

6.4 Patient and public health information support

At present, different library services within the NHS provide varying levels of support to patients, carers and the general public. During the period of this strategy, all NHS Library and

Knowledge Services will be recommended to identify at least one objective related to patient and public information appropriate to local circumstances as part of their local service development plans. A scoping study will be carried out to define the potential range of roles for NHS Library Services within the broader spectrum of patient and public health information services provided by NHS 24, HEBS, the Voluntary Sector, the Patients

Association, public libraries and others. We will aim to work in collaboration with other partners in order to minimise duplication and draw most effectively upon the specific strengths of each partner.

6.5 Central purchasing, archiving and document delivery

A tender exercise for central purchasing by NHS Education of print and electronic information resources for NHS Scotland Library and Knowledge Services will be conducted during 2003, with a view to making resources available to NHS Scotland from 2004 onwards.



15

This project will have major implications for local budget planning, the object being to release funds for local service development and support. It will also necessitate reviews of document delivery (interlibrary lending) and archiving and storage of print journal resources for NHS Scotland.

6.6 Information and learning support in the community

The patient journey model highlights the significant deficit in information and learning support in the community. NHS Library and Knowledge Services still operate largely within the framework provided by the physical libraries located within large teaching hospitals and district general hospitals. As the delivery of health services focuses increasingly on the role of primary care and the Local Health Care Cooperatives, NHS Library and Knowledge Services need to respond appropriately with new models of information support. Equally there is a need to consider the information needs of Local Authority and Voluntary Sector staff working in partnership with the NHS; as well as the wide ranging needs of patients, carers and the general public.

During 2003 –2006 we will:



Develop and implement local and national programmes for outreach information support and training for primary care staff, particularly primary care contractors



Support health information skills training for Local Authority and Voluntary Sector staff working in partnership with the NHS in the community.



Explore the potential for remote access technologies, including PDA s, notebooks, and wireless to support access to information and learning resources at point of need in the community



Actively encourage cross-sectoral purchasing and licensing arrangements to enable

Local Authority and Voluntary Sector staff to access a shared knowledge base in concert with NHS staff in the community.



Via the tendering process, increase e-Library content relevance for primary care users

.

6.7 Support for remote and rural areas

We will work in partnership with RARARI to explore and assess methods for delivery of information and learning support to remote and rural areas. Areas for investigation will include: remote access technologies, e-learning; peripatetic information practitioners. The objective will be to make practical recommendations for support at local and national level.

6.8 Management of internal and tacit knowledge

There is an increasing recognition of the need for the NHS to maximise utilisation of the

“tacit” knowledge generated by the learning experiences of the organisation and the

“internal” knowledge in the form of local guidelines, care pathways, standards, etc. We need to analyse how the librarian’s professional information skills can be applied most to support



16

effective organisation and retrieval of these new categories of knowledge in the modern healthcare context, and to plan for future knowledge management systems accordingly.

6.8 e-Library development

6.8.1 Development of the NHS Scotland e-Library will continue to pursue the essential aims of overall NHS Library Service strategy. The e-Library has the potential to realise in practice the ideals of equitable access to the knowledge base, service unity, cross-sectoral partnership and delivery of evidence to point of need. Key areas for development over the next two years will include:



Analysis of user needs.

This exercise will be conducted as part of the broader user needs analysis for NHS Library and Knowledge Services as a whole.



Evaluation of the e-Library pilot as a basis for planning future development



Development of other methods of sharing information via the e-Library:

 automated document requesting

 administration of print and electronic journals belonging to individual NHS

Boards and Trusts in an integrated manner as part of the whole e-Library

 supporting development of “local portals” focusing on local and internal organisational knowledge and interfacing with the national e-Library



Development of the e-Library as a platform for e-Learning.



Definition of appropriate metadata standards for the information architecture of the e-

Library



Definition of the interfaces and potential for synergy between the NHS Scotland e-

Library and other major health information and learning portals within Scotland and beyond – for example, SHOW, HEBS, NeLH. This to include definition of the future role of the e-Library in supporting patient and public health information.



Definition of indexing standards to meet the needs of the full range of e-Library users



Exploration of potential lines of development and definition of a practical line of approach for integration of e-Library resources with the electronic patient record



Exploration of the potential for developing a unified online books catalogue for NHS

Scotland Library Services



Investigation of the potential to apply search engines operating across multiple resources from different suppliers

 Development of “Editorial Networks” tasked with development of subject portals relevant to the information needs of the full range of users at all stages of the patient journey



17



Optimisation of authentication processes, the ideal being to provide access to all resources for eligible staff without the requirement for usernames and passwords



Completion of a tender exercise for e-Library content, encouraging innovative and creative approaches to multi-sectoral access.

 “Personalisation” of the e-Library interface to reflect the needs of specific staff groups, individuals and patient or professional perspective

6.8.2 e-Library training, outreach and promotion



Local programmes of training for e-Library resources will be implemented, supported by the NHS Scotland e-Library team. Guidance will be provided from national level on key objectives and target groups for these programmes, in accordance with the core principle of equitable access for all.



We will seek to identify central funding mechanisms to support local e-Library training and outreach on a temporary “pump-priming” basis on condition of matching local investment in future years.



Development of e-learning provision via the e-Library will impact upon services in a number of ways – firstly, by improving availability of information skills training via this learning route; secondly by developing the role of the librarian in promoting this new, more interactive category of learning resource; thirdly, in attracting new user groups whose needs are not met by the more traditional learning formats.

7. Development of the Information Practitioner workforce

7.1 New roles and responsibilities need to be defined for the NHS Library and Knowledge

Service workforce in order to deliver this strategy. A family of job descriptions for this new workforce will be developed and evaluated in accordance with

“Agenda for Change”

criteria.

New roles are likely to include:



Managerial posts concerned with coordination of NHS Library and Knowledge

Services at Board and Regional level



Clinical Librarian posts, working in close partnership with multidisciplinary teams



Information scientist roles with an emphasis on expert information retrieval and analysis, working as networks of information specialists.



Training and marketing roles

7.2 A formal analysis will be conducted to assess training, development and skill mix needs to enable the NHS Library and Knowledge Service workforce to implement this strategy and fulfil these new roles. An appropriate training and development programme will be devised accordingly.

7.3 Development of career pathways for the NHS Library and Knowledge Service workforce, and collaboration with Higher Education and the Chartered Institute of Information and



18

Library Professionals to develop the necessary skills and competencies within the accredited

Library and Information Science graduate curriculum.

7.4 Recruitment strategies will need to be devised in order to establish a workforce with the full range of competencies required to deliver the new system. There will be a need to develop innovative approaches to establishing the necessary skill mix, perhaps looking beyond the

NHS sector and outside the traditional library and information recruitment pools.

8. Funding

8.1 There is a vital need to develop sound business planning processes to ensure sustained service development at local, regional and national level.

8.2 At national level, it is essential to define a recurring budget for resources and staffing required centrally to support the new system. The scope of centralised purchasing of print and electronic information and learning resources needs to be clarified and costed. This national planning process must be carried out in conjunction with local budget planning. The guiding principle should be recognition of the local management and support required to ensure effective utilization of centrally funded information resources at ground level to improve patient care.

8.3 We will be seeking to ensure the creation at local level of an agreed recurrent budget for all elements within the definition of Library, Information and Knowledge Services, allocated on an equitable, transparent basis across services. This budget to be derived from the business planning process aligned with local and national strategy.

8.4 At present, recurrent funding for staff and non-staff resource derives mainly from direct

Trust and Board funding streams, in some instances with input from Postgraduate Medical

Education monies. Funding for NHS Library Services is frequently managed via Service

Level Agreements with one or more local universities, and will require re-basing where a historical rather than a business planning basis has been the rule. Generic, “model” Service

Level Agreements will be established, to ensure that provision of services across organisational boundaries is conducted on a basis of clear definition of need and concomitant service costs, with transparent financial processes and effective monitoring systems in place to achieve value for money. Recurring funding under the new system should clearly reflect the overall strategic requirement for service development. It should be on an equitable basis to meet the needs of all user groups within each NHS Board, including primary care contractors and social care, and should incorporate the potential for investment by partners to support the envisioned cross-sectoral service. A transparent audit trail should be in place to ensure that money invested by the NHS is dedicated and used to best effect in meeting NHS needs.

8.5 There is, overall, a lack of clarity at present in relation to investment by different NHS

Boards in Library and Knowledge Services, leading to a sense of insecurity and some absence of confidence over forward planning by service managers. There is considerable discrepancy in levels of expenditure per capita on NHS Library, Knowledge Services by different Trusts and Boards. There is further divergence in service activity and range of users obtained for the same unit expenditure across the whole system. A monitoring process will be implemented to help to benchmark expenditure and corresponding activity levels across Trusts and Boards.



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The aim is to fix a realistic, secure standard cost per capita for a defined set of core services, as a basis for equitable access to the knowledge base across the NHS Scotland system.

8.6 A project will be commissioned to review existing funding models in the light of service requirements, and to recommend a funding model for NHS Library and Knowledge Services for the next three years. Due notice will be taken of funding models employed elsewhere in the UK to support NHS Library and Knowledge Service development, including the national levy for NHS Library Services managed by Workforce Development Confederations in

England

9. Making a Difference: Milestones for Service Development

This strategy provides a framework and a number of specific proposals which will help to meet the commitment to a modern, responsive Library and Knowledge Service fit for purpose in supporting the work of the NHS.

Chapter 4 defines the aim, vision and values for Library and Knowledge Services for NHS

Scotland. Chapter 6 identifies the key result areas for 2003-2006. This section summarises key milestones for service development .

9.1 Strategic planning

By December 2003:

All geographic NHS Boards to have defined their strategic objectives for the following three years, ready for incorporation into Local Health Plans. Special NHS Boards to have embarked upon consultation process for their individual strategies

By April 2004:

All geographic NHS Boards to have draft strategies in place. Special NHS Boards to have defined strategic objectives, target date for completion of draft strategies June 2004.

By February 2005:

Define a strategy for the role of NHS Library and Knowledge Services in management of internal and tacit organisational knowledge.

By February 2005:

Define a strategy for the role of NHS Library and Knowledge Services in provision of patient and public health information.

9.2 NHS Scotland e-Library development

By July 2003:

Achieve compliance with disabled access standards



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By November 2003:

Complete user needs analysis

By December 2003:

Complete re-design of information architecture, including application of metadata and indexing standards.

By January 2004:

Launch cancer, coronary heart disease and mental health subject portals

By March 2004:

Establish online communities (editorial networks)

Make recommendations for unified online books catalogue

By April 2004:

Make recommendations on implementation of local portals

Complete first phase of interlibrary loans and e-journals implementation.

By June 2004:

Complete pilot of e-Library integration with Electronic Patient Record components (within

Managed Knowledge Networks project)

9.3 Information Skills Training

By August 2003:

Appointment of Information Skills Training Manager, NHS Scotland e-Library

9.4 e-Learning

By April 2004:

Complete e-Learning scoping study and option appraisal for Virtual Learning Environment provision

By January 2005:

Complete pilot of e-Learning provision within e-Library platform

By March 2005:

Launch of e-Learning platform within e-Library



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9.5 Development of Library and Knowledge Service workforce

By August 2003:

Appointment of Staff Development Manager

By September 2003:

Definition of generic job family of roles and responsibilities based on requirements of strategy

By March 2004:

Completion of Training Needs Analysis

By June 2004:

Evaluation and grading of generic job descriptions in accordance with Agenda for Change criteria.

9.6 Service Frameworks and Standards

By November 2003:

Complete user needs analysis

By January 2004:

Define in-depth service development plan based on user needs analysis

By April 2004:

Define financial models for service provision, including model Service Level Agreements

By April 2004:

Complete review of archiving and document delivery

Standards and Quality Assurance

By December 2003:

Implement systems for collation of statistics

By January 2004:

Appointment(s) to support local service development plans and definition of service standards.



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By February 2005:

Complete piloting of service standards

By April 2005:

Launch service standards

Managed Knowledge Networks

By February 2004

Presentation of mapping study and models for information support for cancer, coronary heart disease and mental health within Managed Knowledge Networks project

By October 2004:

Define preferred model, operational and business plan for Managed Knowledge

Networks

By January 2005:

Complete pilot of information specialist network in selected region and discipline

9.7 Partnership Framework

By April 2004:

Complete study of health information sharing at NHS/voluntary sector interface

By August 2005:

Complete pilot of multi-sectoral e-Library access; make recommendations for wider context

10. Monitoring and evaluation

10.1 A monitoring template and reporting mechanisms will be set in place to guide development and implementation of local strategies in line with national priorities. Creative approaches to service development, with evidence of planning and measurable progress in key areas will be required.

10.2 At national level, NHS Education will establish processes for collation of activity statistics at service level for benchmarking purposes and to support definition of per capita service costs.



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10.3 NES will also work with the Scottish Library and Information Council and NHS Quality

Improvement Scotland to define and implement quality standards for delivery of library and knowledge services to NHS Scotland, recognising the contribution of information services to delivery of high quality patient care. In order to achieve the fullest possible recognition of this role, we will further aim for incorporation of these standards within the Performance

Assessment Framework for NHS Scotland.

11. Conclusion

To conclude, we appreciate the far-reaching and radical nature of the changes proposed. There is already a strong commitment among NHS Scotland Library and Knowledge Services to rise to the challenge of creating a new service which will keep pace with health care demand and technological innovation. We trust that the necessary financial resources will be forthcoming but are well aware that our main dependence must be on the commitment and steady collaboration of the human element in this period of massive and speedy change. We must never lose sight of our objective, which is to furnish the knowledge base to support the highest level of patient care within society’s power.



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Nature of future strategy for management of the knowledge base of

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2003-2006

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