NATIONAL LIBRARY FOR HEALTH
NHS LIBRARY AND KNOWLEDGE DEVELOPMENT NETWORK
NHS INTERLENDING & DOCUMENT SUPPLY SERVICE
STRATEGIC BUSINESS CASE
NLH/LKDN Document Delivery Project
VERSION CONTROL
Sections were written by Helen Bingham and Ben Toth, with extensive
contribution from Interlending and Document Supply Task Group (Appendix D)
Version 1.0 following consolidation, peer review and consultation.
Version 2.0 following further review by members of the business case team.
Version 3.3 following further review by members of the business case team.
Version 3.4 following further review by members of the business case team.
Version 3.5 following consultation with library community
Version 3.6 following consensus reached at ILSD meeting (21/06/06)
awaiting
comments on specific sections by various people and re-pagination
Version 3.6.1 incorporating comments from Steve Glover and Colin Davies
awaiting comments on specific sections by various people and re-pagination
Version 3.6.2 incorporating comments from members of the business case
team awaiting comments on specific sections by various people
Version 3.6.3 following ILDS meeting (22/09/06)
Version 3.6.4 incorporating critical success factors v3 and the amended case
study
Version 3.6.5 incorporating revised definitions of options following workshop
consultation with library community
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6TH MAY
2005
13TH
JANUARY
2006
6TH
FEBRUARY
2006
30TH
MARCH
2006
JULY 2006
31ST JULY
2006
23RD
AUGUST
2006
11TH
SEPTEMBER
2006
4TH
OCTOBER
2006
18TH
OCTOBER
2006
26 JANUARY
2007
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CONTENTS
SUMMARY........................................................................................................................................................................ 5
STRATEGIC CASE ........................................................................................................................................................... 6
INTRODUCTION .............................................................................................................................................................. 6
1.
2.
CONTEXT .............................................................................................................................................................. 6
VISION, AIMS AND OBJECTIVES.............................................................................................................................. 7
THE CURRENT SITUATION IN THE NHS .................................................................................................................... 7
3.
4.
5.
6.
7.
8.
9.
10.
PROCESSES ............................................................................................................................................................ 7
COSTS ................................................................................................................................................................... 8
LOCATION AND DISTRIBUTION OF NHS-OWNED RESOURCES................................................................................. 8
REGIONAL RESOURCE-SHARING NETWORKS IN THE UK ........................................................................................ 9
NATIONAL DOCUMENT DELIVERY CO-OPERATIVES ............................................................................................. 10
COMMERCIAL OR MEMBERSHIP OR FEE-BASED DOCUMENT DELIVERY SUPPLIERS ............................................... 11
PILOTS WITHIN THE NHS .................................................................................................................................... 11
LIBRARIES IN OTHER SECTORS ....................................................................................................................... 12
DRIVERS FOR CHANGE ............................................................................................................................................... 12
11.
12.
13.
14.
15.
16.
17.
18.
19.
CLINICAL GOVERNANCE ................................................................................................................................. 12
EFFICIENCY .................................................................................................................................................... 13
MOBILISATION AND STEWARDSHIP OF NHS KNOWLEDGE RESOURCES ........................................................... 13
A CHANGING WORKFORCE .............................................................................................................................. 13
USER NEEDS AND EXPECTATIONS ................................................................................................................... 14
ADVANCES IN DOCUMENT DELIVERY SERVICE DESIGN ................................................................................... 14
TECHNOLOGICAL ADVANCEMENT IN RELATION TO DOCUMENT DELIVERY ..................................................... 14
TRENDS IN PUBLISHING .................................................................................................................................. 15
DIGITAL ARCHIVING ....................................................................................................................................... 16
THE INTERNATIONAL PERSPECTIVE: SELECTED SCHEMES IN OPERATION IN OTHER COUNTRIES ...... 16
20.
21.
22.
23.
USA AND CANADA ........................................................................................................................................ 16
THE NETHERLANDS (HOLLAND)..................................................................................................................... 17
ICELAND ......................................................................................................................................................... 17
AUSTRALIA .................................................................................................................................................... 17
DEFINITIONS AND SCOPE; CONSTRAINTS AND DEPENDENCIES ..................................................................... 18
24.
25.
26.
SERVICE ......................................................................................................................................................... 18
TECHNOLOGY ................................................................................................................................................. 18
CRITICAL SUCCESS FACTORS .......................................................................................................................... 18
BENEFITS AND RISKS (HIGH LEVEL) ....................................................................................................................... 20
27.
28.
BENEFITS ........................................................................................................................................................ 20
RISKS ............................................................................................................................................................. 21
ECONOMIC CASE .......................................................................................................................................................... 22
29.
30.
31.
32.
33.
INTRODUCTION ............................................................................................................................................... 22
INVESTMENT GOALS....................................................................................................................................... 22
SOME KEY CONSIDERATIONS .......................................................................................................................... 23
OPTIONS FOR DELIVERY ................................................................................................................................. 23
OPTIONS APPRAISAL ....................................................................................................................................... 25
COMMERCIAL, FINANCIAL AND PROJECT MANAGEMENT CASES ................................................................. 26
34.
35.
36.
COMMERCIAL CASE........................................................................................................................................ 26
FINANCIAL CASE ............................................................................................................................................ 27
PROJECT MANAGEMENT CASE ....................................................................................................................... 28
BIBLIOGRAPHY............................................................................................................................................................. 29
APPENDIX A - SELECTED INITIATIVES IN DOCUMENT DELIVERY DESIGN .................................................. 31
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APPENDIX B - SELECTED ADVANCES IN DOCUMENT DELIVERY TECHNOLOGY ....................................... 34
APPENDIX C - MODELLING THE FULL COST OF DOCUMENT SUPPLY ............................................................ 36
APPENDIX D - INTERLENDING AND DOCUMENT SUPPLY TASK GROUP ....................................................... 40
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Summary
“The large volumes of references retrieved through the various electronic sources, library
financial constraints and stock limitations has increased the need for efficient document
delivery services”
Price, SP., Morris, A., Davies, JE An overview of electronic document request and delivery
research. The Electronic Library 1996 14(5) 435-438
This is the strategic case for an interlending and/or document supply service (ILDS) for the
NHS. It sets out in principle why the NHS should invest in ILDS services for the NHS and
the high level options for the services.
ILDS is a process/service by which NHS staff obtain the full copies (in digital or paper
format) of references found in databases, catalogues, bibliographies, reading lists and
related. The NHS has existing arrangements for ILDS, but there is an opportunity to align
these services with the changing needs of the NHS and improve the efficiency and equity
of service delivery. (strategic case)
The specific investment goals are: supporting clinical governance; patient choice;
improving equity for NHS staff and saving their time; saving NHS library staff time;
improving value for money for NHS library services. (economic case)
There are several options for ILDS. (economic case paragraph)
There is unanimous agreement among the business case team that valuable staff time
freed up as a result of streamlined document delivery could be put to better local uses.
(commercial and financial cases)
A group of NHS librarians is developing the case for the National Library for Health and
National Knowledge Service. (project management case)
Case study: a typical scenario
A nurse does a literature search in CINAHL (a database covering nursing and allied health). She finds a
reference to an article which looks useful but it is not available in full-text via either local or national
collections, so she rings her Trust Library to ask them to obtain it for her.
The Trust Library advise her that they require a signed copyright declaration from her before they can
process her request, and ask her to print off a request form from the library website, complete it and post it
to them.
The library assistant who processes inter-library loans first searches her own catalogue, then a regional
list to see if the article is held in a nearby library with which there is a co-operative arrangement. The item
is not available within the region, so she searches the Nursing Union List of Journals and finds that it is
held at a library in Worcester. A request for the item is despatched by email, with the details cut and
pasted from the original requesters email, augmented by delivery address details.
The item arrives as a photocopy three days later and the requester is emailed to notify her. She comes in
the same day to pick up and pay for the item.
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Strategic Case
Introduction
1. Context
1.1. This proposal considers the case for an NHS-wide interlending and document supply
(ILDS) system. Each year, NHS libraries obtain some 500,000 documents (journal
articles, books, reports and other publications) on behalf of NHS staff who require
them for purposes of patient care, education, continuous professional development,
management decision-making and research. These are documents that are not
accessible to them locally (i.e. not held in the local NHS library, and not locally
available in electronic format), so must be sourced from elsewhere.
1.2. Statistics collated by LKDN indicate that in 2003-04, NHS libraries spent £1.2m in the
business of locating, obtaining and delivering documents for staff. This figure
excludes the cost of library staff time, document transmission and operational
overheads. See Appendix C for modelling the full cost of document supply.
1.3. NHS libraries have developed regional and national resource sharing networks to
support this activity. They also use national libraries to fill requests, notably the British
Library and specialist national libraries such as the BMA Library. NHS librarians have
developed methods for locating, requesting, processing and delivering documents,
according to locally-available information and communications technologies and
financial resources. Systems tend to be intensive of library staff time and reliant on
local library staff knowledge.
1.4. ILDS services are highly valued by users of NHS libraries, and typified by high
standards of customer service. They are key to mobilising the wealth of knowledge
resources that exist within the NHS. However, because they have been and continue
to be developed and funded locally and regionally, variations in the standards, costs
and methods of document delivery services exist across the country.
1.5. Document supply is subject to a complex range of sometimes conflicting influences,
from efficiency drives within the NHS to trends in international publishing and
developments in ICT. The increasingly complex electronic environment in which
libraries operate introduces both opportunities and barriers for document access and
sharing. It is time to review whether the current mosaic of systems is the most
equitable and efficient way of connecting NHS staff with the documents that they need
to meet the governance requirements of today’s modern and patient-focussed NHS.
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2.
Vision, aims and objectives
2.1 The vision is a system to enable all NHS staff to easily access the documents that they
need, at the time, in the place, and in the format that they need them, in ways that are
affordable and that deliver value for money to the NHS.
2.2 The system must meet the requirements and reflect the preferences of NHS staff. It
must meet the requirements of organisations and of the NHS as a whole, in terms of
staff, resources, technological and legislative requirements, and strategic fit.
2.3 This case considers possible approaches to this challenge, from the status quo option,
to options that will require significant new investment, for instance in procuring a
national automated document delivery management system, moving to primary
reliance on a commercial provider, or developing electronic document archives.
The current situation in the NHS
3.
Processes
3.1 End users request documents in various ways (e.g. by completing request forms that
they give or post to their local librarian, by phoning or e-mailing their local librarian, by
completing request forms on library websites). Signed copyright declarations are
required for printed copies as the CLA NHS Photocopying Licence has not been
renewed in March 2006. Library staff source and process incoming requests in a
variety of ways, depending on the systems and sources available to them. Documents
that are available locally will be photocopied and posted or faxed, or downloaded and
e-mailed to requestors. Documents that are not available locally will be sourced from
regional networks, higher education, national sources or commercial suppliers, and
requested by post or fax or electronically. Documents are supplied by post or fax or in
electronic format, for forwarding to the end user.
3.2 The traditional role of library and information services in providing ILDS has become
increasingly complex. Library staff must search many different sources, using different
interfaces, and therefore manage user requests in multiple systems. Some NHS
libraries rely on manual, paper-based systems to manage document supply, others use
in-house developed databases, modules of their computerised library management
system, or standalone software packages to streamline the processes involved.
WinCHILL (http://www.winchill.co.uk/) is very popular with a number of NHS libraries.
Designed and marketed by the Kostoris Medical Library, Christie Hospital NHS Trust, it
allows library staff to check the availability of journal titles simultaneously, hence saving
considerable staff time.
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4.
Costs
4.1
It has already been noted that NHS libraries in England currently spend over £1M
p.a. on ILDS, and that this excludes the costs of library staff time, document
transmission and operational overheads. Moreover, the preceding section describes
a situation whereby the majority of documents are obtained via ‘free’ exchange
within reciprocal networks: none of the costs associated with this activity appears in
records of library expenditure. The only expenditure that is recorded is that spent on
obtaining documents from commercial suppliers or other organisations which
charge, and the cost of belonging to selected schemes. To provide some examples,
the British Library currently charges £4.75 plus VAT per photocopy by mail (or
£4.25 plus VAT by Secure Electronic Delivery) and £7.60 per book loan (as of
3/8/2006); the BMA Library charges £2.50 plus VAT per photocopy by mail or email
and £2.50 per book loan (and £70 per library per year for membership) (as of
3/8/2006), Higher Education libraries typically charge 10p-20p per sheet, the fee for
membership of the Nursing Union List of Journals currently stands at £60 per library
per year (as of 3/8/2006).
4.2
The extent to which these costs are passed onto end-users varies across the
country. The majority of NHS libraries charge their users a flat fee of between 50p
and £2 for each item obtained; however a significant number do not charge their
users, or only charge them for items that must be obtained from the British Library.
In addition to enabling partial or full cost recovery for libraries, end-user charging
does tend to make users consider whether what they are requesting is really
important to them. The opposing view is that charges discourage users from
requesting what is important, and disadvantage those users whose local library
does not hold the journals or books that they require.
4.3
Finally in this section, it should be noted that users of electronic databases and
journals are often presented with the option of by-passing libraries to order
documents directly from publishers, but this involves pay-per-view charges of
anything up to £16 per item. Also available are pay per view documents from other
suppliers. For example, British Library Direct charges £15-20 per article. It is
believed that most NHS staff are not prepared to pay this type of amount from their
own pockets for documents required in connection with their work.
5.
Location and distribution of NHS-owned resources
5.1
There has been and continues to be significant investment in printed journal and
book collections within the NHS, funded by the NHS and partner institutions,
including higher education. Local collections are developed in response to the
needs and anticipated needs of local health communities and students on
placement within the NHS. Whilst many are multi-disciplinary, others focus on
specialist subject areas, e.g. mental health. Library stock retention policies are
locally and regionally determined and increasingly influenced by pressure on space
and cost of subscription. Some of these libraries are managed by higher education
(HE) institutions and/or are joint operations serving both HE and the NHS.
5.2
Electronic journals, particularly those available on an open access or NHS wide
basis, erode the distinction between local and remote holdings which has been the
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mainstay of document delivery in the past. The NHS is making significant
investment in electronic resources. The NHS ‘National Core Content’ service
provides NHS family members in England with variable access to some 1200
electronic journals, and a small but growing number of electronic textbooks.
Electronic resources purchased at regional, SHA or local level are supplemented
with the Core Content collection.
5.3
The growth in electronic resources available directly to end-users via their computer
desktops is inevitably making an impact on document delivery services. Recent
years have seen the number of items requested starting to level off or reduce, and
this is directly attributable to improved access to electronic resources. However,
electronic journals are:
o expensive,
o attract VAT,
o access to them, in terms of archive and perpetuity, is subject to control by
publishers,
o licensing and access restrictions have led to libraries serving more than one
NHS organisation and/or a HE organisation being charged 2 or 3 times by a
publisher to provide a formerly available print document in electronic format to
all NHS and HE stakeholders,
o current issues may be embargoed,
o access may be only via IP address,
o publisher licences sometimes mean that electronic resources may not be used
for document supply purposes (i.e. they may not be supplied to users in
organisations not covered by the licence),
o journals published prior to 1995 are often not available electronically,
o sometimes missing diagrams, charts, or graphics,
o too complicated to access for some NHS staff due to interface issues, resulting
in more library staff time required to print out articles and possible copyright
charge implications.
Despite the significant growth in electronic journals, future libraries will undoubtedly
continue to combine electronic and print resources, and it is in this context that any
document delivery system must be developed.
6.
Regional resource-sharing networks in the UK
6.1
Inter-lending schemes cover the following geographic areas: Eastern England (EDEN)
 London (LENDS)
 North East England and Yorkshire (ULSERS)
 North West England (LIHNN)
 South of England (SENDS)
 South West England (SWRLIN)
 South Yorkshire and North Derbyshire (SULOS)
 West Midlands
6.2
No two of these schemes are identical in their operation, but most have the
following characteristics in common:
 they reflect the boundaries of former regional health authorities, and are
administered by the successors to regional library units.
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






the units have their own dedicated staff, responsible for maintaining a web
catalogue of journals and books, as well as assuring the quality of the data
therein. However, some of the projects rely on librarian involvement from
those in other jobs or contracted out support.
a cooperative philosophy, whereby NHS libraries do not charge each other
for document supply.
a mixed membership of NHS, specialist and higher education libraries. It is
common for non-NHS libraries to charge for each transaction, in order to
recover their costs, unless there is a contractual relationship (as below).
a mainstay of several of the schemes outside London is a large university
health sciences collection - normally a medical school e.g. the Walton Library
at Newcastle University. The arrangement is usually a contractual one, and
NHS staff can often go directly to the university and bypass their local NHS
library if they wish (which is discouraged in other scenarios).
some kind of load-balancing mechanism, so that libraries with large in-depth
collections, or highly-specialised ones, are not over-used. Some schemes
recognise ‘last resort’ status for these kinds of library; others have ‘first
resort’ status, whereby a large library absorbs most of the traffic; some allow
certain libraries to only publicise titles unique to that library; some allow
charging per transaction, and many have a series of ‘concentric rings’, where
local SHA libraries are tried first, and then the search is broadened out
according to an agreed protocol. These algorithms are complex for staff to
administer, so software which can automate the process, such as WinCHILL,
is popular.
The NHS library local to the member of staff generally acts as gatekeeper to
the document delivery system. Library customers are discouraged from
dealing directly with the library which holds the item they want, unless it is
one of the large contracted libraries described above. This is achieved by
not publicising web-based union lists, or by placing them behind access
controls.
A stock disposal policy. Most schemes try to maintain back-runs of important
journals somewhere in the system.
7.
National document delivery co-operatives
7.1
There are two national co-operative networks:
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
Nursing Union List of Journals (NULJ,
http://wads.le.ac.uk/li/clinical/nulj_homepage.htm). This is a cooperative
network of NHS, specialist and HE libraries, whose members must carry
a minimum of nursing stock in order to qualify. There is a membership fee
to cover administrative costs, but document supply itself is free. The
website has a union list of holdings.

Psychiatric Libraries Cooperative Scheme (PLCS, http://www.plcs.nhs.uk)
This runs along similar lines, but there is no minimum mental health stock
required in order to join. One large library charges members for
document supply on a transaction basis.
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8.
Commercial or membership or fee-based document delivery suppliers
8.1
The list of commercial or fee-based document delivery suppliers currently runs to
over 60 organisations, mostly US-based (http://www.library.vcu.edu/tml/docsupp/).
Although in theory NHS staff could use any of these systems directly (including the
British Library), in practice, the professional associations, such as the Royal College
of Nursing, the Royal Society of Medicine or the Chartered Society of
Physiotherapists are most frequently used. Document delivery is charged for on a
cost-recovery basis, or gratis if the item is supplied from the institution’s collections.
8.2
The BMA library is unusual in marketing its services both to its personal members,
and to libraries. The Royal College of Surgeons of England library also supplies
directly to libraries. However, the largest and predominant document delivery
supplier by far is the British Library Document Supply Centre (BLSDC)
(http://www.bl.uk/docsupply). As the most expensive option, NHS libraries often
treat it as a last resort, when all other schemes have been exhausted.
8.3
The new A-Z product being provided by the National Core Content has a module
that could be purchase which would allow either:



pay - per - view, or
unmediated requests seamlessly sent to single linked supplier e.g. BL, or
mediated requests sent to 28 key centres to approve before sending on to
suppliers.
Linking this module to a resolver would ensure that requests were only sent once NHS
content had been checked.
9.
Pilots within the NHS
In NHS there are 2 pilot project related to document delivery in the NHS. These pilots will
share common evaluation criteria and reporting mechanisms.
North West
The North West Health Care Libraries Unit has secured funding to pilot the Dialog
automated document requesting software. Dialog is the current supplier of clinical
bibliographic databases to the NHS. Dialog software already enables linkage between
records in its database (i.e. references to journal articles) and the full-text of these articles,
where these have also been purchased through the NHS, so that end users can directly
access the articles that they find whilst searching. This pilot will additionally investigate the
use of Dialog software to allow end users to make point-of-search requests for articles that
are not available electronically, with rules to determine the sources and charges. Apart
from the technology, the pilot offers the opportunity to scope the use of a standard set of
such ‘rules’. As of August 2006, there is plan for a roll out across the North West pending
minor changes with the software.
Trent
Trent SHA has funded one Trust library service to test the effect of allowing end users unmediated access to inter-library loans, using the document delivery service to be
developed by Dialog. This is a large acute Trust, with a relatively high volume of interlibrary loans, all of which are currently mediated by the library service. The intention is that
end users will be able to request inter-library loans purely on the basis of perceived need
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to support their work, with delivery directly to themselves for a trial period of six months.
The effect of this access on the volume of loans requested will then be monitored to see if
the numbers increase markedly, stay roughly the same or decrease. Costs will also be
evaluated. Commencement of the pilot will be dependent on the speed with which the
Dialog document delivery service evolves.
South West
The South West Regional Library and Information Network (SWRLIN), recently piloted
VDX – Virtual Document Exchange (http://www.fdgroup.com/fdi/products/vdx4.html), a
software product from OCLC PICA.
The software is available with a web based interface. It enables the automatic searching
of suppliers’ catalogues and the electronic sending of requests for papers and books not
held locally to a range of predetermined locations, locally, regionally and nationally. The
system provides the library with a management environment that enables both electronic
and printed delivery of information to the library and to the user direct. Requests may be
placed by the user from any web-enabled PC, or ‘mediated’ through the Library.
Unfortunately, the software was not able to meet the needs of the pilot sites and the
product is no longer being trialled in the South West. It is anticipated however that the
lessons learnt in the pilot, currently being evaluated as part of the project, will prove
invaluable in developing the strategic business case.
10.
Libraries in Other Sectors
10.1
HE libraries in the UK rely almost exclusively on the British Library for the supply of
articles that are not available either locally or electronically; some are considering
offering (and paying for) publisher pay-per-view to their users, as some US
academic libraries already do. Whilst there may be no direct parallels between the
needs and preferences of Higher Education (HE) user communities and NHS user
communities, it is worth noting that the number of requests for journal articles that
HE libraries receive from students and academic staff has declined in recent years.
It is likely that this is in large part due to increased investment in electronic journals.
10.2
In terms of the inter-lending of books, the CURL (Consortium of Research
Libraries) Monograph Interlending Study, which was sponsored by the British
Library and conducted in 2003 http://www.curl.ac.uk/projects/Monographfinal.pdf
recommended the adoption and implementation of a 'BLDSC Plus' option that
would involve the British Library forming a consortium with a range of partner
libraries willing to provide monograph inter-lending services to defined service
standards and charges. Follow-up work was provided in the form of the
Monograph Interlending Project (MIP)
http://www.curl.ac.uk/projects/#MonographInterlendingProject. However, the MIP
has now concluded and they have no plans to do further work in this area. Cost
was a major factor in the decision not to pursue this scheme.
Drivers for change
11.
Clinical governance
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11.1
“Clinical governance is a system through which NHS organizations are accountable
for continuously improving the quality of their services and safeguarding high
standards of care by creating an environment in which excellence in clinical care
will flourish” (Scally & Donaldson, 1998). A prerequisite of this high quality care is
the provision of relevant, high quality information, at the time and place that the
clinician needs it since “increasingly, neither clinical decisions nor health policy
alone can any longer be comfortably based on opinion alone” (Scally & Donaldson,
1998). This information must be available to every member of health care staff.
11.2
The procurement of an ILDS system will enable clinicians to receive the information
they need via ‘just-in-time’ processes. An additional advantage of a national system
would be the scope for greater integration between document requesting and
clinical decision-making, through technological linkages with such innovations as
Map of Medicine.
12.
Efficiency
12.1
In its response to the Gershon review of public sector efficiency the Government is
committed to: share and rationalise back office services where possible; make
better use of NHS buying power; and make better use of staff time. 1 The benefits of
an NHS wide document delivery service are firmly aligned to ‘Gershon savings’, by
sharing and rationalising; making better use of NHS buying power; and saving staff
time through the use of modern systems.
13.
Mobilisation and stewardship of NHS knowledge resources
13.1
A related driver is the need to ensure that NHS ‘knowledge’ (published learning
from NHS research and experience, and information resources that the NHS has
purchased) is available and freely accessible to the NHS. A national document
delivery system could help optimise this access, and help inform and rationalise
local retention and archiving policies at a time when demand on physical space for
local library collections is at a premium.
13.2
Developing shared repositories and use of BioMed Central have the potential to
improve access to NHS knowledge resources
14.
A changing workforce
14.1
Library services need to support flexible working and learning within the NHS, and
provide equitable access to information by an increasingly diverse and distributed
workforce. These demands are stretching fixed local library budgets increasingly
thinly. Inequities that already exist because libraries pass on different charges to
their users, are further accentuated because more specialist and non-traditional
library users are less likely to have their needs met through local collections.
14.2
The provision of document delivery services is undeniably intensive of library staff
time, and the opportunity for saving staff time is accompanied by the opportunity for
1
http://www.hm-treasury.gov.uk/media/801/75/sr2004_ch8.pdf
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modernising library staff roles and delivering added-value services through
involvement in areas of growth such as managed learning environments where
library staff have much to offer in the organisation , retrieval and training inherent in
these systems.
.
15.
User needs and expectations
15.1
The growth in ease of web-based searching, coupled in the NHS with a culture that
encourages the seeking of evidence to support clinical practice, means that end
users are increasingly likely to identify resources which are not available locally in
print format. The fact that an increasing number of resources are available
electronically, tends to increase expectations that all should be available
electronically so that they may be accessed immediately at the point of need. End
user demands for self-service, ease of use, speed of response and seamless
service have been identified in the OCLC Environment scan, and in terms of
document delivery this suggests an expectation that searching and requesting are
seamless and can be done without use of a librarian as an intermediary, or, where
there is a mediated service, that documents are received electronically, and users
can be kept up to date with the progress of their request.
15.2
It is however, likely that by no means all NHS staff currently share these
expectations, for reasons of skill, IT access or preference. Much evidence about
user expectations is anecdotal, with little known about the relative importance that
NHS end-users attach to the various factors surrounding document access, such as
speed of delivery, quality of content, or personal service. It is clear, however, that
any future system must be user focused and intuitive to use, at the same time
enabling library staff to mediate on behalf of their clients when required.
15.3
In terms of the types of documents required by NHS users, it is not known whether
the majority of documents requested by the majority of NHS staff are available
within the collective resources of the NHS. Neither do we know how many requests
are for items over 10 years old or know how many documents are not pursued
because they are not available immediately.
16.
Advances in document delivery service design
16.1
Recent document delivery projects have looked at ways of reducing library staff
involvement in document delivery processes. Appendix A summarises the results
of several projects and initiatives. These point to the advantages of unmediated
document ordering, for both end-users and libraries, including ease of ordering and
opportunity for discovery of related items for end users, service reliability, lower unit
costs, higher fill rates and faster turnaround times, and ease of management and
monitoring for library staff. However, bringing together several document delivery
services into an integrated unmediated service that would meet the diverse range of
needs of the NHS user community would be a further challenge, as would
management monitoring in the relatively much more complex NHS environment.
17.
Technological advancement in relation to document delivery
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17.1
There are now several commercial providers of software for peer-to-peer document
delivery transactions, whilst technological advances in web browsing, resolvers and
open linking software have made end-user searching easier, and the improved
technical interoperability between systems has enhanced the scope for combining
searching with document requesting and retrieval. Technology is advancing rapidly.
Appendix B summarises the views of several commentators, and lists some
technical standards that are relevant to document delivery processes.
18.
Trends in publishing
18.1
Many of the main health journals to which NHS staff require access are now
available electronically. However, individual titles are often expensive to purchase.
Recognition of the difficulty this causes has led some publishers and aggregators to
develop offers of many different titles bundled together. These bundled offers
typically include some high value titles but also many titles which are significantly
less useful. Archive access to e-journals can also be problematic. Some publishers
and aggregators do not guarantee to provide archive access beyond the life of a
contract and older material is often not available at all. Where older material has
been digitized and made available there is often a charge applied to legacy
backfiles. Publishers may offer legacy backfiles free or at a cost depending on the
wishes of the learned society on whose behalf the journal is published. Access to
e-journals is also an issue and is often complex, for example relying on IP
authentication, which does not work in the NHS. Moreover, of particular importance
in the context of this business case, is the fact that e-journals often have prohibitive
licensing restrictions, which prevent their use for document supply to nonsubscribing libraries or individuals. These limitations on the usefulness of ejournals, coupled with customer preference and limitations on IT access for some
NHS staff, are the main reason why NHS libraries have, for the most part, continued
to maintain significant holdings of print journals.
18.2
The main challenge to the traditional subscription-based publishing model is
emerging from the open access publishing movement. There are two main
approaches to open access. In one, authors cede copyright to traditional journals
but retain the right to deposit an electronic copy in a digital repository. The other
model is based on an author-pays model in which journal articles accepted for
publication are charged for the right to publish. A growing number of healthcare
journals are now being published in this format and both the NHS and HE have
shown a willingness to support this model. Emerging evidence suggests that open
access articles are cited earlier, more frequently and more accurately than
conventionally published articles, vindicating this approach. In a parallel
development, some universities have also begun to set-up institutional repositories
in which their academic staff can deposit work. In response, some conventional
publishers have begun to develop initiatives of their own which move at least partly
towards open access, for example making archive access more freely available
(e.g. BMJ Publishing Group, which has committed to making the archive of all
material over one year old freely available).
18.3
There are now over 1,260,000 articles indexed in Medline freely available either via
Open Access or delayed access to backfiles (search of Medline August 2006). In
2005/2005 some of the major funding agencies such as the National Institutes for
Health (NIH), the Wellcome Trust, and Research Councils UK have published policy
statements requiring grant holders to publish in Open Access forums where access
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is free or free shortly after publication. Compliance so far has been poor. The
number of freely available articles will continue to grow but a large proportion of
material will remain behind subscription barriers. Article processing fees by which
open access is funded will continue to rise thus hindering a large scale movement
towards open access. Continued inflation in journal subscription costs will lead to
fewer titles being available to users thus maintaining a requirement for document
supply.
18.4
The mixed economy of traditional subscription-based publishing and open-access
publishing is likely to persist for the next few years at least, but with continuing
growth in the number of open access journals, it is vital that NHS users are
encouraged to fully exploit them.
19.
Digital archiving
A related trend is towards archiving journals in electronic format, often known as
digital preservation. The whole run of the British Medical Journal will be freely
available on the Web within the next 3 years for example, and there is every chance
that runs of other important journals and books will be digitised in the near future.
The international perspective: selected schemes in operation in other countries
Inter-lending and document supply schemes operating in other countries may point
to existing models that are compatible with some of our options. There is variation
in organisational structure, document formats involved, pricing, and evaluation
information for each model explored and this is not a comprehensive overview.
More published research would need to be made available to evaluate the
comparative cost-effectiveness of these models. Nevertheless, it is of interest to
decision-makers to be aware of systems used in other countries.
20.
USA and Canada
Medical libraries in the USA and Canada generally use an ILL request and referral
system for journal articles called DOCLINE. Developed by the U.S. National Library
of Medicine, DOCLINE has been web-based since 2000. Participating libraries
agree to post their journal holdings, including volumes and years held, to a
database called SERHOLD and to give their best effort to process ILL requests
from other libraries. Each library sets up a routing table of other libraries from
whom they would like to request articles. The table is arranged such that larger
libraries do not receive all the requests. An electronic funds transfer service (EFTS)
has been set up by the University of Connecticut Health Center for the
administration of fees. A useful feature of this system is that libraries can
temporarily deactivate their participation in the system if they are short-staffed or
are facing other challenging circumstances. DOCLINE accommodates web-based
document delivery and requests for documents found in MEDLINE via PubMed.
PubMed’s Loansome Doc feature allows the public to affiliate with a medical library
for the purpose of requesting medical articles.
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21.
The Netherlands (Holland)
The Netherlands are working towards a decentralized model for nation-wide ILL
services. This program is not specific to medical libraries. University libraries
began using the OCLC (Online Computer Library Center) PICA cataloguing and ILL
system in 2001. The OCLC system (NCC/ILL) takes advantage of the Netherlands
Central Catalogue Interlibrary Loan system that has been in place for approximately
twenty years. The NCC/ILL system involves a shared catalogue which includes
collections of special libraries, public and university libraries, and the national
library. The national system, primarily used for scientific articles does not fully meet
the needs of the scientific community, accounting for 55% of all document deliveries
and 11% of book ILL requests.
The Netherlands Institute for Scientific Information (NISI) has been operating a
document delivery service in collaboration with the German National Library of
Medicine in Cologne. The Technical University Delft also process requests for
scientific articles. The Netherlands proposes to use Z39.50 and OpenURL
technology to build a decentralised, networked ILL system. The ILL routing network
would be centralized administratively, while the catalogue component would remain
decentralized (i.e. institutions would share their catalogues through standardized
technology).
22.
Iceland
In 2001, a group of librarians in Iceland negotiated a collection of 8000 e-journals
that may be accessed by anyone in Iceland. Access is recognised by IP address.
It is difficult to determine the long-term impact of freely available e-journals on ILL
requests as no general decrease in ILL requests appears during the years 20002003 in the statistics kept by the National and University Library of Iceland. Iceland
is looking into Aleph500 (http://www.exlibris-usa.com/aleph.htm) to improve access
to e-journals and to improve ILL and document delivery. This is a highly flexible
system.
23.
Australia
In 1997, several academic libraries in Australia and New Zealand began a project
using Fretwell-Downing Informatics (FDI) software to route ILL requests and assist
with document delivery. The project expanded to include non-profit libraries in
Australia and New Zealand. In 2002, the Western Australian Group of University
Librarians (WAGUL) started to use FDI’s VDX software to manage all document
delivery between four different libraries. WAGUL found it essential to develop
service level agreements between libraries in order to protect the competitive
environment valued by their parent institutions. System configuration also required
a large amount of collaboration.
Although this was time-consuming, the
collaboration efforts carried over into other initiatives. WAGUL are continuing to
fine-tune their ILL and document delivery services.
GratisNet (http://www.gratisnet.org.au) is an example of a web-hosted consortial ILL
scheme in the health library sector in Australia.
Genoni and Jones (2003) caution that a shift in library collections toward shared
licensed access threatens the diversified collections that allow libraries to meet the
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needs or potential needs of users. Collection evaluation may become an
increasingly important component of consortial ILL programs.
Definitions and scope; constraints and dependencies
24.
Service
24.1
Document delivery is a supply chain service. It can be user- or library- initiated and
relates to the process between identification of an item through a bibliographic
record or other metadata and the receipt of the full text of the item by an end user.
Document supply is a synonym, and inter library loan is one method of document
supply.
24.2
The service scope in this business case includes the complete document delivery
chain, i.e. all stages and intervening processes between user initiation and delivery
to end user. The process may include intermediaries or be unmediated.
24.3
As a minimum, the case will include the supply of journal articles, but it is desirable
to include consideration of the supply of books, reports, e-learning objects, etc, as it
will be essential that a supply system for journal articles dovetails with existing and
possible future systems for the supply of these other types of document.
24.4
The case will consider the supply of documents to all ‘NHS family’ members, to
reflect the strategy and policy of the National Library for Health and National Core
Content. Thus it will include supply of documents to students on placement in NHS
organisations, to social care staff, and to independent and charitable sector staff
providing care to NHS patients. It will not include supply of documents to NHS
patients, but must take into account and again be able to dovetail with
developments in this area.
24.5
The scope includes the NHS in England, but it is desirable to include options for
extension to home countries.
25.
Technology
25.1
In the context of document delivery, technology includes a wide range of process,
manual and digital, including scanning, transmission by e-mail and traditional
postage. Technology includes a link resolver system such as SFX, making use of
standards such as OpenURL and Digital Object Identifier (DOI).
25.2
The minimal technology scope would cover just the technology to enable a specific
document delivery service. A maximal scope would establish a technology
framework to support different and evolving models of document delivery.
25.3
For accessing these services via N3 NHS network it is essential that library and
information services are high on the priority list for connection
26.
Critical success factors
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26.1
Meet quality standards: Quality of service is a key critical success factor. The new
system must deliver added value for end users. Standards (delivery times, quality,
“fill rate’’, customer care) must be as good as or better than at present.
26.2
Ease to use: Ease and convenience of use is another critical success factor. The
system must be intuitive to use and not require significant training and support. At
the very least, the system must not create more barriers than exist now for those
end-users who have poor IT access and/or poor IT skills. Ideally for end users,
locating and requesting documents are integrated, with the facility to incorporate
requests from a number of databases.
26.3
Speed: The system must be able to cope with both routine and urgent requests.
26.4
Request tracking: The system must include provision for tracking requests and
enable provision of a request history for end users.
26.5
Minimal errors: The system must have the potential to reduce errors in the
document requesting and delivery process.
26.6
Flexible managed environment: There is the need for the system to manage an
environment that enables both electronic and printed delivery of information direct
to the user as well as the library. The sytem must encompass the delivery of journal
articles and the supply of books, reports, and e-learning materials.
26.7
Fit with local IT: The system must be manageable and affordable within the IT
infrastructure of the NHS, and take into account the ICT that is available to end
users, including those who work from home or have no access to NHSNet NHS
network, and to libraries. Interoperability is key - it must interface with existing and
planned IT systems.
26.8
Fit with organisational structures: The system must be manageable and affordable
within NHS organisational and economic structures, but also independent of
organisational re-structuring and boundary changes.
26.9
Financially affordable: The system set-up and maintenance costs cannot be met
through local library budgets. There is a risk that an improved system could
increase costs, through being able to satisfy what is currently unmet demand. The
system must therefore fully exploit free resources, and include a mechanism to
support users to be selective in their choice of documents to request, allowing the
charging back of costs to end-users as appropriate.
26.10 Fit with library workforce: The design of the system should take into account the
NHS library workforce, acknowledge that prompt document delivery is key to
customer relations and patient care, and consider current and future library staff
skills, capacity and roles.
26.11 Fit with NHS partners: The system should be able to embrace partner organisations
and their library resources (e.g. HE and FE, social care, independently contracted
organisations), to allow for delivery of services to NHS staff by non-NHS
organisations, and delivery of services to staff contracted to the NHS but working
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outside it. There is a risk that certain key NHS libraries may be unable to meet the
demands of a national system due to increase in workloads.
26.12 Meets legal requirements: The system must be compliant with legislative
requirements (e.g. Copyright, Data Protection, Disability Discrimination) and
publisher licences. These are significant constraints on any document delivery
service.
26.13 Risk-free requirements: Introduction of the system should not disrupt document
access or de-stabilise existing document delivery or publishing systems in any
unforeseen, damaging way. Human resource capacity and technical and
project/change management skills must be available at the required level to support
implementation.
26.14 Fit with national IT: There is a need to ensure a good fit between the document
delivery system and strategic initiatives such as National Knowledge Service,
National Library for Health. NHS Common User Interface, and with operational
initiatives and pilots in the NHS (including the NLH Technical Design Authority
Enterprise/Information Architecture, Single Search Engine, Health Library and
Information Service Directory (HLISD), document delivery pilots, NHS OpenURL
resolver, national A-Z journals list software, library management systems), and with
the growth in managed learning environments (MLEs).
Benefits and risks (high level)
27.
Benefits
27.1
Document requesting and supply services that save users time, that are simpler to
use and access, and that combine searching and requesting.
27.2
Document requesting and supply services that support equitable access for all, and
that ensure that it is as cheap and easy to obtain documents that are not held
locally or available electronically, as those that are.
27. 3 Reduced or eliminated risk of staff not having access to good quality evidence
simply because it is not readily available.
27.4
Document requesting and supply services that directly support clinical governance,
by enabling all staff groups to have just in time access to information at the point of
need.
27.5
Scope for service modernisation through streamlining, and linkage with IT systems
at national and local level.
27.6
Significant time savings for library staff, and opportunities for library staff workforce
modernisation. Library staff released from administrative work involved in
processing requests, in order to develop and deliver other types of value-added
services.
27.7
Improved mobilisation and stewardship of NHS print and electronic library
resources.
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27.8
Saving of space currently used for local library archives, allowing, for instance,
reconfiguration of existing library premises as learning resource centres.
27.9
Potentially reduced unit costs and containment of overall expenditure on document
delivery by maximising the use of local, regional and national resources.
27.10 Raise the profile of library and information services within the NHS.
28.
Risks
28.1
Interrupting document supply or de-stabilising existing document delivery or
publishing systems in a damaging way.
28.2
System(s) developed now being out-of-date in five years time because of the fast
rate of technological change and developments in publishing and storage of
information.
28.3
Changes in library staff roles and ways of working may cause anxiety.
28.4
Reduction in customer contact element of front line service.
28.5
Needing to make decisions in the absence of research-based evidence (e.g. on
user needs, values and preferences, on demand for documents over ten years old).
28.6
Increasing costs through satisfying currently unmet demand.
28.7
In an organisation as complex as the NHS, “one model will not fit all.”
28.8
The delivery of the system may be compromised by the delivery of national IT
projects.
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Economic Case
29.
29.1
Introduction
The strategic case for a document delivery service for the NHS has now been
presented. This section sets out the investment goals for the service and the main
options for delivery. These will be refined and evaluated if the high level business
case is approved.
30.
Investment Goals
30.1
Based on the benefits identified in the strategic case, the investment goals are:
30.2
To minimize variations in service delivery by enabling all NHS staff to have equal
access to document delivery services.
30.3
To save the user time, by enabling him/her to obtain the full text of bibliographic
references. Saving time does not necessarily mean automating document delivery
services, although for some users self-service will be welcome. The following
scenarios are illustrative of other ways in which users’ time may be saved:
 By enabling a user to highlight a series of bibliographic references in a results
set and pass them in electronic format to a library service to obtain full text on
their behalf.
 Enabling a user to highlight the bibliographic data on any web page and either
pass the data to a resolver manually or have the page ‘auto link enabled’.
 Enabling forms based requests, either mediated or unmediated.
30.4
To increase value for money by seeking to decrease the unit cost of document
delivery. For example, by:
 enabling the NHS to continually seek the best price from competing document
delivery services.
 integrating document delivery with archives of electronic full text.
30.5
To contain the overall NHS expenditure on document delivery, for example by:
 routing requests to the most cost effective delivery option, which may be
mediated or unmediated photocopying at a local library.
 highlighting to users the cost of the documents they are requesting, even if
users are not paying for items directly.
 assisting users to request only genuinely required documents, through support
and training.
 enabling the NHS to set individual quotas for document delivery services, and
for users to pay directly above the quota.
30.6
To support patient choice by dovetailing with mechanisms developed to enable
NHS patients and the public to obtain full text documents.
30.7
To support clinical governance by enabling all NHS staff to have rapid access to full
text references in clinical settings.
30.8
To support modernisation by integrating document delivery with Connecting for
Health services.
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30.9
To save the time of library staff, for example by:
 giving users a self-service option.
 streamlining the process of mediated document requesting.
31.
Some key considerations
31.1
A streamlined document delivery service has the potential to increase overall costs
by satisfying unmet need and demand. It is vital that any document delivery system
should address this issue. One way will be to ensure that as far as possible users
request freely available (e.g. open archived) copies of papers, and it is vital that the
document delivery system can use emerging technologies and services such as
Open Archives and Open URL.
31.2
There is an opportunity to build in a service that helps users improve the relevance
and quality of the items they wish to order – some form of intervention (electronic
and/or person based) between finding references and ordering them.
31.3 The document delivery system has dependencies on the NHS search environment
and the NHS Copyright Licensing Agreement.
31.4
The document delivery system must support (and be supported by) the evolving
NHS Library Service Framework.
31.5
Current document delivery services support relations between library staff and
between library staff and users. An example of this approach is the telephone
contact made between libraries when processing urgent requests. Service redesign
should continue to support these relations, including any user training necessary to
utilise a new service.
31.6
The cost of any new service should not be met by reductions in local library budgets
or staff. This is because a) libraries are already relatively poorly funded and staffed,
and b) there will be opportunities to switch resources to other activities. These other
activities include support for clinical librarianship; clinical governance; Map of
Medicine development; training (for example CASP, Connecting for Health, and
information literacy); and supporting health information for patients and public.
32.
Options for delivery
When considering the options for delivery, a wide ranging approach is taken at this
stage so that as many potential models as possible can be considered. The highlevel options shown below range from the current through to enhancements of
existing services to new models and include “do nothing” (i.e. retain the status quo),
invest more in access to electronic content rather than in document supply, creating
a national union catalogue and having a mix of models. The feasibility and costs of
these options will be evaluated objectively during the options appraisal process (see
33.2). This should allow for the option most beneficial to the NHS to be identified.
There is no assumption at this stage that the preferred way forward is a single,
national ILDS system.
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The following long list option sets have been identified, to be explored through the
Treasury Greenbook framework2 refined through consultation, and further analysed
to establish a preferred way forward:
a. Retain status quo of regional coordination, rather than national
Rely on the continued coordination of document supply services on a regional basis
as now, rather than developing national initiatives. Under the terms of this option,
there will be no further development of the business case although there will
continue to be expenditure in the NHS, through regional and other initiatives at this
time.
b. Make a small amount of national investment to improve document delivery
services.
Ways in which a ‘do minimum’ investment could contribute to enhanced end-user
services include: a baseline survey of ILL practices across the country, training for
library staff, development of evidence-based, good practice protocols, setting up a
national interlibrary loan e-mail list, and developing an interlibrary loan request form
on the NLH website.
c. Enhance existing co-operatives.
Enhance existing interlending and document supply partnerships by ensuring
standardisation of service, software systems and participation.
d. Vendor-provided document delivery module Add a document delivery module to
core content databases and/or the NLH single search engine. This would allow
users to order documents direct from libraries, publishers or other suppliers within
an electronic environment Funding for articles supplied would likely need to come
from end users or from a finite NLH budget.
e. Increase link resolver and pointer services
Set up additional link resolver and pointer features within search engines and
bibliographic databases that are available to NHS staff, such as NLH single search
engine, Google Scholar, Dialog Databases, and PubMed. This will expand on the
routes available to full text for NHS staff. Link resolver services would enable users
to seamlessly access full text without having to search separate information
sources. Pointer services would include links to pay per view and other document
delivery options.
f. Improve access to full-text electronic resources through National Core Content,
locally and regionally purchased electronic journals and books, and open access
journals such as those freely available on the Internet; BioMed Central, PubMed,
UK PubMed, publications and those stored in Open Repositories
Improve searchability of the National Core Content, open access and archived
journals and ensure best evidence is what end users find first. Also, improve
stability and currency of current NCC and provision of quality titles that are more
directly relevant to users, including those engaged in evidence-based
commissioning and service planning.
g. NHS libraries negotiate a national or regional aggregated journal collection,
informed by existing subscription and ILDS data, comprising open access and
2
http://greenbook.treasury.gov.uk/index.htm
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commercial ‘gold’ titles (vs bundles), and pay-per-view deposit accounts. Once the
number of articles ordered from a particular title reaches a pre-agreed level, NHS
libraries would get the title for free. Open access with or without embargo must
form part of the subscription terms.
h. Outsourcing of document supply
Document delivery service would be provided solely by an external supplier. This
option could explore various approaches to payment, funding and routing of
requests.
i. A national catalogue that facilitates library staff and users to locate books,
journals (including full-text electronic access to articles) and other library materials
This would include links to the collections of the BMA, Royal Colleges etc but would
include filters for regional locations to be accessed first. ILLs would be between
libraries and mediated by library staff using a national agreed level of service with
individual libraries choosing the scope of service offered. Within this should be
agreements on collection development policy. Funding could be considered for a
national deal for interlending software for ordering and record-keeping. A long-term
goal would be a particular library management system, to encompass catalogue
and facilitate national level interlending. The software would be centrally
maintained. The decision whether to migrate would likely lie at a regional, rather
than a local level.
j. Provide the ability for individual catalogues and journal union lists to link into a
single search engine – eg COPAC
Offer libraries access to a centrally maintained software, which facilitates the import
and/or export of catalogue records from/to a central catalogue, while allowing
local/regional use of preferred, technologically compatible library management
software.
k. A mixture of two or more of the options listed above.
33.
Options appraisal
33.1
At this stage it is more important to identify a range of potentially viable options than
to narrow them down to a preferred way forward.
33.2
The following approaches will be applied at the Outline Business Case stage to
identify those options that most strongly support the investment goals and critical
success factors:



SWOT analysis by benefits case team
User and stakeholder workshops (to include library assistants) – for confirming
and weighting benefits
Cost benefit analysis, including full economic cost analysis and sensitivity
analysis
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Commercial, Financial and Project Management Cases
34.
Commercial Case
34.1
At this stage, the commercial case consists of an overview of the market for
document delivery solutions, including a range of factors that bear on the
commercial deal that will deliver best value for the NHS.
34.2
Much of the material is included in the Strategic Case. Of note:





34.3
ILDS represents the ‘order fulfilment’ part of the supply chain in libraries.
Following identification of a document through a bibliographic reference in a
catalogue or database, a document delivery service enables an authorised user
to obtain a full text copy of the document (typically a book, report, journal or
paper).
There is a pre-existing internal market for ILDS in the NHS. This market is
valuable, but its cost effectiveness needs to be considered in the context of the
next iteration of this business case and the broader strategy for NLH. The
evidence to date (Wilson, 1999) suggests it is much cheaper to base document
supply in the NHS on local circuits than on an outsourced model.
There is a range of commercial suppliers. However, the market is changing
rapidly as the Internet offers new ways to deliver documents. Any commercial
arrangement must reflect the need for change within the lifetime of the contract .
There are a number of important strategic-operational considerations that need
addressing to achieve the best value for the NHS, including the balance
between stock holding and delivery, and mediated and unmediated delivery.
Outside the NHS context users appear to find unmediated services acceptable
More research will be needed to understand user needs in the context of NHS
and health libraries.
A cost of document supply model is available in Appendix C
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35.
Financial Case
35.1
The NHS commits around £1.2 million per annum in direct costs for document
delivery3 and a further unquantified amount (possibly as much as 25% of the cost
of administrative staff salaries) on indirect costs.
35.2
The number of BL requests from the NHS in 2003-4 was 157,000. The number
supplied via local networks was around 250,000. The remaining 90,000 documents
were supplied from other sources, including the BMA library.
35.3
A next step in developing the business case will be the demonstration that any new
service is affordable. The potential sources of funding for an NHS document
delivery service are:



New central funding
Levy on StHAs
Directly from end users
It is conceivable that a service could be funded from one or more of these sources.
3
Financing NHS Libraries. Robert Huggins Associates 2005. The average expenditure per NHS library on
Inter Library Loans in 2003/4 was just under £4000.
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36.
Project Management Case
36.1
The business case is being developed as part of the National Library for Health
Programme, which is part of the National Knowledge Service.
36.2
The business case will continue to be developed collectively by NHS librarians, and
be subject to peer review from NHS libraries and approval by NKS, via NLH
Programme Advisory Board.
36.3
If the case proceeds to OBC stage consultancy, either from within NHS Connecting
for Health or externally, will be sought.
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Bibliography
Antelman, K (2004). Do open access articles have a greater research impact? College
and Research Libraries, September 2004.
Archibald, D; Burrows, T; and McDonald, C. (2003) How the west was one: using VDX to
redevelop cooperative document delivery services in Western Australia. Presented at the
Interlending and Document Supply International Conference in Canberra, Australia,
October 2003. Accessed at http://www.nla.gov.au/ilds/abstracts/ArchibaldD.pdf
14/3/06..
Bell, A, Bower G. and Whitehurst, D (2004). Docusend: the one stop, integrated,
document delivery broker service: final report. Available
http://www.docusend.ac.uk/final.pdf (Accessed 14/3/06.)
Birch, K (1999) The Documents Direct project: evaluating commercial document suppliers.
New Library World vol. 100, no. 1150, pp. 207-212.
Birch, K (2000) Documents Direct: a case study. Presented at 2000 CURL Conference.
Available
http://www.curl.ac.uk/presentations/2000conference/Birch%20presentation%203rd.PPT
(Accessed 14/3/06.)
Birch, K and Young, I A (2001). Unmediated document delivery at Leeds University: from
project to operational system. Interlending & Document Supply vol. 29, no. 1, pp. 4-10.
Bowler, J (2003) Unmediated document delivery: the issues and possibilities. The
Australian Library Journal vol. 52, no. 4, pp. 327-339.
Brophy, P (2003). Single article supply: a report to the Joint Information Systems
Committee (JISC)
Carmel, M J (1988). Library resource sharing in the National Health Service: benefits and
limitations. Interlending & Document Supply vol. 16, no. 1, pp. 12-16.
FAQ DOCLINE -- What is DOCLINE®?. Accessed at
http://www.nlm.nih.gov/services/doc_what.html 14/3/06.
Genoni, P and Jones, M (2003). Consortia and collections: enhancing interlending
effectiveness. Presented at the Interlending and Document Supply International
Conference in Canberra, Australia, October 2003. Accessed at
http://www.nla.gov.au/ilds/abstracts/GenoniP.pdf 14/3/06..
Hlynsdottir, Þ and Gylfadottir, Þ (2003) ILL/DD in Iceland before and after nationwide
access to 8,000 e-journals – the story so far. Presented at the Interlending and Document
Supply International Conference in Canberra, Australia, October 2003. Accessed at
http://www.nla.gov.au/ilds/abstracts/Thorny.ppt 14/3/06..
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NLH/LKDN Document Delivery Project
Jackson, M E (2004). The future of interlending, Interlending & Document Supply vol. 32,
no. 2, pp. 88-93.
Jackson, M E (2004) Assessing ILL/DD services study. Association of Research
Libraries (ARL) bimonthly report 230/231. Available
http://www.arl.org/newsltr/230/illdd.html and http://www.arl.org/stats/newmeas/ill_flyer.html
(Accessed 14/3/06.)
Morris, A; Woodfield J and Davies, J E (1999). Experimental evaluation of selected
electronic document delivery systems. Journal of Librarianship and Information Science
vol. 31 no. 3, pp.135-44 (Reports results of research to test and analyse 5 different
document delivery systems according to requesting and delivery times, document quality
and coverage).
Morrow, T (2002). EASY does it: a fresh approach to electronic article supply. Presented
at VALA 2002 Conference. Available
http://www.vala.org.au/vala2002/2002pdf/25Morrow.pdf (Accessed 14/3/06.)
National Network of Libraries of Medicine Document Delivery Plan. Accessed at
http://www.nnlm.gov/libinfo/docline/docdelplan.html 14/3/06.
Paden, S L (2001). Web-based Loansome Doc, librarians, and end users: results from a
survey of the Southeast Region. Bulletin of the Medical Library Association vol. 89, no. 3,
pp. 263-271.
Robert Huggins Associates (2005). Financing NHS libraries
Scally, G and Donaldson, L J (1993). Clinical governance and the drive for quality
improvement in the new NHS in England. BMJ vol. 317, pp. 61-65.
Stapel, J (2003) Going Dutch: towards a multitiered networked ILL service for the
Netherlands. Presented at the World Library and Information Congress, Berlin, Germany,
5 August 2003. Accessed at http://www.kb.nl/hcc/ifla2003/ifla2003.html.14/3/06.
Thomson ISI (2004) The impact of open access journals: a citation study
Wilson T (1999) Cost benefit analysis of a regional database of documents: a case study
based on the SWRLIN union catalogue. University of Southampton Health Care Libraries
Unit.
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Appendix A - Selected initiatives in document delivery design
Documents Direct http://www.leeds.ac.uk/library/docdel/pubs.htm of University of Leeds
(Birch 1999, 2001, 2002)
 The project aimed to examine possible alternatives to the established collection
development model by:
 Offering a just-in-time policy
 Assessing costs and benefits of on-demand single article supply
 The project involved the testing of unmediated document ordering and delivery from
different suppliers to academics and researchers.
 The British Library’s Inside Web service was the most often used supplier for various
reasons:
 Ease of use for users
 Its multi-disciplinary database which facilitated discovery
 Reliable and predictable service performance
 Easy service management for staff
 The project concluded that:
 Unmediated document ordering offers a value-added service with benefits such as
current awareness and linked document delivery, order monitoring, control and
speed of delivery.
 Unmediated document ordering is a cost-effective alternative to traditional
interlibrary loans.
 The range of titles ordered demonstrates the value of access over holdings
because no title has been ordered significantly to justify purchase.
 Documents Direct started in 3/1999 and ran as a project until 3/2000. It has now
become a service available to all schools in the University of Leeds and with over 700
registered users.
EASY: Electronic Article Supply http://www.illos.lancs.ac.uk/easy.html of University of
Lancaster and Ingenta (Morrow 2002)
 How EASY works:
 Document requests submitted through the ILLOS 2.1E web interface are
automatically checked for availability under the EASY service.
 Institutional subscriptions are verified and, if appropriate, the document is offered to
the requesting user for free download or E-mail delivery. No processing is required
by document supply staff.
 Documents not covered by institutional subscriptions but available under EASY
terms and conditions are flagged as such and passed to document supply staff for
mediation, where users can choose to access the document via EASY or obtain it
by traditional document supply means.
 Privileged users can be granted unmediated access rights, allowing direct ordering
of EASY documents without processing by document supply staff.
 Electronic documents are delivered by E-mail to the end-user, or direct to the user's
web browser (subscription documents only). Alternatively, documents can be Emailed to the document supply office.
 The project was conducted from 3/2001 to 6/2002.
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 The project evaluation of EASY cannot be located.
Docusend: Integrating Document Delivery Services http://www.docusend.ac.uk/ of
JISC (Bell, Bower & Whitehurst 2004)
 The project objectives are:
 Bringing together a wide variety of document delivery services in an integrated onestop service, transparent to the user
 Permitting requesters to choose from a range of supply methods and provide a
request profile service to customers
 Testing the potential for end-user requesting
 Supporting and underpinning cross-searching of databases by linking document
delivery requesting to a number of JISC initiatives already established, under way,
and awaiting future development
 The project uses VDX software provided by Fretwell Downing Informatics (FDI) to
handle the complex routing and management transactions involved. The VDX software
was originally housed at EDINA but later transferred to the FDI managed service
operation owing to the failure of recruiting a dedicated technical officer.
 Although building on the work of the Lamda consortium http://lamdaweb.mcc.ac.uk/,
Docusend investigated ways in which the set of supply sources could be broadened
beyond HE to other types of libraries and the commercial sector, incl. publishers.
 The original intention of the project was to develop a fully operational service. However
halfway through the project, for various issues encountered, the project moved from the
possible establishment of a full service to the demonstration of a Proof of Concept.
 The evaluation of the project in meeting the objectives:
 To bring together a variety of document delivery services in an integrated one-stop
service, transparent to the user > Moderately successful >> rolling out to supply
libraries proved to be problematic; the project was unable to extend the testing to a
commercial publisher
 To permit requesters to choose from a range of supply methods > Very successful
 To allow customers to provide a request profile > Very successful
 To test the potential for end-user requesting > Very successful
 To support and underpin cross-searching of databases by linking docdel requesting
to a number of JISC initiatives already established, under way, and awaiting future
development > Moderately successful >> differences in the delivery timetables of
JISC initiatives
 Other issues encountered include:
 Lack of progress in the take-up by library management system vendors of the
ISO/ILL standard
 Complexity in the technical aspects of the propriety software which requires a series
of special applications and alternations
 Complexities of Docusend’s interoperability with non-Lamda sources of supply
 Nature and scale of the task required in order to secure the involvement of
commercial content providers in Docusend
 Lack of comprehensive information about document delivery traffic patterns in the
UK
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
Increasing awareness of the potential role which eprints might play in document
supply
 The project was completed in 11/2004.
Secure Electronic Delivery (SED) of British Library
 A document delivery method by email containing a hyperlink to the document and
Adobe Reader 6.0 or later.
 SED can be chosen as the document delivery method for requests made via different
document supply services, incl. 1) ARTweb for registered accounts; 2) Articles Direct
for unregistered accounts; 3) LEXICON for both registered and unregistered accounts
ARL Assessing ILL/DD Services Study (2004)
 ARL has undertaken a third study of the performance of interlibrary loan and document
delivery (ILL/DD) operations in 72 North American research, college, and governmental
libraries in 2001/2.
 New to this study is a focus on user initiated, or unmediated, ILL services which
includes INNReach, URSA, Loansome Doc, ILLINET Online, RAPID, and user-initiated
use of commercial document delivery suppliers.
 This study confirms informal, institution-specific studies and speculations that userinitiated services provide better service to users than mediated ILL. Overall, userinitiated services have lower unit costs, higher fill rates, and faster turnaround times
than mediated ILL.
Cost benefit analysis of a regional database of documents. Tina Wilson (September
1999)
Found the cost of a document supplied by one NHS library to another to be £0.71,
compared to the cost of a BLDSC supplied document of £5.10 (or more if the request is
urgent)
CORSALL: Collaboration in research support by academic libraries in
Leicestershire (2001)
Compared the cost of a local network with a commercial service (BLDSC). It found that a
local document delivery service is more expensive than the BLDSC service. The main cost
driver is staff time. The conclusion needs to be considered in the context of the NHS,
where there is a much higher ‘fill rate’.
http://www.library.dmu.ac.uk/Research/CORSALL/Report/
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Appendix B - Selected advances in document delivery technology
 Portals support the ability to discover print and electronic resources in one search. It is
much too early to predict the potential drop in ILL/DD requests, but portals offer the
hope of reducing the number or at least moderating the increase (Jackson 2004).
 Enhancement to library catalogues supports better searching experience (e.g.
relevance ranking, linking to external resources) and/or allows the catalogues to serve
as search targets of portals (Jackson 2004).
 Bibliographic items will be easier to identify, though users will continue to use a variety
of online catalogues, portals, gateways etc. (Jackson 2004).
 Accessibility to documents in electronic format was greatly enhanced by the spread of
open linking software (Bell, Bower & Whitehurst 2004).
 There is continuing growth in the number of open access journals (Bell, Bower &
Whitehurst 2004).
 The development of eprint repositories was gradually picking up pace, and the potential
for free and direct access to either an institution’s own output or the output on a
particular subject area is large (Bell, Bower & Whitehurst 2004).
 The Open Archives Initiative develops and promotes interoperability standards that aim
to facilitate the efficient dissemination of content (Bell, Bower & Whitehurst 2004).
 Web browsers offer a universal interface and the emergence of standard protocols
facilitates the searching, requesting and retrieval of documents by lay users (Bowler
2003).
 Ariel, developed in 1990, provides an electronic document delivery software package
that manages the scanning, communication and printing of paper-based documents
(Bowler 2003).
 Libraries will be using a blend of mediated and user-initiated services, though the
proportions for individual ILL units may vary significantly (Jackson 2004).
 Turnaround time will be faster, but user expectations will have also increased, so that
for many requests, turnaround time will still not be fast enough (Jackson 2004).
 Technical Standards
 ISO ILL (ISO10160/1) protocol http://www.lac-bac.gc.ca/iso/ill/ permits 2 different
ILL applications to exchange messages about an ILL transaction; supports the
mediated inter-lending process, and thus excludes the step of how patrons submit
requests to their ILL units.
 OpenURL http://library.caltech.edu/openurl/ standardizes the syntax for transmitting
a package of metadata to a link resolver; helps users determine whether the library
has a print copy, a full-text copy, whether an ILL or document delivery request can
be generated, whether the item is available from a commercial document supplier,
or whether another library might own the title.
 OAI-MHP (Open Archives Initiative’s Metadata Harvesting Protocol)
http://www.openarchives.org/OAI/openarchivesprotocol.html is a mechanism for
data providers to expose metadata from their repositories or archives; permits
portals to discover content that may have been hidden, and may serve as an
alternative to building a physical union catalog.
 NISO Z39.83 http://www.niso.org/standards/index.html circulation interchange
protocol governs communication between 2 circulation applications or between a
library’s circulation and ILL applications.
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

Generic Electronic Document Interchange (GEDI) (ISO 17933)
http://www.rlg.org/gedistand99.html or
http://www.iso.org/iso/en/ISOOnline.frontpage defines an electronic document
format and describes the Interchange mechanism; enhances unmediated document
delivery and improves turnaround times.
NISO Z39.50 http://www.niso.org/standards/index.html allows standardized
searching across databases
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Appendix C - Modelling the full cost of document supply
National document delivery business case
Meeting 22 April 2005
Estimating whole cost of document supply
1. Progress to date:

Identification of articles on assessing costs of a) supplying items for loan
and b) supplying photocopies of journal articles

Identification of factors to be taken into account when calculating costs for
document supply options, particularly staff time
2. Sources on assessing costs
 Cost benefit analysis of a regional database of documents: a case study
based on the SWRLIN Union Catalogue. (Wilson 1999). Compares direct
cost of BL supply (request forms) with direct costs of local library reciprocal
supply (staff time & materials); costs shared by both systems are excluded.
The article also examines the costs and benefits of maintaining a central
cataloguing system. Timings are based on a fairly typically sized
postgraduate centre library
Available: http://stlis.thenhs.com/hln/database/web/wdcsearch.htm

CORSALL: Collaboration in research support by academic libraries in
Leicestershire. Final Report. (Bloor 2001). Chapter 5. Costs of a local
document delivery service (3 participating libraries) compared to the costs of
obtaining items from BL. Timings based on 3 HEI, namely, De Montfort
University, Loughborough University, and the University of Leicester
Available: http://www.library.dmu.ac.uk/Research/CORSALL/Report/

eKAT/ Bloomsbury Healthcare Library (BHL), London book loan agreement
with Essex and Bedfordshire & Hertfordshire SHAs. Rupert Williams.
February 2005. BHL as first resort service

LKDN statistical returns 2003/04: average cost document supply /library =
£3,700 excluding staff time (requires confirmation?). Personal
communication. National Document Delivery Business Case meeting held on
28 February 2005
3. Factors to be considered in calculating cost of document supply
Factor (staff time first)
Requesting library
Time required locally to check
each request against
catalogues of other libraries in
scheme
(for both loanable items, such
as books, & journals)
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Estimates
2 mins for 2
catalogues
4 mins for 4
catalogues
Note
cost per item = time x
hourly rate of ILL staff
Source
CORSALL
2001
Savings on processing
time could be made by
combining holdings into
a union catalogue (one
for books, one for
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NLH/LKDN Document Delivery Project
Average look up time in
searching regional database
for an item
0.48 mins for
photocopies
0.5 mins for loans
Supplying library
Loans:
12 mins to locate and
despatch; 10 mins to
re-shelve returned
items (CORSALL)
1.48 mins average
time checking post
and searching
shelves; 3.41 mins
average time
returning to office,
despatching,
receiving returns and
reshelving (SWRLIN)
Processing time
journals) but costs
incurred in maintaining
union catalogues.
Carmel (1988) has
shown that the more
resources need to be
checked for locations,
the less effective the
resource sharing
process
Cost per item = total
processing time x hourly
rate of ILL staff
Stationery costs
20mins work per
book loan for A&C
grade 3 (from receipt
to despatch)
£0.20 (average 10
pages@ £0.02 per
page at 2001 prices)
£0.70 per book loan
Record keeping e.g. notifying
end-users, collection of
statistics
Staff costs
11p per minute
Cost of photocopying
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CORSALL
SWRLIN
Photocopies:
20 mins to locate,
photocopy and
despatch an article
and then re-shelve
journal (CORSALL)
1.48 mins average
time handling post
and checking
shelves; 2.91 mins
average time copying
and despatching
(SWRLIN)
SWRLIN
1999
CORSALL
SWRLIN
BHL 2005
For 2005 estimated at
£2.00
20 mins may be on
conservative side
CORSALL
Envelopes, labels, print
toner etc; maybe a little
high but left in the SLA
calculations because
staff costs are probably
too low
BHL 2005
Based on average
SWRLIN
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NLH/LKDN Document Delivery Project
(1999 figures)
Transport to requesting library:
By post
10p per min (2004)
salary A&C grades 2
and 3; mid-point of the 2
scales; basis of a
working week of 1500
hours recommended by
Carmel (1988)
For A&C 3 but probably
underestimated
(recalculate using
Carmel’s 1500 working
hours per year?)
By Post:
Average cost in 2001
per photocopied
article = £0.75
(CORSALL)
Costs would be reduced
if articles sent
electronically but may
need additional
equipment
£2.00 Average cost
of second class
delivery by Royal
Mail per book loan in
2004(BHL)
By transport scheme:
No official postage
cost because post
delivered between
sites via a van
service (SWRLIN)
Stock replacement overheads
£1.00 per item in
2004
Maintenance of union
catalogues
£41,250 SWRLIN
central database
costs 1999/2000
Extent to which scheme is able
to fulfil requests
8% of requests for
loan items and 11%
for photocopies
supplied by local
scheme (CORSALL)
Requesting library
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BHL 2005
CORSALL
BHL 2005
SWRLIN
75% of cases postage
not paid from library
budget so in the
SWRLIN study postage SWRLIN
did not form part of
library costs;
however there is a
hidden cost to the NHS
within organisational
overheads for both
postage and the van
service
Contribution to overall
BHL 2005
costs incurred by BHL
as a result of having to
replace items that are
damaged or lost in the
post
Costs cover software
SWRLIN
and hardware
maintenance and
support, database staff
time, cataloguing
products, management
support (itemised details
given in article, section
4.2)
CORSALL
Potential alternative
suppliers (e.g. Royal
Colleges, BMA) but
SWRLIN
1999
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NLH/LKDN Document Delivery Project
look up hit rates in
1998/9: 64% for
photocopies; 76% for
loans
Supplying library hit
rate for finding item
on shelves 1998/9:
86% for journal
articles; 50% for
loans (SWRLIN)
Additional equipment required
seen as supplementary
suppliers because of the
small, specialist nature
of their collections.
50% may be
conservative as not all
libraries were full
participants in the
“book” ILL system
e.g. scanners
CORSALL
4. Other considerations in addition to costs above
 inconvenience factors
 management overheads
Cheryl Twomey, eKAT, London Health Libraries
ctwomey@londonlinks.ac.uk, 22 April 2005
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Appendix D - Interlending and Document Supply Task Group
Mandy Beaumont, Library Services Manager, Lancashire Teaching Hospitals NHS Trust
Helen Bingham, Library Services Manager, Portsmouth Hospitals NHS Trust
Christine Fowler, Head of Medicine, Health and Life Sciences Faculty Services &
Electronic Library Services, University of Southampton Library
Claire Honeybourne, Project Manager, National Core Content Project
Joan Hunter, Library and Knowledge Services Co-ordinator, Norfolk, Suffolk &
Cambridgeshire Strategic Health Authority
David Johnson, Librarian, Luton & Dunstable Hospital NHS Trust
Bertha Low, IM&T Co-ordinator, West Midlands Library Services Development Unit
Richard Marriott, Learning Resources Manager, Trent Strategic Health Authority
Stella Pilling, University of York
Caroline Plaice, Knowledge Services Manager, North Bristol NHS Trust
Christine Reid, Librarian, Chapel Allerton & Cookridge Hospitals, Leeds Teaching
Hospitals NHS Trust
Sharon Springham, Deputy Head of Library Services, Brighton and Sussex University
Hospitals NHS Trust
Diane Thompson, Library Services Manager, West Hull PCT
Jenny Toller, Electronic Information Resources Manager, NHS South West Workforce
Development Confederations
Ben Toth, Head of Knowledge Management, NHS Connecting for Health
Cheryl Twomey, eKAT Leader, Electronic Knowledge Access Team (eKAT), London
Health Libraries
Pam White, Library Services Manager, West Dorset General Hospitals NHS Trust
As a typical example of volumes of items supplied, EDEN scheme members supplied each other with a
total of 30,000 items during 2004.
Due to space constraints, a library in Portsmouth archives its journals older than 10 years. This archive
is accessed on average 900 times per year. Obtaining the same photocopies from the British Library
would cost £4500 a year.
NHS libraries typically and unsurprisingly find that the number of times journal articles are requested
declines rapidly with the age of the journal. A library in Brighton found that their 1971 - 1983 journals
were used on average 120 times a year, their 1961 - 1970 journals 25 times a year, their 1950 - 1960
journals 7 times a year, and their pre-1950 journals 6 times a year.
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