Enabling Partnerships:
Sharing Knowledge for a Mutual NHS
DRAFT- for consultation
Enabling Partnerships:
Sharing Knowledge for a Mutual NHS
DRAFT- for consultation
A Knowledge Management Strategy and Action Plan for
Better Health and Better Care in Scotland, 2009-2012
February 2009
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Contents
Executive summary......................................................................................... 3
1. Introduction ................................................................................................. 6
2. Why is this important? ................................................................................ 6
3. What will it involve? .................................................................................... 9
4. What will the National Health Knowledge Network look like? ............... 15
5. How will it be delivered? ........................................................................... 16
5.1 Objective 1: Managing Knowledge for a mutual NHS ....................... 17
5.2 Objective 2: Managing knowledge to create an enabling health
service -improving health and delivering health equality. ..................... 20
5.3 Objective 3: Delivering safe and effective patient care .................... 21
6. Conclusion ................................................................................................. 24
References ..................................................................................................... 25
Annex 1: Strategy development process and membership of working
groups
Annex 2: Data, Information and Knowledge
Annex 3: Evaluation of strategic demonstrator projects
Annex 4: Glossary
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Executive summary
The NHS belongs to the people of Scotland and exists to serve their needs. A
mutual NHS is one where patients and the public become active partners in the
NHS and not just passive recipients of care. It also involves the active
engagement of staff and collaboration across NHS organisations. Knowledge
and learning are powerful tools in helping to achieve that level of engagement
and involvement.
This draft strategy and action plan sets out proposals to maximise use of
knowledge and learning to help to create a mutual NHS based on participation by
patients and staff and organisational collaboration. It recognises the rights and
responsibilities for sharing information, learning and knowledge among patients,
carers and staff, and across services that deliver care for patients. It aims to
enable and empower practitioners, individuals and communities to ask questions,
find information and apply it in their own working practice and day to day lives. It
aims to create systems and processes and develop a competent, confident
workforce to translate evidence and knowledge into safe and effective patient
care.
The ultimate vision is of:
A truly mutual health service, transformed through empowering
practitioners, patients and organisations to work in partnership by
accessing, sharing and applying knowledge and learning as a vital
component of improving health and delivering care.
This will be delivered in two main ways:
1. Creating a national infrastructure of knowledge networks and
resources;
2. Developing three delivery channels for access to information
and knowledge.
The national infrastructure will comprise:

A National Health Knowledge Network – this will involve NHS
organisations
and partners in voluntary sector, local authorities and
education working and learning together to realise the shared vision, values
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and standards set out in Enabling Partnerships. Each organisation belonging
to the network will define its own knowledge management objectives in line
with the network’s overall goals. They will receive support and guidance in
knowledge management developments, and will be able to re-use and
customise the shared information resources of the network and to lead on
deliverables aligned with their organisational objectives.

Technology tools will be developed to enable partner organisations in this
network to share information and learning resources. They will also help to
link knowledge support to clinical eHealth systems.

A portfolio of support for information literacy will be available to equip
people with the skills and confidence to share and use knowledge in everyday
practice.
The three delivery channels will comprise:

An online information network – a shared pool of information and
learning resources, integrating content from the many providers in the
NHS and partner sectors. NHS Education’s information-sharing
technology will create this shared pool of resources and will create an
“NHS Google” so that patients and practitioners can easily access, from
any location, the full range of quality assured health information and
learning resources of NHS Scotland and partner agencies.
Organisations belonging to the National Health Knowledge Network will
re-use and customise this shared pool of content and information-sharing
technology to create services tailored to support their different audiences
and priorities.

Person to person sharing of information, underpinned by information
literacy skills. This is central to effective team working to delivering health
and care, and to ensuring that patients and carers feel they are listened
and talked to as equals, with honesty, dignity and respect. It will include
face to face, person-centred communication to share information
effectively among patients, carers and healthcare staff. It also involves use
of online tools for social networking and building online communities. It will
be supported by creating online maps and directories that draw together
information about helplines, counselling services, financial advisory
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services and other information sources that depend on person to person
sharing of information.

A network of physical access and support points which will allow
people both in the community and in hospital to access information in all
formats and receive support in doing so. There will be clear processes for
referral across services and sharing of resources and expertise.
The National Health Information and Support Service led by NHS 24 is rooted in
the consultation and delivery model outlined in this strategy. It will provide the
primary, first-level entry point to public-facing national health information
services. In order to achieve this, it will draw upon the resources and expertise of
the National Health Knowledge Network and will work through the three delivery
channels described.
These developments will empower members of the public, NHS staff and
organisations to deploy knowledge more effectively to deliver more efficient and
effective patient care. They will contribute to health improvement and will reach
out to disadvantaged communities to spread the benefits of quality assured
health information. By building strong partnerships across all sectors and with
patients and the public, the strategy and action plan will seek to realise the vision
of a truly mutual NHS.
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1. Introduction
1.1 This draft strategy and action plan sets out proposals to make best use of knowledge
and learning to improve patient experience and patient outcomes. Through collaboration
and sharing, it seeks to build on existing foundations and make the use of knowledge an
integral part of everyday practice..
1.2 This document sets out why this is important, explains what is involved and
describes how it can be delivered. The proposals are based on extensive consultation
and a series of demonstrator projects to test out the principles and approach. It is
important to get feedback on the proposals from as many people as possible. If you want
to contribute to this process, please complete the questionnaire at
http://tinyurl.com/cvkjzu or contact ann.wales@nes.scot.nhs.uk with your comments.
2. Why is this important?
2.1 Knowledge management is central to equipping patients, public and healthcare staff
in all sectors to deliver the vision of a mutual NHS outlined in the Scottish Government’s
action plan Better Health, Better Care 1. This mutual NHS is based on a common sense
of purpose, full patient participation and ownership in decisions, and using the patient
experience as a key measure of the success of the work of the NHS. The mutual NHS
also depends on strengthening the collaborative and integrated approach across NHS
organisations and partner agencies to plan and deliver services. This knowledge
management strategy is founded on the mutual ethos. Creating a mutual NHS depends
on recognising rights and responsibilities for sharing information, learning and
knowledge among patients, carers and staff, and among the partner organisations
involved in supporting all stages of the patient journey.
2.2 Better Health, Better Care underlines the importance of sustaining and improving
health and addressing inequalities. Effective use of information and knowledge is
essential in analysing and reducing health risks. An enabling health service will
empower individuals and communities to ask questions, find information and make
changes that will improve personal health and wellbeing.
2.3 The Better Health, Better Care action plan reaffirms that the core mission of the NHS
is delivering best quality patient care. Transforming knowledge into practice is at the
heart of patient safety and clinical effectiveness, service improvement, and the delivery
of efficient and timely care. Knowledge management will provide the essential
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infrastructure to support research, leadership and continuous learning while helping to
build a confident and competent workforce at all levels to deliver safe and effective care.
2.4 The principles of mutuality and partnership have been followed in developing this
strategy. NHS Education for Scotland (NES) and NHS 24 jointly led a process of
consultation based on interviews, focus groups and a questionnaire survey involving
practitioners, senior managers, patients and carers. Special attention was given to hard
to reach groups. A steering group and three working groups were established, made up
of representatives from NHS Boards, the voluntary sector and patient groups. A series of
demonstrator projects ran during 2008 to explore the practicalities and costs of the
proposed development model. A national conference was held in December 2008 which
consolidated the findings of the consultation to that point and helped to refine the
proposed collaborative working approach.
2.5 This work took place at the same time as the development of a social services
knowledge management strategy 2 .There has been close involvement between these
two development processes to ensure a shared approach is taken across these closely
related sectors. Annex 1 describes the development process in full.
2.6 The consultation process has highlighted five key development themes:
1. There is a need for a system that supports human skills, confidence, values
and behaviours in finding, sharing and using knowledge as much as the
technology to organise and deliver information. It should focus at the personal
level of individual information and knowledge needs.
“….(it) should be a combined human and technical system that tailors
support to the needs of the individual.” 3
2. A wide range of disparate , overlapping information sources is currently
available. This results in duplication of effort and expense, fragmentation and
confusion. Technology and governance systems need to integrate the
information from different sources into a single pool with tools to tailor and reuse information to meet the diverse needs of different healthcare audiences
and contexts. This principle of sharing and re-use of resources will maximise
benefit from investment in information resources.
“Knowledge management should be a fully joined-up story.” 4
“A collaborative information “hub” (is needed) involving knowledge
services from NES, QIS, ISD, NHS 24, charities etc – it should simplify
access and experience for the end-user.” 5
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3. Information literacy –, the skills and confidence to ask questions, find, evaluate
and share information and put it into practice 6 - is central to building the
partnership between patients and healthcare practitioners in all sectors. If
patients and the public are to become true partners, there needs to be human
contact, support and dialogue, alongside access to information resources.
Sharing personal knowledge and experience through dialogue is as important
as access to published information.
“Professionals should have the necessary level of information access
and skills to act as knowledge brokers in dialogue with patients.” 7
“Public and patients should be enabled to access information directly,
simply, with understanding, and with support available from people
and at a place and time where they can discuss and debate the
information.” 8
4. Information requires to be provided in different ways and in different formats,
focusing particularly on supporting disadvantaged communities and hard to
reach groups. For those without immediate access to a computer, best use
should be made of routes that support person to person information sharing –
for example, helplines, counselling and financial advice services, and health
information access and support points in the community. These routes provide
the highly valued person-to-person contact which helps in the sharing of
information.
“It is not just about technology; also about skills, culture, and support.
For those without IT access at home, best use should be made of
community information points – eg libraries, health information
centres, pharmacies, “silver surfer” services…..” 9
“Phone seems ideal to provide human support and a route to
information for those who are not Internet-literate or do not have
access.” 10
5. Patients and professionals should have access to the same information. It
needs to be presented appropriately in a way that is tailored for different
audiences, but there needs to be equitable access to the same global
knowledge base. This basic right of equity of access to knowledge is crucial in
embedding knowledge management more firmly as part of the culture of day to
day work in the health service.
“Patients and professionals should be accessing the same
knowledge base.” 11
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2.6. In summary, the strategy recognises that the knowledge held jointly by staff,
patients and carers is the most valuable asset available to the health service as a whole.
Organisations and individuals need to accept a shared responsibility to work in
partnership to harness, cultivate and share this knowledge if it is to realise its potential to
modernise healthcare delivery and support the development of a mutual NHS.
3. What will it involve?
3.1 What is knowledge management?
Knowledge management covers the ways in which people and organisations capture,
store, organise, access and share internal and external information - including personal
and collective know-how and experience - and put it into practice to support their vision
and goals.
Components of successful knowledge management are:
People: The emphasis is on building the competencies, values, behaviours and culture
which make it possible to manage knowledge for organisational benefit.
Technology: This is a powerful tool in capturing, organising, accessing and sharing
information and knowledge. It has been said that “computers are incredibly fast,
accurate and stupid; humans are incredibly slow, inaccurate and brilliant; together they
are powerful beyond imagination.” 12
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Processes: Organisations need to design and implement social, technological and
cultural policy and processes that will make best use of knowledge to support their
organisational goals.
Knowledge management builds on effective data and information management (see
Annex 2). It is closely linked to organisational learning, bringing to it an emphasis on
the strategic role of knowledge management, the importance of reflection to learn from
experience, and the sharing of knowledge gained through experience.
3.2 Mission and vision
The mission of this strategy is to:
Equip and empower organisations, staff, patients and carers with the
resources, skills and confidence to seek, access and share knowledge and put
it into practice, when and where it is needed.
The ultimate vision is of:
A truly mutual health service, transformed by empowering practitioners,
patients and organisations to work in partnership by accessing, sharing and
applying knowledge and learning as a vital component of improving health
and delivering care.
3.3 Approaches
The strategy involves developing two approaches:
1. Creating a national infrastructure to support access to knowledge
Access to knowledge and information resources to support evidence based
practice and learning will be provided through national knowledge resources,
networks and support for development of competences. This will be made ,
available to practitioners and patients, wherever they are.
This infrastructure will support the three core elements of knowledge
management - developing organisational processes, technology and people.
It involves:

Establishing a National Health Knowledge Network. Organisations in
NHS and partner agencies will be encouraged to belong to this Network,
working within a partnership framework agreement to commit to working
and learning together to realise the shared vision, values and standards
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of Enabling Partnerships. Organisations belonging to the Network will
benefit from education in knowledge management, templates and
guidance to support development of organisational knowledge
management strategy, and access to information-sharing tools to enable
them to re-use the resources and expertise of the Network to create their
own online services. Each organisation will define a set of organisational
knowledge management objectives which align with the network’s overall
objectives.

Providing technology tools to enable partner organisations in this
network to share information and learning resources. Network members
will be able to provide access to this shared pool of resources within their
own websites, to meet local needs and organisational priorities.

Creating a portfolio of support for information literacy, to equip
people with the skills and confidence to use knowledge in everyday
practice.
2. Developing three delivery channels for access to information and
knowledge.
These channels will comprise:

An online information network - this will use the information sharing
technology tools provided by NES to bring together information and
learning resources from multiple sources, including NHS, local authorities,
education and voluntary organisations. An “NHS Google” will be created
to enable patients and practitioners alike to access the full range of
quality assured knowledge and learning provided by NHS Scotland,
wherever they are.

Information-sharing technology will enable organisations
belonging to the National Health Knowledge Network to re-use
and customise this shared pool of resources and technology to
develop information services to support their own people and
priorities. Clinical systems will be able to link to knowledge
support provided by this network.
Person to person sharing of information – the consultation underlined
the fact that individual human contact is central to sharing knowledge and
information. All healthcare practitioners are also knowledge workers
responsible for applying knowledge to practice and for sharing information
with patients, carers and the public. Person-centred sharing of information
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between patients and healthcare practitioners is the partnership at the
heart of this strategy.
This will be developed through:
a) Information literacy – Learning materials, guidance and support will
help to build the skills and confidence of patients, carers and
professionals in asking questions, identifying appropriate information
sources, evaluating the information retrieved, communicating it to others,
and putting it into practice. This will be linked with development of the
knowledge worker role as an integral component of the activities of
practitioners in NHS and partner agencies. Strengthening the knowledge
worker role of healthcare staff will improve their effectiveness in personcentred sharing of information directly with patients and the public.
b) A directory of helplines and advice services. The information-sharing
technology will draw information from sources such as NHS 24, the
Telephone Helplines Association, Citizens Advice Scotland, local NHS
Board and local authority websites to create a directory and referral map
of local and national helplines, financial and other advisory services, .
c) Social networking tools and guidance for building online communities,
to enable groups of patients and providers to share knowledge and
experience through Web 2.0 technologies.

A network of physical access and support points - this network will
be built through collaboration among existing health libraries and
information support centres in the community, in health, voluntary, local
authority and education sectors. Through this network, patients and staff
will be able to access information materials in a variety of formats and
receive support in selecting, evaluating and filtering the information
retrieved.
3.4 Developing knowledge services through partnership working
The principle of “co-production” outlined for the mutual NHS in the Better Health,
Better Care action plan is central to delivery of this strategy.
The NES Knowledge Services Team will actively seek out development ideas
and contributions from partners in the National Health Knowledge Network to
support delivery on this action plan. Organisations belonging to the Network will
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have the opportunity to lead on delivery of particular elements of the strategy
where this aligns with their organisational goals. They will also be able to use
the national infrastructure and information-sharing technologies to build
knowledge services that work through the three delivery channels to support the
local needs and priorities of their own organisations.
In this way the partners involved in the National Health Knowledge Network will
work jointly to continuously build and renew the strategic action plan.
3.5 Proving the concept - Demonstrator projects
The practicalities and benefits of the National Health Knowledge Network and the
partnership approach were tested in a series of demonstrator projects throughout 2008.
These projects illustrate how NHS, local authorities, education and voluntary
organisation partners can use the national infrastructure to create the three delivery
channels that support access to local and national knowledge for both patients and
healthcare staff.
a) Supporting long term conditions
Cancer Managed Knowledge Network. This demonstrator project involved
NES working in partnership with Macmillan Cancer Support, NHS Highland and
Highland Council Libraries to:

Develop an information website (Cancer Information Plus,
www.cancerinfoplus.scot.nhs.uk) for both patients and professionals.
This uses NES’s information-sharing tools and the common pool of
quality assured local and national information from voluntary sector, NHS
and other sources. This includes helplines, online community tools, and
information centres.

Map community health information access and support points in
Highland, evaluating the feasibility and benefits of closer networking
among these centres.

Deliver information literacy training, linked with the information website,
for healthcare professionals and people affected by cancer.
A Virtual Patient Navigator for Long Term Conditions. NES, NHS Borders,
Borders Council libraries and two major employers in the Borders area worked
together to:
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
Create a website for patients and carers
www.bordershealthinhand.scot.nhs.uk. Again, this uses NES’s
information-sharing tools and the common pool of quality assured local
and national information from voluntary sector, NHS and other sources.

Develop a network of facilitated access and support points in public
libraries and employers’ premises.

Provide information literacy training for patients and professionals, linked
with the Health in Hand website.
b) Sharing health information across national and local services
The Health Information Online demonstrator
(www.healthinformationonline.scot.nhs.uk) shows how the information-sharing
technology provided by NES creates a shared pool of national and local, patient
and professional information. This can be used to widen access to resources and
present information in tailored ways to meet the needs of different audiences. It
also shows how partner organisations in the National Health Knowledge Network
can use this technology to improve searching and information access in their own
websites. Partners in this demonstrator are: NES, Scotland’s Health on the Web
(SHOW), Health Protection Scotland, NHS Western Isles and the Telephone
Helplines Association.
c) NHS Board knowledge management strategies
NES has supported NHS Highland and NHS Borders to develop knowledge
management strategies and delivery plans that apply knowledge directly to local
and national NHS priorities. These include the HEAT (Health, Efficiency, Access,
Treatment) targets, patient safety, the 18 Weeks Referral to Treatment
programme, and the Knowledge and Skills Framework.
d) Managing knowledge for health equality
The Gorbals Healthy Living Network demonstrator in Glasgow shows how locally
based knowledge workers can help people in disadvantaged areas take more
control of their health and wellbeing. Community development staff in this project
used health information literacy skills to share information with members of the
public. This helped to build people’s confidence in finding and using health
information.
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3.6 Together, these projects offer tangible evidence of the feasibility and benefits of the
National Health Knowledge Network approach which is based on deploying national
infrastructure to deliver health information through different channels to support local
priorities. Partners in all sectors – NHS, voluntary, local authorities and employers –
benefit from this inclusive approach through:






easy, cost-effective access to a comprehensive range of health information for
both patients and professionals – a level of access that would not have been
possible without the network approach;
opening up access to the organisation’s own information and learning resources;
shared access to search and information management technology and expertise
which would not otherwise have been available to the organisation;
stronger skills and confidence among staff and patients in accessing and sharing
health information;
communication with peers and colleagues to share experience and expertise;
sharing resources and expertise across health libraries and information centres
in NHS, voluntary and local authority sectors.
Overall, partners involved in the demonstrator projects saw that the combination of
resources, skills, and delivery channels supported by the National Health Knowledge
Network will enable them to put health information into practice in the day to day delivery
of care and the management of personal health and wellbeing.
Full details of the initial evaluation of the demonstrator projects are provided in Annex 3.
4. What will the National Health Knowledge Network look like?
4.1 This strategy aims to translate the positive outcomes of the demonstrator projects
into service-wide improvements on a national scale. The National Health Knowledge
Network will transform how knowledge and learning are applied across the NHS in the
future.
4.2 Staff and patients will be able to access the full range of knowledge and learning
available to NHS Scotland and its partners, wherever they are. This access will be
through:

An online information network. This will be based on a shared pool of quality
assured health information and learning resources. It will use NES Knowledge
Services information-sharing tools to bring together content and services from
providers in all sectors. All users will be able to access the full range of quality
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assured knowledge and learning resources in this shared pool through an “NHS
Google”. There will also be access points tailored to meet the needs of different
audiences and contexts, drawing upon the appropriate content and services.
Knowledge support will be embedded in clinical and managerial systems, linking
users at the point of need to this shared pool of information content and services.

A network of libraries and information centres in the community, sharing
resources and expertise and referring users across the network when appropriate.
These centres will offer guidance and support from staff equipped to act as
knowledge workers in cascading information literacy skills to practitioners and
patients.

Directories of helplines, counselling and advice centres and social networking
tools to support person to person sharing of information. This will be underpinned by
support and training materials for health information literacy and an ongoing
programme of information literacy skills training for patients and professionals,
embedded in learning and development programmes throughout the system. This
will help practitioners and managers in NHS and partner agencies develop greater
skills and confidence to access and share information in person-centred
communication with patients and carers. It will also help them to translate knowledge
into practice or policy as part of their day to day work. Patients and carers will be
more confident to ask questions, find and share information with practitioners, and to
use health information in making decisions about their own health and wellbeing.
4.3 Organisations in NHS and partner sectors will deliver knowledge services together
as part of the National Health Knowledge Network, with a clear understanding of its
benefits and responsibilities. They will have organisational knowledge management
strategies, aligned with the national vision, which develop culture, skills and access to
apply knowledge and learning to local needs. They will share information and learning
resources through the National Health Knowledge Network and will use the network’s
infrastructure to deliver knowledge support for patients and staff.
4.4 This will be an integrated, collaborative knowledge network stretching across
Scotland to realise the mutual benefits of knowledge and learning for patients and
practitioners alike in improving health and wellbeing and delivering care.
5. How will it be delivered?
The approaches described above will deliver support for the goals of Better Health
Better Care in the following ways. They are all focussed around the three delivery
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channels – the online network, person to person information sharing and the network of
physical access and support points.
5.1 Objective 1: Managing Knowledge for a mutual NHS
5.1.1 Developing infrastructure
a) Develop a National Health Knowledge Network to guide service-wide
implementation of the Enabling Partnerships strategy, promote collaboration and
application of quality standards by organisations in all sectors. Actions to build the
network will include the following:
-
implement a training and development programme in organisational
knowledge management for partner organisations within the National Health
Knowledge Network;
-
provide templates, guidance and facilitation for network organisations to
develop their knowledge management strategies;
-
encourage organisations to identify an executive-level lead to take the role of
Knowledge Management Director – similar to Chief Knowledge Officer in
Industry – with a defined remit to oversee production and implementation of
the organisation’s knowledge management strategy;
-
define a quality assurance framework for knowledge management for
network organisations;
-
provide a programme of training and development on the principles and
practice of cross-organisational partnerships and governance.
b) Building on the model of the Cancer Managed Knowledge Network (see Annex 3),
explore the feasibility of similar cross-organisational and cross-sectoral networks for
other clinical priority topics and groups, as part of the National Health Knowledge
Network – including long term conditions such as diabetes, coronary heart disease,
dementia, stroke, child health, remote and rural care. Work with these networks to
develop and implement their knowledge management strategies.
c) Establish a portfolio of developments from National Health Knowledge Network
organisations using the infrastructure of technology, resources and skills
development to develop services aligned with the network vision while, at the same
time, supporting organisational needs and priorities. The demonstrator projects
conducted during 2008 provide examples of such projects.
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d) Establish synergies with related workstreams. This will involve:
o
Ensuring that the National Health Knowledge Network operates in close
partnership with the emerging Social Services Managed Knowledge
Network 2 and that common workstreams are defined and implemented
collaboratively wherever possible;
o
Working closely with the National Health Information and Support Service
development described in Better Health, Better Care, and led by NHS 24,
is rooted in the consultation and strategic model that have informed the
Enabling Partnerships strategy. It will provide the public-facing national
health information services that will draw upon the resources and
expertise of the National Health Knowledge Network, working through the
three delivery channels described. The National Health Information and
Support Service will create the primary, first-level entry point to patient
and public health information from local and national sources. It will
utilise the shared technology and content of the network to achieve this
and to provide links to the more detailed information within the network.
The National Health Information and Support Service will incorporate the
helpline service provided by NHS 24 as a second delivery channel. It will
also provide an overarching framework for building up the network of
health information access and support points in the community, promoting
use of quality assured health information resources wherever possible
and appropriate and developing health information literacy skills.
5.1.2 Developing an online network
a) Transform the NHS Scotland e-Library (www.elib.scot.nhs.uk) from a
collection of professional healthcare literature into a flexible, integrated platform
of information-sharing tools, information and learning resources and services.
Provisionally entitled Knowledge for Care, this will provide access to search the
full range of information and learning resources. Partners in the National Health
Knowledge Network will use this platform to share content and will tailor support
to create services relevant to their local needs and organisational priorities. The
2008 demonstrator projects illustrate how to achieve this combination of
integrated support and diversified access.
b) NES and the National Health Knowledge Network will support NHS 24 in
developing the online channel of the National Health Information and Support
Service as the primary, first-level entry point to information about health and
health services. They will also provide the wider library of more in-depth
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specialist information. Together these will support the public, patients and carers
in accessing information, self-management, shared decision making and
anticipatory care. This will be achieved through collaboration among NHS 24,
NES and other partners in patient/public health information, using the network's
shared pool of technology tools and resources. In this way, the online channel
will incorporate seamless routes into the more specialist information services
provided by Health Information Plus, the NHS Scotland e-Library and other
sources
5.1.3 Person to person information sharing
a) Deliver a national programme of health information literacy training with
supporting tools and guidance. This will use a cascade model to reach
healthcare staff, partners, patients and carers. It will include a specific focus on
evidence-based practice for healthcare professionals.
b) Define and evaluate the role of information prescriptions and bibliotherapy in
supporting self-management, empowerment of service users and carers, and
strengthening the role of information sharing in the patient-professional
relationship.
c) Evaluate and implement social networking tools to support the sharing of
knowledge and experience among patients, carers and staff in all sectors.
d) Create a continuously updated online directory and map of helplines and
support groups, using information-sharing technology to collate information from
national sources such as NHS 24 and the Telephone Helplines Association, and
local websites in NHS, local authority and voluntary sectors.
e) Expand and modernise the portfolio of tools and guidance offered by NES
Knowledge Services to support communities of practice in sharing information
and experience within and across teams and disciplines.
5.1.4 Network of physical access and support points
a) Using information-sharing technology, create a directory and map of physical
health information access and support points available for staff, patients and
public in NHS, local authority and voluntary sectors.
b) Implement and evaluate a programme of health information literacy support
and knowledge worker role development for access and support staff in
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community settings such as GP practices, voluntary health organisations,
community pharmacies and Citizens Advice Bureaux.
c) Provide a training and support programme to analyse and develop the
potential role of library staff in NHS, local authority and further education sectors
in supporting self-management, including application of information prescriptions
and bibliotherapy.
This workstream focussed on the mutual NHS will also lay foundations for developing
knowledge services for health improvement and health equality and improving the
quality of patient care, as outlined below.
5.2 Objective 2: Managing knowledge to create an enabling health
service -improving health and delivering health equality.
5.2.1 Online network
a) Create a Healthy Behaviour Learning Portal to support healthcare staff in
working with patients and public to change lifestyle behaviour and strengthen the
motivation to put information and learning about health and wellbeing into
practice in day to day living.
b) Create linked expert patient and professional online services for long term
conditions, including dementia, depression and addictions. This will be delivered
through the integrated platform of shared information and technology tools
described above.
c) Establish a Child Health Managed Knowledge Network and portal to support
the early years strategy and a child-centred approach to children’s services.
d) Pilot the use of online health information resources and information literacy
training to support health and wellbeing within the school environment.
e) Review and redesign the Remote and Rural Knowledge Portal
(www.elib.scot.nhs.uk/rural) to make use of the new information and learning
tools and resources provided by the integrated platform described above, to
better support the needs of remote and rural practice.
5.2.2 Person to person information-sharing
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a) Evaluate the impact of health information outreach and the knowledge worker
role in supporting people in disadvantaged communities to take more control
over their health and wellbeing. This will build on the success of the demonstrator
project in the Gorbals Healthy Living Network. It will include developing health
information literacy training and support for community development workers in
Healthy Living Networks and other community organisations in voluntary and
other sectors. There will be a particular focus on evaluating this approach in
addressing alcohol and drug misuse and improving mental health and wellbeing.
b) Develop a series of evaluative case studies based on the use of online social
networking tools by the diverse range of disadvantaged communities disadvantaged by, for example, age, poverty, ethnic origin, sexual orientation,
faith, mental health, literacy. This will be used to establish health and wellbeing
support networks involving service users, carers and staff.
d) Work with partners such as Carers Scotland to develop a web-based health
information and learning resource with accompanying information literacy training
for carers, recognising their key role as partners in health and healthcare.
5.2.3 Network of access and support points
a) Pilot the development of resource-sharing networks of health information
access and support points for patients, carers and staff, in selected Community
Health Partnerships, both urban and rural. These networks will connect existing
libraries and information centres in health, local authority and voluntary sectors.
The pilots will include work on defining governance structures, establishing
referral maps and identifying the training and support needs for the networks.
5.3 Objective 3: Knowledge support for safe and effective patient
care
5.3.1 Online network
a) Optimise the Clinical Decisions portal (www.clinicaldecisions.scot.nhs.uk) to
provide clinical evidence and best practice summaries to support clinical
decision-making at point of care in hospital and community settings.
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b) Implement an online evidence enquiry service, building on the expertise of
NHS librarians and other information specialists, to retrieve and summarise
evidence to support clinical and policy needs.
c) Establish an online knowledge service for the 18 weeks referral to treatment
programme. This will provide patients and staff with access to local and national
treatment pathways, linked to relevant evidence, guidelines, patient information
and support. Evaluate the potential for linking these pathways with relevant
clinical systems to support evidence-based practice at point of care.
d) Develop a Patient Safety Portal providing access to information and learning
resources to support quality improvement, reduction of risk and improved patient
outcomes in priority patient safety areas. These include congestive heart failure;
myocardial infarction; rapid response teams; prevention of adverse drug events;
central line infections; harm from high alert medications; pressure ulcers; surgical
site infection; ventilator assisted pneumonia; MRSA and MSSA.
e) Implement single sign-on access for users across these online national
knowledge services and national clinical systems, as part of the eHealth Identity
and Access Management programme. This will support seamless access to
evidence and knowledge alongside use of clinical systems at point of need.
f) Create portable search boxes for Clinical Decisions, e-Library and other portals
and embed them in clinical and management systems to deliver performance
support at point of need.
g) Establish a Knowledge into Practice portal to provide resources, tools and
guidance to support the effective translation of knowledge and evidence into
clinical and managerial practice.
h) Build workforce capacity through learning and development opportunities to
continuously improve the quality of patient care. The technology infrastructure
delivered by this strategy will:
-
provide online collections of information and learning resources for the
unidisciplinary and multidisciplinary educational programmes supported
by NES;
-
support an integrated e-Education system which builds on the knowledge
services platform described above. This will include management and
sharing of e-learning resources, administration, tracking and recording of
learning linked with the Knowledge and Skills Framework and other
competences.
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create an Education Portal to promote best practice in learning and
teaching for healthcare staff;
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implement a Leadership portal working across health and social care,
linked with the Health Management Online service.
5.3.2 Person to person information sharing
a) Embed core information literacy competences in the national educational
programmes supported by NES. This will ensure that the skills of defining
information need, finding, evaluating, sharing and applying information to practice
become a core component of learning and workforce development.
b) Design and evaluate training and support models for implementing the core
competences of the knowledge worker role among clinical and non-clinical
healthcare support workers, and administrative and clerical staff in hospital and
community settings such as practice managers, receptionists, ward clerks and
health records staff. This will support the integration of knowledge into practice to
support patient care at all levels throughout the system.
c) Define competences and evaluate options for implementing clinical
informationist competences 13 as part of existing practitioner roles in primary
care and hospital settings. This role will focus on enabling the delivery of
evidence based practice through providing and sharing information and
knowledge to support decisions at point of clinical care.
5.3.3 Access and Support Networks
a) Implement the Quality Assurance Framework for NHS Scotland Knowledge
Services as a core element of the evidence required for the NHS Quality
Improvement Scotland Clinical Governance and Risk Management standards.
The Quality Assurance Framework is founded on the principle of single-system,
collaborative working among knowledge services within each NHS Board. This
will reinforce the principle of partnership working across services, maximising
benefit from available resource.
b) Define a training and development programme for NHS Knowledge Services
staff to support their central role in contributing to and delivering on the goals of
this strategy.
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6. Conclusion
The strength of the National Health Knowledge Network is that so much of this
integrated service framework already exists. The demonstrator projects have illustrated
how existing resources, skills and technology can be shared and re-used to create a
whole system that is greater than the sum of its parts. The key challenges in establishing
this new system now lie in establishing effective coordinating structures and processes,
informed by clear standards and governance mechanisms. The principles of mutual
ownership and mutual benefit are already engrained in the health service in Scotland.
This strategic action plan shows how organisations, practitioners, patients and carers
can all maximise use of knowledge and learning to strengthen that mutual ethos in
improving Scotland’s health and delivering best quality patient care.
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References
1) Better Health, Better Care: Action Plan. Scottish Government, 2007.
2) Sharing Knowledge, Improving practice, Changing Lives: Draft Discussion framework
to support development of a Knowledge Management Strategy and Action Plan for
Social Services in Scotland, 2009-2012. NHS Education for Scotland and Institute
for Research and Innovation in Social Services, 2009.
3)- 5) Interview extracts
6) Better informed for better health and better care. A framework to support improved
information use for staff and patients. NHS Education for Scotland, 2008.
7) - 11) Interview extracts
12) Albert Einstein
13) Evolution of a mature clinical informationist model. Journal of the American Medical
Informatics Association 2005; 12(3): 249–255.
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