A Pay per View project

Examining the efficacy of a pay per view system as opposed to subscriptions for journal access in an NHS healthcare library setting.


In the Autumn of 2015, Jo Thomas, Trust Library Services Manager at Northern Lincolnshire and Goole NHS FT (NLaG) and Jacqui Smales, Knowledge Services Manager at Hull and East Yorkshire Hospitals NHS Trust  (HEY) discussed submitting a bid to David Stewart to fund a ‘Pay per View’ project within the LKS of our respective Trusts. It led to discussions with Richard Osborn in 2016, under the ‘Discovery’ remit of the KfH strategy that  ultimately bore fruit in the form of some funding from Health Education England, enabling us, after some hitches setting up, to carry out the project from October 2017 until the end of February 2018. Jo and Jacqui enlisted the help of their staff members, Chris Lawton, Specialist Librarian for e-Resources at NLaG and Tim Staniland, Outreach Librarian at HEY, to run the project.

We wanted to see if we could build upon the work that Jenny Lang, Head Librarian at Salisbury NHS FT, had carried out in 2013 regarding Pay per View.


We could see that article requests were declining to a degree within our services, subscription bundles of e-journals were ever increasing in price, and the ‘bundle’ nature of them meant that they always included a considerable percentage of content that we felt we did not need or want.

Although NLaG still subscribed to e-journal bundles, HEY didn’t, meaning that we were potentially good comparison sites to run such a project. We wanted to know if it would be cheaper for our users to access content of journals on a pay per view basis which would mean that we, as librarians/knowledge managers, would only be paying for what was actually being used. We thought that the results of our project may also help inform the procurement decisions surrounding the National Core Content.

Different Approaches

It was decided that we would take a different approach to the project at each site, with NLaG using a debit card to purchase articles online on behalf of our users, therefore taking a mediated approach. HEY purchased a ‘bundle’ of articles/book chapters using Elsevier’s ScienceDirect ArticleChoice®service with the intention of letting their users ‘loose’ in terms of acquiring their own online journal articles via ArticleChoice®

Our Findings

At NLaG we had to promote our PPV article request service regularly to get any uptake, and ultimately used PPV to satisfy our regular article request service.  For the duration of the project we logged ease of access or any difficulties encountered when purchasing articles for our users.

At HEY only 2 people took up the offer of being given access to ArticleChoice® and only towards the very end of the trial, one of those individuals then got in touch to say they were having difficulty using the service.

It was decided at HEY not to open up the project to satisfy regular article requests. However, in order to understand the experience of the individual having difficulties, we tried the ArticleChoice® service ourselves and realised that it could be quite cumbersome for users not regularly searching databases or online journals themselves to access articles via this particular method.


From our small study, it became clear that pay per view using a debit or credit card, albeit a mediated approach, is a viable economic option for LKS with a small budget. However, the drawback of the mediated approach is of, course, that it can only occur during the staffed opening hours of the LKS. The ScienceDirect ArticleChoice®approach can be both a little cumbersome and relatively narrow in scope compared to using a debit/credit card, but has the advantage for the end user of being available outside of normal working hours.


A combination of maintained ILL lending groups that have well thought through subscription plans, spreading the costs across different sites, whilst maintaining access for as many libraries as possible combined with pay per view, British Library On Demand and Open Access, would be an excellent step forward.

Full report can be found here

Chris Lawton, Jacqui Smales, Tim Staniland and Jo Thomas

What goes up, comes down and stays roughly the same?


In this blog I would like to give an overview of the collated activity data that you have been submitting to your regional Library and Knowledge Service Leads. I will look at some of the trends in the hope of starting a discussion about what the trends might mean.

High level overview

In the three years since the 2014 publication of Knowledge for Healthcare, library and knowledge services staff have:

  • Supplied 6.2 million items (books, reports, articles)
  • Handled 3.7 million enquiries
  • Trained 513,000 NHS staff
  • Supported 97,000 expert searches

The breakdown by year is shown below:

  2012-13 2013-14 2014-15 2015-16 2016-17  
supplied 2.1m 2.2m 2.7m 1.8m 1.7m items
handled 1m 1.2m 1.3m 1.2m 1.2m enquiries
Trained* 140k 153k 174k 176k 163k staff
supported 32k 31k 32k 32k 33k expert searches

* includes user education and user induction totals

What is collected?

The Health Education England Regional Library Leads and their predecessors have routinely asked you for data on among other things the following:

  1. Enquiry services – providing answers to questions
  2. Information consultancy – expert search services
  3. User education – training users
  4. User induction – ensuring they know what is available to them
  5. Document supply – books, copies of articles etc.
  6. Current awareness services – keeping up-to-date

The data provides a rich picture of the ups and downs of some of the activity that you NHS library and knowledge services staff undertake to enable your users access the evidence they need to support their work, studies or research.

What does the data show?

1. Enquiry services

A key part of our role as library staff supporting NHS staff and learners is in answering queries from your users.  These take two different forms: procedural /directional enquiries and Information resource related enquiries.

Procedural enquiries e.g. “How do I join?”, “What are your opening hours

Directional enquiries e.g. “Where can I find this book?”,  “Where is the copier?”

Information resource related enquiries e.g. “Where can I find a copy of the Hippocratic oath?”, “How do I search for..?”, “What have you got on..?”, “Can you show me how to..?”.

The split of the categories has remained relatively steady over the years with an average of 61% of enquiries being procedural or directional. The total number of enquiries is steadily dropping off from the highest level in 2014-15. Can we assume our users are more skilled at finding the answers for themselves or can you suggest another reason for this decrease?

Enquiries by type
  2012-13 2013-14 2014-15 2015-16 2016-17
Number of procedural/ directional enquiries 603,762 733,193 796,908 745,738 699,168
Number of information resource related enquiries 418,995 452,651 491,824 474,808 460,299
TOTAL 1,022,757 1,185,844 1,288,732 1,220,546 1,159,467

2. Information consultancy – expert search services

This covers mediated searches i.e. where library and knowledge services staff undertake a literature search on behalf of users. We are experts in searching for information and doing it more quickly and effectively than our users particularly when it is a multi-faceted search or one where results cannot be found in the traditional databases. The figures have remained relatively steady over the last five years although 2016-17 shows the highest figures for this five year period. We are providing more clinical/outreach services which traditionally encourage more requests for mediated searches.

  2012-13 2013-14 2014-15 2015-16 2016-17
Total number of mediated literature searches 31,978 31,121 32,550 31,668 32,819
No. of clinical /outreach librarian services 106 113 111 104 113

3. User education

Complementing the bespoke service we provide, we also support NHS staff and learners to “do it themselves”. We train them (user education) to carry out effective and efficient searches on databases and websites by giving them the skills to narrow down their searches or broaden them as appropriate. We try to show them that “just googling it” is not necessarily the effective way to find answers.  Any thoughts on why the number of users receiving user education is now dropping after increasing each year since 2012-13?

2012-13 2013-14 2014-15 2015-16 2016-17
No. of library users receiving user education 41,301 45,576 51,814 53,594 47,425
Total number of user education sessions 20,097 22,945 26,845 27,748 24,086
Of which no. of 1-1 training sessions 14,651 15,440 18,972 16,533 15,683
Of  which no. of group training sessions 4,171 3,732 4,681 4,421 3,554

4. User induction

We also ensure they know what is services are available for them to use (user induction). We know that in many Trusts library and knowledge staff no longer have a slot at corporate inductions and have to find new ways of introducing services to new Trust staff and the figures back this up for 2016-17.

  2012-13 2013-14 2014-15 2015-16 2016-17
No. of library users receiving induction/year 98,737 107,393 121,709 122,456 115,519
Total number of user induction sessions 34,458 35,457 38,974 40,872 36,596
Of which no. of 1-1 user induction sessions 27,136 29,545 32,299 33,818 29,711
Of which no. of group user induction sessions 5,089 5,269 7,614 5,567 4,652

5. Document supply

Libraries have traditionally been seen as storehouses of printed books and journals. We now our art is sourcing items and supplying them without the requester necessarily knowing the items are not from your own stock.

Where once users relied on library staff to deliver the whole package: conduct the expert search, source and then supply copies of articles or other items – Increasingly users are doing it for themselves. Users issue and renew book loans via our self-service machines and download articles from national, regional and local e-resources or the growing number of open access journals. Downloads of chapters from books by users are also another element of self-service.  Anecdotally we also suspect our users are becoming more discerning and request fewer items or are abstracts now their key source of information?

2012-13 2013-14 2014-15 2015-16 2016-17
Total items supplied  to users 2,117,528 2,059,429 2,781,557 1,820,143 1,554,799
Total items received for users 264,369 270,138 133,551 115,551 90,498

6. Current awareness services

With information overload increasing every year, we help to lay a path through the information forest. We provide a range of current awareness service designed to alert users to new information in their areas of interest or to keep them up to date. We do this in three ways: we create, modify or contribute to someone else’s bulletins or circulate a bulletin from another supplier without any changes.

2012-13 2013-14 2014-15 2015-16 2016-17
Current Awareness Services Provided by LKS 956 961 1,046 1,134 1,215

The chart shows the number of library and knowledge services providing one of more type of current awareness service.  While the production of new acquisition bulletins is decreasing; the number of subject/topic bulletins is increasing with a significant increase in 2016-17 for personalised bulletins (e.g. from sources such as KnowledgeShare).

We also use different means to deliver current awareness:

  • E-toc alerts (electronic tables of content from journals)
  • Library blog or wiki
  • Netvibes or equivalent
  • RSS feeds
  • Social networking (e.g. Twitter and Facebook)

Perhaps most significantly while other formats of current awareness are staying steady, there have been major increases in the use of social networking (e.g. Twitter and Facebook) as a means of delivering current wwareness services with a 156% increase from 2012-13 to 2016-17.

Have you shared what you produce through the CAS portal? Why not have a look at http://kfh.libraryservices.nhs.uk/current-awareness/

Looking forward

Library and knowledge staff are certainly moving with the times and finding new ways to deliver services. From 2017-18 the HEE Leads will be asking you to report on different aspects of the services you deliver (see the 2017-18 annual statistics return). It will be interesting to see what the next five years show about how what we deliver and how we deliver it in a world of increasing automation and collaborative working.

I am also interested to see the outcome of the HEE Leadership project that is currently gathering information about what you collect locally and how you use it. The group will be developing a Statistics Toolbox to help you. Watch out for a presentation/ focus group being held near you soon.

If you would like to see more of the data for 2012-13 up to 2016-17 please download the summary file.

If you have any thought or comments on the data please add a comment to the blog.

Linda Ferguson

HEE LKS Statistics Lead


Core Content Re-procurement Update

As you know, the current contract for core content resources  has been extended to 31st March 2019.  HEE is now in the process of deciding which resources to purchase from April 2019 onwards, supported by a Core Content Re-procurement Group including representatives from HEE and LKS in each region and colleagues from NICE (group members are listed below).  The results of the recent survey of LKS managers and audit of local e-resource procurement are very interesting and have significantly informed our thinking.

The key findings from the survey of LKS managers are that:

  • There is broad support for the selection criteria we have proposed, although several respondents surveyed suggested additional criteria
  • The most popular type of resource for national procurement is bibliographic databases
  • The top three individual resources identified for inclusion in the national collection are Medline, Embase and CINAHL with full text
  • The single resource which was most popular as a suggested addition to the national collection was Clinical Key
  • The most popular resource type suggested as an addition to the national collection is a collection of journals or a specific journal title and there was also considerable support for provision of a point-of-care tool
  • There is general agreement that a bespoke single search solution for access to NHS-funded e-resources is essential, both for end-users and for NHS librarians and advanced searchers
  • There is agreement that it is reasonable to expect NHS librarians and advanced searchers to use suppliers’ interfaces to bibliographic databases, though there is also a significant amount of divergent opinion
  • There is general agreement that evaluation of suppliers’ interfaces should form part of the selection criteria for inclusion of resources in the national collection
  • There is no clear consensus about the desirability of having a national discovery service
  • There is continuing disquiet among some librarians about the reliability and functionality of the HDAS interface and the quality of the ProQuest search interface
  • Most managers indicated that they would definitely or possibly be willing to contribute local funding to collaborative procurement, but with caveats relating to understanding the detail and cost benefits
  • There was broad support for the draft HEE Digital Content Strategy and many useful suggestions for augmentation

If you would like to see the full survey report, if you are in the London & South East please email lucy.reid@hee.nhs.uk, if you are in the Midlands & East please email richard.bridgen@hee.nhs.uk, if you are in the North please email dominic.gilroy@hee.nhs.uk and if you are in the South, please email jenny.toller@hee.nhs.uk.

The audit of local e-resource procurement reveals which e-resources are most commonly being purchased at local level, the total spend on each product/with each supplier, and an indication of usage levels and cost-per-download figures.   We are treating this information as confidential and therefore not in a position to share.

We are now using the survey and audit feedback, together with our knowledge about usage of existing core content resources, to derive a short list from a long list of resources for which we would like NICE to seek quotations. We are, of course, highly mindful of our budget constraints.

In terms of next steps in the process of re-procuring content for 2019-2022, the timeline is:

2018 Activity
End March Confirm with NICE the specific products we would like suppliers to quote for
May Suppliers are invited to quote for our selected products included in tender
July Suppliers respond with quotes and how they meet the tender specification
August – October Quotes evaluated
November Contracts agreed with successful suppliers
April New resources become available

If you volunteered your services to help with the evaluating resources, now’s your chance.  Please see the email from my colleague Lucy Reid from HEE London and South East about what we need you to do and how to get involved.

Richard Bridgen, Knowledge Systems Manager, HEE Midlands and East on behalf of the Content Re-procurement Group:  Nicola Ager, Kaye Bagshaw, Helen Bingham (Chair), Richard Bridgen, Alan Fricker, Imrana Ghumra, Dominic Gilroy, Steve Glover, Celestine Johnston, Lucy Reid, Marion Spring, Jenny Toller