The NHS requires proactive knowledge services as business-critical instruments of informed decision-making. Currently there is significant variation in the ratio of qualified librarians and knowledge specialists to healthcare staff, leading to inequitable service provision across England. This means that the Service is not uniformly able to draw on evidence for #MillionDecisions. The introduction of a recommended staff ratio is a key action by Health Education England to enable individual organisations to identify and address that risk.
For the first time this policy, agreed by the Health Education England Executive in November 2019, provides a set of recommendations from which trusts and arm’s length bodies may look to ensure, and where necessary continuously build, improved staffing levels.
1. To optimise the benefits for the NHS of the emerging new roles for librarians and knowledge specialists, HEE recommends that all NHS organisations:
(i) review regular reports of the positive impact of the library and knowledge service on outcomes
(ii) work with the local library service manager to prioritise allocation of clinical librarian, knowledge manager and other embedded roles to specialities
(iii) take incremental steps to improve the staff ratio between qualified librarians and knowledge managers per member of the NHS workforce, through role redesign and by expanding this specialist workforce
2. HEE recommends that over time, all NHS organisations aspire to achieving a much-improved staffing ratio
3. HEE recommends that those NHS organisations with a staffing ratio in the region of the current average of 1 qualified librarian to 1,730 or more healthcare staff, strive to achieve a ratio of at least 1 qualified librarian or knowledge specialist per 1,250 WTE NHS staff.
4. HEE commits to monitoring the staff ratios annually and to reviewing the recommended ratio in three years’ time.
70 for #NHS70: endorsements for #AMillionDecisions at NHSConfed18
A fantastic two days of advocacy about the role of health librarians and knowledge specialists took place last week at the NHS Confed18 Exhbition in Manchester. Conversations were held with over 70 senior leaders across the healthcare system who signed-up to support the key messages of the campaign, highlighting the critical role of specialist health librarians to encourage the use of evidence and knowledge to inform decisions made in health care.
In addition four of our champions provided interviews about the necessity to use reliable evidence in health care decision making, outlining the multiple benefits from working with health librarians.
Louise Goswami and Sue Lacey-Bryant travelled from Manchester to Keele to deliver a keynote presentation to the CILIP Health Libraries Group Conference which described what has changed as a result of the campaign.
The campaign to-date
Phase One of the #AMillionDecisions campaign reached its conclusion at the end of 2017. The campaign was successful in gathering high-profile senior leader support and enabling conversations to take place about the critical role of library and knowledge services at a national level. Tangible results include the NHS Library and Knowledge Services Policy being embedded in the NHS England researc h plan; a pilot knowledge broker service for the National Association Primary Care (NAPC) care home initiative; regular communications to various NHS organisations about library and knowledge services and trialling questions relating to library services within the GMC survey. Further potential for greater partnership working with a range of organisations, such as the Care Quality Commission, NHS England and NHS Improvement are also underway. Further leads from events such as our presence at the NHS Confederation Conference 2017 are still being followed up.
Featured throughout the campaign were a series of social cards featuring endorsements from high-profile champions and the production of case study vignettes illustrating the impact of the work we do.
At a local level #AMillionDecisions has presented a clear message that can be used by Library and Knowledge service teams to celebrate the impact of their work upon healthcare services.
A meeting was held with CILIP in the early part of 2018 and a decision taken to continue to use the #AMillionDecisions messaging and branding as an ongoing initiative celebrating the critical role of specialist health librarians to encourage the use of evidence and knowledge to inform excellent health care and health improvement. The second phase of this initiative will focus around reaching out to those that employ health librarians and to NHS organisations and individuals which currently do not make use of library and knowledge services. It will share a range of outputs such as the Evidence and Knowledge Self Assessment Tool and the Literature Searching and Knowledge Mobilisation e-learning tools to encourage use of evidence and knowledge within the health service in England.
Further endorsements have been sought and published across social media – in 2018 these have included endorsements from Professor Gillian Leng, NICE; Professor Trisha Greenhalgh, University of Oxford; Dr Andrew Goddard, Royal College of Physicians; Dr Tim Swanwick, Health Education England; Dr Nav Chana, NAPC; Dr Jonty Heaversedge, NHS England and Professor Tim Evans, NHSI.
The illustrative case studies supplied by you continue to be shared as examples of good practice with many senior stakeholders.
How can you get involved?
We ask that you continue to use the #AMillionDecisions logo, collect endorsements from your own local champions and continue to submit impact case studies to the Knowledge for Healthcare Blog. Two basic templates are available for you to develop and share examples of your own local social cards and impact case study vignettes. Continue to use the hashtag in your social media posts and share key messages from the initiative within your organisations.
An Espresso Cafe was held at the CILIP HLG Conference to gather feedback about #AMillionDecisions. Notes from that session are available here.
#AMillionDecisions, the joint campaign by Health Education England and CILIP, the library and information association, was launched at the end of January 2017 with the key message inviting government and health service providers to make use of the skills of librarians and knowledge specialists to ensure that decisions are informed by research evidence.
What success has there been so far?
The campaign has been operating at two levels. Primarily messaging was targeted to senior leaders in the NHS arms-length bodies such as NICE, NIHR and NHS England.
The secondary focus of the campaign was to engage the health library and knowledge service workforce in England to use the campaign logo and messages to highlight the positive contribution they make to health care.
In tandem with the campaign has been promotion of the NHS Library and Knowledge Services in England Policy. This sets out a commitment by Health Education England endorsing the role of Library and Knowledge Services and has been a useful lever with which to engage stakeholders.
Inspired by #AMillionDecisions in England, health library and knowledge services in Ireland and Scotland have launched similar campaigns and Wales are considering something next year.
Following a pause in activity during the General Election period this phase of the campaign was successfully picked up again in June with face-to-face engagement with a number of senior executives at an NHS Confederation Conference exhibition stand.
What else is planned?
An approach has been made to the Secretary of State for Health to endorse the campaign and a breakfast meeting is being arranged with representatives from a range of NHS organisations at which the benefits of using librarians to mobilise evidence for decision making will be discussed. Following this meeting it is planned to issue an online pledge to be endorsed by anyone supporting the key message.
Leading up to the breakfast meeting further social cards with messages of support from our Champions will be released on Twitter along with further case studies illustrating the positive impact of health librarians.
Further activities to promote the message beyond the end of the campaign, including use of the signed pledge, will be taken forward in partnership by the Health Education England regional Library Leads and committee of the CILIP Health Libraries Group.