Librarians set to be NHS cure

Librarians working in the NHS have been given a shot in the arm by the publication of a report that argues they should be as much a part of healthcare as doctors, nurses and other clinical and support staff.

The report recommended that so-called health libraries should be at the heart of an evidence-based NHS, helping to inform decisions about everything from which services to commission to the best treatments available for specific medical conditions.

The issuing of formal guidance by the Department of Health stressing the importance of library and information services is among the recommendations of the national review of NHS health library services in England.

The report, commissioned last year by the National Library for Health and published in March, recommended the appointment of a chief knowledge officer at board-level within each NHS body to ensure that the dissemination of information is given priority.

The report added that health libraries should spearhead staff training and development to help challenge incorrect assumptions among clinicians about the best way to treat patients, and to weed out poor care, mistakes and waste.

As the author of the report, Peter Hill, professor of the University of Newcastle’s Institute of Health and Society, put it: “The challenge for healthcare librarians is to demonstrate that the services they provide actually support clinical care.”

Spreading the knowledge
The document is part of wider moves to make the NHS far more responsive to developments in scientific knowledge. It echoes the findings of the health minister Lord Darzi’s report last year on the NHS in England, which proposed a new NHS evidence service.

The thinking behind such initiatives is that if healthcare decisions are based on the best available evidence, the entire health system will become more efficient, more effective and ultimately cheaper.

The report was welcomed by the Health Strategy Group, a joint initiative between the Chartered Institute of Library and Information Professionals (CILIP) and the Society of College, National and University Libraries (SCONUL), which aims to keep health libraries informed about developments in the health sector.

Kath O’Donovan, chair of the Health Strategy Group, described it as an “excellent report” adding: “It acknowledges the contributions already made by libraries and librarians working in healthcare but sets out a challenging agenda to put them at the centre of supporting an evidence-based healthcare system in England.”

Nearly there
But just how far are the 1,300 health librarians and 267 NHS library services from the vision set out in the report?

According to O’Donovan, not very far at all.

“I think we are a long way down that route,” she told IWR. “Libraries have always had this relationship with their clients where they are well respected and considered equals. They have always been central in keeping clinical practice up to date by informing staff about the latest guidelines and research.

“But this report gives us a new focus. It gives health librarians an authority and the opportunity to be right there in the clinical teams. Clinical staff can see librarians as essential partners in the delivery of evidence-based healthcare.”

Bruce Madge, vice-chair of the Health Strategy Group and president of CILIP, agreed.

“The opportunities will be there for libraries to become established as the lynchpin of this new service and for librarians to become navigators of evidence sources, informing best clinical practice and quality commissioning within the NHS, and supporting the lifelong learning and development of all healthcare staff,” he said.

But Hill, who is also honorary chair of Newcastle University’s Institute of Health and Society, was more circumspect. He acknowledged that the shift required among health staff as well as librarians would be “substantial” if the report’s “lofty aspirations” are to be met.

Among the challenges will be those posed by funding and accessibility.

While the NHS has always valued the input of health libraries and librarians, O’Donovan said there had been problems with resources.

While certain professions such as medicine have historically been able to attract funding for library services, in many cases paying for world-class facilities, others, notably nursing, have found it more difficult.

Meanwhile, as the report points out, some parts of the NHS are harder to reach than others; in particular, fragmented community-based services such as those in mental health.

New funding arrangements which enshrine the rights of NHS staff at all levels to have access to training and development are likely to begin to close those gaps.

The National Library for Health, which aims to make all NHS-funded libraries accessible online through a single search environment and is likely to oversee many of the report’s recommendations, will also be an essential tool.

More than repositories
Hill set out his vision in this way: “Libraries should no longer be thought of as book repositories, but be seen as a modern and essential part of a service to support the NHS by adding measurably to the health improvement of individuals and populations.”

To meet that challenge, health librarians and library services will have to become ever more responsive to those they serve, offering innovation and outreach to make sure their input is felt both by those working within the NHS and the wider public.

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