2025 local e-resources audit
About the 2025 local e-resources audit
Thank you to those of you who participated in this year’s local e-resources audit. We received returns from 99.6% of NHS organisations in England served by KLS, which is the most complete audit since we started collecting this data in 2018.
The audit asked for details of the e-resources bought for NHS organisations in 2024.
The total number of different e-resources purchased was 628. These range from individual e-journal titles, such as the Advances in Dual Diagnosis, e-journal collections such as the High Impact Collection or MAH Complete, and e-books such as Stahl Online or E-book Central, to point of care tools such as Dynamed and UpToDate.
The total estimate for local spend is £13,923,094. While we received cost data for most resources, there were some for which we did not. To reach a total we estimated undeclared costs based on either the median for similarly sized organisations or, if possible, the median for the same e-resources in the relevant workforce FTE tier.
There are 7 tiers from 1 for organisations with more than 15,000 FTEs to 7 for those with less than 3,000. See the explanatory guide on the service desk for more information about the tiers.
Finally, we added an estimate for all e-resources with undeclared costs for which it was not possible to estimate costs individually. Total declared costs was £13,578,699. The balance is derived from our estimates.
The largest amount of expenditure, 65% or £8,837,578, is on e-journals and combined databases of different formats, such as ClinicalKey or Oxford Medicine Online. 26.68% of expenditure is on point of care tools, mostly UpToDate and Dynamed.
The most commonly purchased resources include the ones for which NHSE negotiated national pricing deals based on number of relevant workforce FTEs, Mark Allen collections and the Wiley Medicine and Nursing Collection. Other resources which are bought heavily by NHS KLS, and which would benefit from a national pricing deal, include BMJ Case Reports and ClinicalKey.
The suppliers with £1 million+ of NHS KLS spend include Wolters Kluwer, Elsevier and EBSCO. These suppliers have remained pretty consistent over 5 audits conducted so far.
Looking at the data from previous audits there seems to be a decline in the number of individual e-journal titles being purchased, in favour of e-journal packages. This is likely the result of these offering better value for KLS where budgets do not keep pace with cost inflation in e-resources.
Saying that, some individual e-journal titles remain popular, including British Journal of Psychiatry, British Journal of Occupational Therapy, BJPsych Advances, Drug and Therapeutics Bulletin and the NEJM.
Some KLS buy tokens to higher value content, such as Springer Nature titles, Emerald and Elsevier e-journal collections. This buys x number of downloads. There has been a small, but definite, increase in the number of subscriptions to this type of product. A development being made to INCDocs is to remove these token-access collections from being requested by other libraries, which will enable all tokens to be used by purchasing libraries’ own users.
Some resources seem to have held up well over the years. Although it’s difficult to be precise due to having received fewer returns in past audits, BMJ Case Reports is still proving popular along with MAH Complete, ClinicalKey and UpToDate.
The biggest increases in the number of organisations with access include CINAHL Ultimate, the EBSO Nursing e-book collection and Health Business Elite. The largest falls include Cinahl Complete, Oxford Medicine Online and NEJM. The former will be due to services upgrading to CINAHL Ultimate and the latter probably because of their high costs.
ClinicalKey is still a popular resource which shows an increase on the 2023 audit with the caveat about more returns this time around potentially skewing the figures, but given its cost it’s no surprise that more individual subject collections are being purchased.
More KLS are buying learning and examination resources such as BMJ OnExamination, BMJ Learning and PassMedicine. Our advice is that the purchase of these resources is the responsibility of PGME, but it looks like pressure on Trust budgets is resulting in these costs landing with KLS.
There is a bewildering array of e-resources being purchased by KLS whether from their own budget or with help from other parts of their organisation. There is always something new. As well as AI being offered as part of an enhanced package, such as NEJM AI, other e-resources being bought for the first time include DynaMedex, FRCA Reveal, Maudsley Deprescribing Guidelines, BSI Knowledge, BMJ Impact Analytics and Stockley’s Herbal Medicines Interactions.
Looking at the gaps, there are a lot of resources you'd like to buy if you had the budget. These nclude big ticket items mentioned before, plus BMJ Learning and BMJ Case Reports. The latter helps strengthen the case for seeking a national pricing deal with BMJ Publishing.
National Core Content spend in 2024/25 was £6,140,801. This means 69.39% of expenditure on e-resources is spent locally, with 30.61% nationally. We know that there are cost efficiencies to national procurement and that this is the best way to deliver universal access across all sectors. It continues to be our aim to increase the scope of National Core Content and the data that you have provided is key to making the case for this.
That said, the recent cancellation of the OUP and ProQuest contracts has been a retrograde step. We will be running a mini e-resources audit in the summer to capture any additional purchases you might have made as a result of these cancellations. We will be asking you to tell us what you bought, how much it cost and an estimate of how much time and effort it took. Any intelligence you can share about these additional purchases will help us to show that cutting national resources leads to increased direct and indirect costs.
Note
The analysis is on the NHS Knowledge for Healthcare FutureNHS workspace. To access it you will need to register for FutureNHS and join the workspace.