Reflections from UCL Library and Information Studies students taking the Health Librarianship Module - part 1

Reflections from students taking the Health Librarianship Module

In the early part of this year I had the privilege of supporting the delivery of a Health Librarianship module to Library and Information Studies students at University College London (UCL).

Over ten weeks we delivered a weekly session on a variety of topics integral to the work we do as health librarians and to give the students a broad look at the structure of NHS Knowledge and Library Services.

Many people took the time to support the delivery of the sessions or mentor the students, so a big thank you to everyone who contributed. We had five students who took the module, and two who were being marked for the course.

As part of their assignments we asked the students to write two reflective pieces looking at a topic they had enjoyed from the course. Here we have the first two pieces for you to read.

I hope you enjoy their reflections as much as I did.

Marshalling Evidence Through Advocacy

Andrew Lacey

The first weeks of the Health Librarianship module have been enlightening. It has been interesting to learn where the long-term plans of the NHS and Library and Knowledge Services (LKS) intersect.

What struck me was the push within Health Education England (HEE) policies (Reid and Mitchell, 2019) to directly input into patient care by focusing on the roles of embedded librarianship.

Embedded LKS roles require taking greater responsibility for delivering evidence into patient care and trust services. This is pivotal to HEEs drive for NHS LKS to be regarded as business critical.

Many libraries only reach a fraction of their potential user group, and health libraries are no different. In fact, this is more pronounced due to the extreme time constraints placed on medical staff. Additionally, the ability to reach all users within the Integrated Care Systems (ICSs) model is challenging.

A study of nursing staff’s involvement with Clinical Librarians (McTavish, 2017), demonstrated time pressures as being the main barrier to engagement with Evidence Based Medicine (EBM).

By utilising Clinical Librarians as a tool of instructional outreach and advocacy, the nurse’s application of EBM became simpler and less time constrained. This reinforces HEEs value proposition: the ‘gift of time’ (Health Education England, 2020).

Central to this temporal gift is Clinical Librarians’ ability to find the best evidence; and fostering a clinical environment that encourages the asking of questions and thus the evolution of clinical practice.

Embedded librarians become a tool of advocacy by demonstrating the tangible role that LKS can play in improved patient outcomes and cost saving possibilities. What remains challenging is how to effectively demonstrate value to individual trusts?

These roles mean engaging at all levels in multifaceted ways. From working with clinicians; to imputing into research, clinical governance, and service improvement. Take-up of embedded librarianship across different trusts has been stymied by an ongoing challenge of communicating value to the right people, to secure funding.

The application of which felt frustratingly inconsistent, especially when coupled with the statutory requirement of the NHS to use evidence to inform practice. However, case study promotional material was effective, and work was ongoing to develop LKS professionals with the soft skills to influence at a higher organisational level.

A recent study articulated the value of embedded librarians, not only to qualified medical staff, but also medical students (Gibbons and Werner, 2019). Students experience a culture shock when transitioning from academic learning to practice, and the skills of embedded librarians are currently an underutilised area of learning support.

A way of communicating value to trusts could be a greater alignment with medical students on placement; a user group who potentially engage more with EBM compared to qualified clinicians.

Ensuring EBM is structurally incorporated and that practitioners possess the skills to facilitate it consistently, emerged as the two main barriers to evidence mobilisation. Yet, embedded librarianship can inject energy into EBM application, by articulating the increased need in the cross disciplinary working involved in Integrated Care Systems (ICSs).

With the expected release of a Governmental white paper setting out overhauls to the NHS England model, demonstrating service value will remain challenging. However, a proposed greater emphasis on service integration could benefit LKS going forward (Blackall, 2021).

It has been brilliant to discover the tangible differences that LKS make to service improvement and patient outcomes, and the rigor with which HEE are amplifying the work of LKS staff. Demonstrating their important value to UK health services.

Bibliography

Blackall, M. 2021. Guardian: Boris Johnson planning NHS England overhaul. [online]. Available at: https://www.theguardian.com/politics/2021/feb/06/boris-johnson-planning-nhs-england-overhaul-leaked-paper-shows [Accessed 7th Feb 2021].

Gibbons, P and Werner, D A. 2019. Embedded Clinical Librarianship: Bringing Medical Reference Services Bedside. Routledge. Public Services Quarterly,15 (2), p.169-175.

Health Education England. 2020. Library and Knowledge Services Value Proposition: The Gift of Time. [online] Available at: https://www.hee.nhs.uk/our-work/library-knowledge-services/value-proposition-gift-time [Accessed 15^th Mar 2021].

McTavish, J. 2017. Negotiating concepts of evidence-based practice in the provision of good service for nursing and allied health professionals. Health Information and Libraries Journal, 34, pp. 45-57.

Reid, W and Mitchell, P. 2019. Quality and Improvement Outcomes Framework for NHS funded library and knowledge services in England. [online]. Available at:  https://www.hee.nhs.uk/our-work/knowledge-for-healthcare [Accessed 4^th Feb 2021].

School libraries could learn a lesson or two from health library advocacy strategies

Penny Williams

When a new Health Librarianship module with Health Education England was offered to students on the Library and Information Studies course at UCL this year, I was instantly intrigued.

I had heard within the library community that health librarianship is a growing field, at a time when so many other library sectors are facing threats. The truth was though, I only knew a snapshot of what health librarians do, and it turned out I was not alone.

As I learnt more about the integral role health librarians play within the health services, I was seriously impressed and found myself waxing lyrical to curious colleagues. It became clear why advocacy is so essential.

The lack of awareness within the field came as more of a surprise. I was reminded of similar issues in my school library role and saw areas where schools could model health advocacy strategies.

Advocacy has been described as vital for health librarians in their daily interactions with colleagues in all sectors of the NHS. Librarians are walking adverts for all that the service has to offer. Be visible, be approachable, do an excellent job, prove your value.

As a school librarian, such approaches have become all-too familiar. Funding cuts and library closures have necessitated the #GreatSchoolLibraries campaign, launched in 2018, which could well have been inspired by #AMillionDecisions with its evidence-based approach and use of case studies.

It sought to ‘encourage Ofsted to recognise libraries and librarians in their school inspection framework’ (Great School Libraries, n.d.). This perception of the library as ‘other’ and being treated differently to teaching departments has been echoed to some extent by health librarians in their experiences with clinical departments.

However, greater strides seem to have been made by #AMillionDecisions in raising the profile of the service within the NHS[1], and schools could benefit from considering why this might be.

Whilst the value of NHS Library and Knowledge services are calculated in economic terms, and the potential net economic benefit believed to be £77m per annum, ‘further high-quality NHS based research will help to quantify the ‘gift of time’ for healthcare professionals and the associated quality improvement benefits for patients.’[2] In school terms, the practise of ‘Save the time of the user’[3] could also be better applied and efforts made to quantify the value-added school experience offered to students.

As part of #GreatSchoolLibraries, a CILIP Briefing Note was written for librarians to present to school leadership, explicitly outlining the value of investing in school libraries and professional library staff (n.d.). This letter demonstrated that there was no longer an inherent understanding of the role of the school librarian, forever altered with the arrival of the digital age and new ways of accessing information.

It seems, health librarians too have faced this need to reappraise others about their role and to demonstrate that their skills and working practices have moved apace with digital developments, ensuring they are a huge asset in today’s healthcare organisations.

Developing and showcasing these skills is fundamental to advocacy but, sadly, school librarians are not offered the same opportunities for CPD as their health counterparts. In 2019 only 44% of school librarians completing a national survey had experienced some form of CPD during the previous year.[4]

In comparison, ‘over 1,600 LKS staff attended over 90 different events in 2019-20.’[5] It has been refreshing to encounter an unwavering belief from health librarians in the ‘gift of time’ service they are offering, backed by training and support[6].

With minimal CPD for school library staff, many lack the confidence to effectively advocate for themselves, preventing future CPD funding and exacerbating the problem. The generous training offering from the NHS is testament to the future of the service and schools could look at the possible impact of a similar approach on the value-added student experience school leadership teams are seeking.

References

CILIP. and CILIP School Libraries Group. (n.d.) Briefing note: school librarians empower thriving schools [Online]. Available from: https://www.cilip.org.uk/members/member_engagement/groups.aspx?id=201313 [Accessed 16 February 2021].

Great School Libraries. (n.d.) What are the campaign strategies? [Online]. Available from: https://www.greatschoollibraries.org.uk/about [Accessed 15 February 2021].