Building the workforce Staff ratio policy

About the specialty workforce required and the recommendations to achieve it

Building the specialist workforce required

HEE has an active workforce development work-stream for this specialised workforce. Tailored continuing professional development focuses on up-skilling today’s library workforce in mobilising evidence and knowledge.

To build the talent pipeline, the national team meets regularly with HEIs that offer courses in knowledge management and library science.

HEE has taken a lead role in shaping the new health librarianship module within the Library and Information management Masters at Manchester Metropolitan.

The team is in discussion with other education providers. The team also encourages a research perspective on these emerging roles.


HEE’s analysis demonstrates that library and knowledge services with better staff ratios are more able to work proactively with a wider range of healthcare teams to enable evidencebased decision-making impacting on treatment options and the quality of patient care as well as impacting on productivity gains and cost improvement and the spread of innovation.

The analysis has decisively demonstrated the relevance of staff ratios:

  • knowledge services with fewer qualified staff per workforce headcount are challenged to meet the 90% minimum compliance threshold defined in LQAF
  • where there is greater capacity than the current average staffing ratio of 1 qualified librarian or knowledge specialist per 1,730 WTE healthcare workforce, we see greater compliance with the LQAF standards and greater reporting of positive impacts on healthcare

The data shows that NHS is not yet positioned to optimise the emerging roles of embedded librarians, knowledge specialists and knowledge managers within the skill-mix of multidisciplinary clinical and managerial teams.

The very best staffed NHS library and knowledge services lack capacity to reach all the teams whose patients and staff would benefit from their contribution. There is insufficient capacity to incorporate these roles within teams to inform evidence-based improvement in care, the spread of innovation, improved productivity and cost savings.

The introduction of a recommended staff ratio is a key action by HEE to enable individual organisations to identify and address that risk.

Policy recommendations

These recommendations were approved by the Knowledge for Healthcare Board on 9 September 2019 and by the Health Education Executive on 5th November:

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 muchimproved 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.