Knowledge for Healthcare

Sue Lacey-Bryant: Our strategy for the next 5 to 6 years is firmly focused on working with you alongside you, supporting all that you do. Mobilizing evidence, sharing knowledge, improving outcomes for patients.

This is an introduction to the strategy.

And it's excellent to see that as we put this strategy to the Health Education board last autumn, our brand new chief exec Dr. Navina Evans was really keen to support it. As she says here at the preface to the document, applying knowledge into action is the currency of a successful healthcare organization and taking the heavy lifting out of getting evidence into practice, to improve the quality of care, the services that you're working with offer the gift of time to healthcare professionals. So this is clearly a strategy for knowledge and library staff, but in a sense, it's primarily a strategy for employers so that they can see what you do and the benefits of your work.

This slide gives you an overview of the structure of the document. Significant progress has been made since the first edition of knowledge for healthcare in December, 2014.

And today I'll be looking ahead rather than looking at collective achievements over the past 5 years or so. But I do warmly encourage you to go away and read the document. And as you do it, I invite you to take the opportunity to pause and be pleased with your work, and what you've achieved. So inevitably much of the detail is in the full document. I'd invite you to look at the executive summary as well. That's designed for you to share with your execs and with senior colleagues. And I encourage you to look at it and think about how best you can disseminate the strategy to engage their support in the work that you're doing. And you see here, this outline that's the strategy document.

So you'll know of course that Health Education England is the strategic lead for NHS knowledge and libraries services on behalf of the healthcare system. What we've done here in the 21 to 26 strategy is to build on the previous work and you'll find that much is the same. Our ambition remains the NHS bodies, their staff learners, patients, and the public use the right knowledge and evidence at the right time, in the right place. And that is all about enabling high quality decision-making, learning, research and innovation to achieve excellent healthcare and health improvements for patients.

So this refresh of the strategy though, has given us an opportunity to look at the balance of the document. And it now includes things that were perhaps not so fully expressed in the original version. Not least the need for us to build on the evidence-base for our own practices, knowledge and library services staff, and to pick up on new things like the value proposition, full knowledge on library services in the NHS, a really significant piece of work since the first version.

We know it is not enough to have the right healthcare teams in the right place, collaborating, working together to deliver high quality, and efficient care. It's also essential that they use the right knowledge and evidence at the right time. So evidence is critical to the quality of healthcare work. The work that you do is critical to patient safety, to healthcare, to serve as transformation, the staff and learners alike need ready access to high quality evidence and to your expertise and the resources that you deliver through knowledge and microservices. So we are about encouraging boards to strengthen their capability, to manage knowledge and mobilize evidence. Get it moving, get it applied and getting the right expertise, roles, and resources in place to realise the business benefits of NHS knowledge and library services is a thread right the way through this strategic framework. It sets the direction. It defines priorities with the development of services over the next 5 or 6 years, you'll see a renewed focus on things that you were familiar with getting the right team resources and services in place. As I've said, mobilizing evidence and knowledge, enabling resource discovery, ensuring the quality of knowledge services, improving health literacy, right the way across the piece. And of course, providing opportunities for us as knowledge and library specialists to develop and gain confidence and skills.

So again, we see that significant progress has been made since the publication of knowledge for healthcare, 2015 to 2020.

And I want to take this opportunity to thank everyone who's contributed to these successes. It's your expertise, support and enthusiasm as NHS knowledge and library specialist that's been a powerful factor in the success of knowledge for healthcare and the growing visibility of the profession. And so we're able to build on these achievements as we set our priorities for the next few years. And over that time, We'll be focusing on getting in place a high quality, digital knowledge infrastructure to meet the needs of staff and learners, working with you and your teams to further develop the skills and confidence to deliver the vision of knowledge for healthcare and working with you and employers to shape forward-looking and innovative health knowledge and information services, and all the time our purpose is this it's about enabling staff and learners to benefit equally from high quality knowledge services and to really optimize the expertise that your teams, you and your teams bring to inform decision-making whether that's towards other bedside and in community and primary care settings.

Evidence doesn't speak for itself. We know that. It needs to be mobilized at the right time and through the right people to make a difference in decision-making and partnership working was a vital thread in the first edition and it remains so. None of us can achieve what we want to do on our own. We need a commitment at every level.

So through phase 2, we'll work with our partners to harness this capability to successfully transform policy. Practice and health outcomes, obviously in line with the long-term planners policy level, but locally you'll know how closely your library works with others in your network and often with university in public libraries too.

So this is true, absolutely across the  system and will be ever more significant as the NHS moves forward and as we see new organisations new structures, such as integrated care systems coming in. So partnership working remains absolutely central, optimizing resources, reducing duplication, but also this key issue about buying strategic buy-in and through the strategy we invite stakeholders and partners to continue to work with us to better to deliver knowledge for healthcare.

We live in a time remarkable change. And week by week, we hear promising new technological developments that can help us to provide better healthcare through the national health service. So preparing the healthcare workforce to embrace opportunities is a key element of our work. The healthcare workforce needs to be educated, to be responsive to innovation and new technologies with knowledge about best practice, about research, about innovation. Digital technologies offer the promise to deliver healthcare on a far more rational, efficient and tailored basis. And our profession library knowledge specialists that have key role in this and empowering staff and learners in all disciplines and all specialties and settings to respond effectively, giving them an opportunity to seize these opportunities.

So this is all about the staff and learners. And here we see an increase in usage over the 5-year period, which we can flag and signal to NHS employers. I guess this too really emphasises the importance of the statistics that you collect on a day to day basis. Helping you tell the narrative locally, or for us to tell this narrative nationally.

So we've talked about NHS staff and learners. We talked about the increase in use of resources, and you can see here the confirmation that at a really high profile level, the message about the vital role play as knowledge and library specialist is getting through.

So here we have trust chief excec Rob Webster announced as the chief executive the year 2020 Health Service Journal (HSJ) awards, just recently, saying our library and knowledge service enables us to be a learning organization ensuring our staff are well supported to make informed decisions and to continue to drive innovation.

So we're focused on building on the great work we've done over the past 5 years, delivering knowledge for healthcare and there is still much to do. We've demonstrated the value proposition for NHS knowledge services. An independent cost consequence analysis has demonstrated that return on investment. We carried out work around the benefits of aligning health librarians that we ought to see more services where you've got knowledge specialists working with more teams closely with teams having a greater impact, taking that heavy lifting out of getting evidence into practice. And we know too that there are issues like funding to address. And I'm proud, actually, with my team and together with yourselves, we're addressing some of the things that have been in the too hard box for a very long time. Like funding and like services to primary and community care. And so we know that it isn't all going to be easy sailing or plain sailing as we go ahead.

But using this evidence-base and taking a phased approach and building on the work through phase one, we're going to work with partners to achieve equity of access and opportunity to delivered through the right resources, right team with the right roles on the right services. That's our ambition.

So this, comes from our ground breaking report, the Gift of Time, which demonstrates the value that NHS knowledge and library services deliver against the quadruple aim. Just reminding ourselves of what that is, it's around improving the health of populations, enhancing the experience care. The patients reducing the per capita cost of healthcare and improving the staff experience of providing care.

So the Gift of Time is an independent report commissioned by a Health Education England from economics by design, we found that there is a growing and consistent body of robust international evidence to support this value proposition. The service provides healthcare professional staff with time-saving accelerated access to better quality evidence, which in turn enables the NHS to meet its statutory obligations, to utilize evidence from search and as importantly for health professionals to use their time more effectively to drive improvements. You can see that with a national spend of 55 million cost in the value of the saved time, knowledge and library services across England, delivering a net benefit of 77 million pounds a year to the NHS.

Good for us to know, good for chief finance officers at trust level to know too.

So there are several aspects to meeting the sustainable funding challenge. One is about exploring new funding streams. I'd like you to look out for information very shortly on the opportunity for funding to work with primary and community care training hubs. We're going to carry on pursuing the proposal for tariff funding, for knowledge services, and to advocate the principle for NHS influence match education terrace funding, to enable evidence-based practice and decision-making by their staff. Of course.

So in the NHS, as in other sectors information work, we see growing demand for embedded knowledge, broker roles, responsible for searching and presenting evidence that is synthesized and summarized. With the Gift of Time, we can now have confidence to show in economic terms, how your knowledge and and library services staff saved clinical time. It's a rigorous piece of work and it's a good for everyone in your exec to be able to send out that view, to have the confidence, to share that.

Published case studies here look at a cost benefit ratio of 3 to one for an embedded knowledge specialist, potentially saving time, savings, a greater web library services you use for evidence searching. And again, you see the director of medical education of Brighton Sussex here, citing that library and knowledge services form the backbone of all our efforts to provide healthcare staff with the necessary tools to acquire and disseminate knowledge. The use of specialists, clinical librarians, patient education librarians,  appropriate technology is indispensable in a modern NHS.

So knowledge services are built on the principles of equality, diversity and inclusion, and that's one of the golden threads of Health Education England's work, and it's threaded through our approach and the strategy too. We've got a responsibility to ensure equity of access to the right knowledge services and to work with our stakeholders to ensure that. So working with the healthcare workforce, working with suppliers, working amongst ourselves to understand and adopt the principles of equality, diversity, and inclusion, and working with citizens to develop skills and health literacy, which in our age are underpinned by ability basic digital skills with digital navigation skills too are really key.

So I've taken us through the high level aspects of the strategy. The ambition, purpose priorities, and partnership working. On my next few slides I'm going to just look briefly at how we developed the strategy and how we're going to implement it.

So focused on the future, this strategy is being developed through an extensive process of review and engagement. And you can see an indication here of the environment, the data, the research that we've pulled out on, but just a little now about, 2 elements of the engagement work.

First of all, with your help, we were able to review survey data from 6,000 NHS staff and learners, that you had gathered through NHS libraries during 2018, and 19, really telling us what service users want and what they value. And this analysis actually verifies the findings from our literature review too.

So you can see that NHS staff and learners really value that personalised customer experience, your expertise, 24 hour mobile access to resources, information at the point of need, the services that I've spoken about just briefly earlier, literature, searches, and synthesized evidence information skills training and of course, especially as we move through the last year, the physical space for wellbeing, alongside space for study on collaboration, learning together. Not forgetting things it's so easy to take for granted document delivery and so on. Yet many NHS staff remain time poor, overloaded by information, struggling to find specialized information, frustrated by technical issues. Many more are unaware of the benefits of NHS knowledge services. There are people who don't even know that staff and learners can use our services and remain reliant on colleagues and networks for information. So much that is valued, much more that we can do and have to offer.

And we're really appreciative of the way that yourselves, NHS library knowledge services staff, actively engaged in the refresh of the strategy that took place over 2 years, we began that work in January, 2019. Engaging with, talking with, listening to service managers and their teams. Through our regional networks, online survey or series of dedicated meetings around the country. And we've welcomed input from professional groupings, including Chartered Institute of Library and Information Professionals (CILIP), health libraries group, knowledge and information management group, university health and medical libraries group. We held discussions specifically for technical librarians and power professional colleagues working in NHS libraries. So broad range of engagement, and you can see here again on the left, the things that you value and it will be familiar to you.

And then the things that you want to see more of, so more system-wide place-based working a sustainable funding model. Implementation of the national staffing ratios policy was published last year. Equity of provision for all NHS staff and learners, a key issue. More embedded roles, integration at the point of care tools into clinical workflows and the application of emerging technologies to the delivery of our own services to improve them, extend them, make working life easier for library, knowledge and services staff. So really clear pointers around the things that you wanted to see incorporated into the strategy as we go forward.

So bringing together all the evidence and we continue to see here, we continue to use driver diagrams as a quality improvement technique to shape this iteration of the strategy, but bringing together all the evidence that we have gathered, we identified 5 primary drivers of the transformation needed to deliver on our ambition. And they are familiar things to you. So mobilizing evidence that healthcare organisation services and systems are effective in mobilising evidence, learning knowledge, and know how to enable evidence-based policy and practice, the organisational staff and learners receive quality assured knowledge and library services. They are business critical.

That serves staff, learners, patients, and the public are better equipped to use evidence-based patient health and wellbeing information. So this important theme around health literacy to support self care and to support shared decision-making to give people choices. A really key thing that staff and learners make optimal use of the high quality, digital knowledge, resources, and other resources and evidence at the point of need. And of course, this is thread through, around the great talent that's already working in library and knowledge services that staff have increased capability and confidence to meet the evolving knowledge and information needs of the system in our digital age.

So what will be different?

Along with the drivers we've identified and the principles set out in knowledge for healthcare, looking to align with those, we've developed an evaluation framework specifically for this strategy. And there are 6 objectives. Each offering a clear statement of difference that will be made as knowledge for healthcare is successfully implemented.

So you can see these reflect the drivers coming through the healthcare organisations, mobilise evidence and internally generated knowledge to enable evidence-based policy and practice that the workforce and learners benefit from high quality knowledge and library services that full population patients and the public are equipped to use evidence-based patient health and wellbeing information. The delivery of our services is equitable across England and no postcode lottery. And that we run that in ways that are efficient and productive and that our workforce is fully confident, capable to lead and deliver the changes, as we see a changing healthcare system around us too. And through that, the partnership working is the norm in delivering knowledge to the healthcare system.

As we're coming towards the end of this introductory presentation, again, an opportunity for me to thank you.

The high level of involvement by staff in all roles and from across all regions of our knowledge and library services is quite striking. And again, I'm pleased to have this opportunity to thank you for your input to the strategy, for your enthusiasm and ongoing commitment, but not least for the work you do every day and bringing knowledge to bear. I can't thank you enough, in fact, for the work that you do on behalf of patients and staff and recognizing that this last year has been the most challenging that we've faced.

And yet more than 300 people who have been directly involved in preparing the strategy, that's split over half actually of qualified librarians and knowledge specialists, plus colleagues and paraprofessionals working absolutely on the front line, caring for customers and responding to their needs as a national team. And through our networks, we've benefited from a strong partnership working with CILIP and in particular with health wide risk group and the knowledge and information management group.

Colleagues from academia, government bodies, other arms length bodies, public libraries and the third sector will contributed to this and dialogue with the library leads from Northern Ireland, Scotland, Wales, and the Republic of Ireland, have also been helpful. So a huge layer, layer after layer of contributions, we developed the strategy. And internationally then as we've gone forward, we see that knowledge for healthcare has over the last 5 years and through this strategy and its publication is already having a wider impact.

It's attracted considerable attention. Within the profession it's been widely reported in the professional press, and we've been invited to share information about it and its implementation with colleagues across the UK, Europe, North America, Australia, New Zealand.

So a comment here from Nick Paul, the CEO's of CILIP that the impact of knowledge for healthcare is therefore not being limited to the immediate scope of the healthcare system that has created positive benefits across the industry in which CILIP's of course information professionals.

I want to thank you too, for the wonderful examples that you share of the impact of your services. These stories speak so powerfully to audiences and you'll see, they speak to the millions of decisions made in health service and the different types of decisions, whether that's about the care of individual patients or informing protocols. Staff wellbeing, developing skills in information and healthy literacy. And of course, cost effectiveness too. And I think you'll see a super selection of vignettes woven through the strategy document.

So our invitation to you is to remain involved. We welcome that continuing engagement of health, knowledge, and library, service teams without whose drive and commitment, none of this can be achieved. And we all committed to working with stakeholders and partner organisations to really strengthen their capability, to manage knowledge and mobilise evidence to bring it to healthcare and put the right expertise, roles and resources at your disposal, to realise the business benefits in this digital age.

So we warmly invite everyone to continue to work with us and to extend and enhance knowledge for healthcare. There is no doubt that knowledge and library services staff really do make a difference. And that's the key takeaway from my introduction.

So I thank you for your time.