Quality and impact Workstream

Clare Edwards: Welcome everyone and thank you for taking the time to join this webinar. For those of you who don't know me i'm Clare Edwards, Deputy Head of Knowledge and Library Services for the Midlands East and North of England. I am also the Lead for the Knowledge for Healthcare Quality and Impact work stream. 

In this webinar I will provide an overview on the quality and impact priorities for Knowledge and Healthcare. This is our strategy for the next 5 to 6 years and it's firmly focused on working with you supporting all that you do, mobilizing evidence, sharing knowledge and improving outcomes for patients.

You may have already seen this slide on other Knowledge for Healthcare webinages, but I just wanted to emphasize the support from the Health Education England (HEE) board and the new Chief Executive Dr Navina Evans. She says applying knowledg into action is the currency of a successful healthcare organisation, taking the heavy lifting out of getting evidence into practice to improve the quality of care in the NHS.

Knowledge and Library Service teams offer the  the gift of time to healthcare professionals. This is clearly the strategy for Knowledge and Library staff, but also the primary strategy for employers, so that they can see what you do and the benefits of your work.

The priorities of quality and impact have been important for this in the presentation today. We will go through the ambition of the strategy and then we'll concentrate on turning strategy into action.

Section 4.2 of the strategy looks at the quality and impact priorities, the outcomes framework, value the impact library space and innovation and research. We will then look at delivering the ambition and the evaluation framework, ending with what we have achieved between 2015 and 2020.

Our ambition builds on the previous strategy from 2015 to 2020. Our ambition is that NHS bodies, their staff, learners, patients and the public use the right knowlede and evidence at the right time in the right place, enabling high quality decision making, learning research and innovation to acheive excellent healthcare and health improvement.

This refresh of the strategy has also given us an opportunity to get the balance right. It now includes things that were not so fully expressed in the original version such as the need to build on the evidence base for our own practice, as Knowledge and Library Service staff, and to also pick up new things like the value proposition for Knowledge and Library Services. 

The strategic direction and priorities for quality and impact can be found on pages 29 to 35 of the strategy, and I will go through a next set of slide to present this section.

Effective knowledge services are busines critical for high quality healthcare, ensuring high quality Knowledge and Library Services provides the evidence the NHS needs for evidence-based decision-making to make a positive impact on patient care, economic benefits and gives the gift of time to healthcare professionals.

The strategy highlights that as a steward of the national NHS investment in Knowledge and Library Services, Health Education England will assure the quality of these services, driving improvement and innvation on behalf of patients carers, families and the taxpayer.

This slide provides an overview of some of the key priorities around the quality and impact workstream within the strategy. We will implement the outcomes framework, continue our advocacy of the Knowledge and Library Services and specialists, build the evidence base and promote value and impact, showcase and share good practice and innovation and evaluate the impact of Knowlege for Healthcare. This all builds on the achievements of the last 5 years.

The use of the driver diagrams has enabled us to shapre the interventions and priorities for quality and impact. The overall strategic aim is that healthcare organisations, staff and leaners receive quality assured business critical Knowledge and Library Servies. The 3 specific outcomes related to the aim are that quality of healthare Knowledge and Library Services continually improves. The quality of NHS funded Knowledge and Library Services is assured on behalf of staff, learners, patients and the public and the postiive impact of knowledge and library specialists on the quality of health care is evidence and showcase to meet the outcomes we have identified.

As you can see on the slide, to demonstrate the impact of the strategy, to ensure quality of NHS funded Knowledge and Library services, to engage employers to embed quality assurance requirements into appropriate frameworks, to promote the impact evidence base and to demonstrate value and impact. 

The Quality and Improvement Outcomes Framework 2019 signals a step change to help knowledge and library staff, both to improve service delivery for patients and to better articulate the positive outcomes of their work. This assurance framework represents a fundamental shift in emphasis, focusing on outcomes rather than process and the approach is informed by robust research on impact and evaluation methodologies.

Effective knowledge services are business critial for high quality healthcare. By implementing the new quality and improvement outcomes framework, it will assure the quality of these services - supporting NHS organisations and knowledge and library specialists to concentrate attention on quality positive outcomes and to drive improvement and innovation.

The outcomes framework has 2 main roles. For Knowledge and Library Services themselves, it provides a tool for driving service improvement and user satisfaction. It provides a framework to consider the outcomes needed for the service and highlights the support and resources needed from the organisation to develop the service. For NHS organisations, it provides quality assurance that the library services they commission or procure are continually developing and improving to meet their needs.

However, and just as important, it also challenges the organisation to consider whether they are making the most of the services available from knowledge and library specialists. The framework is there to support you and your service development - please use it to demonstrate while you're doing good pratice and innovation, but also to highlight where there are difficulties, issues and risks. It will allow for conversation within your organisation.

The quality improvement outcomes framework is also integral to both the quality framework and the requirements of the new education contract. Both of these, again, emphasize the requirements and responsibilites of the organisation.

In relation to implementation of the outcomes framework in delivering a quality learning environment, the overarching aim of the outcomes is that the NHS organisations and the healthcare workforce deliver an evidence-based national health service by accessing high quality, customer focused knowledge and evidence service enabled by the expertise of the healthcare knowledge and library specialists.

The framework consists of 6 outcomes that you can see on this slide. The priority this year is the base-line self-evaluation and validation of the outcomes framework. We have recently done 2 webinats for managers on the process and a recording of this is available if you want to find out more

One of the achievements of Knowledge for Healthcare 2015 to 2020 was the refreshed impact toolkit and how this has been implemented across services. We have defined impact as the difference or change in an individual or group resulting from the contact with library services. We now have well over 350 impact casestudies and vigneetes that have been developed. The impact case studies and yet are key resources for developing the evidence for advocating the business benefits of Knowledge and Library Services, and attracting more decision makers to make best use of the evidence base. Evidence of impact also illustrates the contribution of Knowledge and Library Services teams to improving patient care and supporting the workforce within the strategy.

We have highlighted the different types of impact that are made by Knowledge and Library Services and specialists as outlined in the value impact toolkit. Knowledge and Library Services and attracting more decision makers to make best use of the evidence base evidence of impact also illustrates the contribution of Knowledge and Library Services teams to improving patient care and supporting the workforce. Within the strategy we have highlighted the different types of impact that are made by Knowledge and Library Services and specialists as outlined in the value impact toolkit. These impacts are around reducing risk and improving safety, improving quality of patient care, reducing costs and contributing to financial effectiveness, informing decisions, contributing to service improvement, facilitating collaborative working and enhancing personal and professional development.

One of the things you will notice about the strategy is that we have lots of examples of impact throughout. It was great this time round as we had so many to choose from and could only use a small selection in the quality and impact section. We have used the quotes from case studies to demonstrate the range of impacts made by Knowledge and Library Services and on this slide you can see just 3 of the quotes on page 32 of the strategy. I'll give you a moment to read these. There were 2 other quotes on page 32 - one about space which said "the great learning environment provided me with a space to work that was hugely benefit to my productivity" and the other about saving time "it has saved me a huge amount of time it was also reassuring to know that a comprehensive literature search had been undertaken by someone much more skilled in this than me".

Although not in the quality and impact section I wanted to include the work around the value proposition and the report on the gifted time as this is key in both demonstrating the benefits and value delivered by Knowledge and Library Services in the NHS. It highlights the role of a high quality Knowledge and Library Service and what it can achieve in economic benefit the work carried out provides the evidence to support the ambition and priorities of Knowledge for Healthcare, particularly around ensuring that we have the right resources. Altogether there are 10 key messages, but I just want to focus in on just a few of the key messages from the report. So the services provided take the heavy lifting out of getting evidence into practice and give the gift of time to health care professionals. When supported by high performing Knowledge and Library Services NHS provider organizations are able to demonstrate how they are meeting their statutory obligations to use evidence to inform practice and hence improve their CQC ratings.

The value proposition is simple: the service provides healthcare professional staff with time-saving accelerated access to better quality evidence this enables the nhs to meet its statutory obligations to utilize evidence from research. It enables healthcare professionals to use their time more effectively to drive improvements against the quadruple aim which is improving the health of populations enhancing the experience of care for patients reducing the per capita cost of healthcare and improving the staff experience of providing care. There is a growing and consistent body of robust international evidence to support this value proposition, assuming findings from the international literature are applicable to the NHS. The service is potentially already generating an overall economic benefit of 132 million pounds per annum for the NHS,  delivering a net economic benefit of 77 million per annum and this could increase to 106 million per annum were the target staff ratio for librarians achieved.

To support delivering the message about, the value proposition we have developed an animation aimed at stakeholders and this will be launched in the awareness week in June. This is one of the impact case study vignettes included in the strategy; it demonstrates how the Knowledge and Library service has helped inform next steps to take forward an issue highlighted by the cqc. As you can see we have recently changed the format of the impact case study vignettes the layout improves the accessibility, but as you can see it is also linked to the message that knowledge and library specialists take the heavy lifting out of getting evidence into practice.

The strategy also focuses on the physical library space and highlights the new policy on this published in January this year. Health Education England recognises that physical library space is crucial element in providing a quality learning environment and is aligned to the wider he quality framework. The policy is evidenced and shows that the library and learning space is essential and that creative and resourceful use of the space secures key benefits for the workforce. It is also essential for the development recruitment retention and well-being of the workforce and is highly valued by staff, educators, learners, and researchers. The 4 key benefits of library space are offering a space for reflection and private study, for health and well-being, for collaborative working, and learning and as a technology hub - a place to complete e-learning and explore new technologies and augmented reality.

The strategy discusses how NHS knowledge and library specialists play an important role in promoting a positive workforce culture helping to make the NHS the best place to work. Knowledge and library specialists are ideally placed to provide the evidence base to underpin the work of the nhs wellbeing guardians, the physical library provides space and resources to support the health and well-being of all staff.

Knowledge and library specialists provide the expertise in leading these creative approaches in the development of the library learning space and in facilitating the exploration of new technology. The strategy refers to the 2 policy recommendations for NHS providers. Developing the evidence and sharing adoption of innovation and good practice to inform strategic development will be done in partnership working with yourselves, academic partners and the professional body. Intrinsic curiosity research in an appetite to adopt innovation that advances provision to the communities we serve are markers of a forward-looking service and a forward-looking profession.

Our focus through the next stage of Knowledge for Healthcare will be on return on investment models of service delivery and impact of embedded roles. We also aim to devise reliable measures by which to assess the impact of initiatives to mobilize knowledge and improve health literacy. The Sally Hernando Innovation Awards has been key in highlighting innovation within Knowledge and Library Services and we hope to continue to build on this through integration with wider HEE innovation and good practice awards.

This is the second impact case study vignette that is included in the quality and impact section of the strategy. It demonstrates how knowledge and library specialists provide the evidence for guidelines and support benefits to patients in changes in treatment.

How will we know if we have delivered on the ambition? We have developed an evidence-based evaluation framework which is modeled on the impact planning assessment and used internationally with the global libraries programme of the Bill and Melinda Gates Foundation. This form is part of the quality and impact work stream to demonstrate the impact the Knowledge for Healthcare strategy and delivery against the vision.

Aligned with the drivers and principles of the strategy, the evaluation framework defines 6 impact objectives each offering a clear statement of difference that will be made as knowledge for health care is successfully implemented. These 6 outcomes will be used to develop annual reporting on the strategy.

I would like to end the session by leaving you with a slide that provides an overview of quality and impact achievements and progress during the first phase of Knowledge for Healthcare.

Thank you to all that have been involved, be it in the development engagement and or implementation of the outcomes of this work stream.