Category Archives: Drivers

Shining a light: the future of public libraries across the UK and Ireland

Impact on library policy/practice: NHS libraries are being encouraged to partner with local library services; this report will give NHS librarians an understanding of the current public library landscape.  Central to the report is the theme of wellbeing (see page 9) which may be a useful way for NHS libraries to open a conversation with their local public library colleagues.  The report also encourages partnership working and clearly there is an opportunity for NHS and local authority libraries to work together to work towards the five recommendations laid out in the report.

An accompanying data booklet summarises ‘how people in the UK and Ireland use public libraries and what they think of them’ which could be of use for business cases, impact reports or understanding how to target local services.

Source: Carnegie UK Trust

Link to main document

Publication format: PDF

Date of publication: April 2017

Summary of driver: This report outlines how public libraries can continue to contribute to government policy goals and improve people’s wellbeing for many years in the future. The report presents recommendations drawn from research conducted by Carnegie into library use and attitudes towards library across the UK and Ireland.

Public libraries have the ability to contribute to individual and community wellbeing and to many of the priorities of local and national government.  Moving forward, library services and their advocates need to be future focused and outward looking, and resist the temptation to embrace a backwards-looking ethos.

Key features of driver: This report seeks to contribute to the debate by sharing the ‘state of play’ for public libraries in the UK and Ireland revealed by our research.  The reports sets our five recommendations (‘lessons’) for how libraries can continue to improve people’s wellbeing both in today’s political, economic and social context and into the future.

These lessons are as follows:

  1. Demonstrate value to policy makers, decision makers and funders to maximise public and other investment
  2. Increase focus on tailored, personalised services whilst maintaining a focus on delivering a universal service
  3. Accelerate the development of a user-centred, data rich service with a strong online presence
  4. Invest in innovation, leadership and outcomes-based partnerships (one point is ‘Local and national governments and voluntary organisations to explore the value of partnering with public libraries to deliver services and outcomes’)
  5. Enhance learning between libraries and across jurisdictions

Primary audience: Members of the public and public library stakeholders.

Date last updated: August 2017

Due for review: August 2018

Group member responsible: VT


King’s Fund report – Caring to Change: how compassionate leadership can stimulate innovation in health care

A Policy Briefing aimed at healthcare professionals is available for LKS staff to share in their own organisations. This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice:

  • Knowledge Management opportunities
  • Promote research and innovation opportunities to support the culture of learning and providing evidence based research in the relevant areas
  • Working with managers, commissioners, transformation teams to support the organisation and staff whilst undergoing this change
  • Current awareness / linking into other organisations and disseminating that information- condensing the amount of information available/ do once and share
  • Cross boundary work/promotion with public libraries to engage staff with health and wellbeing
  • Listening in action/coaching – opportunities for LKS to branch out into other areas of the organisation and showcase transferable skills

Source:  The King’s Fund

Link to main web site

Link to report

Publication format:  Web site and pdf

Date of publication: 4th May 2017

Summary of driver: This paper looks at compassion – which involves attending, understanding, empathising and helping – as a core cultural value of the NHS and how compassionate leadership results in a working environment that encourages people to find new and improved ways of doing things. It also describes four key elements of a culture for innovative, high-quality and continually improving care and what they mean for patients, staff and the wider organisation:

Key features of driver:

  • More money on its own is not enough to transform the NHS – transformative changes are needed
  • BUT examples of radical and sustained innovation are exceptions
  • The best examples have triumphed over adversity by:
    • Re-designing whole systems
    • Radically rethinking organisational roles
    • Giving teams the power to be innovative
    • Persistently nurturing continuous improvement
  • Leadership – and a culture – that makes change possible are essential to spread innovation and make it a cultural norm in the NHS
  • Compassionate leadership makes a culture of improvement and radical innovation possible
  • Compassionate leadership motivates NHS staff and reinforces their fundamental altruism
  • Compassionate leadership promotes learning and encourages people to take risks
  • Compassionate leadership helps people feel safe to raise concerns and develop new ideas
  • Compassion is the core cultural value of the NHS
  • There are four elements to a culture conductive to innovative and high-quality care
    • An inspiring vision and strategy
    • Deliberate attempts to include people and get them to participate
    • Enthusiastic team and cross-boundary working
    • Support and autonomy for staff to innovate
  • Most leadership development occurs by experience – it’s vital leaders are good role models
  • All staff should get timely feedback to make sure that they are behaving compassionately, consistently
  • People should be allowed to respond autonomously to challenges by innovating
  • Shared leadership results in significantly higher levels of innovation and better team performance
  • Leadership has to be consistent with all leaders being authentic, open, transparent, curious, appreciative and compassionate
  • NHS organisations do not generally have quality improvement and radical innovation as parts of their strategies but this might change as the National Improvement and Leadership Development Board takes effect promoting compassionate and inclusive leadership

Primary audience: All NHS staff

Date last updated: 4th May 2017

Due for review:  4th May 2019

Group member responsible: LK

British Medical Association (BMA) evaluation of the General Practice Forward View – One Year On : Policy Briefing

A Policy Briefing aimed at healthcare professionals is available for LKS staff to share in their own organisations. This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice:
Offer support with LKS resources and expertise
Concentrating on building relationships with VTS in order to maintain links once people move into General Practice
Link in with Medical Education to strengthen GP training.

Source: British Medical Association

Link to main website

Link to report

Publication format: Website and pdf

Date of publication: April 2017

Summary of driver:
The General Practice Forward View (GP Forward View) was published in April 2016. The paper commits to an extra £2.4 billion a year to support general practice services by 2020/21. This will improve patient care and access, and invest in new ways of providing primary care. This is an update of the last 12 months from the BMA.

Key features of driver:
• An extra £220m was added to the GP funding pot for 2016/2017. CCGs added £102m to cover population growth and for local investment. Together this represents an immediate increase in funding of 4.4%
• £40m has been committed over four years to reduced workload of which £16m was committed for 2016/2017. By the end of March 2017 £17.2m had been spent reducing workload in 1,279 practices
• £10m was committed for supporting struggling practices of greatest concern. By the end of March 2017 £10.1m had been spent on 714 practices
• £30m was committed to a 9-12 month programme of workshops and learning sessions as part of the Time for Care programme. To date 86 schemes covering 107 CCGs are being supported by national resources and expertise
• 18 transformation areas have received £1.50 per patient to accelerate increased opening hours
• 653 schemes have been completed under The Estates and Technology Transformation Fund but the BMA are worried about the delay in the provision of this money leading to slow progress of the delivery of some projects
• There has been an increase in GPs in training but between September and December 2016 there was a decrease in the total of GPs of 390 (headcount) and 445 (FTE). The BMA is very worried that progress is not enough for the 2020/21 workforce targets to be achieved
• 370 GPs are now on the Induction and Refresher Scheme, 76 have completed so far and have now re-entered the GP workforce
• £112m was committed to fund clinical-pharmacist posts in General Practice on top of £31m for a pilot project already announced by NHS England. So far 491 clinical pharmacists have been funded by this scheme
• CCGs should plan to spend £3 per person as a one-off non-recurrent investment starting in 2017/2018 either as £1.50 per person over two years or £3 per person in one year. The money should be used for:
o Stimulating development of at-scale providers for improved access
o Stimulate implementation of the 10 high-impact actions to free up GP time and secure the sustainability of general practice
• BUT some CCGs have said they won’t be able to come up with the money or that it might come from other budgets. The BMA have raised this with NHS England at the highest levels
• £30m will be spent to tackle the rising costs of GP indemnity and the BMA, NHS England and the Department for Health are discussing this further

Primary audience: GPs CCG staff local government NHS organisations

Date last updated: April 2017

Due for review: April 2019

Group member responsible: LK

NHS England Research Plan

Impact on library policy/practice:

Library and Knowledge Services are specifically mentioned in the Research Plan. Firstly, NHS England will work in a supporting role with NHS LKS in the development of communities of practice and enabling the translation of evidence into practice (p. 17).

Secondly, NHS England will work with HEE to support NHS LKS to ensure best evidence underpins research, and that researchers can freely access LKS, including training in advanced search and information handling skills (p. 17).

Information skills training is something that NHS libraries are already offering, though it may be necessary to promote our ability to provide more advanced training to researchers, or to review what other training we can offer to researchers. Whilst researchers in many NHS trusts will have access to LKS, there may be other organisations such as CCGs where there is limited access, and it may be necessary to put an SLA in place; this driver could be used as an argument that organisations need to ensure their researchers have access to libraries and the necessary information skills training.

The development of communities of practice is a new area for libraries, especially across organisational boundaries, but there are initiatives such as the KnowledgeShare service that are already enabling this where organisations subscribe, and NHS Education for Scotland have national systems in place such as People Connect. At a local level, there is an example in the KfH Knowledge Management Toolkit of the development of communities of practice using the Intranet within Pennine Care NHS Foundation Trust. Part of our role may also be to signpost to existing communities of practice.

There may also be a role for libraries as part of the PPI agenda to promote recruitment into local research, and the Research Plan specifically mentions improving public access to research opportunities and recruitment (p. 15).

There are some more ideas on how libraries can support research on a blog post on the KfH blog.

Overall, this document makes clear the importance of research and its use in the NHS and could be used by NHS LKS to push to be more fully involved in the research agenda in the NHS.

Source: NHS England

Link to main document

Publication format: PDF

Date of publication: April 2017

Summary of driver:

NHS England is mandated by the Department of Health to promote and support research in NHS organisations, whether funded commercially or non-commercially. This plan sets out NHS England’s strategic approach to research and how it links with work across Government, including the Industrial Strategy.

It recognises that research is vital to provide the evidence to transform care and improve outcomes.

There are three main areas of focus:

  • Driving the direction of research by ensuring commissioned research addresses the needs of the NHS. Part of this will include defining what research is needed. A Research Needs Panel has already been created.
  • Contributing to creating an environment that fosters research and innovation by supporting commissioners, CSUs, AHSNs, and national programmes to facilitate research in the NHS. It will also include supporting the recruitment of patients into trials, and the allocation of funding for Genomic Medicine Centres.
  • Supporting the use of evidence in decision making, and translating research into practice by using a range of ways to share good practice such as partnership working, networks and guidance. A ‘research and use of evidence self-assessment’ tool for CCGs has already been produced.

Key features of driver:

The document lists all of the partners that NHS England will work with to promote and support research, and in some cases gives a brief description of the role they play in research.

A part of the strategy is to develop the genomic medicines service, with the aim of sequencing 100,000 human genomes by the end of 2018, and developing a genomic medicine laboratory infrastructure. Initially the focus is on cancers and rare inherited diseases.

There will be work to promote patient and public participation in research, such as recruitment to clinical trials, by contributing to NHS Choices and the UK Clinical Trials Gateway.

Primary audience: Chief executives and accountable officers of NHS organisations, national bodies with an interest in healthcare research, higher education institutions.

Date last updated: July 2017

Due for review: July 2018

Group member responsible: JC

HEE Quality Strategy 2016-2020

Title of driver:  HEE Quality Strategy 2016-2020

Source:  Health Education England (HEE)

Publication format:  PDF

Date of publication:

Link to main document

Impact on library policy/practice:

  • Work with relevant education departments to ensure that LKS is supporting the needs of all healthcare learners.
  • Offer support and raise awareness of LKS to those healthcare leaners and those responsible for providing and delivering learning.
  • Both of the above should lead to increased awareness in library resources and services.
  • Possibility of collaborative purchasing opportunities with other LKS in order to deliver financial savings and fitting in with the theme of de-duplication and silo working.

Summary of driver:

The HEE Quality Strategy 2016-2020 together with the multi-professional HEE quality framework, set out how HEE will measure, recognise and improve quality in the education and training environment. Together, these are intended to be dynamic documents that will evolve over time to reflect transformation of the healthcare learning environment.

This strategy sets out HEE’s vision of continuously improving the learning environment whilst supporting the ambitions of the Five Year Forward View.

Key features of driver

  • HEE is one organisation with local teams- this strategy attempts to pull everything together into one shared vision and remove duplication and silo working and demonstrate commitment to an education infrastructure.
  • This shared vision with its standards and measures for quality and improvement in education and training will ensure a comparable view between local and national enablement.
  • Improvement in the quality of training will deliver a workforce with the right skillset, values and behaviours to deliver high quality care to patients
  • Ensure value for money, innovation and continuous improvement in the quality of education and training.
  • Demonstration of investment supporting delivery of quality of patient care
  • HEE will align educational infrastructure and leadership with educational investments with local teams offering support to Higher Education Institutions.
  • Promote a culture that maximises learning opportunities across all sectors. This will ensure that all learners will have access to equitable and high quality support during learning which will prepare them for future healthcare careers.

Primary audience: All health and social care providers in England with training and educational responsibilities

Date last updated: May 2017

Due for review:  May 2018

Group member responsible: LK

Long-Term Sustainability of the NHS: Policy Briefing

A Policy Briefing  aimed at health care professionals is available for LKS staff to share in their own organisations.  This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice:

  • With a longer term strategic plan for the transformation of the NHS LKS teams may be asked to deliver evidence and knowledge to managers, commissioners and transformation teams as health care services undergo this change.
  • Any longer term plans for the NHS may impact on the actual delivery of LKS regionally and nationally and therefore, LKS will need to consider whether existing models of service delivery meet the requirements of a transformed NHS.
  • LKS need to consider developing a longer term strategic plan for the next 15-20 years for NHS library services which maps to the recommendations outlined in this report.

Source: House of Lords Select Committee

Link to main web site

Link to report

Publication format: Web site and pdf

Date of publication: 5th April 2017

Summary of driver: The House of Lords appointed a Select Committee on the Long-Term Sustainability of the NHS on 25 May 2016 to consider the long-term sustainability of the National Health Service. The report was published in April 2017 and found that there was no short term solution to sustainability recommending that an Office for Health and Care Sustainability should be set up to look 15-20 years ahead and focus on:

  • Demographic Change
  • Service Demand
  • Workforce and Skill Mix
  • The balance of funding between health and social care

Key features of driver:

  • The fragmentation and regulatory burden that stops integration between health and social care should be tackled
  • NHS England and NHS Improvement should merge and then include strong representation from local government
  • The NHS should remain funded from taxation and free at the point of use and health spending beyond 2020 needs to increase in line with GDP growth
  • Beyond 2020 funding for social care should reflect increased need or, at least, rise by the same amount as NHS spending
  • Responsibility for the social-care budget should be transferred to the Department of Health which should be renamed the Department of Health and Care
  • Those who can afford care should pay for it subject to the funding caps recommended by the Dilnot Commission
  • The Government should implement new mechanisms to help people to pay for their own care – this could be an insurance-based system starting in middle age
  • There is an absence of long-term skills planning
  • Health Education England should be “substantially strengthened” and transformed into a new, single, integrated strategic workforce-planning body – looking 10 years ahead. Its independence should be guaranteed with a protected budget
  • The Government should identify parts of the NHS which are falling behind in innovation and technology and make it clear that there will be funding and service-delivery consequences for those who “repeatedly fail to engage.”
  • The Government should require NHS England/NHS Improvement to achieve greater levels of consistency in efficiency and performance at a local level. Greater levels of investment and service-responsibility should be given to those who improve the most.
  • The Government should restore the public-health budget and maintain a ring-fenced budget for the next 10 years. It should remind the public that access to the NHS involves rights as well as responsibilities

Primary audience: All trust staff

Date last updated: 11th May 2017

Due for review: 11th May 2019

Group member responsible: TP

Making IT work

Title of driver: Making IT work: harnessing the power of health information technology to improve care in England (Wachter review)

Impact on library policy/practice:

Whilst the report focuses on electronic health records (EHRs), there are still areas that may impact on library services.

One of these may be in integration between point-of-care systems such as UpToDate, DynaMed, ClinicalKey or CEBIS, and the electronic patient record, so clinicians have easier access to healthcare library and knowledge resources. It may be necessary to share knowledge about what point-of-care systems work with which EHRs, and how to make it work successfully. Library staff may need to work with the proposed Chief Clinical Information Officers in their Trusts to push for embedding or visibility of library services in the EHR. As well as integration with commercial point-of-care systems, library and knowledge services may want to try to make their literature search or clinical question answering service or similar, easily accessible through the EHR.

Another area may in supporting the digital literacy education of students or staff, something that HEE have been asked to look at developing. Depending on what the plan developed by HEE entails, there might be areas that library and knowledge services can get involved, but this may require library staff to have the necessary training and support themselves.

Source: National Advisory Group on Health Information Technology in England, chaired by clinician and digital expert Professor Robert Wachter

Link to main document
Link to summary version

Publication format: PDF (HTML version also available)

Date of publication: September 2016

Summary of driver:

Making IT Work is concerned with the digitisation of secondary care in England (focusing on the electronic health record). The report lists 10 principles of how to do this effectively, and makes 10 recommendations on how to achieve successful digitisation, along with timescales.

In late 2015, the Secretary of State for Health and the leadership of NHS England asked for the creation of a broadly representative external body: The National Advisory Group on Health Information Technology in England, to advise the Department of Health and the NHS on its efforts to digitise the secondary care system.

In 2016, £4.2 billion was allocated to support the work of digitisation.

A specific action for Health Education England, in collaboration with the Royal Colleges and other relevant bodies, is to develop and begin to implement a plan to raise the level of digital education in all health professional educational settings, including medical, nursing and pharmacy schools, and in continuing education settings for practicing healthcare professionals.

Key features of driver:

There is a useful history of the NPfIT programme, and some history of the US experience in digitising its healthcare system.

The 10 overall finding and principles are:

  1. Digitise for the correct reasons
  2. It is better to get digitisation right than to do it quickly
  3. ‘Return on investment’ from digitisation is not just financial
  4. When it comes to centralisation, the NHS should learn, but not over-learn, the lessons of NPfIT
  5. Interoperability should be built in from the start
  6. While privacy is very important, so too is data sharing
  7. Health IT Systems must embrace user-centered design
  8. Going live with a health IT system is the beginning, not the end
  9. A successful digital strategy must be multifaceted, and requires workforce development
  10. Health IT entails both technical and adaptive change

The 10 recommendations made are:

  1. Carry out a thoughtful long-term national engagement strategy
  2. Appoint and give appropriate authority to a national chief clinical information officer
  3. Develop a workforce of trained clinician-informaticists at the trusts, and give them appropriate resources and authority
  4. Strengthen and grow the CCIO field, others trained in clinical care and informatics, and health IT professionals more generally
  5. Allocate the new national funding to help trusts go digital and achieve maximum benefit from digitisation
  6. While some trusts may need time to prepare to go digital, all trusts should be largely digitised by 2023
  7. Link national funding to a viable local implementation/improvement plan
  8. Organise local/regional learning networks to support implementation and improvement
  9. Ensure interoperability as a core characteristic of the NHS digital ecosystem – to promote clinical care, innovation, and research
  10. A robust independent evaluation of the programme should be supported and acted upon

Primary audience: NHS England, NHS Digital, Care Quality Commission, Senior management of NHS Trusts, senior IT staff.

Date last updated: May 2017

Due for review: May 2018

Group member responsible: JC