Working with Public Health and the Clinical Commissioning Group (CCG)

Project Team
Caroline Timothy – Public Health & Commissioning Librarian; Gary Sutton – Knowledge & Evidence Service Manager; Tracy Flute – Head of Public Health Analysis

Resources Required
A Service Level Agreement (SLA) between Warrington & Halton Hospitals NHS Foundation Trust (WHHFT) and Warrington Public Health.

Timeframe
A recent successful tender bid secured the contract for WHHFT for a further 3 years until July 2016.

“The Story”
As part of an SLA between WHHFT and NHS Warrington (the former PCT), an Outreach Librarian post was established in 2010. In April 2012, I was employed as Outreach Services Co-ordinator and then in October 2012, the job title was changed to Public Health & Commissioning Librarian to more closely reflect the work of the position. The main purpose of the post is to provide knowledge and library services to Warrington Public Health and Warrington CCG when and where they are needed.

I work as an embedded member of the Warrington Public Health and Warrington CCG teams. Mondays, Thursdays and alternate Fridays are spent working with the CCG, sitting with the staff in their office. Tuesdays, Wednesdays and alternate Fridays are spent with the Warrington Public Health team, again sitting with the team. The main service provided is literature searching. The searches that are requested are quite often on a large scale, in-depth, and require innovative resources to be consulted to find information! Current awareness is the second most requested service. The CCG and WPH Library Bulletins provide news and evidence for requested areas. The Knowledge & Evidence Service’s website is used to both market the service through the Public Health & Commissioning page and also to provide a daily update on the latest news items in public health and commissioning. Inter-library loans are another service that is requested and I provide all papers and books that are required. I also carry out training, which includes “Finding the Evidence”, and this has been requested as a one to one session up to now, although group training sessions are available. I really enjoy my job and am glad to be working with the CCG more closely now that we are in an open plan office. Agile working opens up the opportunity to meet more of the commissioning staff on a daily basis and to sit with different people. I like the fact that no two days are the same, that you are always meeting new people and that you get to help lots of different people with their information needs.

Alignment to local, regional and national drivers
The Warrington Public Health Memorandum of Understanding with Warrington CCG states that Public Health will provide library resources and outreach services to the CCG and local commissioning support should this be the expressed need of the recipients of the service.

Public Health Library and Knowledge Services Audit Report (July 2012)

Impact of this project/service for the:
• customer
• organisation
• library
Feedback from the two teams has been very complimentary and examples are below…
“This stuff is absolutely perfect and spot on with what we’re after”
“This is so useful, just scanned and found a few things that I needed to know”
“Thanks very much for your help with this- really useful – and at the right kind of detail”
The bi-annual reports produced as part of the SLA, show that there has been an increase in usage of the service, especially for literature search requests.

Lessons Learned
The main lesson learnt as a result of this work is that it is essential that the librarian is embedded into the 2 teams that they are working with. The bi-annual report shows that when the librarian has not been present (due to sickness absence with the previous post holder and during long periods of annual leave) the service usage statistics decrease quite dramatically. When the librarian is sitting with the teams, the team members come over to chat or meet the librarian at the photocopier or in the kitchen and often place their request for information then!

Sustainability / next steps?
The SLA between the Knowledge & Evidence Service at WHHFT and Warrington Public Health will end in July 2016 and it is envisaged that a new tender process will begin around that time.
It is possible that the service may be opened up/marketed to social care workers and others in the local authority where Public Health is now based.
My next steps are to attend more team meetings within Public Health and the CCG and to increase the usage of the library service amongst the two staff groups.

Contact details
Caroline.Timothy@nhs.net

Date case study completed
14/08/2013

Supporting a Practice Development Unit

Title of project: Practice Development Unit (PDU) support

Lead library: Integrated Library Service, Wirral University Teaching Hospital NHS Foundation Trust www.whnt.nhs.uk/library

Summary: The Clinical Librarian was invited to support the Wirral Renal Unit in meeting the required criteria for gaining Practice Development Unit (PDU) status accredited by the University of Leeds. The accreditation criteria required the Renal Unit to demonstrate commitment to evidence based practice and staff development.

Partner organisations: Wirral and Chester Kidney Service http://www.wirralchesterkidney.nhs.uk/

Key Audiences: Multidisciplinary team involved in renal care in Wirral University Teaching Hospital.

“The story”:
Steering Group member
As a steering group member the Clinical Librarian attended all Steering Group meetings and offered updates on the projects the library was involved in, as well as bringing to the group details of new library services and resources.

Literature Searching support
The Clinical Librarian supported staff in identifying the evidence base on the following topics:

• Evidence of the psychological impact on chronic dialysis patients
• Examples of PDU accreditation processes in other NHS Trusts – problems encountered, lessons learned, impact and evaluation
• Published literature about haemodialysis non-compliance, deviation from dialysis prescription, reasons for missed sessions and what effects this has on mortality
• Evidence about the prevention and control of blood borne virus infection for renal dialysis Sexual Dysfunction in relation to renal patients
• An overview of leadership styles, in particular transformational leadership

Journal Club support
The Clinical Librarian worked closely with the Clinical Nurse Lead who had an interest in research to establish a Journal Club. The team decided to take a more informal approach to a traditional Journal Club that would be inclusive to all levels of staff.
To many of the staff involved Journal Club was a new concept so some training in searching the literature, practicing critical appraisal and understanding some of the key concepts of evidence base practice was delivered.

Kidney Diseases blog
The Kidney Diseases blog was established in response to a request from the Renal Unit team for a way of collating and distributing alerts about the latest evidence, resources and news relating to kidney disease. Staff were also encourage to submit items for inclusion that they would like to cascade to colleagues, with the aim of reducing the quantity and length of team e-mail chains and also providing a reference point in which to share knowledge within the team. Staff continue to receive email updates from the blog.

Accreditation assessment visit
The Clinical Librarian submitted a personal statement to the assessors and delivered a verbal presentation and display stand on the day of the accreditation visit about library input to the project.

How the initiative or service is delivered: The project was led by the Clinical Librarian Service with support from library colleagues. The project involved promotional activity and attendance at steering group meetings, as well as providing a point of contact for literature search requests, training requests and general enquiries. It also required the Clinical Librarian to write a personal statement, present the involvement of the library service and be interviewed by the assessors during the accreditation visit.

Customer involvement in this piece of work – or service development? The project required the PDU leads to participate in activities to support evidence based practice within their team.

Benefits of this case – activity – service – for the customer: The PDU leads benefited from literature searching support, Journal Club support and current awareness services via a named point of contact from the Integrated Library Service to support evidence based practice and staff development. All of these developments were used as evidence in their accreditation submission.

Benefits for the library/libraries: The library service benefited from the opportunity to work alongside health professionals in actively improving service delivery. The project has resulted in a close working relationship with the Renal Unit and has raised the profile of the library service within the organisation as a whole.

Evaluation: The Leeds University accreditation team awarded the Renal Unit a full stage 2 accreditation.

Feedback: Extract from the final Accreditation visit report:

“The relationship with Victoria is a marvellous example of using her skills to bring new, credible evidence to the attention of clinicians. This work should definitely be written up and published in an appropriate journal as it provides wonderful evidence of the value of a clinical library service to the improvement of practice.”

“Victoria’s blog is a wonderful example of using the available technology to bring up-to-date evidence and research work to the attention of everyone quickly and conveniently.”

Marketing: Many of the staff involved weren’t aware of all the library services available to them, so the marketing approach was face-to-face contact with ward staff and PDU leads at the regular steering group meetings.

Collaborative working: An enthusiastic approach was taken from both the library service and the PDU leads. Collaborative working was helped by the clear criteria set by Leeds University which gave us a shared objective and timeline.

Funding streams: n/a

Lessons learned: The project established a good relationship with the staff working in the Renal Unit who continue to use library services.
The library service can successfully support teams applying for practice development status.

Sustainability; next steps: Although the team was successful in achieving accreditation status, the projects that were initiated are continuing to run, including the Journal Club and kidney diseases blog.

Sources of further information: Wirral and Chester Kidney Service http://www.wirralchesterkidney.nhs.uk/

Start date: September 2008

End date: Stage 2 accreditation achieved in November 2009

Contact: Victoria Kirk, Clinical Librarian, Victoria.kirk@nhs.net 0151 604 7223

Related resources links:
University of Leeds School of Healthcare, Enhancing Practice
http://www.healthcare.leeds.ac.uk/enterprise/enhancing-practice.htm

Date submitted: May 2010

Systematic Review

Title of project: Case Study Systematic Review

Title: NW Clinical Librarian Systematic Review

Lead library: No lead Library. Contributors from Salford University, Edge Hill University/Aintree Hospital, Univ Hospitals of Morecambe Bay NHS Trust, Bury PCT, Christie Hospital, Blackpool Hospital, NICE/Manchester University.

Summary: A systematic review into Clinical Librarianship will be published in HILJ Dec 2010. This is a collaborative project involving 8 Librarians from the North West. The project contributed to the professional body of work relating to Clinical Librarianship by delivering a Systematic review. In addition, the contributors also developed their own skills base and understanding of the processes involved; this learning will be shared through a reflective process model.

Partner organisations: LIHNN; HCLU

Key Audiences: Clinical Librarians; Library Managers

“The story”: The systematic review aimed to assess the most effective methods of evaluating clinical librarian services. The review was undertaken over a 2 year period and the learning achieved by all concerned was immense. In addition to the main aims of completing the project, the review also identified a dominant model of CL in the UK – one which differed to the original US model. Also through reflective processes the team hope to share their learning, to support other librarians in the health sector who wish to undertake this type of research. The processes involved will be outlined and shared at HLG 2010 and ultimately will be provided via a toolkit. All participants unanimously asserted that they would undertake such a venture again, but would be clearer about the time involved – this was perceived as a key barrier. The richness of the learning experience however, made the experience a worthwhile one.

How the initiative or service is delivered: The project will be published in HILJ Dec 2010 and was presented at EBLIP and ICML 2009. It will be presented at HLG in 2010

Customer involvement in this piece of work – or service development? This project did not involve customers as such.but enhanced understanding of the research process – skills which are integral to the post. By learning valuable skills in the systematic review process, this can be translated librarian support and advice for Trust staff undertaking this type of research.

Benefits of this case – activity – service – for the customer: All clinical librarians felt that it developed their skills and improved confidence in this area. This ultimately will enhance the delivery of librarian support for research (particularly systematic reviews). As a direct result of the experience, the CL at UHMBT felt able to cost librarian time for supporting a systematic review within the Trust.

Benefits for the library/libraries: Raises the profile of the library service within the Trust and the fact that CL’s are actively engaged in this type of work means that confidence in CL ability is improved.

Evaluation: None

Feedback: None as yet

Collaborative working: This regional collaboration across the Northwest has created links and allowed shared learning

Funding streams: Funding for the project was obtained from HCLU to cover some conference costs, purchase of Refworks, Ill’s

Lessons learned: TIME!!! Everyone underestimated the amount of work and time that this review would involve. Lessons learned will be documented in the toolkit and shared with others.

Sustainability; next steps? This project will come to an end shortly, but will be presented via 2 posters at HLG (SR findings; Processes and reflection).
There may be some follow up papers relating to the processes and a toolkit will be developed.

Sources of further information? Not available currently

Start date: April 2008

End date: 31.12.2010 (although may be extended if a further research report undertaken

Contact: Tracey Pratchett
Job title: Clinical Librarian
Telephone: (01524) 516224
e-mail: Tracey.pratchett@mbht.nhs.uk

Aligned to:
Local drivers
UHMBT Strategic Direction Document 2003-8 “We are here to provide … A resource for teaching and research and development, generating new knowledge leading to improvements in population health and in health care delivery”
National drivers
Hill review 2008 highlights that health libraries are essential for supporting clinical decision making, commissioning & policy making, life-long learning and research.
Darzi review

Date submitted: 22.6.2010