The Topol Review: Preparing the healthcare workforce to deliver the digital future.

Impact on library policy/practice: 

• The review makes a strong assertion that effective knowledge management is essential for a digitally ready NHS, with a specific recommendation (OD5 p.70) that “NHS Boards take responsibility for effective knowledge management to enable staff to learn from experience (both success and failures) and accelerate the adoption of proven innovations.”
• It makes clear that the adoption of digital healthcare technologies should be based on evidence, of both clinical and cost-effectiveness, and knowledge of new technologies needs to be spread throughout the NHS (p.20). Librarians are well-placed to help access the evidence-base, to encourage the development of the knowledge base (for example through support for research and writing for publication) and to help ensure knowledge is disseminated (OD6, p.68)
• LKS staff are ideally placed to train, support and engage healthcare professionals in engaging with the technology (OD3, p.66, E6 and E8, p.78)
• Knowledge management opportunities are abundant – the review specifies that an increase in knowledge specialist posts to support healthcare professionals is required (DM4/AIR5, p.49 and 57)
• LKS can provide support via digital and healthliteracy/needs based targeted education and support upskilling of current workforce (OD3, p.66 and E6 and E8, p.78)
• LKS are well positioned to link up with local community via GP surgeries and community events/local libraries/education to support both patient/public and healthcare professional education (P2, p.25 and HI1, p.25)
• There’s an opportunity for LKS staff to be the champions and create the collaborative networks required to support workforce with lifelong learning/continuing professional development
• A culture of learning is recommended as an educational recommendation to support a digitally enabled health system, something that LKS enhance in multiple ways across NHS Trusts (E1, p.74)
• As training and educational programmes evolve to address digital technologies; to adequately support these programmes LKS may need to review and / or expand on their provision of resources covering the areas of genomics, artificial intelligence, robotics, and digital technologies. Or should see how they can facilitate access to such resources e.g. via inter library loans.

Source:  An independent report on behalf of the Secretary of State for health and Social Care

Link to review

Publication format:  PDF

Date of publication: February 2019​

Summary of driver:

The Topol Review, is based around the following three principles which support the implementation of digital healthcare technologies across the NHS.

• Patients should be suitably informed about health technologies, with particular  focus on vulnerable groups to ensure fair access
• The healthcare workforce needs knowledge and guidance to evaluate new technologies
• The adoption of technology should be used to give healthcare staff more time to care and interact directly with patients

Key features of driver: 

• Patients need to be included as partners and informed about healthcare technologies, with a particular focus on vulnerable/marginalised groups to ensure equitable access
• NHS is to invest and upskill existing workforce  
• The healthcare workforce needs expertise and guidance to evaluate new technologies
• The gift of time, adoption of new technologies should enable staff to spend more time to care
• The review covers the implications of these changes for both healthcare professionals and patients. New technologies will bring stronger patient-clinical relationships as well as improved accuracy of diagnoses and treatment and the efficiency of care and workflows for the healthcare professional.
• Although the workforce is changing, automation should improve efficiency but not replace human interaction
• Emphasis on that to deliver this change, investment in people is as important as the investment in technology. NHS organisations are expected to develop learning environments in which the workforce is encouraged to learn continuously.
• NHS Boards to take responsibility for effective knowledge management to support innovation and change
• Core training and lifelong training
• NHS IT will have to be updated to support the training resources and educational opportunities in digital healthcare technologies
• Apps and wearables – patient becoming more involved with self-management

Primary audience: Healthcare workforce, national and local government, educational institutions

Related document: CILIP response to the Topol Review of Technology in the Healthcare Sector https://www.cilip.org.uk/page/TopolReview

Date last updated: February 2019

Due for review:  February 2020

Group member responsible: LK

NHS Library and Knowledge Services in England

Health Education England (HEE) has published a new policy on NHS Library and Knowledge Services in England.

Impact on library policy/practice: The policy urges NHS organisations to capitalise on the specialist skills of librarians not only in education and research, but also as ‘knowledge brokers’, a role in which librarians share their expertise with teams in the workplace, enabling staff to find, evaluate and use evidence.  There are many examples from across the country where library and knowledge services are embedded in health care teams and enhancing service delivery, enabling transformation and driving innovation.

The policy also signals a move towards developing a “coherent national service”, highlighting a desire to work more collaboratively and across health care systems to reduce duplication and ensure that library and knowledge services are freely accessible to all NHS staff.

Library and knowledge service staff may wish to highlight this new policy to executive teams and senior managers in their organisations.

Source: Health Education England (HEE)

Link to main document 

Publication format: PDF

Date of publication: January 2017

Summary of driver: Applying and embedding knowledge into action is the currency of successful organisations.  HEE recognises the value of NHS librarians to act as knowledge brokers, enabling staff to find, evaluate and use evidence.

Key features of driver:

·         The policy asserts the duty under Health and Social Care Act 2012 to ensure “the use in the health service of evidence obtained from research”. It acknowledges the role of NHS libraries in supplying the evidence base to enhance decision-making relating to treatment options, patient care and safety, commissioning and policy, as well as to support lifelong learning, undertake research and drive innovation.

·         The policy statement sets out key points to ensure the use in health care of evidence gained from research and HEE commitment to:

o   Enable all NHS staff to freely access library and knowledge services so that they can use the right knowledge and evidence to achieve excellent healthcare and health improvement;

o   Invest in NHS librarians and knowledge specialists to use their expertise to mobilise evidence obtained from research and organisational knowledge to underpin decision-making in the NHS in England;

o   Develop NHS library and knowledge services into a coherent national service that is proactive and focussed on the knowledge needs of the NHS and its workforce.

Primary audience: All NHS England organisations, particularly Executives and senior managers

Date last updated:  January 2017

Due for review: 11.1.18

Group member responsible: VT

Building a knowledge enabled NHS for the future

Source:  Link to main document:

Publication format:  PDF

Date of publication: February 2016

Summary of driver:

‘The report identifies the successful characteristics of a knowledge-enabled organisation and how and why these can encourage knowledge sharing behaviours…. and concludes with recommendations on the best way for KM to support the NHS’ future success’. (p4)

• Looks at how role of KM has developed and the drivers which encouraged the development
• Identifies successful characteristics of a knowledge-enabled organisation.

It is hoped that ‘sharing learning and best practice approaches and making decisions based on accessible and , up-to-date evidence will enable the NHS to be more efficient and offer the best care.’ (p4)

Key features of driver:

• Acknowledges that following initial momentum and focus on knowledge management and the role of Chief Knowledge Officer, there is no longer national coordination or support in this area
• Good examples of KM practice – most relevant one is page 18 ‘NHS Scotland and Knowledge into Action’ which integrated LKS with knowledge translation/quality improvement/safety. Evidences the sepsis screening tool app (which won the Scottish Health Awards Innovation Award in 2014 and was shortlisted for a BMJ Award in 2015.
• Lists the characteristics of a successful KM organisation and references Hill and Darzi reports and relevant sections of LQAF
• NHS must adopt a systematic approach to knowledge and utilise power of connections via networks and social media

The following are accepted as challenges when embedding KM in the NHS

• Reorganisation
• KM and business goals
• Culture
• Introduction of change
• Technology
• Focus on explicit knowledge

The report ends with the following recommendations

• Develop knowledge sharing and learning capabilities
• Encourage leaders to support a knowledge sharing culture and behaviours
• Collect and promote examples of the value of KM to the NHS
• Develop communities to facilitate sharing of best practice and KM skills
• Utilise technology to enable widespread and accessible sharing of best practice

Primary audience: LKS staff, all healthcare staff across all areas of the healthcare sector

Impact on library policy/practice:

• Opportunity to showcase to others in organisation how LKS demonstrates effective knowledge management behaviours
• Opportunity to strengthen KM criteria in LQAF
• Promotion of current awareness
• Highlight LKS use of sharing best practice and collaboration (useful when highlighting the section about region-wide coordination and funding for resources)
• Look at the KM section on the MAP toolkit for further ideas (useful resources/Welcome to KM stories)
• Aligning LKS strategy and vision to the organisation via KM tools

Date last updated: 26^th February 2016

Due for review: 26^th February 2017

Group member responsible: LK

Spotlight on… categorising and tagging the MAP Tookit

In November 2014, we undertook a project to categorise and tag all the posts on the MAP Toolkit. This article explains why and how we did this.

Categories and tags in WordPress

The MAP Toolkit is hosted on WordPress.com, and one of the features of WordPress is the ability to use categories and tags on posts and pages.

Categories are generally broader in scope, and could be used to define the type of post, or a broad subject area. Generally, you’d use a small number of categories, perhaps one or two.

Tags can be more specific, and there is no limit to how many can be used to describe a post. Categories can be hierarchical, whereas tags cannot. Categories are like the chapter headings of a book, while tags are more like the index.

Why does this matter?

Categories and tags are entirely optional, but in the same way that subject headings can aid retrieval of articles from bibliographic databases, categories and tags can help locate information on a website.

There are also other things categories and tags can do in WordPress:

• RSS feeds can be created from any category or tag. For example https://maptoolkit.wordpress.com/category/drivers/feed/ provides an RSS feed of items in the category ‘drivers’ on the MAP Toolkit
• Google indexes category and tag archive pages (lists of posts), and this can increase hits to a site from search engines. Search engines can also use the categories and tags as internal links when crawling a site to ensure no pages are left out.
• You can link to lists of posts under a category or tag, so you could refer readers to previous posts on the same topic (e.g. ‘see our previous posts on education and training’).
• Tags can be displayed as a ‘tag cloud’, with more popular tags given greater prominence (we’ve added a tag cloud to the MAP Toolkit).

How did we do this on the MAP Toolkit?

As the MAP Toolkit had moved from a wiki to a WordPress site, it lacked any tags and had limited categorisation. I was tasked with looking at the content, applying consistent categories, and adding tags from scratch. It wasn’t very time-consuming to do, and once done it is easy for new posts to be categorised and tagged by the post author (in many cases using the list of popular tags that can be displayed when editing a post).

Jason Curtis
Shrewsbury and Telford Health Libraries

Stars to guide your way

Image: (CC): http://pixabay.com/en/compass-antique-map-of-the-world-429772/

Graham Breckon from Wirral University Teaching Hospital NHS Foundation Trust provides us with an example an important role which libraries deliver within their organisations.

As library staff we often have a good working knowledge of the organisation, particularly with regard to departments, key contacts and internal processes.  We are often asked about this by staff or students who are new to the Trust and still trying to find their way around the organisation. I was working on the enquiry desk when a junior doctor approached and asked where the ‘Audit Department’ was.  I explained that, rather than having a dedicated Audit Department, each division in the Trust has a Clinical Governance Co-ordinator whose role includes assisting junior doctors with their mandatory responsibility to complete an audit. I directed the doctor to the appropriate Clinical Governance Co-ordinator so that the doctor could contact her and arrange to meet with her.

On the library desk we are often an approachable and accessible point of enquiry and are frequently asked these kinds of questions.  Although this is a small example, it’s an illustration of how the library service quite often helps to match the right person to the right knowledge.

Leader of the Pack

Lucy Anderson from Pennine Care NHS Foundation Trust tells us how keeping up with Twitter

Image: (CC): http://pixabay.com/en/shield-transport-panel-board-229112/

has raised the profile of the knowledge service:

I keep up to date with Twitter and regularly read tweets from my Trust. I noticed that a service director had tweeted about how forward thinking one of our falls prevention teams is. I had just done a communication about horizon scanning bulletins and thought I would email him directly to make him aware of the Falls Prevention Horizon Scanning Bulletin.

This caught his interest and he came to see the Knowledge Service team to find out about what we do.

He was just setting up a team to produce ‘data packs’ to inform trust strategy developments. He could immediately see how we could fit in with this team.

The Knowledge Service was invited to be on a working group to produce the ‘data packs’. Accompanying us was Information and Performance, Communications and Finance.

The final ‘data pack’ informed a group of senior managers when they were discussing strategy and business plans. The ‘data pack’ team now know more about each other’s areas of expertise and feel at ease contacting each other. It was great for the Knowledge Service to get exposure with other services linked to Knowledge Management activities.

Equipment on trial

Image: (CC): http://pixabay.com/en/gavel-hammer-judge-justice-court-568417/

Matt Johnston a Knowledge Service Administrator from Pennine Care NHS Foundation Trust explains how visiting other teams and sharing objectives helps with improved referrals:

A therapy team who use the knowledge service to request articles and searches embarked on a project to trial some equipment. The team had limited experience of conducting equipment trials or how to evaluate in a structured way. In fact they were at a loss on how to begin the project. They contacted the Knowledge Service to see if they could provide any advice. I knew that the best team to speak to would be the Innovation & Research (I & R) Team. The Knowledge Service team had spent a day with the I & R team a few months ago to share our teams objectives, so I was confident that they could assist.

The Therapy Team Leader met with I & R; this resulted in the therapy team completing templates for their project and receiving advice about the methods they can use to evaluate and report results. The team are now embarking on a new project to reduce the incidence of repeat fallers and now know where to get the support they need.

End of Year Learning Guidance

Title of driver: End of Year Learning Guidance

Source: NHS Improving Quality

Link to main document http://www.nhsiq.nhs.uk/capacity-capability/knowledge-and-intelligence/iq-handbooks/learning-handbook/end-of-year-learning-guidance.aspx

Publication format: Interactive Prezi slideshow with hyperlinks to supporting documentation. Also available as a PDF.

Date of publication: 2014

Supporting documentation: NHS Improving Quality, (2014), Learning Handbook http://www.nhsiq.nhs.uk/capacity-capability/knowledge-and-intelligence/iq-handbooks/learning-handbook.aspx

Summary of driver:

Outlines the need for teams to conduct end of year, or end of project, lessons learned reviews.

Provides information on the recommended style of learning activity – retrospect review.

The guidance highlights the benefits of conducting lessons learned reviews and capturing the knowledge acquired during the team’s work.

Key features of driver:

• This guidance focuses on documenting tacit knowledge, through learning activities and the production of a lessons learned report.
• Capturing and sharing this knowledge is seen as key to ensuring that NHS organisations are resilient, and positive outcomes can be repeated.
• The benefits of end of year, or end of project, learning activities include: sharing knowledge throughout the organisation; and identifying positive and negative actions so that they can be repeated or avoided in the future for similar projects.
• Recommends using the retrospective review method.
• The guidance acknowledges there are other possible learning activity methods. The guidance includes hyperlinks to the appropriate pages of the NHS Improving Quality’s Learning Handbook for further details of the methods.
• Stresses that learning activities should focus on the ‘how’ and ‘why’ projects progressed in the way they did; and why they were successful or not successful compared to the team’s expectations prior to the work.
• Learning activities should include all members of the team involved in a project – NHS staff and any external members, to ensure that everyone’s learning points and knowledge are included.
• The lessons learned reports should be produced in an appropriate format, and stored and distributed in a way that makes them accessible to all staff within the organisation.
• Includes links to a suggested lessons learned report template in the Learning Handbook.
• Document also includes a link to a YouTube video explaining the concept of tacit knowledge.

Primary audience: Anyone working in the NHS

Impact on library policy/practice:

• Although the guidance focuses on end of the financial year learning activities, the method could be used at the end of any project.
• Library or information service staff could use learning activities to review their own work and projects.
• Library staff may be able to facilitate lessons learned activities for other teams, or provide training on the use of various lessons learned activity methods.
• As a contribution towards knowledge management, libraries may take on the task of storing and making available the lessons learned reports from departments throughout the organisation – using the library’s cataloguing system, other document storage system or Trust intranet.

Date last updated: March 2015

Due for review: March 2016

Group member responsible: FG

 

Fancy a brew? Randomised Coffee Trials

Find out how Liz Hedgecock at Health Education North West (HENW) helped improve

Image: (CC): http://pixabay.com/en/coffee-cup-coffee-beans-coffee-cup-171653/

organisational networking and understanding by simply going for a cup of coffee.  Liz explains the origins of the ‘Randomised Coffee Trial’ and her experiences of implementing a trial over on the Health Education NW blog.

Participants found it useful to support links between departments, build internal relationships, improve communication and staff engagement within the organisation.

The blog post also provides some useful reflections for the future rounds and some useful follow up reading.

No longer lost in translation

This is a story by Outi Pickering from Oxford Health NHS Foundation Trust.

Our interlibrary service occasionally provides articles in languages other than English when a

Image: (CC) http://pixabay.com/en/traveller-world-ball-globe-person-349963/

library user is doing a review which must include other languages. Oxford being very international, our users often have colleagues who can help with some of the languages – but not always, and this is where the library has been able to help. I’m a native speaker of Finnish; in addition, I can call myself fluent in Swedish and Italian and competent in German. As these languages are related to others which may be called for (Dutch, Spanish, Danish come to mind), I’ve been able to decipher a number of different languages sufficiently to say whether for instance the article is about inpatients only, whether there was co-morbidity, etc. The agreement is that if I can provide the information within half an hour, it’s a value added service given by the library, but if more time is needed – particularly if a proper translation is needed – I put my freelance translator’s hat on and do the work in my spare time and the user pays for it. Outcome: satisfied users who spread the word that the library is a useful place! We’re not planning to take this any further though since the service depends on one individual (though there could be others, depending on who we employ!), and we don’t advertise it as part of our official “menu”.

On another similar theme, a Greek junior doctor asked if I knew of anyone who could help her with her English. She didn’t want a language school but an individual who could help her get the feel of the language at a deeper level, and besides, due to her work she couldn’t commit herself to a course. I said I know one – my husband! He is a retired university lecturer (English language, specialising in linguistics) and needs to feel useful and have contacts outside the home. They reached an agreement, and both parties were delighted. In addition to the lessons at our house which my husband provided, we often went out all three together, and were introduced to the doctor’s friends when they visited! She has now moved away from Oxford, but we’re still in touch with her occasionally.