Clicks and mortar: technology and the NHS estate

July 31, 2019 Comments Off on Clicks and mortar: technology and the NHS estate

What does this mean for libraries? 

  • Libraries can help retrieve evidence to support innovations around technology and building use, both from inside the NHS (from initiatives such as the Global Digital Examplars programme) and also from other sectors. Interviewees in the report felt they lacked access to best practice and that more learning needed to be shared, and librarians are well-placed to help provide this to managers, commissioners and transformation teams.
  • As technology is introduced to allow more digital consultations, or virtual reality for surgery (p. 19), libraries may be able to benefit from being able to use digital technologies themselves to provide services such as information literacy training. There may also be a role for libraries to help healthcare staff make use of new technologies such as Skype, as some have already done.
  • The report recognises that working spaces need to be pleasant and encourage a positive culture of working, including reducing the potential for burnout or loneliness. Where libraries are used for hot-desking or agile working, there is a need to provide attractive spaces, perhaps with different areas for different types of working, refreshments, and wellbeing resources.

Source: The King’s Fund

Link to main document

Date of publication: May 2019

Summary of driver:

This piece of research looked at the physical NHS estate, covering the primary, community and acute sectors, with a focus on buildings. It covers the impact of digital technology and medical equipment on services and patient care, and touches on technology supporting the management of the estate. The evidence came from a literature review, and interviews.

Developments in technology will affect the NHS buildings and way buildings are used. It is likely to result in the estate being used differently, rather than necessarily being smaller.

Technology and the NHS estate need to be considered together as part of long-term plans for change, and organisations need to work together, including organisations outside the NHS.

Local systems play a key role, but nationally there needs to be support for shared data and technology standards, and sharing of learning needs to be facilitated.

HEE Quality Framework 2019-20

July 31, 2019 Comments Off on HEE Quality Framework 2019-20

Impact on library policy/practice

The HEE Quality Framework 2019-20 specifically mentions LKS in Quality Domain 1- Learning Environment and Culture.

  • 1.5 The learning environment provides suitable educational facilities for both learners and educators, including space, IT facilities and access to quality assured library and knowledge services
  • 1.3 Opportunities for learners to be involved in activities that facilitate quality improvement/ improving evidence based practice and research and innovation
  • Learners and educators must have access to quality assured Library and Knowledge Services including provision of resource and information handling skills to support evidence based practice
  • Placement providers are required to provide high quality education learning environments for all users – including continuous improvement of the placement learning environment and educational provision
  • Health Education England are required to benchmark outcomes across regions- and providers are required to demonstrate the capacity/resources/facilities to deliver safe and relevant learning opportunities could lead to more equitable resources for LKS nationally

Source:  NHS Health Education England

Publication format:  PDF

Date of publication: June 2019

Link to main document

Summary of driver:

Health Education England (HEE) is responsible for ensuring that there are high quality learning environments for all healthcare learners in England. The original multi-professional framework was tested across England 2016-17 and has been refreshed for 2019-20. MAP has already looked at the implications of the HEE Quality Strategy 2016-2020 on LKS.

Together with other HEE quality documentation this Quality Framework enables HEE to drive sustainable quality improvement across all learning environments. This will lead to improvements in patient care via high quality education and training which in turn delivers the multi-skilled and sustainable workforce required.

Priorities for 2019/20 include applying this Quality Framework to undergraduate medical training.

The Quality Framework is based on six domains and each of those domains is supported by a set of evidence-based Quality Standards:

  • Learning Environment and Culture
  • Educational Governance and Leadership
  • Supporting and Empowering Learners
  • Supporting and Empowering Educators
  • Delivering Curricula and Assessments
  • Developing a Sustainable Workforce

Designing integrated care systems (ICSs) in England: An overview on the arrangements needed to build strong health and care systems across the country

June 21, 2019 Comments Off on Designing integrated care systems (ICSs) in England: An overview on the arrangements needed to build strong health and care systems across the country

Impact on library policy/practice:

MAP has already looked at the implications of ICSs for LKS in a policy briefing on Integrated Care Organisations – a reminder of the impact below.

  • There may be an opportunity to deliver evidence and knowledge to managers, commissioners and transformation teams as health care services undergo this change.
  • As organisational boundaries blur and take a ‘whole population’ approach, LKS may be required to adapt their service delivery models accordingly.
  • If healthcare moves away from a competitive structure and towards a collaborative one, there will be many opportunities relating to knowledge management that could support the sharing and dissemination of good practice, innovation and organisational knowledge.
  • LKS will have to consider how the negotiation and procurement of resources needs to adapt to reflect the changes in organisational structures.
  • There is a clear role for technology in supporting the emergence of integrated care systems and Accountable Care Organisations that presents an opportunity for digitally enabled
  • Highly likely that LKS in sustainability and transformation partnerships (STPs) and the wider region are already working together in partnership and  can share experience of partnership working and collaboration
  • Fabulous opportunity to showcase our health literacy skills

Source:  NHS England

Link to main document

Publication format:  PDF

Date of publication: June 2019

Summary of driver:

The NHS Long-Term Plan set the ambition that every part of the country should be an integrated care system by 2021. It encourages all organisations in each health and care system to join forces, so they are better able to improve the health of their populations and offer well-coordinated efficient services to those who need them. This overview is for all the health and care leaders working to make that ambition a reality, whether in NHS acute or primary care, physical or mental health, local government or the voluntary sector. It sets out the different levels of management that make up an integrated care system, describing their core functions, the rationale behind them and how they will work together.

There are three important levels at which decisions are made:

  • Neighbourhoods (populations circa 30,000 to 50,000 people) – served by groups of GP practices working with NHS community services, social care and other providers to deliver more coordinated and proactive services, including through primary care networks.
  • Places (populations circa 250,000 to 500,000 people) – served by a set of health and care providers in a town or district, connecting primary care networks to broader services including those provided by local councils, community hospitals or voluntary organisations.
  • Systems (populations circa 1 million to 3 million people) – in which the whole area’s health and care partners in different sectors come together to set strategic direction and to develop economies of scale.

This overview recognises that each area is at a different stage of its journey and provides examples of best practice from all of these three levels. Regional and national support will be delivered by NHS England and NHS Improvement.

 

Interim NHS People Plan

June 21, 2019 Comments Off on Interim NHS People Plan

What does this mean for libraries? 

Increasing use of technology and scientific innovation can transform care (p.5) and LKS can support this through current awareness services to alert staff to new developments, and through knowledge management to enable sharing of knowledge and best practice.

Libraries can provide access to evidence, for example through evidence searches, to evaluate and support the introduction of new technologies and ways of working, to help create a culture where digitally supported care is the norm (p.52).

There will be a need to help NHS staff gain new digital skills to help transform care pathways and clinical practice, and enable more efficient ways of working (p.5). While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

Increases in student numbers as urgent workforce shortages such as in nursing are addressed (p.5) may require the introduction of new services to support them whilst on placement with NHS organisations, and may require LKS to work more in collaboration with university library services. Libraries support lifelong learning and continuing professional development of the whole workforce, and this will be key as technology changes and careers become more flexible (p.30) and will support the retention of staff.

The move toward Integrated Care Systems (ICSs) may have implications for the way library services are organised locally, and there may be a need to greater collaboration and partnership across a whole ICS. There will also be more partnership working between ICSs and local authorities that may lead to greater collaboration with public library services. It is expected that ICSs will become the main main organising unit for local health services by 2021 (p.55).

Source: NHS England

Link to main document

Date of publication: June 2019

Summary of driver:

The Interim NHS People Plan sets out the vision for 1.3 million people who work for the NHS to enable them to deliver the NHS Long Term Plan, with a focus on the immediate actions that need to be taken.

It argues that work will be much more multidisciplinary, people will have more flexible and less linear careers, and technology will enable people to work to their full potential. People want a better work/life balance.

The plan is organised around several themes:

  1. Making the NHS the best place to work

There is compelling evidence that the more engaged staff are, the more effective and productive they are. Staff report not having enough time, and sickness absence is higher than in the rest of the economy. The NHS needs to become an employer of excellence.

The report sets out actions to attract and retain staff.

  1. Improving our leadership culture

Leaders need to develop a positive, compassionate, inclusive and people-centred culture.

  1. Addressing urgent workforce shortages in nursing

Although there are shortages in lots of NHS professions, nursing is seen as the most urgent challenge.

  1. Delivering 21st century care

The NHS Long Term Plan sets our priorities such as increasing care in the community, redesigning and reducing pressure on emergency hospital services, more personalised care, digitally enabled primary and outpatient care and a focus on population health and reducing health inequalities.

This requires continued growth in the workforce and its transformation to one that is more flexible and adaptive, has a different skill mix and – through changes in ways of working – has more time to provide care.

The workforce needs to be ready to exploit the opportunities offered by technology and scientific innovation to transform care and release more time for care.

  1. A new operating model for workforce

Workforce activities need to happen at the optimal level – whether national, regional, system or organisational – with the expectation of an increasing role for integrated care systems (ICSs) as they develop.

The Plan starts to set out how the principle of subsidiarity will apply to people-related functions by setting out what functions can potentially be carried out at which levels.

  1. Immediate next steps

The Plan focuses on the urgent actions that need to be taken over the next year, and a full People Plan that cover five years is still being developed.

At the end of the Plan is a table detailing all of the proposed actions, who will do them, and the timescale.

National survey of local innovation and research needs of the NHS

May 28, 2019 Comments Off on National survey of local innovation and research needs of the NHS

What does this mean for libraries?

  • Libraries can actively look to disseminate information about national or local research and innovation projects to their users / organisation through current awareness services, literature searches or in specific focused events or activities to raise awareness.
  • This could be an opportunity to establish links with local research & development departments to establish which subject areas are of interest so current awareness services or bulletins addressing those topics can be provided; and raise awareness within the research and development team of the library’s ability to assist with literature searches, access to information databases, and searches for grey literature.
  • Libraries could host research coffee mornings or similar as meeting opportunities for researchers and those interested in innovation in their organisation to meet up and discuss potential projects, and lessons learned from failed projects.
  • Libraries could find out about their local regional Academic Health Science Network and disseminate to their organisation / service users information about what projects the research network is currently running.

Source: AHSN (Academic Health Science Network)

Link to main document

Date of publication: April 2019

Summary of driver:

This report summarises the national findings from a survey to identify local NHS innovation and research needs in England.

The views of local health stakeholders, including clinical leaders, managers and directors, within each AHSN (Academic Health Science Network) were sought.

There were some differences in regional priorities, but common themes emerged that reflected wider challenges facing the NHS and align with the NHS Long Term Plan.

These include a need for innovation and research addressing:

  • workforce challenges
  • delivering mental health services and providing care for patients with mental health needs
  • integrating services to provide effective care for patients with complex needs – including multi-morbidity and frailty.
  • research into the needs for specific patient groups – people with mental health conditions, older people and socially-isolated people.
  • using digital and artificial intelligence technology.

The survey also asked about respondents’ ability to access innovation and research in their region and confidence in implementing it.

The survey identified where research existed in the respondents’ priority areas, using it and implementing the research were identified as potential problems.

Improvements in communication and dissemination of information were identified as improvements needed to raise awareness of research and innovation; whilst sharing knowledge was identified as important for improving the application of innovation and research.

NHS Constitution

April 1, 2019 Comments Off on NHS Constitution

What does this mean for libraries?

  1. Library & Knowledge Services are clearly aligned with principle 3: “The NHS aspires to the highest standards of excellence and professionalism” as we continue to train and support staff to deliver high-quality, evidence-based healthcare.  Identifying and appraising evidence to inform service development means that good practice and learning are incorporated into the planning and delivery of NHS services. LKS are committed to developing people; we support academic endeavours, enable NHS staff to employ effective knowledge management behaviours and promote critical thinking.  LKS work closely with research practitioners and departments to assess and grow the evidence base to improve health care for the future.
  2. That the NHS is patient-centric is a key theme of the Constitution.  There are opportunities for LKS to ensure patient information is communicated plainly, accurately and in an accessible way, whether through supporting the development of patient information leaflets, or helping healthcare staff to translate evidence in a meaningful way.
  3. LKS professionals are skilled in building relationships, harnessing technology and networking to enable effective knowledge transfer across healthcare systems. This expertise clearly supports principle 5: “The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population”.
  4. Ensuring that effective, evidence based decision-making is employed across the NHS is crucial to achieving principle 6: “The NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources”. LKS can accelerate effective decision-making by harnessing evidence, learning and knowledge for health care systems to apply.
  5. The values of equity, openness and partnership working described in the Constitution are echoed in the principles that underpin the delivery of Library and Knowledge Services, as outlined in Knowledge for Healthcare.

Source: Department of Health and Social Care

Link to main document

Date of publication: Published March 2012, updated October 2015

Summary of driver:

The NHS Constitution establishes the principles and values of the NHS in England.

Seven key principles guide the NHS in all it does:

  1. The NHS provides a comprehensive service, available to all
  2. Access to NHS services is based on clinical need, not an individual’s ability to pay.
  3. The NHS aspires to the highest standards of excellence and professionalism
  4. NHS services must reflect the needs and preferences of patients, their families and their carers.
  5. The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population
  6. The NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources
  7. The NHS is accountable to the public, communities and patients that it serves.

Protected: Meeting 1st April 2019

April 1, 2019 Comments Off on Protected: Meeting 1st April 2019

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GP Partnership Review: Final Report

February 21, 2019 Comments Off on GP Partnership Review: Final Report

Optional wording for policy briefings ONLY: A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? This report outlines the challenges that GPs are facing with increasing workloads and the rising complexity of patients resulting in clinical risk challenges.

  • LKS could support GP partnerships with the evidence base and current awareness services to support complex care.
  • LKS could approach local CCGs / GPs to make them aware of the services available or see if they wish to take up the offer where provision doesn’t exist.
  • Libraries serving GPs or organisations in partnership with GPs may wish to review resources and collections to offer leadership resources for staff looking to develop leadership skills.

Source: Department of Health and Social Care

Link to main document https://www.gov.uk/government/publications/gp-partnership-review-final-report

Date of publication: January 2019

Summary of driver: This review considers the challenges that currently face GP partnerships and makes the following recommendations to revitalise and transform the partnership model:

  • There are significant opportunities that should be taken forward to reduce the personal risk and unlimited liability currently associated with GP partnerships.
  • The number of General Practitioners who work in practices, and in roles that support the delivery of direct patient care, should be increased and funded.
  • The capacity and range of healthcare professionals available to support patients in the community should be increased, through services embedded in partnership with general practice.
  • Medical training should be refocused to increase the time spent in general practice, to develop a better understanding of the strengths and opportunities of primary care partnerships and how they fit into the wider health system.
  • Primary Care Networks should be established and operate in a way that makes constituent practices more sustainable and enables partners to address workload and safe working capacity, while continuing to support continuity of high quality, personalised, holistic care.
  • General practice must have a strong, consistent and fully representative voice at system level.
  • There are opportunities that should be taken to enable practices to use resources more efficiently by ensuring access to both essential IT equipment and innovative digital services.

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

February 13, 2019 Comments Off on 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 Long Term Plan

January 7, 2019 Comments Off on  NHS Long Term Plan

What does this mean for libraries?

Increases in demand from students, such as nursing students on placement in NHS organisations, and increases in medical student numbers will have an impact on the workload of LKS, and may require the introduction of new services to support them, such as having access to good WiFi or lockers, and more collaboration with university library services.

A move towards more Integrated Care Systems, and potentially more collaborative working under the auspices of Sustainability and Transformation Partnerships (STPs) could have implications for LKS that have SLAs with only some local organisations, and more work may need to be done to encourage organisations that currently don’t contribute to LKS to do so, so that all staff in an area have equitable funded access.

LKS are ideally placed to help get better value for the NHS and get the most out of the investment in it by making the evidence base accessible and encouraging its use and application. It could be a good opportunity to promote time saving services such as current awareness and mediated evidence searches. LKS can also support innovation and change through encouraging and supporting knowledge management.

There may be a need to help NHS staff become more familiar with digital systems, particularly to help retain staff that are less confident with IT. While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

With the focus on preventing illness, LKS will have a role to play in supporting the provision of good-quality health information for patient and carers.

Katie Nicholas of Health Education England has prepared a useful summary of references to evidence, knowledge, innovation and Topol in the NHS Long Term Plan.

Source: NHS England

Link to main document

Date of publication: January 2019

Summary of driver:

This is the first stage in planning for the next ten years of the NHS in England. Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) will have until the autumn to say how they are going to implement the plan locally.

It is said to be ambitious but realistic.

There are three main areas of health and care this plan aims to tackle:

  1. Making sure everyone gets the best start in life

This includes taking further action on childhood obesity, increasing funding for children and young people’s mental health, reducing stillbirths and mother and child deaths during birth by 50% and delivering the best treatments available for children with cancer, including CAR-T and proton beam therapy.

  1. Delivering world-class care for major health problems (both physical and mental)

This includes preventing 150,000 heart attacks, strokes and dementia cases, spending at least £2.3bn more a year on mental health care, delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24, and saving 55,000 more lives a year by diagnosing more cancers early.

  1. Supporting people to age well

This includes increasing funding for primary and community care by at least £4.5bn, bringing together different professionals to coordinate care better, developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home and upgrading NHS staff support to people living in care homes.

The planned means to do this include:

  1. Doing things differently

This includes encouraging more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities.

  1. Preventing illness and tackling health inequalities

This will include action on helping people stop smoking, overcome drinking problems and avoid Type 2 diabetes.

  1. Backing our workforce

There are planned thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. There will also be work to improve staff retention.

  1. Making better use of data and digital technology

Among other plans, there will be a new NHS App, better access to digital tools and patient records for staff.

  1. Getting the most out of taxpayers’ investment in the NHS

Identifying ways to reduce duplication in how clinical services are delivered, and make better use of the NHS’ combined buying power to get commonly-used products for cheaper, and reduce spend on administration.

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