Health Service Focus

The Future Library

Wayne Sime, director of library services at the Royal Society of Medicine, speaks to NHE.

With Jeremy Hunt’s ambition for a paperless NHS by 2018, organisations must look to update their processes and systems and embrace new technology. The Royal Society of Medicine (RSM) is taking radical steps to modernise its library, and seeing the benefits.

Director of library services, Wayne Sime, spoke to NHE about managing the transition, and how trust and leadership are essential to overcoming cultural resistance.

The RSM’s library contains about 600,000 volumes, covering more than 50 medical specialities, as well as 13,000 videos and training guides.  In 2006 the society was subscribed to some 2,000 current paper journal titles, but from next year there will only be 150 – those unavailable by remote access. All other journals will be provided electronically. 

‘No one big bang’

“That’s a big thing for us from January 2014,” Sime said. “We’ve moved heavily down the electronic route. Each year we’ve introduced more and more electronic resources, eBooks and eJournals: we’ve been rolling this out since about 2008.”

But a reduction in paper copies hasn’t harmed physical visits – the number of visits went from 16,000 in 2006 to over 30,000 in 2013. Not only is this a record number, but satisfaction rates for the library service are at an all-time high. At a time when many NHS libraries are closing, this is even more impressive.

Sime explained that people “have become more aware of what the Library has to offer”, including 50,000 rare or unique items in its historical collection.

He said the key was to target resources to what its members want, to take ‘hearts and minds’ with them into a different type of service. A virtual library users group and sessions to improve members’ IT skills also offer ways to encourage greater familiarity and confidence in using digital resources.

Sime explained: “It isn’t just one ‘big bang’; by phasing the move to electronic resources over several years, members have got used to it – they’ve come to expect it and expect more. When we first started some members didn’t want to have electronic resources, but now it’s very much: ‘Well, why aren’t my journals electronic yet?’ That has definitely changed over the years.”

An information skills programme was launched in 2009 and includes four CPD-accredited courses: introduction to literature searching, advanced literature searching, introduction to evidence-based medicine and introduction to critical appraisal.

The courses were useful, Sime said, for bringing older generations up to speed with new technology, and to equip the younger users with higher critical appraisal skills.

“We try to target it to the age demographic to get the right information across.”

People first

Discussing the rocky history of the NHS and major IT projects, Sime said there needed to be far more collaboration between the different parts of the organisation. In terms of NPfIT, he said: “The programme had problems because it hadn’t looked at the organisation of the NHS. In one [trust] there were lots of different NHS organisations all on the same site; they weren’t necessarily talking to one another.

“They put IT first and they really needed to put their people and processes first, before IT even came in.”

By contrast, in the RSM’s case, a lot of work went into building up trust before the switchover to digital. Meetings, testing and “work behind the scenes” with staff and suppliers including Elsevier aimed to ensure that from 1 January 2014, when the society goes electronic-only, everyone is on board with the change.

For the wider NHS, leadership will be key to achieving a paperless, digital system.

“There is something here that could be useful for the NHS as a model,” Sime added.  Clarifying exactly what an organisation wants to achieve with digital is also essential; identifying how the information can help the body to deliver services, “rather than it just being an adjunct; a luxury product”.

Digital librarians

Moving the library from print to digital has clear implications for staff; and getting librarians to move with this new technology can be difficult.

Sime said: “Staff need to stop thinking about it as just physical – I’ve never understood why some librarians think about ‘the collection’, looking at the library as a physical collection. It’s the same, just electronic.

“You’re still going to have to develop searches to get that information, to procure it, send alerts, and [develop] information products to make people aware of the information that’s out there.

“Some people can’t imagine not having the physical ‘thing’. There are still going to be hundreds of thousands of different volumes, all this information. There still needs to be somebody to index and sort it and retrieve it; I think that’s quite exciting.

“A lot of librarians in the NHS need to come out of the libraries and make more impact, either in clinical governance or medical education and training – getting embedded in how the GP practice or the hospital achieves its objectives.”

This is where the information skills programme can be “quite empowering” for both members and staff, he added.

RSM Library membership for individual professionals starts at £176, or for a NHS corporate trust is £100 a year (plus VAT)