From Knowledge to health: the implementation of the National Service framework for quality assurance of NHS Libraries

From Knowledge to Health : the Implementation of the National Service Framework for Quality Improvement of NHS Libraries Tricia Ellis CILIP CDG UK National Conference 20 th April 09 National Library for Health – now part of NHS Evidence

Introduction to this presentation To provide an overview of NHS Health Libraries in the context of the NHS. To give an overview of quality assurance processes in NHS Libraries. To explain the National Service Framework for Quality Improvement of NHS Libraries as a service improvement tool. To consider the impact of the Framework on the continuing professional development of library staff.

Consider these questions How do we know that our libraries are the best that they can be? How do we know that our libraries are fit for purpose and meet our customers’ needs? How do we know that our libraries are constantly striving to improve their service delivery? How do we know that our library staff have the best possible support to develop their skills to deliver services?

Background to the National Health Service in England. The NHS is committed to providing quality care that meets the needs of everyone, is free at the point of need, and is based on a patient's clinical need, not their ability to pay. The NHS in England is controlled by the UK government through the Department of Health (DH), which takes political responsibility for the service. The DH controls 10 Strategic Health Authorities (SHAs), which oversee all NHS operations, particularly the Primary Care Trusts, in their area. These are coterminous with the nine Government Office Regions for the most part, with the South East region split into South East Coast and South Central SHAs.

How the NHS is delivered 152 NHS Primary Care Trusts (PCTs), which administer primary care and public health. These oversee 29,000 GPs and 18,000 NHS dentists. PCTs control 80 per cent of the total NHS budget 1600 NHS Hospital Trusts and NHS Foundation Trusts administer hospitals, treatment centres and specialist care. Some Trusts run between 2 and 8 different hospital sites. A variety of: NHS Ambulance Services Trusts NHS Care Trusts, providing both health and social care services NHS Mental Health Services Trusts Some services are provided at a national level, e.g. NHS Direct which provides telephone and online support

NHS Staff The NHS employs a large number of staff including nearly all hospital doctors and nurses in England. Currently the NHS has 1.3 million workers, and is the third largest workforce in the world, after the Chinese Army and Indian Railways. The NHS also plays a unique role in the training of new doctors in the British Isles, with approximately 8000 places for student doctors each year, all of which are attached to an NHS University Hospital Trusts.

NHS Health Libraries There are 267 NHS Health Library Services and 365 NHS Health Library Service Points in England There are approx 1270 NHS Librarians. NHS Library Services provide the knowledge base to support clinical staff and non-clinical staff in delivering high quality healthcare. Resources and services are purchased and managed nationally, regionally and locally to provide the evidence base to underpin clinical and health management decision making, clinical research, professional development, as well as basic skills.

Quality Assurance of Health Libraries NHS Health Libraries are subject to quality assurance processes as are all library services. Quality in the NHS is assessed by independent bodies such as the Care Quality Commission according to standards set by the Department of Health and the National Institute for Health and Clinical Excellence. Regulatory bodies in the UK include government-based, e.g. Department of Health, General Medical Council, Nursing and Midwifery Council, and non-governmental-based, e.g. Royal Colleges. Until 2008 NHS Health Libraries have undertaken a peer review assessment with accreditation awarded for the quality of service.

How quality assurance of NHS Health Libraries changed from 2008 onwards March 2008 press release of the Review of NHS Library Services: from Knowledge to Health in the 21 st Century by Prof Peter Hill and the National Service Framework for Quality Improvement through National Library for Health (NLH). Clinical decision making by patients, their carers as appropriate, and health professional Commissioning decision and health policy making Research Lifelong learning by health professionals.

March 2008 – publication of National Service Framework for Quality Improvement of NHS Funded Libraries in England The Framework defines the outcomes required for library/knowledge services in England. It provides the national quality assurance framework for service improvement. The intention is that library/knowledge services are aligned to the business needs of the NHS and are demonstrably delivering to need and expectation. The framework is aligned to international and national quality standards and is referenced to key NHS policy and standards.

Purpose of the Framework To establish a quality cycle To drive forward the modernisation of health libraries and knowledge services To align library services with the business objectives of the NHS To meet demonstrably both national & local requirements & expectations Applies to all NHS funded library services in England

The Framework’s 5 Domains and Standards

The Standards Domain 1 Managing Services, Knowledge, Risk and Information Governance Domain 1.1 Strategy Domain 1.2 Policy Domain 1.3 Operational Management Domain 1.4 Performance Monitoring Domain 1.5 Corporate Risk Domain 1.6 Information Governance 5 Domains:

Domain 2 Domain 2 Commissioning, Finance, Contracts and Partners Domain 2.1 Commissioning Domain 2.2 Finance and Budgets Domain 2.3 Service Level Agreements and Contracts Domain 2.3 Partnership Working

Domain 3 Domain 3 Human Resources and Staff Management Domain 3.1 HR Strategy Domain 3.2 Staff Structure Domain 3.3 HR Policies Domain 3.4 Recruitment Domain 3.5 Orientation and induction Domain 3.6 Job Descriptions Domain 3.7 European Working Directive Domain 3.8 Skill Mix Domain 3.9 Appraisal Domain 3.10 Training and Development Domain 3.11 Staff Communication Domain 3.12 Staff Involvement

Domain 4 Domain 4 Infrastructure, Facilities and Safety Domain 4.1 Information Technology Domain 4.2 Facilities and Equipment Management Domain 4.3 Environmental Management Domain 4.4 Work Space Domain 4.5 Health and Safety

Domain 5 Domain 5 Customer Engagement Domain 5.1 Access Domain 5.2 Customer Induction Domain 5.3 Customer Education Domain 5.4 Customer Service Domain 5.5 Customer Facilities

Categories of compliance Full Compliance : The criterion is in place There is evidence to prove this There is written, observable, established practice All staff are aware Partial Compliance : The criterion is not fully met It is being worked on (but not draft documents) There is evidence to show it is being actively addressed – resources identified, plans in place

Categories of compliance Non Compliance: This has not been considered No work towards implementation May be a willingness to progress but no supporting action or plans to move forward What is observed falls far short of the guidance Draft documents Unsafe systems of practice Not applicable: Individual standards or criteria that do not apply to the knowledge service. These need to be agreed with the lead surveyor and documented as to why they are not applicable.

Example - 1.5 Corporate Risk Criterion 1.5a There is a dated, documented risk management strategy for the NHS funded library/knowledge services which is reviewed on an annual basis . Guidance The strategy details aims, objectives, committee structures and accountabilities and individual responsibilities, and covers all types of risk including environmental and organisational (finance, human resources, legal compliance, health and safety). It should include the following elements: the process for reviewing the service’s performance with regard to the management of risk, the identification of how risk is measured, key objectives for managing risk, guidance on what constitutes "acceptable" risk, links between the strategy and risk management policies and procedures and how staff are to be trained in risk management.

Example – Domain 3.2 Staff Structure Criterion 3.2e A named person is responsible for the co-ordination of local quality improvement/management activities. Guidance: The service quality co-ordinator should also link into organisation-wide quality initiatives and structures, both formally and informally. The responsibilities of this person may include leading on the implementation of the quality assurance/accreditation programme for the service.

Benefits of the Framework Mechanism for quality assurance, quality management and quality control for all library/knowledge services that support healthcare organisations. Generic to any type of knowledge service. Standardised approach to quality improvement and service modernisation for library/knowledge services across the whole local healthcare economy. Provides a clear action plan for service improvement. Staffing opportunities within quality assurance.

Identify gaps in service provision Self assessment service improvement reporting and ensures robust service delivery by planning for future service needs Opportunities for partnership working Risk assessment and risk management Skills and competencies to deliver to a high specification.

Implementing the Framework During 2008 - Training for Quality Leads, Project Managers, Surveyors, organisations. Workshops on standards interpretation A range of support tools on National Library for Health’s website ‘For Librarians’, e.g. FAQs, guidance, etc. By April 2009 self-assessment of all 267 NHS Library Services for compliance to the standards with preparation for peer review visits in 2009. National analysis of self assessment to identify trends and patterns, gaps and service improvement needs.

Opportunities for Staff Development There will be a need for skills in the following to support quality improvement: Change Management Leadership Project Management Negotiating Surveying Assessing Data capture and handling, e.g. Excel, Communications

What happens next? There are multiple roles for library staff within quality assurance, including those of: Quality Leads Project Leads Project Managers Surveyors

More information from http://www.library.nhs.uk.uk/forlibrarians/quality Tricia Ellis – Interim Head of Knowledge Management and E-Learning, NHS South West Strategic Health Authority [email_address]

Questions….. How does the quality assurance process of the National Service Framework for Quality Improvement of NHS Libraries compare with the quality assurance processes within your libraries? How do you use quality assurance processes to support the customer experience within your libraries? How do you work with your customers to improve your services?

From Knowledge to health: the implementation of the National Service framework for quality assurance of NHS Libraries

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From Knowledge to health: the implementation of the National Service framework for quality assurance of NHS Libraries