From NeLH to a National Knowledge Service for the NHS

1. From NeLH to a National Knowledge Service for the NHS Veronica Fraser ASSIST Annual Conference May 21 2003

2. Progress and Plans • Progress in 2002/2003 • Planned achievements 2003 – 2005 • Programme Leads • Technical Integration - Dr Ben Toth • Content & Quality - Ron Stamp • Mobilisation - Margaret Haines • Partnerships - Veronica Fraser

3. Knowledge is the Enemy of Disease Applying the knowledge we already possess could improve the health of patients more than any drug or technology likely to be developed in the next decade • Nationally produced healthcare knowledge is not put into practice, not available consistently, held in silos • DH investment in knowledge systems is considerable, but we are not getting best value from this investment • Clinicians and patients are confused by multiple sources of information including NHS/DH advice • Urgent , important safety information cannot be promptly delivered

4. Learning from Bristol “We are creating a National Knowledge Service for the NHS…which will meet the needs of professionals, patients & the public for up to date evidence based information by fully integrating the development of NHS knowledge systems (eg NHS Direct, NHS UK, National electronic Library for Health, Department of Health websites)… This is a complex development which will take time and resources” (Learning from Bristol: the Dept of Health response to public inquiry into Bristol Royal Infirmary Jan 2002) Vision – to access consistent knowledge: Reduce confusion Create Value for Money

5. NKS Aims • To provide access to common knowledge cores for NHS staff and the public • To provide a coherent and comprehensive service framework in which common standards are developed at local and national levels • To ensure that all users of the NKS have support and training • To achieve best value in acquiring knowledge and information produced outside the NHS

6. NKS Partners • National Electronic Library for Health • NHS Direct Online • nhs uk • Department of Health - IPU, RDD, NHSMA, COMMS, ISG • Electronic Library for Social Care and working closely with: • NHSU • National Patient Safety Agency • NHS Libraries

7. National electronic Library for Health • fast and easy access to best evidence • 100,000 users in April 03 • Cochrane, Clinical Evidence • Guidelines Finder • Specialist libraries • Hitting the Headlines • Document of the week

8. National electronic Library for Health • long term funding now agreed • £6m pa 2003-06 • nominated for eHealth Exhibition, Brussels • in development • Oral Health • Primary Care • www.nelh.nhs.uk

9. National Knowledge Service Common technology, tools and infrastructure Consistent, flexible, quality content Manage resources and Partnerships Mobilise knowledge

10. Technical Integration Knowledge management is NOT a technology problem, but... Technology can support business transformation (and knowledge management is about business transformation)

11. Helper Technologies • web services • XML and RSS • content management systems and meta data • digital archives and digital identifiers • weblogs and portals

12. NKS Technical Stream will • help implement standards • create services for users • support a distributed environment • improve content management

13. NKS Content & Quality Stream will • provide quality assured information in variety of levels, languages and formats • offer equity of access to information for all in healthcare process • utilise a wider range of public access technologies • develop tools to support quality evaluation

14. Content & Quality • quality labelling – NeLH resources • commissioning knowledge sources – eg. medicines • content licensing – Cochrane, Clinical Evidence, Core Content • question answering services - ask a librarian ? • appraisal of decision support systems • quality of patient information – CHIQ & Information Partners

15. NKS links - Informed Patient • Improving Patient Experience programme • national patient information content bank • direct patient access via NHS Direct Online, digital tv etc • quality assured resource for NHS organisations

16. Enabling Access • NHS Direct Digital TV from 2004 • new licensing arrangements for public touch screen kiosks • national translation and interpreting service by end 2003

17. NKS and NHS libraries • National Core Content project • set up to purchase specific knowledge-based resources on a national basis. • resources complement those purchased by the National Electronic Library for Health. • many of these resources have already been purchased by the NHS regions. • funded by the NHS Workforce Development Confederations. • National Core Content Group has nominated representatives from across England inc HE

18. Timescales involved • April 2002 - Project approved by WDC Chief Executives • August 2002 - Project Manager appointed • August 2002 - OJEC advert placed • November 2002 - User Evaluation days • December – February - Negotiations with suppliers • February 18th 2003 - Decision made • 1st April 2003 - Service Launched

19. Resources Procured (1) • Indexing and Abstracting Databases • Medline, Cinahl, Psycinfo, Embase, British Nursing Index, Amed and DH-Data • available to NHS in England (excluding London/SE) from April 1st 2003 • easy to use web interface • can be accessed from any location using ‘Athens’ access system • will include a interactive computer based training package (available May 2003) • supplied by Thompson Dialog

20. Resources Procured (2) • Full Text Journals • database of over 850 journals covering Medicine, Psychology and Nursing • linked to the indexing and abstract databases • available to NHS in England (excluding London/SE) from April 1st 2003 • can be accessed from any location using ‘Athens’ access system • supplied by Proquest Information and Learning • Ebsco business collection of journals • input from you !

21. Resources Procured (3) • Biomed Central Membership • available to NHS in England from April 1st 2003 • allows authors to publish to the Biomed collection of freely available peer reviewed journals • allows the NHS to establish its own journal titles at no additional cost • easy to use web interface • can be accessed from any location using ‘Athens’ access system

22. NKS and Library Service Development • The 9 confederations that make up London/SE (KA24) are expected to join in Core Content inApril 2004 • resources will grow to include other important databases and/or electronic journals • working with the suppliers to improve the services provided • marketing and feedback from users

23. NKS and Knowledge Mobilisation • actively promote the use of NKS partner services so that health and social care decision making is supported by high quality information and knowledge • development of training and capacity development programmes in collaboration with other partners e.g. NHSU and StHAs • this will also involve active support to knowledge networks using NKS resources • improve access across NHS and HE

24. Supporting Communities of Interest Development • already underway using 19 NeLH specialist libraries (led by Anne Brice) • mapping specialist libraries against four stages of community of practice development • communities review and produce information for specialist library • online discussion forum supports interaction and knowledge sharing around content in NKS as well as other issues

25. Providing Knowledge Capacity and Training Support • NHS Modernisation Agency is developing appropriate web tools and resources e.g. KM Skills Toolkit and KM web domain (www.nelh.nhs.uk/km) • NHS Modernisation Agency is also working with StHAs and WDCs • to promote geographic knowledge networks • to promote access to knowledge resources including libraries and NKS • to support KM capacity development in NHS organisations

26. NKS In 2002-3, with minimum investment, we have progressed... • technical and content quality sub-groups to develop standards for NKS partners • national licences for content, producing consistent access and better value for money (Cochrane Library, Clinical Evidence) • co-hosting of key partner websites (nhs.uk, NHS Direct Online, NHS MA) to achieve better value for money • pilots in core NSF areas to mobilise knowledge in communities of practice • NKS website, a Programme Manager, a Communications Plan...

27. Technical – delivering integration and standards create a digital archive provide a standard content management system implement all e-GIF Standards integrate NHS D O Digital TV, Kiosks NKS Management establish NKS Executive Board create NKS Secretariat to manage operations, investment, relationships add new NKS Partners commission independent evaluation of NKS Content – maximising quality and consistent knowledge consistent, rational processes for content creation create quality standards and labelling enhance National Patient Information Bank commission and re-shape knowledge for multi-media delivery Knowledge Mobilisation – providing access to all support local access and use of NKS resources in partnership with NHS libraries further development of NSF-based on-line knowledge networks and COPs With funding in 2003-5 we will….

28. Conclusion • Current investment in knowledge does not provide value for money, nor is knowledge managed to ensure quality, consistency and availability • Small investment of funding, resources in 2002 has created a firm platform for future efficiency and value of NHS knowledge – for patients and staff • Future investment will have high payback for patient care, communications and acquisition / retention of staff in the information age

29. A National Knowledge Service for the NHS Thank You www.nks.nhs.uk veronica.fraser@doh.gsi.gov.uk scott.gibbens@nhsnet