Library Services


NHS-HE Forum

The NHS-HE Forum is an informal forum for IT and networking managers from both the NHS and Higher Education, with an interest in achieving two-way communication and connectivity.


Formation of the NHS-HE Forum

In these days of wireless networks and home working, there is still great frustration among doctors, nurses, professions allied to medicine, clinical teachers and researchers that there is no seamless access between the NHS network and systems and those of the universities. This applies both to network connectivity issues stopping access to computer software applications as well as licensing and authentication issues making it difficult to share access to knowledge bases and e-journals.

Its first members included Robin Arak, who was to become Chief Executive of the UK Education and Research Networking Association (UKERNA); Ted Woodhouse (then IT Director of the largest NHS Trust in the country, Leeds Teaching Hospitals); and key national figures such as Jeremy Thorp, when he was Head of Infrastructure Policy at the Department of Health NHS Information Policy Unit. On the library and knowledge management side then inaugural members included Ben Toth and Veronica Fraser and Paul Ayris.

Since 2002 the Forum has met twice a year to share information and to champion a series of initiatives including:

  • an agreed NHS-HE connectivity model using a client-server approach.
  • the identification and sharing of case studies where NHS-HE connectivity has been implemented in various ways
  • attempts to procure content jointly for the NHS and Higher Education sectors (for instance, important medical e-journal subscriptions)

Current Priorities

The activities of the NHS-HE Forum are being more widely broadcast , e.g. by exhibitions and posters at relevant conferences; The Forum has its own JISCMAIL discussion Forum at http://www.jiscmail.ac.uk/lists/NHS-HE-FORUM.html

The priorities of the Forum are:

  • improving access to content e.g. through joint procurement of e-journals
  • improving NHS-HE connectivity - the NHS-HE Connectivity Project, below
  • developments in the Athens authentication system to improve access to all resources for members of staff with both NHS and HE entitlements
  • the development of Shibboleth and how that impacts on the interface between the NHS and HE
  • how best to support the plans for further development of clinical research in the UK

The NHS-HE Connectivity Project

The aim of the NHS-HE Connectivity Project is to co-ordinate and support network connectivity between the NHS and universities involved with education and research in medicine, nursing and the professions allied to medicine. The objective is to achieve good interoperability between the NHS and HE networks that make it feel irrelevant to students and clinical teachers where they happen to be when accessing networks and resources, whilst also maintaining the appropriate security integrity of both networks.

The main focus of the NHS-HE Connectivity Project at present is the development of the proposed gateway or gateways between the new broadband NHS network in England, N3 and the UK-wide education and research network JANET.

Benefits of connecting N3 with JANET

For students and staff:

  • Improved ease of collaborative working between NHS and University based staff
  • Best use of work and study time and available resources
  • Independence from study or work location, whether in NHS or University
  • No need for duplicate IT facilities such as PCs
  • Fewer usernames and passwords

For NHS Trusts and Universities:

  • Help attract and keep the best students, clinical teachers and researchers
  • Improved ease of collaborative working between NHS and University based staff
  • Cost savings through some shared network infrastructure
  • Cost savings through the avoidance of duplicate IT resources
  • Improved integration and efficiency of IT support
  • Cost effective access to extra applications for some services from the other sector

Content Issues

The work of the Forum is not solely geared to technical issues. Content is a large part of its work. It is important that the Forum does have this dual emphasis, so that both connectivity and content issues can be tackled side-by-side. The work is being led by Paul Ayris for Higher Education, by Veronica Frazer when she was NHS Library Advisor, and now by Ben Toth, Director of the National Knowledge Service (NKS).

Users First: removing barriers to knowledge access across HE and the NHS

The project was jointly commissioned by Paul Ayris, Director of Library Services, UCL (representing Higher Education) and Veronica Fraser, NHS Library Advisor (representing DoH Information Policy Unit) as part of the work programme identified by the NHS/HE Forum, with the NHS/HE Forum Content Group acting as a Project Steering Group.

Funding for the project was provided by JISC, SCONUL, LLIDU and IPU/IA funds.

Background to the Project

There is a considerable flow of people and funding between the NHS and HE covering research contracts, provision of services, consultants and other staff who have joint contracts of employment and "workers who are learning and learners who are working". Although many of these staff require access to both NHS and HE e-resources from work and home, the existing networks have not been able to facilitate this.

In an attempt to meet users' needs, the NHS and HEIs are providing 24-hour access to e-journals and databases that can be accessed from work and increasingly from home. However for some, access is being provided to the same key resources (e.g. journal titles via both the NHS and JANET) whilst others have no access at all.

The NHS/HE Forum was established to review the barriers to effective access to knowledge sources across HE/FE and the NHS. The Forum itself has focussed on identifying technical solutions to access problems between the academic network, JANET, and the NHS network, NHSnet.

Technical solutions look likely to resolve many of the issues over the next few years. However, this by itself will not automatically improve knowledge access as members of the Forum have also identified significant other barriers that impede staff and students who work, teach and learn or for other contractual reasons have need to access information. These include:

  • funding transparency
  • eligibility to use resources and access
  • copyright and licensing issues
  • administrative complexities

This study explores the above issues through interviews with key stakeholders and a subsequent consultation with the wider HE/NHS constituency.

The main output of the Content Group was the Users First Report, commissioned by the Content Group.

"Users First: removing barriers to knowledge access across HE and NHS" -Final Report -June 2003 by John Thornhill BA MCLIP Library & Information Consultant

The content Group drew up a generic presentation, which was used in a number of fora to disseminate the contents of the report.

The Report appeared in June 2003 and made a number of recommendations for practical ways forward. Using the recommendations in the Report, the Content Group drew up an Action Plan consisting of the following areas of work:

  1. Framework for Service Level Agreements (SLAs) for Library Services between
  2. NHS and HEIs
  3. Standards for Library Services for health and social care staff and learners - phase 1
  4. NHS/HE common content: scoping study to map e-resources for health care licensed by the NHS and HE
  5. Tracking of funding
  6. Educational contracts
  7. Joint Training
  8. An information Literacy Curriculum for users of NHS and HE Library and Knowledge Services
  9. User Needs Analysis for the UK NHS and NHS/Higher Education interface; a basis for management by NHS and Higher Education of the Knowledge Base of Healthcare
  10. Authentication
  11. JISC Health Special Interest Group
  12. Develop a joint NHS/HE core collection of journals
  13. Directory of NHS/HE contacts
  14. NHS/HE statement on joint working

NHS-HE Content Group Activity Plan June 2003-Summer 2004

A number of lines of action proceeded based on this Action Plan.

Within the NHS, the Content Group saw an increasing emphasis on modernization and making better use of IT and Information Literacy programmes such as the National Programme for IT (NPfIT) and the National Knowledge Service.

Within Higher Education, University Libraries were seen to be increasingly trying to work with the NHS to provide pathways for the common use of information resources purchased across the NHS and HE. In librarianship, professionals were and are concerned to promote information literacy and the development of collections available in networked environments.

All such developments led the NHS-HE Content Group to invite the JISC and the NHS jointly to fund two Invitations to Tender, action lines 7 and 8 in the above list, for An Information Literacy Skills Pathway for Health, and a User Needs Analysis for the UK NHS and NHS/Higher Education Interface.

The Content Group believed that the two projects would:

  • lead to better value for money
  • identify better services for staff, students and users
  • promote Information Literacy, since shared work between HE and the NHS would identify a common baseline
  • support and improve patient care in the NHS

Unhappily, funding for the two ITTs was not forthcoming and this effectively marked the end of the first phase of activity for the NHS-HE Content Group.

Structures revised 2004

The failure of the two bids to fund the ITTs co-incided with a review by SCONUL (Society of College, National and University Libraries) of its ACOSC - Advisory Committee on Health Services. In 2004, this Committee was restructured as a high-level strategic body to interact with Government, the NHS and HE. Two Chairs have since led this body forward, with representation from HE and the NHS, Judith Palmer of Oxford University and Maggie Haines of King's College London.

The Forum's NHS-HE Content Group was given two places on this body and the representatives are Paul Ayris (HE) and Ben Toth (NHS). Additionally, the Content Group looked for alliances with truly cross-sectoral groups within the four home countries, to enable it to continue its work within the Forum.

One truly cross-sectoral body, of which the Content Group is a member, is the M25 Consortium's London Health Libraries grouping. See website: M25 Consortium of Academic Libraries

Scholarly Communication issues

The re-alignment of the work and outreach of the Content Group also co-incided with the publication of Dr Ian Gibson's Parliamentary Report Scientific Publications: Free for All? in July 2004. The objective of this influential Report was to look at the current state of scholarly publishing and at drivers for change within the existing infrastructures. In particular, recommendation 9 was of particular importance:

We recommend that the Joint Information Systems Committee and the NHS work together to implement joint procurement procedures that reflect the close working patterns of NHS and the higher education sector and represent value for money for both. (Paragraph 36).

The JISC takes the joint procurement agenda forward 2004-05

The Parliamentary Report was very influential, particularly in Higher Education. The JISC approached Paul Ayris, as co-Chair of the NHS-HE Content Group, to see how the recommendation of Dr Gibson's Report could be taken forward. The result of this discussion was the reformulation of the Content Group as the current JISC NHS-HE Procurement Group, to take forward recommendations 3, 10 and 11 of the Users First Report, under the aegis of the Parliamentary Report on Scholarly Communication issues.

The reformulation of the Forum's Content Group was successful. Still part of the NHS-HE Forum, the Content Group was now allied to a national Parliamentary Report, to the cross-sectoral SCONUL Health Strategy Group and to cross-sectoral Groups such as the M25 Consortium's London Health Libraries. The Content Group, under the new aegis of the JISC's NHS-HE Procurement Group, began in earnest to plan the joint procurement of two pieces of content between the NHS and HE - one piece of content from an Open Access publisher and one from a traditional commercial publisher. In the course of this work, a joint licence was developed by HE and NHS representatives to be used in the procurement activity. This forms one of the outputs of the Group in this new mode of working.

After extensive discussion, two pieces of content were identified for this procurement - membership of the PLoS (Public Library of Science) and content from one commercial publisher. In the summer of 2005, it became apparent that a cross-sectoral agreement for membership of PLoS between the JISC and NHS England, through the National Knowledge Service, and NHS Wales was possible and this is indeed going ahead.

No agreement was possible over the joint procurement of the commercial content between the JISC and the NKS. Why was this so? A number of reasons and issues were identified:

  • the journals did not meet NKS quality standards for the reporting of clinical trials (CONSORT, Quorum etc.)
  • the range of eligible users excluded a number of groups supported by NKS
  • the differential value of the journals to the NHS and the HE sectors was not included in the contract
  • there was no provision for the FE sector to be included in the procurement
  • JISC had not included the FE sector because the Learning and Skills Council no longer funds the JISC's content activities
  • JISC had not included the FE sector because the Learning and Skills Council no longer funds the JISC's content activities
  • NHS procurements above £100,000 generally require open competition
  • the NKS was and is fully committed to the principle of joint procurement provided this approach brings value to the NHS

Future activity 2006

The NHS-HE Procurement Group of the NHS-HE Forum is determined to build on the learning it has gathered, and disseminated, since the formation of the Forum in 2001. The joint membership deal for PLoS shows what can be done when both NHS and HE sectors work together. Four further pieces of joint work are planned for 2006:

  • the JISC and the National Knowledge Service will be working closely together to try and align procurement activity and cycles in NHS England and in the JISC
  • the JISC and the National Knowledge Service will be working closely together to try and align procurement activity and cycles in NHS England and in the JISC
  • the NHS-HE Procurement Group will work with the NHS in the four home countries to try once again to procure one piece of commercial content across the NHS and HE
  • recommendation 3 of the Users First Report is being taken forward with funding being provided jointly by the LKDN and the JISC. At the time of writing (1 February 2006), an Invitation to Tender for a Mapping Study of Procurement Practices in the NHS and HE is being drawn up and will shortly be issued. The JISC NHS-HE Procurement Group will act as the Project Board for this piece of work
  • through the NHS-HE Forum, Phil Leahy, Business Development Manager, Eduserv Athens: Access Management, is leading the Athens Account Linking Project in collaboration with the JISC NHS-HE Procurement Group. The purpose of this project is to allow NHS staff with joint NHS and HE status to have full access to all their e-resources from whatever login account they are using. A healthy number of HE and NHS bodies are keen to act as pilot sites in this project