HLG Nursing Bulletin Vol. 39 (3/4)
Rebecca J Scott
Library and Knowledge Services Manager
Royal Papworth Hospital
Cambridge Biomedical Campus
In April 2019, Health Education England introduced the new Quality and Improvement Outcomes Framework for Library and Knowledge Services in the NHS in England. This reflective article discusses how the new framework for self-evaluation has been used by Royal Papworth Hospital Library and Knowledge Services to support the reflective practice and professional development of new staff during a period of large-scale organisational change.
In April 2019, Health Education England (HEE, 2019a) introduced the new ‘Quality and Improvement Outcomes Framework’ (Outcomes Framework) as a method of self-evaluation for NHS funded Library and Knowledge Services (LKS). It replaced the Library Quality Assurance Framework which had been used to benchmark library services since 2010 (NHS Library Services and Wirral Health Informatics Service Internet Division, 2019). The prospect of transitioning from one method of quality assurance to another was initially a daunting process. Firstly, it coincided with the large scale organisational change at Royal Papworth Hospital. On 23rd April 2019, our hospital moved 12 miles from the village of Papworth Everard to the Cambridge Biomedical Campus. Secondly, the Royal Papworth LKS transitioned from a physical library to an integrated service operating without a dedicated space. Thirdly, the staffing of the LKS changed with two staff leaving the organisation and two new staff joining the team. Both new starters had not previously worked in a healthcare library setting but brought a wealth of experience from further education and school libraries. The LKS has continuously improved through this period and the introduction of the Outcomes Framework has contributed to the successful transformation.
In the post-hospital-move period (April-September), the focus of the service was on improving our operational processes and communicating key messages to our users. From October, the focus shifted as we were no longer in a post-move phase but into ‘recovery’. The attention of the service shifted to the Outcomes Framework. The framework is a maturity model for NHS libraries and guides the direction of service development and improvement. There are six key outcomes against which LKS are required to self-evaluate. There are four levels of development with 0 being ‘not developed’ and 4 being ‘highly developed’.
In November, a team away day was organised to designate time for reflection, evaluation and service planning.
Outline of the day:
- Reflections on progress since the hospital move
- Identifying areas for service improvement based on user feedback
- Exploring each of the six outcomes in depth and assigning actions
- Visit to the William Morris Gallery to explore shelving solutions
Prior to the day, each member of the team was asked to watch 3 of the 6 webinars on the Outcomes Framework (see HEE, 2019b). Each webinar related to a different outcome. They were also asked to read the associated guidance in the Outcomes Framework document (see HEE, 2019a). The LKS Manager selected which 3 webinars each staff member should review based on the relevance to their role.
Library and information professionals are encouraged to engage in reflective practice as part of their professional development; for example, individuals who choose to undertake the CILIP certification, chartership or fellowship accreditation process are required to submit reflective portfolios (CILIP, no date). Reflection requires time and structure to identify what works well and what can be improved ‘to move both decisions and practice forward’ (Brettle and Koufogiannakis, 2016, p. 73). The team away day provided a protected opportunity for team reflection. This learning from reflection is embodied in Outcome 4:
‘All NHS organisations receive library and knowledge services provided by teams with the right skill mix to deliver on organisational and Knowledge for Healthcare priorities requires’ (HEE, 2019a, p. 6). As LKS develop, staff should move from engaging and reflecting on CPD to using this learning to improve ‘service improvement and development’ (HEE, 2019a, p. 13).
During the away day, each outcome was discussed and as a team we completed an initial service evaluation. Through our shared reflection we were able to recognise that our service has developed the dual mind-set of a start-up company; we have the overall vision of where we want to be and yet we have the agility to rapidly respond to the changing needs of the organisation (Camfens, 2019). This approach has emerged from our transformation as a service without the traditional library space. The away day enabled a triangulation of viewpoints as each staff member shared their reflections on the challenges ahead due to the unconventional model of service operation. By the end of the away day, the new team members were engaged with the Outcomes Framework and it had facilitated a shared understanding of the vision for LKS in the NHS.
The Outcomes Framework supported the professional development of the new staff. Outcome 4 provided the impetus to implement the Royal Papworth Hospital six month-appraisal tool and to set clear and achievable objectives for the new staff. Since the away day, progress against these objectives has been reviewed in monthly one-to-one meetings which are now more effective as purposeful support can be offered and feedback shared. Rather than feeling micromanaged, staff feel empowered to move projects forward and report that they have more ‘aim and focus’.
The impact of this more structured approach to professional development can be seen in the following:
- Increased uptake of health literacy training after the LKS Administrator attending Dream Copywriting Training and improving our advert
- Development of a series of marketing personas to use for targeting our service offer
- Increased confidence in approaching clinical teams to attend meetings (and increased uptake) after shadowing another Clinical Librarian
Using the new Outcomes Framework to guide reflection and service evaluation has supported the professional development of new staff. It has facilitated a shared vision and led to incremental improvements for our service. The benefit of a maturity model is that it can continue to be used to improve practice as the service moves through the different levels of development.
Brettle, A. and Koufougiannakis, D. (2016). ‘Adapt,’ In Koufougiannakis, D and Brettle, A. (eds.) Being evidence based in library and information practice. London: Facet, pp. 71-78.
Camfens, Y. (2019). Keynote. ‘Create, innovate, collaborate: learning from startups’, Internet Librarian International Conference, London, Olympia, 15-16 October.
CILIP. (no date). Professional Registration. Available at: https://www.cilip.org.uk/page/ProfessionalRegistration (Accessed: 26 February 2020).
HEE. (2019a). Quality and Improvement Outcomes Framework for NHS Funded Library and Knowledge Services in England, 2019. Available at: https://kfh.libraryservices.nhs.uk/wp-content/uploads/2019/07/Quality-and-Improvement-Framework-2019.pdf (Accessed: 26 February 2020).
HEE. (2019b). Quality and Improvement Outcomes Framework Webinars. Available at: https://kfh.libraryservices.nhs.uk/quality-and-improvement-outcomes/quality-and-improvement-outcomes-documentation/quality-and-improvement-outcomes-framework-video-podcasts/ (Accessed: 26 February 2020).
NHS Library Services and Wirral Health Informatics Service Internet Division. (2019). Library Quality Assurance Framework (LQAF). Available at: https://www.libraryservices.nhs.uk/forlibrarystaff/lqaf/ (Accessed: 26 February 2020).