Kate Jones, Librarian, Birmingham Community Healthcare NHS Foundation Trust
To mark my 50th birthday, after nearly 20 years in the same role at Birmingham Community I made a fresh start as a “Primary Care Knowledge Specialist” (PCKS) thanks to a pilot project funded by NHS England.
This launched me into a world of ICBs, ARRS and many other acronyms and organisation structures. Working with Primary Care after years in Community Care was invigorating and varied with many differences in my experiences between Buckinghamshire and Oxfordshire despite them both being part of the same Integrated Care System.
I spent 23 months working in Buckinghamshire closely followed by another 23 month secondment in Oxfordshire. Buckinghamshire Healthcare is an acute and community Trust whilst Oxford Health is predominantly mental health with a side order of community and primary care. Such blends within a single organisation seem to be becoming more common. The directorate which included Primary Care in its remit served to show how Primary Care can mean different things in different places! Their Primary Care was largely hospital based! I found myself focusing on General Practice – GPs and their staff. My many efforts in both roles to reach out to Community Pharmacy and Community Dentistry – which also come under the remit of Primary Care – were almost complete failures.
During my time at Buckinghamshire I was supported by NHS England staff and a community of 25 other PCKS also engaged in this pilot. However by 2024 most of these roles had run out of funding so my time at Oxford Health was more isolated in terms of peer support. At both Buckinghamshire and Oxfordshire I took responsibility for managing my own service. I was given autonomy to reach out to Primary Care however I thought best; they can be as elusive as grabbing hold of sunshine. In both roles I was working remotely with as many trips down as possible whenever invited. This worked very well as Primary Care is everywhere and nowhere. Most training was delivered via MS Teams. In Primary Care there is no single practice or base to serendipitously meet at a water fountain or in a canteen. There were the occasional conferences and events and I elbowed my way onto many Protected Learning Time afternoons to deliver training and induction. Health Literacy was a session that I particularly promoted. I was well supported by the library team at the local KLS in terms of helping with new member registration, OpenAthens subscriptions, ILLs etc., and many publishers were happy to open their resources up to Primary Care at no additional cost.
Despite both secondments being based within the same ICB I found that the different ‘places’ had very different ways of working. Buckinghamshire had a much more established and active community of GPs and Clinical Pharmacists that I could link up with such as FedBucks, an active Interface group (dealing with the interface between primary and secondary care), Buckinghamshire Health and Social Care Academy and lots of large Whatsapp groups. These helped hugely to raise my profile and gather evidence searches. In Oxfordshire, I needed to develop a database of contacts for myself which was very time consuming. It turned out that there are commercial companies who can be commissioned to do this work for you – but my own work was more extensive than anything that I could buy! GP practice websites are full of staffing information and with a bit of digging, I built an extensive network of contacts.
Starting a KLS service from scratch can be liberating – how often does that happen? So I ran a few Knowledge Cafes to coincide with awareness weeks and ran some randomised coffee trials – these in particular were successful and such low effort! In Oxfordshire I did try to establish some Communities of Practice in an effort to set up the sense of community that I had seen in Buckinghamshire.
In general, metrics of success were : OpenAthens registrations, training attendees, evidence searches requested. In Buckinghamshire I was given some wonderful testimonials but, at the end of the day – Funding is King.
Lessons learned –
- It’s never a good time to implement changes in Primary Care! I’ve been working on and off in Primary Care since 2020 and they’re always in crisis. First Covid, then restructuring, then flu season…
- A well connected advocate is worth their weight in gold
- Primary Care works in small silos all over the country. Reducing their professional isolation should be a priority.
Kate Jones, Librarian, Birmingham Community Healthcare NHS Foundation Trust, Kate.jones31@nhs.net
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