J4 – Developing leaders in health knowledge and library services: the Knowledge for Healthcare experience in England

Sue Lacey Bryant1 and David Stewart2

1 Health Education England Thames Valley, Oxford, UK
2 Health Education England North, Wigan, UK;

Corresponding author: David Stewart, david.stewart@nhs.net

Abstract

Introduction
Workforce planning and development is a strategic theme, critical to the success of the Knowledge for Healthcare, an ambitious strategic development framework for NHS funded library and knowledge services in England published by Health Education England in December 2014.

Rapid progress has been made in introducing a coherent set of resources to support workforce development.

Providing clear, effective leadership and strategic planning at all levels (national, geographic and local) is central to transforming knowledge services across the health system in England. A new leadership programme for mid-career professionals was launched in March 2016 and steps have been taken to strengthen the national leadership team.

Objectives
This paper describes the context, gives an overview of the workforce planning and development work-stream, reports on rapid progress through 2015/16 and highlights emerging priorities and issues.

The focus has been two-fold: 1) introducing core resources to support the personal and professional development of librarians and knowledge specialists; 2) strengthening the leadership of library and knowledge services across the healthcare system.

Methods
Operating via a series of Task and Finish Groups, we have reviewed leadership capacity, analysed workforce and training needs data, undertaken background research into the definition of competencies and identified a wealth of relevant resources to support continuous learning.

Outputs

  • Established training priorities and commissioned training programmes
  • Developed an online Learning Zone signposting learning resources for our specialist workforce
  • Considered core competencies, partnering with Chartered Institute of Library and Information Professionals (CILIP) to produce a health themed Professional Skills and Knowledge Base
  • Revised our Talent Management toolkit
  • Commissioned a leadership programme tailored for mid-career healthcare librarians and knowledge specialists.
  • Established new geography based roles

Discussion

The key goals are to develop our workforce to introduce new roles and ways of working, and to shape a robust leadership model.

We report on significant progress while exploring the challenges we observe as we focus on establishing strong professional leadership.

Future plans focus on sourcing reliable workforce data, better understanding the development needs of front line staff, and defining some of the advanced competencies needed as well as continuing to focus on leadership structures.

Conclusions
Knowledge for Healthcare sets a clear direction. This helps to galvanise a high level of engagement in implementing this large scale programme. There are barriers to be overcome, some resistance to change. Effective leadership will be central to fulfilling the early promise of this work.
Key words: Staff Development; Leadership; Librarians; Library Services;

Full text of the presentation

Introduction
Leadership, workforce planning and development are critical to the successful implementation of Knowledge for Healthcare, which was published by Health Education England (HEE) in December 2014.1 This is an ambitious strategic development framework for National Health Service (NHS) funded library and knowledge services (LKS) in England, 2015-2020.

This paper describes the context, gives an overview of the workforce planning and development work-stream, reports on rapid progress through 2015-16 and highlights emerging priorities and issues.

Context
There are 215 library and knowledge services in England, primarily based in hospitals. The librarians and knowledge specialists are directly employed by each individual organisation. HEE is the steward of the country’s investment in healthcare library and knowledge services on behalf of the NHS. It carries out its multiple responsibilities, including strategic leadership and professional guidance on library and knowledge services, through its 13 Local Offices.

We know that healthcare library and knowledge services underpin all aspects of high quality healthcare. Our services are part of the life-blood of evidence-based treatment options, patient care and safety. They lie at the heart of education and provision for lifelong learning for the health and care workforce. They pump research and innovation in healthcare. Yet, in our hearts, we also know that these services are underutilised, and have much more to offer.

We are proud that the UK health systems provide universal coverage for our population. Relative to other countries, the NHS provides highly equitable care and performs well internationally on reported measures of patient experience and access. Nevertheless, analysis of specific effectiveness measures shows that, for some conditions, there is significant room for improvement.2 So, the mission is for librarians and knowledge specialists to play a pivotal role in helping the NHS to improve the quality of patient care at the same time as helping it to become more productive and efficient.

Back in 2014 HEE’s Advisory Groups, and its Directors of Education and Quality, told us that “Awareness of healthcare library and knowledge services is not as widespread as it could be across all professions and sectors”. 1

Charged with no more, nor less, than transforming the service, we shaped a development framework to articulate the direction of travel for healthcare library and knowledge services in England.

The vision
The vision for Knowledge for Healthcare is that:

  • NHS bodies, their staff, learners, patients and the public use the right knowledge and evidence, at the right time, in the right place, enabling high quality decision-making, learning, research and innovation to achieve excellent healthcare and health improvement.

Not only is this mission compelling, but our librarians and knowledge specialists are doing something important that no one else is going to get done3. It is then, “all about the people”.
Engagement, support and development of the 1,200 or so people that comprise our specialist workforce is of paramount importance. This underpins the success of the whole endeavour to transform knowledge services across the health system in England.

Objectives
The strategic library leads took time to consider practical ways in which we could intervene to enhance leadership of these services, and encourage and empower the workforce to generate and seize opportunities to innovate, enlarge and extend roles. This is depicted in Knowledge for Healthcare:

Ways of working
Through the Workforce Planning and Development Group we have sought to be inclusive and to model the partnership working to which HEE is committed. We work closely with CILIP, the Chartered Institute of Library and Information Professionals.

Operating via three Task and Finish Groups, and with the support of virtual reference groups, nearly 30 people have been involved in this work-stream. The sheer level of discretionary effort that they bring to the work is impressive – galvanised by the vision of Knowledge for Healthcare and their commitment to colleagues. Together they have harnessed the expertise of practitioners from all around the country. They benefit from a direct line of sight to the professional development needs of the workforce, contextualised by an understanding of operational pressures.

As a result, rapid progress has been made. Together, they have analysed workforce and training needs data, illustrated the knowledge and skills base and identified a wealth of learning resources – preparing a coherent set of resources to support workforce development.

What we have achieved in 2015-16
The focus of this work-stream of Knowledge for Healthcare through the first full year of the implementation programme was two-fold:

  • introducing core resources to support the personal and professional development of librarians and knowledge specialists;
  • strengthening the leadership of library and knowledge services across the healthcare system.

Training wants and needs
Our Continuing Professional Development (CPD) Task and Finish Group has established training priorities to inform planning through 2016/17.

A survey of development needs conducted in January 2015 was completed by 71% of health librarians in England. This provided the basis for a training needs analysis (TNA). The workforce identified these priorities:

  • Demonstrating value and impact
  • Service transformation/innovation
  • Strategic planning and thinking
  • Creative thinking
  • Social media including ‘Apps’
  • Virtual learning environments
  • Digital literacy
  • Advanced information searching
  • E-books

The CPD group identified two key issues to take into account in shaping a national approach to defining training priorities, which will also inform any decisions on investing in programmes or resources:

  • The 2015 survey represented a self-assessment – identifying aspects of professional development that individual respondents want and believe they need
  • There are other factors that need to be considered in formulating a national approach to workforce development including: training to support core competencies, training to address skills gaps and development needed to deliver the service transformation and role redesign expressed in Knowledge for Health plus training to address emerging technologies that may not have been present when the survey was conducted.

Learning resources
Tasked to develop a Learning Zone an enthusiastic small group came together to develop an online resource, to support skills development in the context of Knowledge for Healthcare :

“Focused on NHS priorities, new models of service delivery call for flexible, multi-skilled knowledge specialists confident to apply their expertise within healthcare teams and at points of care and decision-making. … Now, and going forward, many more responsive, problem-based, ‘just-in-time’ and ‘just-for-me’ services are needed.” 1

Group members applied their information skills to identify a wide range of pre-existing electronic resources. Some were sourced from within the profession. They also drew more widely from areas such as organisational development and human resources.

The resource went live in March 2016. It signposts health library staff to relevant learning resources categorised in three broad sections: specialist skills, generic skills and career development,

We have made this resource available without delay. We anticipate that in time it will be presented, with other products to support the delivery of Knowledge for Healthcare, via a more elaborate website. Meanwhile, you are invited to explore and use the Learning Zone at http://kfh.libraryservices.nhs.uk/learning-zone/ and let us know what you think.

The Knowledge and skills base
Partnering with the Chartered Institute of Library and Information Professionals (CILIP), a task and finish group has produced a health themed Professional Skills and Knowledge Base (PKSB).4

CILIP owns the rights to the PKSB which maps the knowledge and skills in the library, information and knowledge professions. The task and finish group worked closely with CILIP colleagues to enrich the PKSB, creating a complementary version that is illustrated with examples from health librarianship.

This work was completed in April 2016. The unaltered CILIP text is displayed on the left hand side of the page and the health version on the right hand side. This resource is now available, via a password on the CILIP website. It will be used by health LKS staff to underpin their CPD – as a self-assessment tool and to support their progression through gaining professional qualifications. It is also offered as a framework for skills analysis, staff training and development plans. We are recommending it use in annual appraisals as well.

Many library service managers, and all the HEE strategic library and knowledge services leads, report to non-librarians. The PKSB provides a new tool to help their managers understand the skills that health librarians and knowledge specialists bring to their roles.

Treasuring our talent
‘Talent management’ is about ensuring organisations maximise their talent by:

  • recruiting the right people into the right roles
  • developing employees to enable them to realise their potential
  • motivating individuals who are identified as having talent to stay with an organisation, the sector or profession in the longer term.

To ensure NHS bodies, staff, learners, patients and the public have the right knowledge and evidence, when and where they need it, library and knowledge services must harness and attract rich and potential talent. This is why the toolkit was commissioned.

Claire Bradshaw Associates undertook this work, on behalf of the Working Group, refreshing and updating a version ppublished in 2011. We worked closely with the consultant throughout to ensure the final product met our needs to help identify tomorrow’s leaders and develop a flexible workforce. The toolkit, which is available via our Learning Zone, includes:

  • A detailed overview of Talent Management and links to resources and further reading
  • A user guide to the Talent Management Toolkit
  • A guide for interviewers and a guide for interviewees
  • A talent grid: ‘Recognising Talent: a resource for librarians and information professionals in healthcare setting’
  • Podcasts and presentations to support the Talent Management Process.

An awareness and training programme is being scheduled throughout this year.

Developing leaders for today and tomorrow
Many of the healthcare knowledge service leaders we have today, and the senior leaders we will have tomorrow, are part of the current workforce. Therefore we commissioned a one year leadership programme tailored for mid-career healthcare librarians and knowledge specialists.
CILIP launched a 12 month, cross-sectoral leadership programme in 2015. We wanted to take advantage of its expertise and experience in developing that programme to create a version particularly relevant to health librarians. Working closely and rapidly with CILIP, we helped the training provider to adapt the course with more health-related content.

We issued a call for written applications in autumn 2015 and selected 24 candidates. This first cohort attended the first workshop in March 2016. The learning objectives are that at the end of our course, delegates will be able to:

  • Identify different leadership styles; reflect on their appropriateness in different situations
  • Reflect on their own preferred personal leadership style and its effectiveness in different working environments to influence and inspire others
  • Consider leadership in context for different organisations (i.e. governance, culture, policies)
  • Appreciate approaches to strategic thinking, change management and evaluation
  • Understand the importance of stakeholder engagement and the requirements of project management
  • Show an understanding of the leadership skills needed to develop the application of knowledge management in healthcare settings
  • Build upon experience, skills and knowledge developed through the programme and engagement with a wide range of experienced professionals to drive innovation and improvement
  • Identify their leadership development needs and how consider how to address these, and understand the opportunities available through the NHS Leadership Academy: http://www.leadershipacademy.nhs.uk/

National and regional leadership
We benefit from the expertise and commitment of a dispersed team of highly experienced senior leads. Knowledge for Healthcare committed to supporting their work by shaping a robust leadership structure for healthcare library and knowledge services in England. We see that it is critical to establish and embed this within HEE. This will enable national and ‘regional’ oversight and support to ensure the strategic framework is turned into action, and offset any risk of wide variation in service delivery around the country. Meanwhile, more local professional leadership remains crucial to head up healthcare library and knowledge services networks and engage with local partners

Over the past year we have made some progress, taking opportunities arising from organisational changes to establish strategic posts. A model of regional leadership is emerging on which we aim to build through 2016/17.

Looking ahead

These are the priorities the Workforce Planning and Development Group has set for 2016-17:

  • Developing the PKSB for Healthcare to illuminate advanced and specialist skills in areas such as knowledge management and clinical or outreach librarianship.
  • Develop a national CPD curriculum and prepare for a new TNA in 2017. It is vital to optimise our investment in the CPD of our workforce
  • encompassing better understanding the development needs of front line staff,
  • Keep our new Learning Zone up to date
    Build a detailed profile of the health library and knowledge services workforce, sourcing reliable workforce data, to support planning
    Introduce a staff satisfaction survey. Research using data an annual survey of all NHS staff shows that the more engaged staff are, the better the outcomes for patients5
  • Continue to focus on strengthening our leadership structures.

Discussion
There is much more to do in this five year programme. The key goals are to develop the workforce to introduce new roles and ways of working. Certainly, there are barriers to be overcome, and we observe some resistance to change. We have not found any new or unfamiliar factors at play, however. As leaders we know we are challenged to win hearts as well as minds. Through this work-stream we aim to ensure that our small specialist workforce has every opportunity to build the confidence and capability needed to drive improvement and seize fresh opportunities to bring knowledge to bear in healthcare.

Learning to view change and service transformation as an infinity cycle, rather than a journey between two fixed points has helped us. Initially we conceptualised our work in phases. We want to be inclusive and avoid burdening individuals and so we thought in terms of a series of sprints to which we would bring new energy and perspectives through successive Task and Finish Groups. We have come to appreciate that the implementation of Knowledge for Healthcare also calls for the strength of marathon runners, for whom both training and personal resilience are critical. This year we will be sharing resources to support our specialist workforce to think about their own resilience.

Conclusions
Knowledge for Healthcare sets a clear direction. We see that this helps to galvanise a high level of engagement in implementing what is a large scale programme. We celebrate what the library and knowledge services workforce in England has already achieved by pulling together around a shared vision and we aim to keep up the momentum. Our progress through 2015-16 gives us a strong sense of optimism.

References

  1. Knowledge for Healthcare
  2. Natalie, Berry. How does the NHS compare with health systems in other countries? The Health Foundation, March 2015
    http://www.health.org.uk/publication/how-does-nhs-compare-health-systems-other-countries
  3. See Peter Thiel, Zero to One: Notes on Startups, or How to Build the Future, Ebury Publishing Virgin Books, 2015. ISBN: 9780753555200
  4. Professional Skills and Knowledge Base, CILIP
    http://www.cilip.org.uk/jobs-careers/professional-knowledge-skills-base
  5. Michael A West and Jeremy F. Dawson. Employee engagement and NHS performance. The King’s Fund, 2012
    http://www.kingsfund.org.uk/sites/files/kf/employee-engagement-nhs-performance-west-dawson-leadership-review2012-paper.pdf
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