Breakout session: Extending access to e-journals for NHS partners

Alan Fricker

Liaison Manager, Kings College London

Kings College London (KCL) is part of an Academic Health Sciences Centre - big institutions aimed at bringing together research, education and health care – and has been the library provider for a number of hospitals and NHS trusts in London.

A quick timeline

In the past, NHS staff had excellent access to paper journals.  Libraries were dotted around, so all they had to do was walk down and grab.

In the 90s, the switch to e-journals started, and they had excellent on-site access to journals across various formats.  All they had to do was use the sneakernet (Wikipedia), walk down with a floppy disc and grab.

Coming nearer to the present day, KCL, as a member of the UK Research Reserve,were able to get a good level of electronic access to content and were able to dispense with their paper content.

But to get access to these e journals NHS staff still had to go down to a library and log in – counter to the change in user expectations.  This led to frustration!

About NHS procurement

A NHS library is very different to one in the HE environment.  A big NHS library typically has 5 members of staff.

In KCL’s case, there have been lots of local efforts made to provide access for patrons, including:

•  KA24 (Knowledge Access 24) service for health and social care staff in London and the south-east of England in the 2000s
• National Care Content, an England-wide procurement program

And the London Health Libraries met their goal of being e-only by January 2014.

NHS working together with HE for procurement

There have been many attempts at getting these two to work together.  

Users First  (2003)  report  by  John  Thornhill  identified ways this could happen: 

• develop joint HE/NHS licensing
• longer contracts – monitored
•  joint working at all levels
•  explore common authentication
• local and national initiatives

In 2008, Imperial, KCL, QMUL, UCL and St  Georges formed the London  Medical  Schools Procurement Group, focussing on purchasing for the medical schools and extending access to the affiliated NHS trusts. This was great for the affiliated trusts, but bad if your NHS trust was not affiliated.

2011-2012 saw the start of the AHSC pilot.  

Cambridge, UCL, Imperial, KCL, and Manchester University worked with a number of publishers including Elsevier, Springer, Nature and Thomson Reuters, to extend the licences to the NHS trusts.

A number of issues were highlighted, including:

• Problems with varying licences
• Low NHS usage relative to the HEI (0.5%)
• The proposed business model was for no charge for  NHS  trusts  unless  the usage  in  current  year  exceeded 10% 

The NHS staff experience?

There are lots of different access options for the NHS at KCL:

• You can walk into the library to register for an NHS account
• Self-registration for NHS OpenAthens, where you can access national, regional and local content
• Use university affiliate status, and log on and access your university’s research via Shibboleth

But this is tricky to explain and navigate and so it is basically an access nightmare for NHS staff.

And they weren’t very happy:

• The GMC survey highlighted the problem
• User surveys echoed dissatisfaction
• Customer service staff received negative feedback regularly

A survey of doctors identified what they most wanted, which showed that there was a problem of people not realising what they already had access to.  People had a different impression of what they actually had. 

More outreach was necessary so they decided to try and extend the NESLi deals.

What KCL did

The Finch Report recommended licence extensions for the NHS, so this was the context for this approach.

The rationale was:

• The same people will be accessing the content as before – the current setup was an oversight, as the JISC deals doesn’t allow access for users who aren’t institutional, but KCL is their library support
• They were not undercutting any NHS subs
• Mobile access was very important.  The same content needed to be delivered, but in a way that is easily accessible to offsite staff.

There has been a national 1 year pilot that started in April 14, and this had led to agreements with six publishers (pilots and purchases) and 7,000 additional titles through OpenAthens.

Results so far

It is not all plain sailing, as there are a number of issues with link resolvers, authentication and challenges in promotion, but overall there are more NHS staff logging in via Open Athens each month and the GMC survey shows an increase in positive perception of access to e-journals.

Q: Why is NHS usage level low?

The NHS usage is not the same kind of intensity as in HE – there is a fall in the time staff have to read content, but not an increase in number of papers read.

Much of the content available is research, not “hands on” clinical content, so not all is relevant to them

The usage is low but very broad, e.g. one journal used 50 times, which would be very expensive if subscribed to in the traditional way.

Q: Barriers to access?

In Norway it has been proven that IP based access is best, but there are difficulties in NHS as they NHSN3, so you can’t tell the difference between IPs.