Information Scotland

The Journal of the Chartered Institute of Library and Information Professionals in Scotland

October 2007 Volume 5(5)

Health libraries

A systematic remedy

A unified library management system for Scottish health libraries is mid-way through its ten-month implementation schedule. In the first of a two-part article, Andrew Jackson explains the background to this important project.

There are approximately 70 library sites within the NHS in Scotland, varied in nature and remit. They include hospital-based libraries, serving the needs of medical students and clinical staff; public health libraries, serving the needs of NHS management and specialising in literature searches; and health promotion libraries, providing health professionals and the general public with health improvement literature for use in the community.

Some of these services are allied to universities, with HE institutions responsible for both medical and nursing degrees. In Lothian Health Board, for example, most hospital libraries have their catalogues managed by the University of Edinburgh and are included on the Voyager library management system. In the main, however, services are managed at local level in terms of library systems.
With patient care and evidence-based practice a priority, the primary focus of NHS Scotland services is on journals rather than bookstock. The demand for journal articles generates a high amount of inter-library requests, both internally within the NHS (Scotland or England) and to the British Library. Within Scotland, the Scottish Health Information Network (SHINE) facilitates this document delivery process, with a database of journal holdings available to library staff and a voucher scheme in place to track requests between services.

There has been no similar inter-lending mechanism for books and other library stock, with a dependency on the British Library to fulfil inter-library loan requests. This has been compounded by the nature of library systems within NHS Scotland, and the lack of online catalogues.

The Iron Curtain – a network problem
Network security for the NHS as a whole in the UK is managed by BT. Formerly known as NHSnet, and now upgraded as N3, this network is protected by a national firewall which allows for no incoming data from the Internet. The sensitive nature of NHS data, including patient record information, is reflected in this single-level secure zone. The result is a virtual Iron Curtain, in effect, blocking all connections from the outside world.
Library systems work entirely on the basis of information exchange, and the result of this Curtain was to effectively disable the NHS with regard to system deployment and development as it is known in most library sectors. Library systems operate on a minimum of one database server and one web server communicating with each other in a ‘live’ environment. New data registered on the database server (new bibliographic records added, item A issued to borrower X) is reflected immediately on the online catalogue via the web server. Activity on the online catalogue (item requests, borrower X logging in to access their account information and renew items) is similarly relayed back to the database server.
The N3 rule of ‘no incoming from the Internet’ made this live connection between the two servers impossible, if the database server was hosted within the NHS and N3.

There were only two options available to library services:

host both the database server and the web server within N3, thus restricting access to the ‘public’ online catalogue to internal NHS users only.

manually transfer bibliographic data from the ‘internal’ (N3 hosted) database server to the ‘external’ (Internet hosted) web server each day, thus creating a relatively up-to-date online catalogue but with no live functionality, e.g. no requests, no user log-in, no reliable circulation status for items. ‘Incoming’ includes Z39.50 requests, so the first option would not allow for any interrogation by external services – even if NHS systems had Z-server capabilities, which (HE environments aside) they did not.

The library system landscape
The Knowledge Services Group (KSG) within NHS Education for Scotland (NES) is responsible for the funding, management and development of the eLibrary (www.elib.scot.nhs.uk) and has a remit to support library and information services across NHS Scotland. Between 2003 and 2005, KSG commissioned a survey into the library system landscape in order to assess the possibilities for a unified approach to the problems described above.

The key findings were:

A diversity of library systems, policy frameworks, funding streams and management arrangements. Funding for library services was generally a low priority.

The most common system in use was Heritage (version 4), with others including Calm, Alice, Cardbox, InMagic, AdLib, Reference Manager, and locally developed Access databases. Within a single Health Board, three services might be using three different systems; others (e.g. NHS Fife) had taken the joint decision to use Heritage across all services.

The majority of Health Promotion services were using HPLib, an Access-based system originating from the video hire shop environment.

Some library services had no automated system.

Only 30% of the 54 services represented in the survey had a web-based catalogue, either restricted to internal NHS access or without live data.

Server support from local IT departments was variable and not prioritised. Available system upgrades were often not installed because the existing server was too old.

Due to the nature of existing systems, cataloguing was not done to MARC standard; knowledge of AACR2 was also limited.

With no inter-lending agreements between Boards, and often no indication of holdings available, average spending on inter-library loans from the British Library was £172,000 per annum in total.

Only those services operating within a University-funded environment (e.g. School of Nursing and Midwifery Library at the University of Dundee) had the advantage of a high-level library management system and OPAC.

The ULMS project
The business case for a Unified Library Management System (ULMS) for NHS Scotland was accepted by NES in 2005. The proposal was for a system to be centrally-funded and managed by the KSG. In August the post of Senior Information Manager was filled within KSG – and this is where I come in, as project manager for the purchase and implementation of the new system, and as system administrator.
My first job was a hearts and minds exercise in persuading library services to commit to the project and to promote the advantages of such an approach. Given that any system implementation is possibly the greatest (and most stressful) change process any library service will undergo, it was to be expected that library staff would need to consider their commitment with due diligence. The sheer scale of the implementation, and the creation of a union catalogue from so many diverse data sets and cataloguing practices, was also a source of anxiety. For example, it was difficult to answer the librarian who demanded to know what would become of her extensive in-house subject index, so painstakingly created over the previous five years.

Most crucially, perhaps, the inter-lending of stock between NHS Scotland services was a new and untested workflow, and policy decisions of this kind were entirely in the hands of Boards and services. Library staff imagined that they would be inundated by requests, that their stock would fly off the shelves, that local users would be disadvantaged. With services unused to working on a collaborative, strategic level of this kind, the early prospects of a high take-up on the project were not good. I began to wonder what I would do with my days if everyone said ‘no’ – a project manager without a project, a system administrator without a system.
As the months passed, however, and with a Working Group set up to discuss the knotty issues, the commitments were made: of the geographical Health Boards, Ayrshire and Arran, Dumfries and Galloway, Fife, Forth Valley, Grampian, Lanarkshire, Shetland and Tayside; of the national services, the Health Management Library and Blood Donor Centre in Edinburgh, NHS 24, NHS QIS, and NHS SIGN. In addition, two non-NHS health libraries were taken into the fold as partners: the Scottish Motor Neurone Disease Association in Glasgow, and the Dementia Services Development Centre at the University of Stirling. The courage and vision of these services is not to be underestimated.

This, then, was the scope of ‘Phase 1’ implementation: 42 libraries (roughly 60% of the possible total), with an estimated 200,000 bibliographic records between them. The first outline of a single library system at the heart of the Scottish Health Information Environment had been defined. Whether it would actually work remained to be seen.

Andrew Jackson is Senior Information Manager, Knowledge Services Group, NHS Education for Scotland. e: andrew.jackson@nes.scot.nhs.uk

Information Scotland Vol. 5(5) October 2007

Information Scotland is delivered online by the SAPIENS electronic publishing service based at the Centre for Digital Library Research. SLAINTE (Scottish libraries across the Internet) offers further information about librarianship and information management in Scotland.

Last updated: 13-Dec-2007