The NHS in England at 70

To celebrate 70 years of the NHS, St George’s Library takes a look over its history

As the NHS marks its 70th year, a look over its history can help to draw into focus the achievements of its time so far, along with the changes that have taken place both within the service itself and in the society which it serves. Created on the basis that good quality healthcare should be available to all, the NHS rested upon three core principles: that it meet the needs of everyone; that it be free at the point of delivery; and that it be based on clinical need, not the ability to pay. These principles retain their importance 70 years on.

At its inauguration in 1948 the NHS was a three part system, with hospitals, general practice and local health authorities being run separately, though by the 1960s this model was increasingly seen to be ineffective. Numerous reports during the 1960s set out recommendations for the future development and structure of the service, but it was 1974 before the NHS was reorganised into regional authorities covering all three parts of the system. In the intervening period, authority for NHS services has continued to change, from 1991 when the first NHS Trusts were established, to 2002 with the introduction of Primary Care Trusts, and the current situation which gives authority and responsibility to Clinical Commisioning Groups (CCGs) and NHS Foundation Trusts, amongst others.

Amidst the 70 year history of the NHS, sit a number of innovations in treatment. The first kidney transplant was carried out in 1960, the first IVF baby was born in 1978, and the first successful gene therapy took place in 2002. In addition, changes to the approach to treatment have taken place, such as the Mental Health Act 1983, which introduced the issue of consent to treatment; under the prior Act of 1959, there was no requirement for patient consent.

Underpinning developments in healthcare services and practice all the while, has been the accessibility and use of relevant information and knowledge. As outlined by a blog post on The King’s Fund website, that organisation (when named King Edward’s Hospital Fund for London) provided an information service for hospitals and other organisations interested in hospital work even before the advent of the NHS. In November 1948 the service was formalised as the Division of Hospital Facilities, which included an Information Bureau and a Reference Library.

Today, Health Education England continues that commitment to enable NHS staff to access the information that can help shape good quality healthcare, and the library at St George’s is one of 215 NHS library services that supports NHS staff access and use of information resources for study, research and clinical practice. St George’s Library existed before the advent of the NHS as it supported St George’s Hospital and Medical School going back to the 1700s. Fortunately, developments in the provision of library services have also taken place over the years, meaning that current members no longer have to observe the following regulation:

11. A Member wishing to read a Book in the Reading Room must write the title of the Book, and his name on a piece of paper, and hand it to the Librarian, who alone is to take books from the shelves and replace them.

(Historic Regulations for the Library and Reading Room of St George’s Medical School)

The NHS70 website provides more on the history and the future of the National Health Service, as well as up to date news on celebrations of this milestone. The NHS England website also provides a decade by decade timeline of the service outlining more of the significant medical developments and innovations to have taken place in the NHS, alongside the key pieces of legislation and structural changes affecting the delivery of services by NHS staff throughout the past 70 years.

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NHS OpenAthens resources now accessible through Google Scholar and PubMed

All St George’s Trust staff with OpenAthens accounts now have access to those resources directly from Google Scholar and PubMed. The display of OpenAthens links in these platforms can be set up by following a few quick steps.

Setting up Google Scholar links:

  1. Click on the menu at the top left of the Google Scholar home page
  2. Select ‘Settings’
  3. Select ‘Library links’
  4. Search for ‘st george’
  5. Select ‘St George’s University Hospitals NHS Foundation Trust’
  6. Click Save

All searches in Google Scholar will display a ‘St George’s Trust OpenAthens’ link next to results where full-text is available:

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(Note that these steps need to be followed separately on each device you use).

Setting up PubMed links:

  1. Login to My NCBI. If you do not have an account, register here
  2. Under ‘Filters’, ensure that PubMed is selected in the drop-down menu, and click on ‘Manage Filters’
  3. Select LinkOut from the available filter categories, and search for St George’s
  4. Next to the entry for St George’s University Hospitals NHS Foundation Trust, check the boxes under the Filter and Link Icon columns

All searches in PubMed will display a ‘St George’s Trust OpenAthens’ filter when you are signed in to My NCBI. When viewing the abstract of an individual result, where full-text is available a St George’s Library icon will be displayed under ‘Full text links’ on the right of the page:

 

More detailed step-by-step guides are available on the SGUL Library website.

Copyright: What NHS staff need to know

CLA NHS England copyright- posterThe rules regarding copyright and knowing what you can legally copy can be confusing. Questions about copyright might arise when considering whether a journal club can print multiple copies of an article for members? Whether staff are allowed to distribute printed or digital copies of articles to other colleagues? How much of a book are you legally allowed to photocopy?

The CLA Licence for NHS staff in England is the licence that provides the terms for what NHS staff are allowed to photocopy, scan and share from most copyrighted print and digital works.

What is covered by the licence?

The licence allows individuals to make copies from almost everything which has been purchased, subscribed or donated to the NHS in England. There are a small number of excluded works, if you’re unsure if a work is covered by the licence then the best way to check is via the CLA’s Check Permissions tool https://www.cla.co.uk/index.php/nhs-england-licence

Who is covered by the licence?

The licence covers all staff working for or contracted by the NHS including primary and acute care staff, public health staff employed by local authorities, those working for DHSC arms’-lengths bodies and special health authorities, and those providing NHS-commissioned care such as Hospice staff. The licence also covers HEI students and staff who are on temporary or permanent placements with the NHS in England.

What can be copied under the licence?

  • 2 articles from a single journal issue or several articles from an issue if it is dedicated to a particular theme.
  • 1 chapter or 5% of a book (whichever is the greatest)
  • There are no restrictions on how many copies you can make, and you can make copies of copies too.
  • Digital copies can be stored – but they must be kept on your own PC or a secure network which you may share with colleagues.
  • Only single paper copies can be made for patients or carers

What can I share?

You may share print or digital copies with work colleagues covered by the licence including via email.

What else do I need to know?

You are obligated to protect the rights of copyright owners, to always copy within the limits of the licence and to always acknowledge sources of information when writing.

More information about copyright can be found at the Copyright Licencing Agency website

A poster is also available for staff to display next to photocopiers.

Or if you have any questions regarding the copying and sharing of copyrighted works for NHS staff please contact the NHS Liaison Team liaison@sgul.ac.uk

New NHS e-learning programme on literature searching now available

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A new e-learning programme providing guidance on how to plan and carry out literature searches is now available on the e-Learning for Healthcare (e-LfH) platform. The project is intended for both clinical and non-clinical healthcare staff, and aims to help develop confidence in searching for and identifying relevant articles in support of work, study and research.

The seven module course is specifically for those with less experience in searching healthcare databases for literature, or those who wish to refresh their knowledge of the principles of effective searching. Each of the short modules can be completed in 20 minutes or less, and have been designed such that they might be used individually, or completed as a course.

The first three modules titled, ‘Building the Foundations’, were launched in November of 2017 and provide users with some guidance on the resources that are available, how to get started with planning a search, and the use of OR/AND in combining search terms.

The second set of three modules, ‘Developing the skills’, has recently been made available, and these focus on how to narrow a search when too many results are returned, how to broaden searches with too few results, as well as covering how to search using subject headings.

The seventh and final module on ‘Applying the skills’ will be available in April 2018.

You can access the modules password-free, but if want to record and save your learning, log in via NHS OpenAthens. To access the e-learning  visit: https://www.e-lfh.org.uk/programmes/literature-searching/

#AMillionDecisions NHS Pop-up Library: Wednesday 29th November 12-2pm, Ingredients Restaurant

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Every day more than a million decisions are made across the NHS and healthcare sector. Under the Health and Social Care Act 2012, there is a responsibility for health services to ensure use of evidence obtained from research to inform these decisions.

#AMillionDecisions is a campaign from CILIP and Health Education England, calling for decisions in the health care sector to be fully evidence based.

In support of the St George’s Trust’s Quality Improvement Week, 27th November – 1st December, we’re highlighting how St George’s Library can help staff make those million decisions evidence-based at our pop up library stall on Wednesday 29th, 12-2pm.

The Library provides a wide range of  free information services with the aim of  providing timely and efficient access to information to underpin quality healthcare provision.

These services range from providing access to high-caliber relevant e-resources and training on how to search for and critically appraise information, to CARES, our Clinical and Research Enquiry Service.

To find out more, visit our pop-up library stall on Wednesday 29th November, 12-2pm, Ingredients Restaurant, Level 1, Lanesborough Wing or join the campaign by sharing your thoughts and experiences on Twitter using the hashtag #AMillionDecisions.

A Million Decisions

a million decisions logo

Every day more than a million decisions are made across the NHS and healthcare sector. Under the Health and Social Care Act 2012, there is a responsibility for health services to ensure use of evidence obtained from research  to inform these decisions.

#AMillionDecisions is a campaign from CILIP and Health Education England, calling for decisions in the health care sectore to be fully evidence based.

During #Librariesweek, we’re highlighting how we can help make those #amilliondecisions evidence-based for our NHS colleagues.  At St George’s Library, we provide a wide range of  free services to support St George’s NHS staff, from access to relevant e-resources and training on how to search for and critically appraise information, to CARES, our Clinical and Research Enquiry Service.

Join the campaign by sharing your thoughts and experiences on Twitter using the hashtag #AMillionDecisions

 

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App Review: DynaMed Plus

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DMP logoName: DynaMed Plus

Publisher: EBSCOhost

Devices: Any iPhone® or iPad® or iPod touch® running iOS 9.3

or higher. Any Android device running Android 4.4 or higher.
The app requires at least 500MB of memory.
Can be authenticated on up to 3 devices per activation link.

We’ve tested this app on an iPhone 6 and an iPad Air2.

Available from: iTunes App Store or Google Play

This app is available to NHS staff and SGUL staff and students.

*Details on how to download and authenticate the app are included at the end of the post.*

Price: Free to download

Type of information: Clinical decision making support tool.

For: doctors and other healthcare professionals at point of care, and healthcare students.

Main Pros: Similar in design, layout and functionality to the web-based version. Content available offline after initial download. Links to full-text supporting articles and guidelines within topic summaries where available.

Main Cons: Requires around 1GB of storage space depending on device. Link to calculators not available on home screen of the app, unlike the web-based version, requires a separate search to access them.

An in-depth look

The DynaMed Plus app is the app version of a point of care resource that St George’s Library subscribes to. It provides access to over 3,400 clinical summaries covering a broad range of specialties and is designed to support healthcare professionals in clinical decision making. It covers the same content as found on the web-based version of DynaMed Plus, with the added benefit of being accessible offline. However, the content can require a fair amount of storage space on your device. The publishers recommend to have a minimum of 500MB free, but in our testing we’ve found the App has required around 906 MB on iPad Air 2 and 1.16GB on an iPhone 6. Presumably this will likely increase as more content is added and updated over time.

In terms of functionality the app is really simple to use and fairly intuitive – it is almost identical in layout and design to the web-based version which presents a nice continuity of usage. The home screen presents you with a search bar and in the top-right hand corner you’ll find a Bookmark icon which houses your previously saved pages, and search history. There is also a settings icon that allows you to change the text size, check for updates to the app and search the help pages, which does require an internet connection.

The search function has an intelligent auto-suggest feature, which will show you your results in the form of topics and searches that match your terms as you type. You can then either review the topic summary directly, or view the search terms instead. Once you are viewing a topic you can scroll through the entire summary as you would a web page, or you can browse by section. How you do this depends on how you are holding your device. In landscape view the section headings can be found on the left of the summary, allowing the user to dip in and out of the topic sections. Holding the device in portrait forces the section headings into a separate bar at the top – you can navigate these by selecting the magnifying glass icon that will appear on the top right of the screen, next to the topic summary heading. There are also other icons in the bottom right of the page that allow you to bookmark the summary, email or print the topic, or make notes if required. If you do any notes to the summary, the empty notepad icon will fill with lines to indicate you have done so.

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Many of the topic summaries provide external links to webpages and supporting articles which will display the article abstract or full-text article if available through an institutional subscription (OpenAthens or St George’s, University of London). Again, despite the app content being available offline you will need to be connected to the internet to access anything linked outside of the app.

Despite being very easy to use, some of the resource’s most useful features are buried within the app somewhat, which is unfortunate. The calculators and decision trees have a direct link in the title bar of the web-version, but no counterpart within the app. They can be found by searching for them, which isn’t as user friendly as a link or icon. This can also be said for the thousands of supporting images the resource has – they can be found and browsed in your search matches, but we felt that embedding them in their own section within the topic summary would make them much more identifiable.

Available to SGUL staff and students

PDF for how to download DynaMed Plus App for SGUL staff and students

Available to NHS Staff

How to download and authenticate the DynaMed Plus app for NHS Staff:

1. Access DynaMed Plus via NHS OpenAthens or the Hospital intranet page

2. Click on the Mobile use – Get the DynaMed Mobile App link under Spotlight.

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3. Enter your email address and click send.

4. An authentication link is emailed to you.

5. Open the email from your device and follow the links to download the app via the iTunes Store or Google Play.

6. When prompted, authenticate the app via the OpenAthens link- look for the Athens link at the bottom of the authentication page.

Note: If you do not tap the authentication link in the email within 48 hours you will need to request a new authentication key from within DynaMed Plus.

7. The DynaMed Plus App opens on your device and begins the initial content download.

Note: It is recommended that you are on a Wi-Fi connection for the initial download of DynaMed Plus content as well as when updates become available. Initial download can take up between 10-30 minutes.

Getting more help

DynaMed Plus have produced this useful video to get you started with DynaMed Plus.

If you need support with your OpenAthens account please contact Stephen Reid sreid@sgul.ac.uk

NHS Staff who are eligible for an OpenAthens account can register here: https://openathens.nice.org.uk/

For training or if you have any questions about access to DynaMed Plus please contact liaison@sgul.ac.uk