quote HEE facebook linkedin twitter bracketDetail search file-download keyboard-arrow-down keyboard-arrow-right close event-note

You are here

Library and Knowledge Services

Library and knowledge services

Healthcare library and knowledge services underpin education, lifelong learning, research and evidence-based practice. Our ambition is to extend this role so that healthcare knowledge services become the integral part of informed decision-making and innovation.

We published Knowledge for Healthcare, sharing our vision 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.

This development framework sets out an ambitious vision for provision of Library and Knowledge Services and is a significant transformation programme.  

The development framework is now supported by a new Outcomes Framework that helps NHS-funded organisations review and improve their healthcare library and knowledge services.

We are committed to enabling all NHS staff to have free access to library and knowledge services so that they can use the right knowledge and evidence to achieve high-quality, safe healthcare.

Here's what people say about the important role of healthcare library and knowledge services...

Professor Ian Cumming OBE, Chief Executive, HEE:

Every day across the healthcare sector more than a million decisions are made which have a profound impact on people’s lives and which influence the quality and cost of healthcare services. The Government and health organisations have obligations under the Health and Social Care Act 2012 to ensure the use of evidence from research and to make use of the best available evidence in their decision-making.

Lisa Bayliss-Pratt, Director of Nursing and National Deputy Director of Education and Quality, HEE:

All healthcare students and trainees/learners should have access to the best available evidence to ensure they do their very best to care safely and effectively for those that put their lives in their hands. Our excellent library and knowledge services, easily accessible and available, underpins the training that nurses undertake and supports them through their revalidation.

Patrick Mitchell, Regional Director – South of England, HEE:

With the NHS striving to reduce clinical variance across the system to improve clinical efficiency and effectiveness, improve patient safety and save money, the importance of strong evidence to a Board or a healthcare professional at the patient’s bedside can never have been more crucial. The knowledge management skills of our healthcare librarians are at the fore and I am very excited to be leading this major change for a key but almost ‘hidden’ workforce in the NHS. The direct benefit to patients is evident from case studies and it is a delight to see so many healthcare librarians put themselves forward for the variety of development programmes we have established to underpin this transition. Our librarians are the backbone of support for learning and I encourage everyone to see what they are doing.

Professor Wendy Reid, Director of Education and Quality, Medical Director, HEE:

Putting timely knowledge into the hands of healthcare professionals working across care settings is vitally important for making clinical decisions that are based on sound evidence. With unprecedented time pressures on health professionals, embedded health librarians and knowledge services to support them in clinical and community settings are a vital resource.

Healthcare relies on knowledge to be successful. It is not enough to have the right teams with the right skills in the right place, working together to deliver high quality and efficient patient care. It is also essential that they use the right knowledge and evidence to make informed decisions about patient healthcare.

Health Education England (HEE) is committed to enabling all NHS staff to freely access library and knowledge services so that they can use the right knowledge and evidence to achieve high-quality, safe healthcare.

NHS bodies are encouraged to check that they have arrangements in place so that their staff can capitalise on the specialist expertise of healthcare librarians and knowledge specialists, ensuring that decision-making is underpinned by evidence derived from research. Organisations are invited to contact their Strategic Library and Knowledge Services Lead for help in setting up or strengthening these arrangements.

Library and knowledge services across health have a strong track-record of sharing expertise and working across boundaries. Resource sharing and collaboration are vital to implementing the framework we call Knowledge for Healthcare.

Agreed by the HEE board, our policy sets out for the first time our approach to delivering on our key objective of enabling access to knowledge and evidence for healthcare decision-makers.

The policy is supported by the new Knowledge for Healthcare Quality and Improvement Outcomes Framework for NHS-funded library and knowledge services. The Outcomes Framework is an integral element of HEE’s Quality Framework and it enables HEE to assure the quality of NHS-funded library and knowledge services and support delivery of the vision and aims of Knowledge for Healthcare and the HEE Quality framework.

The NHS requires proactive knowledge services as business-critical instruments of informed decision-making. Currently there is significant variation in the ratio of qualified librarians and knowledge specialists to healthcare staff, leading to inequitable service provision across England. This means that the Service is not uniformly able to draw on evidence for #MillionDecisions.

The introduction of a recommended staff ratio is a key action by Health Education England to enable individual organisations to identify and address that risk. For the first time this policy, agreed by the Health Education England Executive in November 2019, provides a set of recommendations from which trusts and arm’s length bodies may look to ensure, and where necessary continuously build, improved staffing levels.


1. To optimise the benefits for the NHS of the emerging new roles for librarians and knowledge specialists, HEE recommends that all NHS organisations:

(i) review regular reports of the positive impact of the library and knowledge service on outcomes

(ii) work with the local library service manager to prioritise allocation of clinical librarian, knowledge manager and other embedded roles to specialities

(iii) take incremental steps to improve the staff ratio between qualified librarians and knowledge managers per member of the NHS workforce, through role redesign and by expanding this specialist workforce.

2. HEE recommends that over time, all NHS organisations aspire to achieving a much-improved staffing ratio.

3. HEE recommends that those NHS organisations with a staffing ratio in the region of the current average of 1 qualified librarian to 1,730 or more healthcare staff, strive to achieve a ratio of at least 1 qualified librarian or knowledge specialist per 1,250 WTE NHS staff.

4. HEE commits to monitoring the staff ratios annually and to reviewing the recommended ratio in three years' time.

Organisations are invited to contact their Senior Library and Knowledge Service Lead for support in progressing these recommendations.

New Quality and Improvement Framework will take NHS Healthcare Library & Knowledge Services to a new level

Healthcare is a knowledge industry. Health Education England (HEE) has developed a new Quality and Improvement Outcomes Framework that sets the standards and ambition for Healthcare Library and Knowledge Services. This signals a step change to help organisations work with their knowledge services team, both to improve service delivery for patient care and to better articulate the positive outcomes of the knowledge service. The Framework is an integral part of HEE’s Quality Framework and replaces the former Library Quality Assurance Framework (LQAF).

What does this mean for your organisation?

The new Outcomes Framework is a tool for NHS organisations to ensure that all NHS funded librarians and knowledge specialists manage and deliver high quality, high performing services that develop and improve to meet the changing needs of NHS organisations and staff.  From 2020, if your organisation benefits from a Learning and Development Agreement with HEE you will be asked to complete a self-evaluation and submit evidence using this new framework.  

Why is this changing?

Library and knowledge services are business-critical for today’s NHS. The focus of the Outcomes Framework is on service improvement (rather than compliance with process). It uses a maturity model, recognising that services may progress faster in some domains than in others and will therefore have varying levels of maturity across each domain.

Which Service Outcomes are being prioritised?

The new Framework supports the progression of NHS-funded library and knowledge services as thriving systems grasping the opportunities and facing the challenges of the 21st century. It emphasises six Quality and Improvement Outcomes:


1. All NHS organisations enable their workforce to freely access proactive library and knowledge services that meet organisational priorities within the framework of Knowledge for Healthcare.

2. All NHS decision making is underpinned by high quality evidence and knowledge mobilised by skilled library and knowledge specialists.

3. Library and knowledge specialists identify the knowledge and evidence needs of the workforce in order to deliver effective and proactive services.

4. All NHS organisations receive library and knowledge services provided by teams with the right skill mix to deliver on organisational and Knowledge for Healthcare priorities.

5. Library and knowledge specialists improve the quality of library and knowledge services using evidence from research, innovation and good practice. 

6. Library and knowledge specialists demonstrate that their services make a positive impact on healthcare.

Every day across the healthcare sector in England more than a million decisions are made that have a profound and lasting impact on people's lives and which influence the quality of healthcare and the cost of services.

The Chartered Institute of Library and Information Professionals (CILIP) and Health Education England are campaigning for decisions in the healthcare sector to be fully evidence-based, calling on everyone involved in policy making and care delivery to make use of the skills of librarians and knowledge specialists in meeting their obligations under The Health and Social Care Act 2012.

Under the Act, The Secretary of State must ensure the use of evidence obtained from research and healthcare providers are required make use of the best available evidence in their decision-making. Arms' length bodies and those commissioning or influencing healthcare services have a responsibility to promote and monitor the use of evidence-based decision making.

The campaign started on 30 January 2017. Join in by sharing your thoughts on Twitter using the campaign hashtag #AMillionDecisions.

The regional library and knowledge services leads work together to:

- Provide strategic advice and professional leadership to NHS organisations

- Undertake a range of activities which benefit from economies of scale including commissioning, procuring and managing a suite of electronic knowledge resources accessible to all health and social care staff

- Uphold standards that minimise inequality of service and demonstrate that NHS library and knowledge services provide value for money through the new Knowledge for Healthcare Quality and Improvement Outcomes Framework for NHS-funded library and knowledge services. The new Outcomes Framework replaces and builds on the success of the national Library Quality Assurance Framework (LQAF). It provides a tool for NHS organisations to review and ensure delivery of a high quality, high performing service that develops and improves to meet the changing needs of the organisation and staff. The emphasis is on service improvement through self-evaluation and submitted evidence.  

- Provide a targeted range of appropriate professional and personal staff development opportunities, for the Library and Knowledge Services workforce

- Act as a conduit between local and national NHS programmes

- Promote innovation in library and knowledge service design and delivery

- Enable the adoption and spread of good library and knowledge services practice throughout the NHS

- Engage with non-NHS healthcare libraries via Royal Colleges, independent and third sector organisations, and the Chartered Institute of Library and Information Professionals.


Sue Lacey Bryant, Senior Adviser, Knowledge for Healthcare.

David Stewart, Regional Director of Health Library and Knowledge Services North.

Midlands and the East
Ruth Carlyle, Head of Library and Knowledge Services and Technology Enhanced Learning.

London and the South East
Louise Goswami, Head of Library and Knowledge Services and Technology Enhanced Learning.

Helen Bingham, Head of knowledge Services and Technology Enhanced Learning.

You may also wish to discuss with your regional library and knowledge service leads what needs to be done in-house to achieve the Knowledge for Healthcare vision within your own organisation.

Library and knowledge services underpin all aspects of the NHS. They supply the evidence base to enable excellent healthcare; support and inform policy, commissioning, and service redesign decisions; enable lifelong learning and research; and through partnership working offer health and patient information.

The Health Library & Information Services Directory allows you to look up your local library by area, trust or county.

An NHS Open Athens account provides access to a large number of electronic journals, books, databases and e-learning resources. If you haven’t got an NHS OpenAthens account, register on the Athens registration link (please use an NHS computer if possible). If you have registered, but have forgotten your password please go to the Athens forgotten password page.

You can search for databases, e-journals, e-books on the Healthcare Databases Advanced Search page. At NICE Evidence Search you can search evidence sources in health and social care.