health and social care information...health and social care information provision iv basis for...

Health and Social Care Information: A review of provision in the North East

Suzanne Lockyer and Elizabeth Blenkinsopp

February 2006

Health and Social Care Information Provision i

Contents Acknowledgements............................................................................................................ ii

Executive Summary .......................................................................................................... iii

1. Introduction...............................................................................................................1

2. Strategic Review.......................................................................................................2

2.1 Politics and Funding............................................................................................................ 2 2.2 Public perception................................................................................................................. 3 2.3 Providers.............................................................................................................................. 4 2.4 Delivery ................................................................................................................................ 7

3. Methodology ...........................................................................................................10

3.1 Questionnaires .................................................................................................................. 10 3.2 Focus group....................................................................................................................... 10 3.3 Interviews........................................................................................................................... 11

4. Results ...................................................................................................................12

4.1 Summary of responses..................................................................................................... 12 4.2 Examples of best practice ................................................................................................ 16

5. Conclusions and recommendations ........................................................................21

5.1 Recommendations ............................................................................................................ 22

6. References .............................................................................................................25

Appendix 1: Strategic Review - Bibliography .................................................................26

Appendix 2: Questionnaire Survey ................................................................................32

Appendix 3: Ideas for ‘ideal’ health and social care information provision .....................50

Appendix 4: Supplementary material sent by organisations ..........................................53

Appendix 5: Focus Group .............................................................................................54

Appendix 6: Interviews ..................................................................................................61

Appendix 7: Examples of health and social care information provision to the public......64

Health and Social Care Information Provision ii

Acknowledgements The authors would like to record their thanks to the following:

Members of the project team at Loughborough University Claire Creaser, LISU Janet Harrison, Department of Information Science Graham Walton, Pilkington Library

Members of the project steering group Michael Long, NEMLAC Sharon Dobbins, County Durham and Tees Valley SHA Audrey Harmer, North East Skills for Care Learning Resource Centre Network David Peacock, Northumberland and Tyne & Wear SHA

All those who took the time and trouble to respond to our questionnaires or send other information.

All interviewees, and focus group participants.

Mary Ashworth and Sharon Fletcher at LISU for formatting the questionnaires and report.

Health and Social Care Information Provision iii

Executive Summary There are currently many drivers for change in the provision of health and social care information to the public. Health is of particular concern in the North East region of England, as the population has above average levels of long-term health and chronic illness (North East Health Summit 2003). To address this and to be pro-active in the current health and social care agenda, the North East Museums, Libraries and Archives Council (NEMLAC) together with partners in the health and social care sectors commissioned a review of current practice in the North East. The aims of this review were to collect examples of good practice from the North East and to propose a model for co-ordinated and sustainable provision.

The study was undertaken by a team from LISU, the Department of Information Science and the Pilkington Library at Loughborough University, between September and November 2005. The first stage of the project was an extensive literature review to provide background for the study. There followed three strands of data collection.

Questionnaires were sent to named contacts in public libraries, primary care trusts and social care departments. The aim of the questionnaire was to collect evidence of current good practice and partnership working. All sectors provided examples of initiatives, many in partnership with other sectors. The questionnaire also sought practitioners’ views on future health and social care information provision and the barriers to such provision. Although the rate of response was variable, with a good coverage of public libraries but poor coverage of social care departments, the questionnaire survey obtained several examples of current good practice from all sectors and insight into actual and perceived barriers to ideal information provision.

A focus group provided additional information on the key issues and barriers experienced in the North East, but also demonstrated the enthusiasm and synergy possible when the three sectors are brought together.

In-depth interviews were held with key stakeholders at national and regional level to give a broader context to the findings. The interviews confirmed the increasing importance of health and social care information in both the national and regional agenda. Of particular interest to this study was the view that partnership working was essential to maximise resources, not least the exchange of skills between sectors. Some interviewees noted that funding was available for projects, but required defined objectives. These views contrasted with those expressed by practitioners, who often felt frustrated by funding issues: funding was usually project based and subject to policy and organisational changes, therefore successful projects ended when funding ended.

Lack of resources was the main barrier to health and social care information provision cited by respondents. However, overall the study found no evidence of lack of information. The main barrier appears to be lack of awareness of available resources between and within organisations leading to duplication of effort and information overload. Staff in each sector have particular skills, not least knowledge of their users and these skills need to be communicated more formally between sectors.

Recommendations are made to overcome these barriers by short-term, minimum resource projects which will demonstrate the potential for collaborative working. This will provide a

Health and Social Care Information Provision iv

basis for further development and provide evidence for funding applications. In summary, the recommendations outline ways to:

• Develop the evidence making long term projects more viable

• Provide direction and linkage for information professionals to increase awareness of initiatives in each sub-region and promote collaboration

• Disseminate good practice

• Obtain funding

A key aspect of the success of the recommendations is an umbrella organisation to take ownership. In the short term it is suggested that NEMLAC would be the ideal organisation to fulfil this role.

INTRODUCTION

Health and Social Care Information Provision 1

1. Introduction People want to be able to make their own decisions about choices that impact on their health and to have credible and trustworthy information to help them do so (Choosing Health)

There are currently many drivers for change in the provision of health and social care information to the public. Information is a key factor in several national and local government agenda which emphasise the change in health and social care from practitioner direction to patient choice. Another feature of recent policies is the need for collaboration: information provision in health and social care is central to many voluntary and statutory agencies and co-ordination is required to maximise resources.

Health is of particular concern in the North East region of England, as the population has above average levels of long term health and chronic illness (North East Health Summit 2003). To address this and to be pro-active in the current health and social care agenda, the North East Museums, Libraries and Archives Council (NEMLAC) together with partners in the health and social care sectors1 commissioned a review of current practice in the North East. The aims of this review were to collect examples of good practice from the North East and to propose a model for co-ordinated and sustainable provision.

This report focuses on the key issues uncovered during the research and on the examples found of current good practice in the North East across public libraries, Primary Care Trusts and Social Care departments. The research was carried out during September to November 2005 by a team from Loughborough University, and used questionnaires, focus groups, and interviews to gather evidence. These methods, and details of the findings are described in Sections 3 and 4. To put this study in context, a review of current strategies and literature in health and social care provision to the public was undertaken. This review is summarised in Section 2. From the examples obtained, together with input from providers and key stakeholders in the three sectors, a model for future provision is proposed in Section 5.

1 Northumberland, Tyne and Wear Strategic Health Authority; Durham and Tees Valley Strategic

Health Authority; North East Skills for Care Learning Resource Centre Network; Durham and Teesside Health Libraries Alliance.

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2. Strategic Review This section presents a summary of the extensive literature review carried out to inform and underpin the field work. A full bibliography is given at Appendix 1; numbers in brackets refer to this bibliography. Material has been grouped into four broad themes.

2.1 Politics and Funding 2.1.1 Government policy The provision of public health and social care information has been recognised by government as providing a significant improvement to the health and well-being of the nation. Through a range of policies and papers, the Department of Health (91) (92) (93) (94), the Museums, Libraries and Archives Council (95) (96) (97) (98) and the Department for Culture, Media and Sport – together with the NHS (99), charities such as Young Minds (100) and the North East Public Health Observatory (101) (102) have engendered to produce an environment whereby the public will have increased access to health and social care information. Greater multi-agency work, exploitation of technology, full involvement and commitment from all partners and a higher profile for public libraries are all seen as factors ensuring equitable access to public health and social care information.

2.1.2 Local government involvement By 2005, all local government services are to be (where practicable) available online (33). This in turn impacts on local government information providers such as public libraries and social services to provide electronic access to public health and social care information. One-stop-shop centres (for health, social needs and information) such as the nationwide Healthy Living Centres (43), the north eastern Bunny Hill Customer Service Centre (84) and the Ebbisham Centre in Surrey (47) are managed by local government (together with primary care trusts, charities and voluntary organisations). A website is being planned by Hillingdon Borough Council to provide health and social services information to the local community (82). Glasgow Health Information is an Internet portal for patients and the public, with local authority input (39). Infopatient is a patient information centre at Tameside General Hospital, with support from Tameside Council (40) and the Signposts Information Service (a health, disability and community care information service) has contributions from Somerset County Council (41). The ‘Books on Prescription’ project (GP prescribed reading via public libraries) has been established with local government involvement throughout Wales (90) with Welsh Assembly backing, and in other parts of England such as Gloucestershire (83) and Kirklees and Calderdale (90).

2.1.3 Funding streams Our research identified only three examples where funding streams were discussed for particular projects:

• The Welsh Assembly Government has provided funding to all 22 library authorities in Wales for the Books on Prescription scheme (90);

• Equip (the patient information website for West Midlands patients) is funded by Strategic Health Authorities and Primary Care Trusts in the West Midlands region (38);

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• The Skilled for Health project in Essex is funded jointly by Thurrock Primary Care NHS Trust and Thurrock Adult Community College (Essex) (94).

Funding is an issue that needs to be addressed in the first instance, before embarking on any project for the provision of public health or social care information.

2.2 Public perception 2.2.1 Traditional vs unconventional information Conventional information sources include patient leaflets, health professional consultation, libraries - although some research indicates there are differing perceptions that the library is the place for health information (9) - and the Internet. Unconventional information sources can be dictated by location or delivery format: the use of supermarkets or pharmacies for health information kiosks (57), or nurses offering drop-in sessions at supermarkets (21); the potential provision of health/social care information at Citizens Advice Bureaux in Scotland (68); Thomson Local phone directories containing health information (77) and utilising ‘alternative culture’ marketing for public health messages aimed at teenagers/young adults (30).

2.2.2 Access: public vs professionals There is some public misconception about the target audience for health information kiosks located within the working environment of the health professional, such as the GP surgery. They were often viewed as being solely for use by the GP, nurse etc. Two studies identified this as a particular problem(23) (28).

2.2.3 Urban vs rural Our literature search indicates that there is no difference in policy or approach between the provision of public health and social care information to urban, as opposed to rural populations. The widespread availability of information technology (e.g. the Internet and digital platforms) may have assisted in eroding this issue.

2.2.4 Affluent vs poor (social exclusion) Providing health and social care information to the socially excluded has been a significant part of Government policy. As a result, there are reviews of projects such as the provision of touch screen kiosks sited in targeted locations to reach socially excluded groups (35) and Healthy Living Centres aimed at the most disadvantaged (43). The success, or otherwise, of a project such as touch screen information kiosks is partially determined by the economic well-being of an area (62).

2.2.5 Digital divide (information/information technology literacy) Age appears to be a factor in determining whether a member of the public has had past experience of the Internet (52). For example, in a study of UK and US young people aged 11-19 using the Internet for health information, the majority of this age group had extensive Internet experience (66). Conversely, a British Life and Internet Project survey indicated that members of the public aged 65 and over were four times more likely to email their GP (27). A further survey examined the effect health information intervention had on different age groups and concluded that older adults were no less likely (and sometimes more likely) to use health information as a result of intervention than younger adults and that those aged 65 and over were 17% more likely to consult self-care books than 18-29 year

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olds (29). A final report indicated that older patients were more likely to obtain medical information direct from their doctor and that television or the radio were not effective channels as they failed to attract this age group’s full attention (56).

However, the use of interactive television is seen as an opportunity to close the digital divide and, as such, to be an ideal medium for the delivery of health information to the public. Its success is only ensured by the user’s ability to use this platform effectively (33). Information kiosks have an advantage over the Internet or other technologies in that they are more readily used by those who are not willing or able to use the alternative technologies (63). One survey, however, indicated that the In Touch with Health touch screen information kiosks were more successful in providing the information required if intermediary help was available (62). Further findings related to touch screen information kiosks suggest use of technology is not the only barrier. A report on kiosks installed at the Royal Cornwall Hospital revealed an information literacy issue. Whilst the technology of touch screen information kiosks may be easy to follow, users with difficulties in reading and understanding the information provided may find they are hampered in their quest for information through this medium (58). A review of UK websites/providers of consumer health information indicated that the readability levels of information contained was well above the average reading ability of consumers (50).

2.2.6 Quality There are several projects or organisations concerned with quality issues for consumer health information: JUDGE (aims to develop guidelines for consumers seeking health information on the Internet and judge the quality of sites found)(44); DISCERN (general set of guidelines to help consumer health information users judge quality of written information about treatment choices) (49); CHIC (Consumer Health Information Consortium): (autonomous UK organisation promoting high quality, free, open access health information to the public) (48).

A study undertaken in 2004 outlines a public misconception that seals of approval or trustmarks for consumer health information (particularly online) indicate both proxy indicators of information quality and direct assessment of information content. In reality, these trustmarks only apply to information quality, rather than content (22). Consumer health librarians have a role to play in educating the consumer to locate quality health information (73).

2.3 Providers 2.3.1 Collaboration 2.3.1.1 Medical libraries + others Our literature search identified three UK examples of collaboration between medical libraries and public libraries. Southampton public library refers complex enquiries to Royal Hampshire Hospital and Wessex Medical Library (97). In a similar vein, Portsmouth public library refers in-depth enquiries received from patients to the Health Information Line at the Queen Alexandra Hospital (97). A Yorkshire based access project had added the NHS library at Huddersfield Royal Infirmary to current partners (University of Huddersfield and Kirklees public library) and the project also aimed to target other NHS-based libraries (98).

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Additionally, Infopatient (a Patient Information Centre at Tameside General Hospital) is an example of collaboration between hospital and local authority – namely Tameside Council and Tameside General Hospital, with resourcing backed by Tameside Libraries Information Service. Users are in-patients and outpatients and they can obtain information on health, post hospital care, council information and referral to support groups (40).

2.3.1.2 Public libraries + others Two types of collaborative projects between public libraries and other agencies can be identified as examples of good practice. Firstly, the multipurpose customer service centre. Bunny Hill Customer Service at Sunderland is such a centre. This is a one-stop-shop for a range of council, health and information services to be available to local residents (including public libraries) (84). Likewise, The Ebbisham Centre in Epsom, Surrey is a similar example. This is a Lifestyle Centre, housing a range of health, information and social resources under one roof and includes a library and learning centre (47).

The Books on Prescription scheme is the second example of collaboration between public libraries and others. This scheme entails public libraries and health & social services (such as primary care trusts) working together to provide a service to patients given GP-prescribed reading lists and is offered throughout Wales (90) and also in Gloucestershire (83), Kirklees and Calderdale (90) and elsewhere.

2.3.1.3 Local community + others The local community, in partnership with other agencies such as the voluntary sector and NHS, is seen by the Department of Health as having a significant role to play in the successful provision of public health and social care information. Local communities (in conjunction with the voluntary sector) are seen as channels of information (particularly with regard to health promotion (91). The North East of England Health Summit of 2003, however, highlighted the danger for deprived communities of project saturation (101).

2.3.1.4 NHS + others A range of initiatives have been identified with regard to collaboration between the NHS and other partners:

• NHS Direct, the Department of Health and Thomson Local telephone directories have produced a new health guide in phone directories (77).

• In Somerset, Signposts Information service is a referral service for the local community on health, social care and council issues and is operated in conjunction with Care Direct, NHS Direct and Somerset County Council (41).

• Healthy Living Centres have been established in 350 UK centres including Firthmoor in the north east of England (101) to target the disadvantaged and provide a range of services including health promotion/education, activities and health classes. Partners include primary care trusts, local authorities, charities and voluntary organisations (43).

• CarePlus (a local information service for users and health/social care providers of health in the Trent region) is project managed by NHS Trent, the School of Nursing and Midwifery and Sheffield University (46).

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• Glasgow Health Information is a gateway for health information and learning resources and is a partnership of Greater Glasgow NHS Board and voluntary, council, NHS and educational organisations (39).

• The Action Diabetes Bus in Slough (providing health promotion and health testing) is run by Slough Primary Care Trust with other agencies (94).

2.3.1.5 Academic institutions + others The Help Yourself Database is a partnership of the Department of Information Studies, University of Sheffield and Voluntary Action Sheffield. It is a signposting service providing (amongst other subjects) a guide to health and community care groups and organisations in Sheffield (42).

2.3.1.6 Role of the voluntary sector The Department of Health Strategic Agreement launched in September 2004 between the NHS, the Department of Health and the voluntary and community sector (VCS) outlined a framework for all these agencies to have a more central role in supporting or providing NHS services. Current best practice examples identified include: NHS Direct and Coalition for Cancer Information to kitemark patient information; Brent Primary Care Trust Patient Advice and Liaison Service (PALs) and Brent Association for Disabled People providing advice surgeries (with British Sign Language interpreter) for the deaf community (80). The National Strategic Partnership Forum (NPSF) launched in February 2005 aims to review how the Strategic Agreement will work, co-ordinating best practice and innovation in England and disseminating this across health and social services (79).

A further example of collaboration between voluntary organisations and other partners is Healthy Living Centres (43). Young Minds (a children’s mental health charity) provides a signposting service to a range of counselling/support/drop-in centres for socially excluded young people with mental health or social issues. The centres are based in Bradford (88), Cardiff (85), Manchester (87) and Croydon (86). The charity also produced a report on examples of good practice in planning and providing services for the mental health of black and minority young people (89). Such examples include Bedfordshire’s Campaign Against Living Miserably (CALM) (helpline, newsletter, website for young men with depression) and a range of children’s services for counselling/support for mental health issues in the London Borough of Croydon.

2.3.1.7 CAB role The Citizens Advice Bureaux in Scotland are in negotiations with the Scottish Executive’s health department to provide an advice service to patients and staff. The Bureaux are increasingly playing a supporting role to patients/families in providing information on practical/legal help, easing the burden of healthcare professionals (68).

2.3.1.8 Working with local community Community-based projects will by definition require the co-operation of the local community in order to operate successfully - whether this is the location of the service (e.g. use of community centres), or the resources required to provide the service (possibly drawing on local community voluntary assistance).

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2.3.2 The changing role of public libraries The West Midlands South Strategic Health Authority Conference identified the importance of public libraries in ensuring the public has as access to as wide a range of consumer health information as possible (20). Public libraries were also identified as one of four UK models of delivery for public health and social care information by a report published in 2004, with the provision of a signposting (rather than advice) service (21). Interview findings from a Durham and Teesside Health Libraries Alliance project indicated that public libraries have an important role to play in the provision of consumer health information in the Durham and Teesside region (54). However, perceived barriers such as interactions with public library staff and the differing perceptions of the public library as the place for health information need to be overcome (9). The Books on Prescription Scheme is an ideal project to bridge the gap between the traditional library role and the library as provider of health information in partnership with health services. The scheme has been adopted by several public library authorities (83) (90) and illustrates the beneficial partnerships public libraries can establish with the NHS. Gloucestershire public libraries have taken this example a step further with the appointment of a departmental ‘champion’ for health and social care issues, to liaise with local social services (83). A further example of the changing role of libraries could be to satisfy the demand for the provision of multi lingual health information (74).

As more information becomes available electronically, libraries can fulfil an important role by providing training and mediation in internet use. The Senior Health Project for Access to Electronic Health Information, a US-based partnership with the Pacific College of Oriental Medicine medical library, a church-based clinic and a community centre provides, amongst other services to its users, computer training workshops (18). In the UK, a report in 2004 identified plans to establish a national library for health using electronic resources and NHS library collections. This was initiated in response to the threat to libraries of Internet search engines and networked information facilities (67). However, such a facility requires trained users and so represents an opportunity for libraries to extend their role.

2.4 Delivery 2.4.1 Technology Technology can play a key role in the delivery of public health and social care information to the consumer.

2.4.1.1 Digital interactive TV The provision of public health information via digital interactive television has so far proved successful. The Department of Health funded a study in 2001 to pilot four pilot digital interactive television services in the UK to provide consumer health information via text, video, interactive and transactional services (71).

A more recent report reviewed the take-up of Living Health (a pilot digital interactive television health information service) by cable TV subscribers in Birmingham, where success was also highlighted. Over 8 in 10 users found the service easy to use and understand and more than one third of subscribers visited the digital health TV site at least once during the 20 week pilot period (37). Digital interactive television may fill the gap for consumers not yet linked to other forms of technology, but its success is dependent on the usability and effectiveness of the service available (33). In December 2003 the Department of Health announced the launch of a pilot NHS Digital television service, to provide

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information via images and video clips on NHS services (directories of GPs, dentists), treatments, healthy eating and self-care advice (76). A year later, NHS Direct Interactive was launched, to be available via digital satellite television, but by 2005 via Freeview and cable (81).

Reviewing user characteristics and services available through digital interactive television, a 2003 study of a pilot service found that users tended to use the text-based service, as opposed to the videos provided. Further, users tended to be keen information seekers, viewing the service as a first port of call for general information, before more in-depth enquiries (to be made at a later date) (34).

The future for digital interactive mediums for health information may be the use of interactive televisions by the bedside, or the use of digital radio to transmit information (36) and the possibility of ordering repeat prescriptions (76).

2.4.1.2 Health information kiosks By 2003, there were over 70 health information kiosks located throughout the UK, sited in a wide variety of locations including hospitals, pharmacies, supermarkets, information centres, community centres, NHS Direct, InTouch with Health, Wellpoint Health Centres, Department of Works and Pensions and GP surgeries. Levels of use and success of health information kiosks are affected by a range of factors: location (57), proximity of kiosk to the user, specific purpose of the kiosk, computer literacy of user, quantity and comprehensiveness of the information, user’s perceptions of authority (32), lack of engagement by health staff (23), the economic well-being of the area and word of mouth from other users (62).

2.4.1.3 Internet The Internet is a significant part of the provision of public health and social care information. As well as providing access to a wide range of UK/international health information websites, the Internet is also used in a range of local settings e.g. Glasgow Health Information – Internet portal for web-based health information for public access (39); CarePlus - local health and social care information website in Trent (46).

Variability in the quality of public health and social care information available via the Internet has been an issue of some concern. Projects such as the JUDGE project aim to address this by developing guidelines for consumers looking for health information on the Internet and judging the quality of websites located (44).

Both younger and older members of the public have Internet experience. The Internet is increasingly being accessed for health information by older patients (56) and 11-19 year olds had extensive Internet experience, using this delivery format for information on health and medicines (66). In 2004, a British Life and Internet Project survey concluding that those in poor health were 10 – 13 times more likely to have participated in an online support group and those aged 65 and over were four times more likely to email their GP (27). Factors affecting non-Internet use (specifically by adult carers) included age, gender, socio-economic status and caring responsibilities (52).

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2.4.2 Methods of delivery 2.4.2.1 Libraries Libraries (public, academic and health) all need to play a part in addressing the needs of health and social care information provision to the public. The Internet and networked information facilities are proving a threat to the place of the library as the key information provider (67) and libraries must respond to such changes. Public libraries, in particular, can assist the socially excluded by the provision of free, readily accessible health and social care information. The West Midlands South Strategic Health Authority Conference in 2004, for example, identified public libraries as key in ensuring that the public has access to a wide range of information resources (20). Hospital libraries in the USA are ensuring the future of their place as health information providers by both collaboration and marketing of their services (11). Whilst hospital libraries in the north east (specifically those in Durham and Teesside) may not wish to provide direct public access, they recognise the need for both signposting services and partnerships (54). Libraries need to become more high profile as an information source, particularly for those members of the public receiving home care, who at present (according to recent research findings) have rarely used libraries to satisfy their information needs (51).

2.4.2.2 Helplines Helplines are presently used primarily to assist in the provision of social care information. Examples include the Black Health Agency (Manchester) providing a helpline for cancer and AIDS sufferers (87), and Guide-line (Bradford) offering a helpline for sufferers of mental illness (88). The aims of such helplines vary from the provision of a signposting service, to providing in-depth counselling.

2.4.2.3 Community centres/drop-in centres As with helplines, community centres or drop-in centres are being used essentially to provide social care information to the public. Examples include Men-Zone in Bradford with a drop-in facility for males with mental health or emotional problems (88) and the 4 Winds Association which also provides a drop-in advice service also for sufferers of mental illness (85).

2.4.2.4 Multi-purpose customer service centres The multi-purpose customer service centre may be the way forward for the all-encompassing provision of public health and social care information. The Ebbisham Centre in Surrey (47) and Bunny Hill in Sunderland (84) provide two examples of such centres. They require multi-agency co-operation and partnership (local authorities, housing groups, primary care trusts, private sector) but can satisfy a wide range of community needs from fitness, to education, to information, social interaction, to training and health provision. Whilst the initial outlay (in terms of building costs, relocation, inter-agency training) may be high, the long term benefits to the community should be considerable (i.e. accessibility, convenience and gaining a wider perspective of health issues).

METHODOLOGY


3. Methodology The field work was undertaken by a team from LISU, the Department of Information Science and the Pilkington Library at Loughborough University, between September and November 2005. An extensive literature review was undertaken to provide background for the study (see Section 2). Questionnaires were used to gain evidence of current practice. A focus group provided valuable information on the key issues and barriers as experienced in the North East, and in depth interviews were conducted with key stakeholders to give a broader context to the findings.

This section describes the methodologies used; results from each of the three strands have been synthesised and are reported in the next section.

3.1 Questionnaires Examples of current practice were sought by a questionnaire survey of public libraries, primary care trusts and social care departments in the region. In all cases named contacts were obtained in an attempt to target the questionnaire:

• In Primary Care Trusts, questionnaires were sent to Patient Advice and Liaison Service (PALS) managers

• For social care, the names of relevant contacts in social care departments were obtained from a local member of the Association of Social Care Communicators (ASCC)

• Public libraries were contacted by telephone for the name of the person responsible for health and social care information provision

A slightly different version of the questionnaire was devised for each sector to try to overcome the differences in their objectives and language. A list of contacts and copies of the questionnaires are given in Appendix 2.

The questionnaires provided a useful summary of current practice. Respondents were also asked for ideas for and barriers to ideal provision of health and social care information to the public. These were very helpful in devising the model for future provision. A list of the ideas and barriers given by respondents is given in Appendix 3. Several respondents also provided examples of promotional and other material and this is listed in Appendix 4. Several of the initiatives are described in section 4.2 of this report and a full list is given in Appendix 7.

3.2 Focus group Key providers from the three sectors were invited to take part in a focus group held at NEMLAC offices. Eight people attended with representatives from all three sectors. Participants were asked to write ideas on ‘Post-it’ notes, these were then grouped and used as a basis for discussion. Notes from the focus group (including a list of attendees) are given in Appendix 5.

METHODOLOGY


The focus group was a very successful method of eliciting ideas and promoting discussion. Representatives from the three sectors found much in common and expressed interest in more regular cross-sector meetings. This factor features strongly in the proposed model.

3.3 Interviews Telephone interviews were arranged with key national and regional stakeholders from the three sectors. A semi-structured interview method was used with questions based on the themes emerging from the strategic review. However, the interviews were tailored depending on the expertise and/or interests of the individual interviewee.

The interviews revealed the very wide range of policies and guidelines which feature in information provision to the public. Despite this range, there was consensus on several points which again demonstrates the potential for collaboration across the sectors. Further information on the interviews and a summary of the discussions are given in Appendix 6.

RESULTS


4. Results The results are given in two sections. Section 4.1 summarises the responses from the investigative stages and Section 4.2 outlines examples of current good practice in health and social care information provision to the public in the North East.

4.1 Summary of responses

The problem is not lack of information …but messages about health are sometimes inconsistent or uncoordinated (Choosing Health)

This section summarises the key issues raised by stakeholders at all levels during the data collection stages of the study. In particular, the responses revealed the barriers to ideal provision, particularly barriers to collaborative working. Further details of the questionnaire responses, focus group and interviews are given in Appendices 2 - 6.

4.1.1 Current and changing roles: opportunities and barriers The study revealed areas of overlap between all three sectors, but also differences in their individual target client groups and visibility of relevant staff and resources to the public. Therefore, an outline of the services provided and the views expressed by each sector are summarised below.

4.1.1.1 Public Libraries Information provision is the major part of the library’s role but there is an increased emphasis on the provision of health and social care information. This role is embraced by respondents to the questionnaires and also by the focus group participants. However, the main barrier noted by all respondents was lack of resources. None of the libraries had a separate budget for health and social care information provision and no dedicated member of staff. However, libraries within the region provided several examples of initiatives from leaflet display through special collections to providing meeting place for groups (see Section 4.2 and Appendix 7). There was some evidence of partnership work, mainly with PCTs and the voluntary sector.

4.1.1.2 Health Within the health sector, questionnaires were sent to PALS Officers (Patient and Public Liaison Service) and/or Patient and Public Involvement Officers) within the North East. PALS and PPI have a remit of information provision to the public, and so have separate resources (staff and budget). In health, information to the public is part is of the national agenda, for example the NHS Direct Service is now available by phone, online and interactive TV. From the questionnaires and focus group, the information role of PALS officers includes production and dissemination of information. This includes leaflets, telephone service and websites. Dissemination is mainly to health locations, but some also mentioned public libraries; PALS also work with the voluntary and social care sectors. Promotion of the services is an important part of the role, and officers visit events and organisations to publicise the service. North of Tyne PALS also mentioned the use of volunteers, mainly within hospitals to signpost the public to PALS officers.

RESULTS


4.1.1.3 Social Care Social Care is part of same government department as health (Department for Health) and information is also increasingly part of the Social Care agenda. However, it was more difficult to obtain local views. A key organisation is the Association of Social Care Communicators, and North East members of this organisation were sent questionnaires. Although the response rate was low, the respondents provided some insight into how information was generated and disseminated in Social Care departments. Most importantly, it revealed that at least some departments have staff with the role of co-ordinating information. The main role of respondents to the questionnaire was to oversee the quality of information used by the department; this included production of information, which often needed to be targeted to a specific group, and also training to all staff and contractors. Although the response rate was poor, due to initial difficulties with contacts, the evidence provided suggested an increasing awareness of information provision within the Social Care sector backed up by enthusiasm and skills.

All sectors demonstrated considerable current activity in the area of health and social care information provision, and also provided ideas for future provision. However, it is interesting that whereas not all questionnaire respondents listed ideas for future provision, they all provided barriers (see Appendix 3). Therefore, the following sections highlight problems with current provision and these issues form the basis for recommendations for future provision (Section 5).

4.1.2 Targeting health and social care information The focus group provided an ideal opportunity to discuss awareness of current information provision. Several examples of current and planned provision were mentioned, many in partnership. However, examples of gaps in knowledge and also duplication were also revealed. For example, it was noted that within Darlington there were several outlets for health and social care information claiming to be ‘one stop shops’ (not necessarily provided by the sectors involved in this study).

It was clear from the focus group and questionnaires that information overload and duplication were a problem. However, there was also the clear message from all strands that a multi channel approach to information provision was needed. Without collaboration, this only adds to duplication. It was agreed that knowledge of the target audience was important and partnership working was essential to maximise this. Several respondents mentioned putting information where users/potential users go. The potential of the public library was recognised, particularly by interviewees. The benefits mentioned included: neutral space, information expertise, internet access, knowledge of local communities.

An important library role was seen as providing access to internet resources, including training to the public and guidance, particularly in health and social care information sources. This was mentioned by all sectors and in all strands of the data collection. Several examples of current provision were given by questionnaire respondents. For example, Newcastle Library Service has links to NHS Direct recommended websites from the library’s web pages; Sunderland Library Service has a Community Information Database and Redcar and Cleveland Library Service have a Virtual Health Library. The interviews explored views about the quality of internet sources. Most interviewees considered the initial fears about quality of health information unfounded, but agreed that the public needed guidance in use. Internet resources are also important for staff in all sectors, to provide information which can be reproduced in another format, and as a back up to consultations, for example

RESULTS


Patient.co.uk (www.patient.co.uk) is used by doctors to print off leaflets for patients, as well as providing a quality site for the public.

4.1.3 Training Lack of training was seen as a barrier to the provision of health and social care information to the public. This issue was expanded during the Focus Group, with one participant noting the increasing number of health enquiries of a difficult and sensitive nature received by the library. Questionnaire respondents felt that training was needed to expand their role in information provision, for example library staff need training in communication skills to deal with sensitive enquiries; another point raised was that no one person or service can deal with all enquiries and so signposting was essential; therefore awareness of other resources and services is required. Although specific cross-sectoral training was not in evidence, organisations did promote their services to other sectors. For example, North of Tyne PALS provided a presentation of its services to Northumberland Libraries; Middlesbrough Libraries, South Tyneside Libraries and Stockton Libraries all mentioned outreach work to promote services.

Training within libraries tends to be on a cascade basis. Within other sectors it may be more formal. For example, the Communications Department at Redcar and Cleveland Social Services provides training to all staff including contracted providers to ensure effective communication with service users; North of Tyne PALS provides training as part of the NHS induction for staff.

4.1.4 Evaluating services Two aspects of evaluation were mentioned by respondents:

4.1.4.1 Evaluating services and uptake of services Libraries usually count enquiries and some are moving to counting health and social care issues separately to general issues. However, the benefit of more specific monitoring was demonstrated by Gateshead Library. Gateshead was involved in a national study of impact measures in the library service, and measured the impact of health information. The results demonstrated the benefit of libraries to health and well being beyond the use of health stock and the library is now a key player in Gateshead’s drive to improve health and well being in the area.

Further examples of evaluation were evident in the health and social care sectors. For example, the Customer Services and Marketing section at Newcastle Social Services evaluate publicity material; South Tyneside Resource Service produce information in consultation with partners.

An example of collaboration in evaluation was provided by Stockton Libraries, which is part of a multi-agency team (including health and social care) which arranges annual ‘are you being served…well?’ days to obtain feedback on services for older residents of Stockton.

4.1.4.2 Evaluating the information provided. Evaluation of information is a key part of the library service role and was mentioned by respondents in all sectors: the public library was seen as an essential provider of quality information. In particular, the role of the library was important in guiding the use of online resources (see above). However, some librarians also raised the issue of the lack of print resources of an appropriate level.

RESULTS


The NHS has national guidelines for information provision to the public and these are disseminated throughout trusts. Respondents from the health sector mentioned the use of patient fora to highlight information needs and to evaluate information.

Respondents from the social care sector had responsibility within their organisations for the quality of information, in particular ensuring the content and format were appropriate to the audience.

Participants in the focus group stressed the need for professional information skills to effectively produce and disseminate health and social care information to the public.

4.1.5 Collaboration: advantages and barriers The data collection stage included interviews with regional and national stakeholders. Interviewees saw partnerships as a way of maximising resources, especially through the exchange of skills. In general, interviewees did not see funding as a problem and one interviewee noted that partnerships were key in securing funding, but must be working to defined outcomes. However, questionnaire respondents and focus group participants were more concerned about funding. Several had been involved in successful projects which had to end when funding ended. Funding was seen as too dependent on current policies and organisations, with good ideas and working partnerships lost when agendas changed. Lack of funding was seen as a barrier to projects within organisations and also to collaborative working. However, the major barrier to partnerships was cited as initiating and maintaining contacts. Participants at the focus group stressed the importance of strategic level involvement to the success of projects, particularly in collaborative working.

This section has highlighted some of the problems in health and social care information provision. However, there are many examples of good practice throughout the North East region and a selection of these are given in the next section.

RESULTS


4.2 Examples of best practice Selected examples from the questionnaire survey are described below and a full list is given in Appendix 7. Organisations across the three sectors provided examples and also suggested ideas for future provision. Most of the examples are extensions of their usual role, often in partnerships with other organisations. However, there is considerable scope for more focused activity if collaboration can be co-ordinated across the region (see section 5.1).

4.2.1 Electronic access Public library is key point in the community for providing online access (questionnaire respondent)

The internet is recognised as an important source of health and social care information, but it is not available to or appropriate for everyone. There are also concerns about the lack of control over content. Information providers in the three sectors play an important role in providing access to the internet, training users, and guiding users to appropriate content.

• Guides or portals to quality health sites were mentioned by Newcastle Libraries (in collaboration with NHS Direct); Sunderland Libraries and South of Tyne and Wear Mental Health Trust although most of the organisations provide links to useful sites from their own websites.

Newcastle Libraries Services – Virtual Reference Library – Health Links

• Sunderland Libraries has a Community Information Database listing societies and support groups in the area. Societies are actively sought by scanning local press etc; as a result of this process Sunderland Libraries provided assistance to a local group of amputees (TAGS – the Amputee Group of Sunderland) to design and launch a website, the library service mediated to provide funding from the e-government section of Sunderland Council.

RESULTS


4.2.2 Hitting the right targets

Information in more innovative (real!) places – places people visit to relax. (‘idea’ from questionnaire)

Printed sources remain popular and are particularly useful to support advice, for example during consultation with a doctor. Technological advances have made access and production of material easier. However, there is a danger of overload and professional information providers play an important role in selecting, producing and targeting information.

• Books on prescription is a national scheme involving PCTs, Mental Health Units and Libraries: patients with mental health issues are ‘prescribed’ books which are provided by the local library; within the North East region, this service is provided in Middlesbrough, Redcar and Cleveland, North Tyneside and Gateshead involving the library service and PCT.

Books on Prescription service: Middlesbrough Libraries and partners

• Northumberland Libraries provide support to students whilst on placement in the county,

this also increases stock for library customers; the scheme supports the Department of Health ‘Expert Patient’ programme and includes several partners in the region such as Northumberland Tyne and Wear Strategic Health Authority, NHS Libraries and Northumbria University.

RESULTS


• Redcar and Cleveland Libraries hold a collection of books provided by the Health Libraries Alliance for use by health service professionals, but available to all library users.

• Stockton Libraries have a reminiscence therapy collection, which is available for loan.

• Directories of targeted services are provided by several of the respondents in the health and social services sectors, for example Newcastle, North Tyneside and Northumberland Mental Health Trust produces a Mental Health Services directory, a Carers directory and an Ethnic Services directory

• Leaflet display is common to all of the responding organisations. It is common practice to make leaflets available to other agencies, so leaflets on health and social care are available in several locations including PCT offices, hospitals, GP surgeries, pharmacies, Social Service offices and libraries.

• Libraries may use the mobile/home service for targeted leaflet distribution e.g. Hartlepool has a target within its Library Plan to provide relevant and useful information to its Home Library Service users; Stockton Libraries distribute leaflets for other agencies, for example information on smoke alarms for the Fire Service.

• Darlington Social Services’ Information for All project produced DVDs/Videos outlining public services in Darlington. Versions were available in community languages and BSL. The project involved several partners including Durham Constabulary, Darlington PCT and NHS Trusts in the area.

Darlington Social Services: poster for ‘information for all’ DVDs/videos

RESULTS


4.2.3 The personal touch We need to turn staff into good communicators (questionnaire respondent)

Many people prefer face to face contact, particularly for personal health and social care issues (rather than general information or health promotion). Although health and/or social care professionals are the obvious providers of such information, other agencies can play an important role in signposting effectively.

• Several organisations visit events or groups to promote awareness of their services, this includes Middlesbrough Libraries, South Tyneside Libraries, Durham Dales PCT Patient Advice and Liaison Service (PALS), Stockton Libraries, North of Tyne PALS

• Organisations may also act as host to voluntary and statutory agencies for displays and meetings for example South Tyneside Libraries host displays in collaboration with South Tyneside Health Promotion team; Stockton Libraries host a PCT showcase and hold Library Health Club meetings every month.

• Drop in sessions for health checks and other advice are provided at Middlesbrough Libraries, South Tyneside Libraries, Patient Information Centre Newcastle General Hospital and Gateshead Libraries.

• Bunny Hill Centre, Sunderland (planned opening May 2006) will provide a purpose built site incorporating library, PCT, Wellness Centre, Community facilities etc. It is a joint venture with several council departments and the health sector. Sunderland Library Service is seeking an active role within the centre to demonstrate the potential of the library service and hopes to obtain funding for a Community Health Information Officer.

4.2.4 Maximising professional input Library staff are not health professionals – if they are to take a greater role than at present in terms of health information provision they will require greater knowledge/in depth training (‘barrier’ from questionnaire survey)

All of the above methods require professional input to ensure quality of content and delivery. Information staff require training on their own and other services, but can also provide training within their own organisations and beyond. Information professionals can also offer valuable advice on targeting information for different audiences.

• Staff at Northumberland Libraries receive training from organisations in the health sector to raise awareness of resources and other providers.

• The Communications Department at Redcar and Cleveland Social Services provides training to all staff including contracted providers, stakeholders and commissioned service providers to ensure effective communication with service users.

• Northumbria Healthcare NHS Trust has a Patient Information Policy with clearly laid out objectives and guidelines for producing patient information, including evaluation of information by the public.

RESULTS


• Sedgefield PCT uses panel of local people to evaluate leaflets and other written information.

• Newcastle Social Services, Customer Services and Marketing has guidelines for staff producing information, which includes details of house style and advice on producing targeted information. Planning and evaluating information are seen as important parts of the section’s role and the service has won a Community Care Communication Award for their campaign to promote fostering in the Black and Minority Ethnic Community.

4.2.5 Didn’t we do well? Monitoring the impact of service provision is essential to demonstrate the value of services within the region and beyond, both to secure support and as an example of good practice for other providers.

• Gateshead Libraries measured the impact of health information as part of a national study of impact measures in the Library Service. This provided valuable evidence of the benefits of libraries to health and well being, beyond use of health stock. 97% of respondents found the health information they had obtained from the library ‘useful’ and 57% said the library service contributes positively to their health or well being (Price Waterhouse Cooper 2005). As a result the library service is regarded as a key part of Gateshead’s drive to improve health and wellbeing in the area.

• The Priority Services Officer at Stockton Libraries is part of multi-agency team (including several departments at Stockton Borough Council and the health sector) which arranges annual ‘are you being served….well?’ days to obtain feedback on services for older residents of Stockton.

CONCLUSIONS AND RECOMMENDATIONS


5. Conclusions and recommendations There is evidence of a wide range of provision, with no shortage of information available. There are enthusiastic and professional providers in all sectors. However, collaboration is needed to maximise the individual skills apparent in the three sectors.

Libraries emerge as having great potential. They are viewed by both the public and other providers as a neutral space and as a recognised ‘place’ for information. However, there is also potential to extend their role and this may be more challenging.

Overall, four barriers were identified by the research:

• Information Professionals lack awareness of available resources – both within and between organisations

• There is duplication of effort and information overload by Information Professionals (related to above).

• There is a need to raise public awareness of where to go for information. This also relates to the placing of information; many respondents to the questionnaire noted the value of placing information in ‘non-health/social service’ locations.

• There is a current lack of staff training across all three sectors (Health, Social Services and Public Libraries) in information skills, people skills and dealing with queries outside own profession.

The barriers are related as lack of awareness of available resources by professionals leads to duplication of effort and public confusion. The current situation is illustrated by Figure 1.

Figure 1: The current model health and social care information provision: many providers, little co-ordination, duplication of effort.

Other statutory providers

Private sector

Voluntary sector

Public library

Social services

Health sector



5.1 Recommendations

Coming up with a win/win situation (Questionnaire respondent)

The following recommendations outline ways to move from the current model to a more coherent model which spreads good practice across the region (Figure 2).

Figure 2. An ideal model of health and social care information provision: many providers; co-ordinated provision; exchanges of information.

It is imperative that a “kick start” is given to these recommendations and in the short term they can be developed without specific resources being allocated. However, it is acknowledged that if the recommendations are strategically adopted extra resource allocation will be required to maintain and develop the processes begun in the initial period. Also a strong network of communication will need to be established to develop effusive collaboration around health and social care information provision in the North East.

5.2.1 Developing the evidence Within the health setting, evidence based practice is deemed a central strand in the process of effective decision making. In order to take the work forward, mirroring this approach is recommended. Small scale projects should be originated that will pilot and monitor various health and social care information activities. By embedding evaluation processes from the outset, intelligence will be generated to disseminate and inform future patient information developments. Three projects are suggested:

1. Training needs analysis of South Tyneside public librarians involved in delivering health information

2. Darlington Social Services evaluation of the effects of improved liaison with the public library and NHS

3. North of Tyne PALS evaluation and dissemination of work relating to outreach to other sectors

Other statutory providers

Private sector

Voluntary sector

Public library

Social services

Health sector



5.2.2 Providing direction and linkage for Information Professionals The project has successfully identified examples of good practice very often in the same geographical area. There is a low level of awareness of this local good practice. At the same time it is crucial that the recommendations are the responsibility of a group and are proactively taken forward

4. A Steering Group should be established that has responsibility for delivery of the recommendations. This could consist of some North East enthusiasts along with people at the strategic level. Many individuals who took part in the focus group expressed a willingness to participate in further cross sector collaboration.

5. A short term project plan should be developed with timelines to complete the work resulting from the recommendations.

6. Brokerage arrangements should be set in place to bring together people working in similar areas who would benefit from collaboration.

5.2.3 Dissemination Having effective dissemination of the project and resulting opportunities will largely depend on ensuring the outcomes are conveyed to all the major stakeholders.

7. There should be a regional launch of the project report to which key players at sub-regional, regional and national level are invited.

8. Three sub regional dissemination events should also be delivered.

9. A executive summary should be circulated throughout the Region to public libraries, NHS and Social Services asking for comments and responses.

10. The identified examples of good practice should be prominent in 7-9 above.

11. The NEMLAC website should act as the major mechanism to distribute (in the short term) good practice/recommendations/summary from the project.

5.2.4 Resource allocation This project has shown that funding is not needed to develop more patient information outputs or to set up new patient information services. However an element of time commitment is essential.

12. All agencies/organisations engaged in the collaboration process must gain strategic commitment for Information Professionals to be involved in the process: time away from the routine job is required to develop contacts, attend meetings and share knowledge. The knowledge base cannot be developed without this commitment.

13. Included in this short term work is the action to contact various possible funders

(charities/ Strategic Health Authorities/ Social Services/ Local authorities) to generate funding for the medium to long term.



5.2.5 Ownership of Recommendations It has become apparent that there is a need for an umbrella organisation to take ownership of the recommendations in the short term and so assume responsibility for taking them forward. It is also apparent that NEMLAC is the obvious organisation to fulfil this role. In the medium to longer term, there will still be need for a facilitating organisation and a local university or NHS Trust may be more appropriate. In developing these recommendations, the project team were very much aware that there were areas of overlap between all three sectors, but that there were also differences in their individual target client groups and visibility of relevant staff and resources to the public. The development of generic recommendations is especially difficult in this context.

There is already a significant quantity of health and social care information available to the public from a number of providers in the North East. Where the resources are lacking is in the systems and processes to develop linkages and partnerships to support effective, efficient and innovative patient information and patient information services. Addressing some of these issues in the short term will demonstrate the benefits of a co-ordinated service and the results can be used to develop a longer term strategy and as evidence in bids for funding.

REFERENCES


6. References Department of Health (2004), Choosing health: making healthier choices easier. London: TSO

Department of Health (2000), Information for social care: a framework for improving quality in social care through better use of information and information technology. London: TSO

North East of England Health Summit 2003. Available from www.nepho.org.uk.

Price Waterhouse Cooper 2005, Libraries impact project. London: Laser Foundation. Available from www.bl.uk/about/cooperation/laser-pubs.html

Weisen, Marcus 2004, New directions in social policy: health policy for museums, libraries and archives. London: Museums, Libraries and Archives Council

Appendix 1: BIBLIOGRAPHY


Appendix 1: Strategic Review - Bibliography

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83. Middleton (2005). Prescription for healthy partnership. Public Library Journal Autumn 13-14

84. City Talk (2005). Bunny Hill gets stoned. Sep, (44) 6

85. Young Minds (2004). Minority Voices Cardiff. Where to go when you are feeling low

86. Young Minds (2004). Minority Voices Croydon. Where to go when you are feeling low

87. Young Minds (2004). Minority Voices Manchester. Where to go when you are feeling low

88. Young Minds (2004). Minority Voices Bradford. Where to go when you are feeling low

89. Kurtz, Z et al (2005). Young Minds Research. Minority Voices. A guide to good practice in planning and providing services for the mental health of black and minority young people

90. Weisen, M (2005). Cornucopia of health – widening the contribution of museums, libraries and archives

91. Department of Health (2004). Making partnership work for patients, carers and service users: a strategic agreement between the Department of Health, the NHS and the voluntary and community sector

92. Department of Health (2001). Information for social care: a framework for improving quality in social care through better use of information and information technology

93. Department of Health (1998). Information for health: an information strategy for the modern NHS 1998-2005

94. Department of Health (2004). Choosing health: making health choices easier

95. Museums, Libraries and Archives Council (2004). New directions in social policy: health policy for museums, libraries and archives

96. Museums, Libraries and Archives Council (2003). Framework for the future: action plan 2003-2006.

97. Museums, Libraries and Archives Council (2003). Creating access to the National Electronic Library for Health in public libraries.



98. Museums, Libraries and Archives Council (2004). Partnerships in practice: empowering the learning community demonstration projects evaluation report

99. NHS Expert Patients Programme

100. Young minds: research (2005). Minority voices: research into access and acceptability of services for the mental health of young people from black and minority ethnic groups

101. North East Public Health Observatory (2003). North East of England Health Summit

102. North East Public Health Observatory (2004). Towards a healthier North East: a profile of health and its determinants in the North East of England

Appendix 2: QUESTIONNAIRE SURVEY


Appendix 2: Questionnaire Survey

1. Summary of responses 2. Questionnaire recipients 3. Questionnaires 1. Summary of questionnaire responses

Public Libraries Responses were received from 11 of the 12 library services in the region.

Libraries’ role is information collection and dissemination, therefore they seek to make information relevant to clients needs (either expressed or as part of policy) – this includes health and social care. Increasingly libraries offer a neutral space for activities which are proved to promote well being such as learning and social activities, as well as space for health related events and displays. This role is taken seriously in the library community at all levels.

From the eleven responses received the following points emerge:

• None have a specific ‘health librarian’, responsibility for provision of health and social care information rests with the community librarian or information services; provision is team-based

• Health and social care information is seen a part of normal duties not something requiring a specific amount of time

• No separate budget, but one library had funding for a special project (three years funding); another library had a bid for funding a Community Health Information Officer

• Libraries provide several services related to health and social care information provision, for example an enquiry point, collections, and special initiatives with partners

• Majority of staff receive some training in provision of health and social care information – usually cascaded down, but one library service had training by outside organisations (PCTs, NHS Direct).

• Collection includes books and journals, and to lesser extent multi-media; leaflets are often provided and library is an important outlet for PCTs, Social Care departments and voluntary organisations; Leaflets are provided in central, branch and mobiles and one library noted that they distribute to housebound readers.

• Libraries are also important in providing access to online health and social care information for those who do not have internet access. Several libraries produce printed guides to quality sites and/or have links on their home page



• All libraries provide assistive technology items, and staff can readily access leaflets in alternative formats

• No libraries currently provide training in health and social care information provision to the public

• Most of the libraries undertake some promotion, usually of special initiatives. General use of health and social care information is measured by issues and enquiries. Three of the libraries mentioned impact measures. One library had been part of a study of impact measures focussing on health information and used questionnaires in addition to issue count. This provided evidence of the role of libraries in health and social care information provision and in promoting general ‘well being’.

• All of the libraries had worked with partners to some extent – at the minimum level this involved leaflet distribution, but several had more specific initiatives. The most usual partners were PCTs and voluntary organisations, but four of the libraries had active contact with social care departments.

Of the responding libraries, 10 gave examples of good practice, 10 gave ideas, and 11 barriers!

Health and Social care Although different sectors, they form part of the same central government department and so share some agendas. Both sectors take information provision seriously, and guidelines are set nationally. However, tends to be a ‘captive audience’ – information is very much aimed at those already in system – this applies to both content and dissemination. Information is corporate – what client needs to know to use/get best from/understand service. Within this sector there is an additional definition of information – that of data used by managers and others to provide the service. Although this was not a problem for this project, it does need to be recognised when planning partnership activities. These sectors are good at co-ordinating information, and attempting to target/format appropriately. The public are often used to evaluation and pilot information output. This project has found evidence of partnership working and the focus group and interviews raised awareness of the potential of public libraries in health and social care information provision.

Social care Four of the 12 social services departments returned completed questionnaires. Although response was rather poor, those who did complete questionnaires provided much additional material and demonstrated the enthusiasm and co-ordination of information provision within their departments. Evidence of good practice in social care sector was also sought from other departments in the UK via the Association of Social Care Communicators. Valuable input was also received from the Commission for Social Care Inspection (CSCI) which has a statutory duty to ensure quality information on social care services is available to the public in England 2.

2 Banerji, Robin. Reaching our target audiences, Presentation at the 2005 ASCC Conference.



The major role of the NE respondents was co-ordinating information provision within the social care department. This involved ensuring quality of material in both format and content and offering advice and training to other staff.

The sections also produced information in the form of leaflets, websites and posters.

Special initiatives involved partnership working with libraries, PCTs and voluntary organisations.

All respondents gave examples of good practice, and ideas for and barriers to ideal provision.

Examples from other parts of the UK reflected those in the North East, with work concentrating on collecting and presenting information about services in ways appropriate to certain target audiences and with provision of guidelines and information provision.

Research within the UK demonstrates that 2, 3

• the majority of social care users/potential users prefer personal contact and tend to be information poor

• Many users experience difficulty in obtaining the information they need

• Technology should be used carefully and additional delivery methods used

• Partnerships with other organisations can play a big role in reaching target audience

Health sector Within the health sector, each Trust has a Patient Advice and Liaison Service (PALS) which has a key role in public liaison. A total of 24 questionnaires were sent to PALS managers, NHS Direct North East and the Patient Information Centre at Newcastle General Hospital (Newcastle, North Tyneside and Northumberland Mental Health NHS Trust). Ten responses were received.

All Primary Care Trusts, Acute Trusts and Mental Health Trusts in the region have good websites with many links

There is clear evidence of quality control and use of guidelines in production of information. Guidelines are set out by the NHS nationally and several of the respondents included details of how information production was co-ordinated or evaluated.

There are staff within all of the responding Trusts with specified role in health and social care information provision, spending 10-100% of their time on this role.

These specialist staff provide advice on health services via leaflets, websites, posters and in person (phone or office). Usual outlets are health locations – hospitals, GP surgeries 3 Continental Research (2005). Information sources: research report for CSCI. London: Continental Research



Seven respondents mentioned working with partners to some extent – partners included social care departments, libraries and voluntary sector. Main partner was NHS libraries.

Of the ten responses, four gave examples of good practice, three gave ideas for information provision and five gave barriers.

2. Questionnaire recipients (*denotes questionnaire returned)

Libraries To named contacts (obtained by telephoning each library service) in the 12 library authorities:

Gillan Gibson Darlington Library Service*

Nigel Canaway Durham Department of Culture and Leisure

Steven Walters Gateshead Library Service*

Eileen Tourrett Hartlepool Library, Arts and Information Service*

Diane Fleet Middlesbrough Libraries and Information*

Lynn Toy Newcastle Libraries, Information and Lifelong Learning*

Peter Hebden North Tyneside Library Service*

Eileen Parker Northumberland, Arts and Archives*

Ian Wilson Redcar and Cleveland Information and Communication*

Sandra Purvis South Tyneside Library Service*

Pam Wilson Stockton on Tees Libraries and Information Service*

Margaret Simpson Sunderland Libraries, Heritage and Information*

Health To Patient and Public Involvement Officers and/or PALS officers in the Primary Care Trusts; responses were also received from some of the Acute and Mental Health Trusts:

Clare Hinton Darlington PCT*

Pam Gwynn Derwentside PCT

Amanda Dexter Durham & Chester le Street PCT

Linzi Quinn Durham & Chester le Street PCT

Katharine Humby Durham Dales PCT*

Katrina Bage Directorate of Public Health, Easington

Clare Nesbit Gateshead PCT

Shirley Hazeldine Gateshead NHS Trust

Kevin Aston Hartlepool PCT*



Margaret Crawley Langbaurgh PCT

Mathew Thornton Middlesbrough PCT

Jackie Moon Newcastle PCT*

Catherine Lee North of Tyne PALS*

Karen O’Rourke Newcastle General Hospital (Patient Information Centre)*

Carolyn Siddle North Tees PCT*

Audrey Hetherington Northumberland Care Trust*

The Roundhouse Health Information Shop

Heather Inglis Sedgefield PCT*

Kathleen Sheeham Sedgefield PCT*

Caroline Wild South Tyneside PCT*

Deborah Spraggon Answers Health Information (Sunderland TPCT)

Mark Burns Sunderland Teaching PCT*

Gill Foster NHS Direct, North East*

South of Tyne and Wearside Mental Health Trust*

S. Harrison Northumbria Healthcare NHS Trust*

Social Services To named contacts (obtained via local member of ASCC) in the 12 Social Service Departments:

Julie Lumb Darlington Social Services*

Linda Lindsay Durham County Council

Lesley Kell-Shervington Gateshead Social Services

Rebecca Thomas Hartlepool Social Services

June Dickinson Middlesbrough Social Services*

Jill Clark Newcastle Social Services*

North Tyneside Social Services

Jackie Rutter Northumberland Social Services

Ann Simpson Redcar and Cleveland Social Services Department*

Judith Auty South Tyneside Social Services

Stockton on Tees Social Services

Catherine Rutherford Sunderland Social Services Department



3. Questionnaires and covering letter Health and social care information Review of public information provision in the North East LISU has been commissioned to survey public sector organisations in the North East which provide health and social care information to the general public. This is part of a project for NEMLAC (North East Museums, Libraries and Archives Council) and partners in the health and social care sector, which aims to identify current provision in the region, highlight best practice and develop a sustainable model for future provision. I would be grateful if you could complete the attached questionnaire with details about health information provision by your organisation. Much of the questionnaire only requires a ‘yes’ or ‘no’ response, but as the project aims to identify best practice further details of any initiatives would be particularly welcome: this includes initiatives you may have with other organizations, or projects you have heard about. There is also a brief section at the end of the questionnaire for your own suggestions. Please do not feel limited to the space provided on the questionnaire. A pre-paid envelope is enclosed for return of the questionnaire. If you have any questions about the project or the questionnaire, or would prefer to discuss health information provision in a telephone interview, please contact me. Many thanks for your time and co-operation. Kind regards Suzanne Lockyer Research Associate LISU

Appendix 3: IDEAS FOR ‘IDEAL’ HEALTH & SOCIAL CARE INFORMATION PROVISION


Appendix 3: Ideas for ‘ideal’ health and social care information provision

Respondents were asked for ideas for health and social care information provision in an ‘ideal world’; they were then asked to list barriers to provision. Responses (unedited) are listed below.

• Collections placed in self help venues – community houses, youth clubs, hospitals(Library)

• Mixed media health information sections – leaflets, periodicals, DVDs, dedicated PC (Library)

• Have regular ‘surgeries’ involving organisations such as Macmillan nurses, Alzheimer’s Society, cancer etc (Library)

• Having library points within GP’s surgeries (Library)

• Provision of a health information service/sessions in a library run by a health care professional (Library)

• Health care professionals, social services workers going out with our mobile library team, and also our housebound service (Library)

• Sharing databases with healthcare organisations so we could mail out relevant library health information/booklists (Library)

• A partnership of providers similar to the Community Legal Services Partnership which has been successful in creating a network and easing the passing of information (Library)

• A good selection of information leaflets automatically supplied upon production (Library)

• Probably work with partners to provide a dedicated bus with stock, IT and trained staff (Library)

• On line health information points in all libraries (Library)

• Information in more innovative (real!) places – bingo halls etc – places people actually visit to spend some time and relax not places they usually visit for a specific reason and leave ASAP i.e council building (Social Care)

• Info in post office (Social Care)

• Non social care buildings – people in social care buildings do need info but probably not as much as those who do not have any contact with social care services YET! (Social Care)

• Raise awareness by inclusion on TV soap storyline (Health)

• Looking at providing health information through key points in main towns of patch, in collaboration with local voluntary groups, using trained volunteers (Health)

• From one central point encompassing PCT/local authority/voluntary sector and access to further specialist information as required (Library)

• Information available in all required formats and languages (Library)

• Effective electronic distribution system that internal audiences look at (Social Care)

• We know we’ve got good quality information – recent inspection highlighted it – what we need to do now is turn staff into good communicators across all areas (Social Care)



• With fresh, attractive displays of new material which can be used in many different service points. (Library)

• Cutting edge portal for health information for use by all libraries – overcomes problems of space (Library)

• Through a public service channel providing information on health and social care 24 hours a day with option to save and retrieve various types of information at will (Social Care)

• Collections located outside of libraries e.g. health centres etc (Library)

• Better use of websites (Library)

• More partnership work (Library)

Barriers to ‘ideal’ health and social care information provision General Collaboration

• Funding to buy stock and resources (Library)

• Lack of space and furniture to display material effectively (Library)

• Red tape – Health and Safety rules, worries about losing stock if we were to plan self help collections in unsupervised venues (Library)

• Health information is not as popular as it was a few years ago – customers use internet rather than ask us for info. We had enquiry forms designed by NHS Direct and sent them to all branches – but little take up (Library)

• Provision of sensitive information regarding certain conditions (Library)

• Lack of information, books in other languages (Library)

• Ensuring the quality/accuracy/reliability of material (Library)

• Staff time (All)

• Budget (All)

• Duplication (Library)

• Lack of display space and materials (Library)

• Library staff are not health professionals. If they are to take a greater role than at present in terms of health information provision they will require greater knowledge/in depth training (Library)

• Time (All)

• Different priorities (Library)

• Potential partners not being aware of what the library service can offer them (Library)

• Time and staffing (several)

• Problems getting all interested parties together at the same time

• Money (All)

• Getting information from (Health) professionals

• Finding right contact (All)

• Difficulty in getting GPs involved/interested (Library)

• Trying to get all parties together to meet on a regular basis (Library)

• Trying to develop project aims that satisfy targets/action plans for a number of different organisations (Library)

• Knowing who does what (All)

• Lack of staff time (Library)

• There is always a weak partner who sometimes holds up a project or slows it down (Library)

• Size of organisations, poor communication within and across organisations (Social Care)

• Lack of awareness of other organisations (Social Care)



General Collaboration

• Languages (Social Care)

• Masses of notices, posters etc – getting yours lost in the crowd (Social Care)

• Info overload (Social Care)

• Clear messages accessible to all (Social Care)

• Lack of awareness of service [PALS] – need national marketing strategy or be included in soap storyline! (Health)

• Language if English not first language (Library)

• Jargon (Health)

• Sheer number of information providers can be overwhelming – also leads to duplication (Health)

• Confidence in communications staff from politicians (Social Care)

• Internal communication is an issue, i.e. making staff understand they are the face of the services and that everything they say, do, write, produce has an effect on how services are promoted or explained and the overall impression the public has of the organisation (Social Care)

• Libraries are ideally placed to promote health information, but often health professionals do not see this potential. Libraries need to be better briefed re useful potential partnerships – we are fortunate because we have developed one (Library)

• Profile of information to the public needs raising (Social Care)

• Literacy levels (Library)

• Fear of entering building (Library)

• Stock not well displayed (Library)

• Organisational targets/deadlines (Social Care)

• Lack of willingness from other organisations (Social Care)

• People being precious about ‘their’ info when in fact it is the public’s info (Social Care)

• Different agendas (All)

• the more individuals involved the slower the process (Health)

• People don’t always want to communicate information across agencies (Health)

• Some professionals don’t like to de-professionalise texts and information to help the public understand more about the key messages (Health)

• Time taken in seeking out partners (Library)

• Finding funding (Library)

• Coming up with win/win situation (Library)

• Language – specialisms (Social Care)

• People don’t like change or ‘letting go’ (Social Care)

• Engaging with partner who can help best and understands public library remit (Library)

• Cultural and political differences between agencies (Social Care)

Appendix 4: SUPPLEMENTARY MATERIAL SENT BY ORGANISATIONS


Appendix 4: Supplementary material sent by organisations

Respondents were asked to include any promotional materials or other examples of health and information provision.

Organisation Supplementary material NHS Direct Not feeling well? NHS printed self help guide which is sent to

householders with the Thomson directory Information leaflet

Patient Information Centre, Newcastle, North Tyneside and Northumberland Mental Health NHS Trust

Range of publications produced by the centre: Annual report 2004/2005 Services available in Newcastle, North Tyneside and

Northumberland for people from Black and Ethnic Minority Groups

Carer Organisations in Newcastle, North Tyneside and Northumberland

Mental Health Services Directory (includes statutory and voluntary organisations)

Information leaflet – Meet and greet scheme Newsletter – Information Exchange

South Tyneside PCT Information leaflet and newsletters for the Resource Service in South Tyneside which produces, collects and loans a range of resources for health professionals working with the public

Northumbria Healthcare NHS Trust

Marketing strategy Example leaflets Patient Information Policy

Middlesbrough Libraries Books on Prescription – Poster and flyer

Darlington Social Services Information for all poster Information for all DVDs:

Sign language and subtitled; multi language Workshop presentation on the Information for All project at

ASCC Conference October 2005

Newcastle Social Services Range of publications produced by the service: Newcastle Carer’s guide Services for people with learning disabilities Services for people with physical disabilities Services for older people Services for children with disabilities Services for children and families Careers in Social Care pack Range of information booklets on fostering and supported

lodging scheme.

Further information concerning this material may be obtained directly from the relevant organisations.

Appendix 5: FOCUS GROUP


Appendix 5: Focus Group

Review of Health and Social Care information provision to the Public in the North East – FOCUS GROUP – 14 October 2005 – NEMLAC Facilitators Janet Harrison, Department of Information Science, Loughborough University Suzanne Lockyer, LISU, Loughborough University Participants Margaret Simpson, Electronic Services Librarian, Sunderland Libraries Sue Childs, Research Associate, IMRI, Northumbria University Sandra Purvis, Reference Services, South Tyneside Libraries Julie Lumb, Joint Information Co-ordinator, Darlington Social Services Caroline Cornwell, North of Tyne PALS Peter Hebdon, Senior Librarian for Learning and Access, North Tyneside

Libraries Ian Wilson, Lending Services Officer, Redcar and Cleveland Libraries Gill Foster, Librarian, NHS Direct North East Following an introduction to the project, the aims and structure of the focus group were outlined: participants would be asked to individually list ideas in response to certain questions, these would then be grouped and discussed.

How would you ideally provide health and social care information to the public?– imagine there are no restraints!

The following ideas were submitted and grouped as shown.

Radio Radio – news and phone in TV TV – articles and interactive Adverts

Free publicly available info Budget

Dedicated health info librarian

Trained staff Care workers Community groups Other informed people Access to expertise Personality endorsement Hospital/consultant

Taking on board the views of the patient, carer, public, voluntary sector

Target groups – specific/non specific

Focus groups Talks Conferences Presentation Campaigns

Online service – authoritative website

Web site lists 24/7 access Library website Internet Web page phone

Plain English Up to date health books Stock: books, multi media, leaflets Books Leaflets, posters Leaflet Print media – newspapers/magazines Papers Stock at various levels Books, magazines

On demand – GP/hospital GP surgery Transportation Shops (newsagent?) Space in library for surgeries/

counselling sessions Separate private area/office Public places, e.g. railway

stations Supermarkets

Training and support Light touch accreditation of

information quality

Partnerships Collaborate activity between all

sectors Multiple access routes to information,

e.g. face to face, phone, paper, web, libraries, GP surgery, hospitals, community centres, shops etc

A wide range of formats to suit varying needs e.g. web, leaflets, video, translation

Distribute widely Publicise everywhere Flood the market



There are a lot of responses for ‘the web or internet’ Is this where you want to start?

• It would reach a wide audience

• Gives access to wider range of resources than could otherwise provide

• Looking at stats on client groups [within social services], very few could access the web, therefore need to think about target audience

• Quality issues with web information

• But high quality gateways available, e.g. NHS Direct – this is one way libraries can use the web

• But people don’t use these gateways, just enter terms in a search engine. For example People’s Network use portals but they aren’t used

• Can’t control what people do

• We have provided help and funding for a specialist group [amputees] to set up a website – need for information, because it is such a limited area. They control website

This was agreed as a good strategy, and further examples were acknowledged.

• Web not for everybody, even in an ideal world would miss many groups

• It is only one of many resources

From a public library setting would you like to be able to offer an evaluative service

• It’s more offering a contact to get at the right thing – helping people to help themselves, but people don’t always come to library staff

As providers do you have a role in ‘quality’?

• we would recommend going through staff

• we provide internet lists [ of reputable sites], this includes one on ‘health’ , and provide leaflets/signpost, but don’t have time for one to one help

• NHS direct phone-in service tries to tailor to individual needs. The operators have access to database of websites and leaflets, which are regularly evaluated and updated.

• It is not only the web that gives bad information

• But the positive point is it is so easy to update

• It has an important role for the person who becomes expert about their condition

What about TV as a delivery medium?

• A topic needs to be picked up by the media to get impact, but providers also need to be aware a topic is featured. For example, NHS direct put an advert in during World Cup match and were swamped with calls



• But with TV get great influx, then people forget about it

• An example is MMR [Mumps, Measles Rubella vaccination] – kept cropping up in media and demand went down, however NHS direct had a lot of calls to clarify what they had been told by the doctor

• People who come to the library for health information often haven’t understood what the doctor told them.

This points to targeting – has PALS been advertised on TV?

• No, but use leaflets, posters, outreach

There were several suggestions around ‘the personal touch’

• We [public library] get some difficult enquiries, quite desperate enquiries

• This is where staff training comes in – need interpretation and training in dealing with enquiries beyond just finding information as with other reference enquiries

There is no telling where the public will go, so what is ideal?

• Use skills and knowledge to signpost – need to know who to contact

There are various ideas about ‘space’. Where are your public libraries placed?

• Shopping centre

• All over

• There is no library at the Metro centre

• There are Health Information Points at the Metro [discussion on where they were etc]

It is interesting that someone has thought about siting and put an information point at Metro centre, but people in health information don’t know it is there.

• There is a ‘one stop shop’ in South Shields

• We had discussions in Darlington [Social Services] about a ‘one stop shop’ but when we looked into it there were a lot of facilities selling themselves as ‘one stop shops’. We are now looking at training and customer care, and have just appointed a worker to look at linking services/info provision

• We are involved in talks for inclusion of a library at a health and social care village, this includes GP, dentist, social services etc [Redcar and Cleveland]

• North Tyneside are doing something similar

• New Gala centre were looking at getting voluntary groups, but didn’t

• North Tyneside has area which has been successful



TV reaches more people than internet?

• NHS has launched interactive service on Sky

• You can also get health and social care topics featured on dramas (e.g. Eastenders) and give out helplines

• In remote parts of US and Australia TV used for diagnosis i.e. 2 way communications

• Also community based TV and radio

If you go down the road of interactive TV, what is the role of the information professional?

• Positive because you can base it on UK or local provision and background, much of the web is US based

What about sponsorship for adverts?

• We looked at this for leaflets, it was considered acceptable where there was no direct conflict of interest, e.g. sponsor was a provider of a product or service connected with the leaflet topic.

• TV is good if they are featuring a topic when you are

• Information must be multi source

Lots of input on ‘print’, is this still important?

• Yes, we will often print off leaflets from a website

• We subscribe to ‘FRILS’ (Free Information Leaflets), but more and more people (e.g voluntary organisations) are finding they have to charge for leaflets

• There is also a problem with identifying quality, especially dates

• And with estimating need – if having to pay for printing etc

• Health Promotion Units are a source of printed information, but don’t always have up to date information

• Our Health Promotion Unit is very good and provide leaflets and posters for key topics

• People feel they have got to supply glossy leaflets, but these have large minimum print runs and so go out of date. We have a basic template and print information to that as required – it is seen as a back up to what individuals have been told by a social worker.

• Importance of stock is literacy level. The Mental Health Unit [at North Tyneside] have raised this. Much of the book stock is not relevant and there is no information at an appropriate level – a publishing niche to be filled

• At a local level it is possible to gauge public requirements, but national leaflets cannot do this.



Talking with people – experts etc, is this the ideal scenario?

• It is ideal to speak with person when you want, but this can’t happen. Talking with people raises questions and can be helpful or confusing.

• Libraries can help by providing space for groups, possibly with experts

• In the health service, ‘patient forums’ offer regular meetings which include this kind of thing

• Support groups are good for this, need to include these in ‘signposting’ activities

• A group at Social Services take sessions out, for example at coffee mornings, people like these and it is an accessible, neutral environment. Darlington Library have coffee morning and specialists.

• We have ‘Books on prescription’ working with PCTs. Health workers suggest books and direct people to the library.

• PALS conducted drop in clinics at GPs surgeries but people not accessing, however a similar initiative at a supermarket had fantastic results.

We have hinted at partnership working, and you have all come and exchanged views today, but do you talk to each other regularly?

• We are outside the normal library service, but came out of Info North and so had contacts; contact now is more with health libraries than public, this based on personal knowledge rather than formal partnerships

• PALS attend a lot of groups to share information – at all levels

• We currently have three partnership initiatives going: [Redcar]

• Health and social care village

• Tees and North Yorkshire Books on Prescription (with Middlesbrough Libraries)

• Tees Health Libraries Alliance – they have placed books into the library for health professionals, although they are public access.

• North Tyneside Mental Health Unit have put books into libraries in liaison with GPs, they use people with contacts in the area to publicise the service

• Funded five bibliotherapy collections

• Approached by a midwife to set up a ‘breast feeding club’ in the library – to hold books and also a self help group, but not finalised

• Public library is good neutral ground

Do people think partnerships difficult to handle?

• They are essential for providing information, because people are interested in lots of things not just provided by one service, so have to forge partnerships to get information

• Working with partners can be difficult, e.g. different ‘language’ and culture

• May not be aiming for same goal



• Corporate identity versus public information provision

Should partnerships be planned at the strategic or partnership level?

• Needs to be at strategic level, but operational is what gets things done

• Good models are an example to others. We are part of Health Net in South Tyneside included voluntary groups, PALS, PCTs, we have a monthly meeting with speaker

• We work with Age Concern – they come to the library to give talks and also ‘hands on’ health e.g. blood pressure tests, Flu jab, alternative therapies

There is value in partnership working, but it takes energy, or is it seen as part of your role?

• Yes it is part of the role now

• Our ‘art and health’ project went well but funding ran out

• This is main problem – sorting out funding

• There was a previous ‘Health Information Plan’ and it is still worth considering as a model. This fell because it was taken up under previous health authority structure

• In health and social services the importance of information is not realised – it is not funded, but tacked on.

• Public libraries now have a remit to provide health information so this gives some backing to getting funding.

What is ‘dream team’ deal?

• We found health promotion leaflets in library very popular compared to doctors surgeries, but no funding to continue this

But what is ideal partner? For example re funding, has anyone engaged Director of Finance?

• No, work is done at an operational level this is problem

So who would you go to at strategic level?

• Depends on authority

• If the issue is part of government target there tends to be money, but then this drops off

• Yes, need consistency

Today’s group is a robust grouping – but not necessarily the people prospective partners would seek out – so does it happen by serendipity?

• We [IMRI) have a research partnership with Sunderland [Libraries], so this is one type of partnership

• At the moment it is a bit haphazard and there is not commitment from above



• Trick is to know what ‘box wants ticking’

• South Tyneside is an authority wide grouping

• Information providers are not recognised as information professionals; there are so many people just dying to produce a leaflet because they’ve got ‘Publisher’ on their computer. It is important to get recognition for the profession

Recognition of people in alliances important, need dissemination; for example NEMLAC will publish report of this project – it doesn’t just happen by talk

How are PALS regarded, how are your alliances made?

• We have to have strategic alliances, these are laid down by SHAs and PCTs etc, but also local alliances to do job effectively. Takes a huge amount of effort, but it is part of my job – although have the rest of the job to do as well!

In an ideal world would you like to talk to each other regularly?

• Yes

• Meeting together would deal with duplication of effort

• In Public Libraries have to do impact measures, so help from other sectors would be good

It is difficult making first contact and need to remove fog, that you can’t talk to people in other sectors. Would you talk online or is it a pain?

• It can be

• Meetings on a regional basis are not that difficult

• Need to give people who can’t get to a meeting access

• ASCC have regional meetings as well as national, and some more local e.g. we have an outreach group and work with Darlington PCT, but not library. Today has been useful and I would like to repeat

• A lot of authorities represented today

Appendix 6: INTERVIEWS


Appendix 6: Interviews

Summary of interviews Eight telephone interviews were conducted.

Policies and funding Interviewees mentioned a wide range of policies that affect information provision. However, there was agreement that information is an essential part of current agendas across the library, health and social care sectors. An important issue to consider when planning partnerships is the possible difference in definition and role of information in the different sectors.

Partnerships have important role, for example:

• in communicating agendas between sectors

• to maximise delivery of information in an appropriate way

• to maximise resources including skills,

• securing funding: collaboration as working best if working towards defined outcomes

• Role of national/regional agencies in fostering partnerships and providing support, research etc.

Providers/delivery The problem is not lack of information – it is accessing it, getting it in the right place

All interviewees agreed on the important providers of health and social care information: GPs and other health professionals, voluntary organisations, family and friends, library, local council.

The Internet was mentioned by some as increasingly important, but there remains a vital role for providers in guiding public use.

Importance of voluntary sector, particularly for support, real knowledge and experience of conditions and needs, was noted.

Co-ordination and collaboration was generally seen as important – within organisations need knowledge of who does what, and this is increasingly important across sectors. There were seen to be opportunities for exchange of skills and resources, and great potential for collaboration in NE, which has a strong regional identity.

The potential for public libraries was agreed by all – even if not currently used. Some common elements mentioned by most interviewees were:

• neutral space

• information expertise

• internet access



• know their communities

• accessible – in High Street but also mobile/housebound service

Respondents from the library sector mentioned the importance of professional skills and the need to maintain this input.

Several interviewees mentioned need for multi-channel delivery – serving different needs at different times.

Public perceptions The inability to use internet is becoming less common, and there is an important role for the library sector in providing access and training, mediation in use.

Although some thought the initial fears concerning the quality of information on the internet had largely proved unfounded, the need for guidance was often mentioned, and it was thought that all of the providers could play a role in this. Respondents from the health and social care sectors mentioned the role the public can play in evaluating information. For example, the involvement of Patient Forums in planning information and the use of feedback forms.

Personal contact remains important, but needs information to support it.

All interviewees acknowledged that there were many different user requirements to consider when producing information. Translation into different languages and formats is expensive, and may not always be necessary: the important point was to know the target audience and make information available in a form they could understand and in places they frequented. Partnerships can help with this, and also with technical skills, for example one respondent mentioned use of library Braille production service.

The overriding message from all was – ‘put information in places where people go’.

Interviewees Bob Little, Regional Development Manager, North East Skills for Care Resource Network

Bob Gann, Director of New Media, NHS Direct

Stephen Walters, Principal Library Manager, Gateshead Libraries

Ann Johnson, Quality Assurance Lead North Tees and Hartlepool NHS Trust and NE Representative for Patient Information Forum

Michael Long, Head of Information and Communications, NEMLAC

Catherine Lee, Manager, North of Tyne PALS

Judith Thomas, Director, Communications User and Public Involvement,

Commission for Social Care Inspection



Dr Tim Kenny, writer and editor of health information, including Patients.co.uk; practising GP in the North East

Interview themes The interviews aimed to cover the themes emerging from the literature. The exact form and order of questions depended on individual interviewee’s role and responses to questions.

Policies and funding Which national policies in the field of health and social care are shaping information provision to the public?

How do these policies affect how information is delivered?

Providers Who are the important providers of health and social care information to the public?

Where do the public go for health and social care information?

What is the role of public libraries in health and social care information provision?

To what extent is co-ordination of delivery required – both within and between organisations?

Public perceptions Where to the public go for health and social care information?

Accessibility of information – format, readability etc

Quality of information

Appendix 7: EXAMPLES OF HEALTH & SOCIAL CARE INFORMATION PROVISION TO THE PUBLIC


Appendix 7: Examples of health and social care information provision to the public

The table below summarises all initiatives mentioned by questionnaire respondents.

Organisation Description Partners

Staff receive training from external providers in awareness of resources, awareness of health info providers, awareness of support organisations e.g. PALS

Training provided by SHA and NHS Direct

Publicity package currently in preparation with partners

SHA, and NHS Trust

Northumberland Libraries

Library service to provide support to students (health) whilst on placement in the county, this will increase resources available for library customers; supports DH ‘Expert Patient’ initiative

SHA, NHS Libraries, Northumbria University

List of health websites approved by NHS Direct on library website

NHS Direct Newcastle Libraries

Work with NHS Direct to provide information packs, enquiry form, database, website list and training

NHS Direct

Community information database – has list of local societies, support groups etc (not just health and social care). Societies to include are actively sought by staff by reading local newspaper, awareness of need etc.

Not specific, but requiring cooperation of societies; Sunderland Council Voluntary Organisations

List of quality health web sites

Provided assistance in support and funding for a local group (TAGS – The Amputee Group of Sunderland) to provide a website – there was a current lack of relevant info as most websites USA based. Library assisted in finding funding from e-government section of Sunderland Council

Voluntary org (TAGS), Local authority

Sunderland Libraries

Bunny Hill Centre, Sunderland. Project in progress to provide purpose build site providing library, PCT, Wellness Centre, Education, Surestart, Community facilities, Council advice centre. Library seeking an active role as see site as ideal for piloting initiatives and demonstrating the potential of the library service. Have put in bid for funding of Community Health Information Officer.

Centre is joint venture with various council departments and PCT. Bid for funding to NEMLAC

Middlesbrough Libraries

Books on prescription – Health care professionals prescribe books on mental health issues, can then be accessed from library. Staff received training for this initiative. It is promoted by poster

Library, Social Care, TNEY HA, Middlesbrough PCT, MIND, STAMP



Organisation Description Partners

Active partnership activities, named contacts in Social Services and PCT; organisation of joint events and services

PCT, Social Care

Attendance at events in local area to promote library; invite organisations to library to promote their activities

Vol orgs, social care Middlesbrough Libraries (cont)

Health checks at the library PCT

Displays on health topics, e.g. smoking, breast cancer awareness; in collaboration with South Tyneside Health Promotion team

PCT

Involvement with South Tyneside HEALTHNET, monthly meetings

Several

Training for library assistants on awareness of stock and signposting to health information specialists

Talks, participation in meetings with/to various groups and organisations

Several

Age concern hold sessions providing blood pressure checks, other health related info

Age Concern (vol org)

South Tyneside Libraries

Bibliotherapy

Darlington Libraries Training in awareness of resources and providers

Hartlepool Libraries LPSA for Home Library Service with target to send 3700 items of useful and relevant information to our home library users – mostly health/social care related

Social care

Collection of books for use by health service professionals provided by Health Libraries Alliance, these are available for use by library customers

Health Libraries Alliance

Books on prescription service planned TNY Health Trust; Middlesbrough Libraries

Redcar and Cleveland Libraries

Virtual Health Library – links from libraries homepage to authoritative health related websites (in progress)

North Tyneside Libraries

Working with local mental health unit on provision of ‘self help’ stock promoted via local practitioners – stock selected by mental health unit

North Tyneside Mental Health Unit

Promotion of library as meeting place, exhibition place – hosts health displays, e.g. PCT showcase; Library health club meetings monthly

PCT, Voluntary organisations

Stockton Libraries

Promotion/use of library’s role in the community e.g. leafleting housebound readers (for Fire Brigade – smoke alarms; Keep Well Keep Warm); Reminiscence Therapy collection (for

Fire Service, Social Services, PCT



Organisation Description Partners loan) Part of multi agency arrangements for ‘are you being served well?’ day for older residents

PCT, Social Care, Local Authority

Evidence collection and presentations

Drop in sessions regarding health information in partnership with community health team e.g. blood pressure checks, lung capacity etc. Also daytime and evening healthy living events provided in partnership with range of other agencies

Community health team; others

A wide range of staff training at all levels

Promotion of library’s role in health information at meetings to other council services and PCT

Gateshead Libraries

Books on prescription PCT

South of Tyne and Wearside MHT

Public portal shared with other local health agencies, complies with best practice guidance

Health sector

Durham Dales PCT, PALS

Promotional activities include awareness talks to community groups, staff groups and other organisations; attend public events e.g. Health Living Exhibition at the Great North Walk.

Northumbria Healthcare NHS Trust

Patient Information Policy with clearly laid out objectives and guidelines for producing patient information; includes procedure for public checking of information and for production of information. Contains contact names/websites for advice on various aspects of patient information

South Tyneside PCT, PALS/PI

South Tyneside Resource Service provides and produces information on health and social care issues for staff in PCT and other organisations to use for promotional/support/education. In particular promote national days/weeks associated with health issues e.g. No Smoking Day. Information is produced proactively seeking to fill gaps and in consultation with partners.

Social Services; Libraries; Voluntary Organisations

Sedgefield PCT, PPI Information produced by the PCT and publicity are monitored and evaluated by a group of local people

Compiling directories e.g. Mental Health Services directory, Carer directory, ethnic services directory

library

Half day advice centre at PIC by various groups CAB, DWP, Carer nurse

Patient Information Centre, Newcastle, N. Tyneside and Northumberland MHT

Information exchange newsletters distributed to self help groups, GPs in area/PCT bulletin to all community based Newcastle PCT staff

Vol orgs, PCT

Newcastle Social Services (Customer

Guidelines/advice to all social services staff for producing information; house style; producing



Organisation Description Partners Services and Marketing)

targeted information on services e.g. for learning disability using illustrations

Newcastle Social Services (Customer Services and Marketing) (cont)

Planning and evaluating publicity including benchmarking and consultations to assess the effectiveness of information: won Community Care Communication Award for campaign to promote fostering in the Black and Minority Ethnic community – activities included local radio and press, flyers, posters, post cards, events, visiting community groups, linking with national campaigns, positive ‘word of mouth’

Training provided to contracted providers, stakeholders, commissioned service providers.

Various health information distributed e.g. antibiotics; keep warm, keep well; Flu jab

PCT

Redcar and Cleveland Social Services

Develop and deliver Public Information Plan including standards to ensure consistent delivery of information across the service

Darlington Social Services

Information for all – DVD/video. Information on public services in Darlington for people whose first language is not English, use BSL, visual or hearing impairments, or would prefer non written information. Involved partnership working, working with outside agencies (to produce DVD) and co-ordinated promotion/launch

Durham Constabulary, Darlington PCT, Co. Durham and Darlington Acute Hospitals NHS Trust, and Priority Services NHS Trust

Provision of information leaflets to libraries and carers centre etc

Library, PCT, voluntary orgs

Middlesbrough Social Services

Plasma screen to provide information (in progress)

North of Tyne PALS Works across eight trusts providing seamless and co-ordinated services. An important part of their role is promotion of the service throughout the region to all sectors; this includes training as part of NHS induction schemes and presentations to public libraries. PALS also have volunteers working mainly in hospitals to provide information about the service and to signpost people to PALS officers.

GPs, Hospitals, voluntary sector, libraries, social services

health and social care information...health and social care information provision iv basis for...

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