Considering http://www.library.nhs.uk

Layout and Ease of Access to Clinicians

http://www.library.nhs.uk

This is primarily a search engine and portal to resources, with some additional explanation of the library service, and a bringing to focus news of clinical and related developments. As such it benefits and suffers in the way of all portals, being on the one hand a one entry place for enquiries and yet being bypassed when the clinician finds his or her place of online speciality.

In this portal, prominence is given to logging in and searching resources. The website has frames but:

http://search.library.nhs.uk/

goes to the same place as the original url and this is:

http://search.library.nhs.uk/nhs_sse/zengine?VDXaction=ZSearchSimple

A search area allows a user to, in effect, write their own link into one place - a quick procedure - but it has the disadvantage of producing many results and some reading lists to find the right result. Search results are divided into the database categories of All Results, Guidance, Evidence, Clinical databases, Journals & Books and For Patients using virtual tabs.

Below the search area is GO DIRECT TO THE NLH RESOURCES where the different colouring of RESOURCES suggests a link but it is not, and no part of that title is a link. They are all below. These are basically a menu of pre-selected choices. Some of these choices seem not to work: for example Muskuloskeletal gets lost into many redirects and ends in error (25 April 2005). Most links work well and go to other websites. These websites will be visited more directly, however.

Really Simple Syndication (RSS) is available for a number of areas including the home page. It comes with links to the complexity of setting it up; it needs XML (of which HTML 4 is a part) and clicking an orange RSS link attached to a news item produces an XLM page. The availability of RSS means that news providers provide their own link and thus clinicians can find additional up to date information, and it makes the portal useful as a place to receive headlines about and connections to new developments.

Searching on the Internet in general has failed to use a classification system and this seems unavailable here. This would involve entering the NLM (or DDC, LC) number or part number and bringing up a list of materials. Clinicians as well as library staff may well know NLM codes.

It is a fixed width site giving problems for 640 by 480 screens and (for them) horizontal scrolling. This is odd in that much of the source code consists of ordinary tables which could be relative in size and fit any screen resolution. At the same time the site depends upon a large amount of Javascript.

The area for Librarians gives background information on the development and usfulness of the website. As it is, a number of the links there are slow or fail in process. It would help if that philosophy was highlighted: on searching, the usefulness of the portal, and such as the place of the National electronic Library for Health (NeLH) and Library and Knowledge Development Network (LDKN).

Three Resources Useful for Consultants

Areas of Guidance, Specialist Libraries and Evidence are highlighted and an example of information within each.

1. Guidance

National institute for Health and Clinical Evidence normally provides a section of overall guidance. One specific area of guidance shows what is possible at:

http://www.nice.org.uk/page.aspx?o=20

This gives access to current consultations with an economical presentation and coloured areas access for ease of use. Going deeper, the area of colorectal cancer shows more specific matters.

http://www.nice.org.uk/page.aspx?o=250495

This offers consultant based preliminary recommendations. Areas covered are clinical need/ practice, technologies, evidence/ interpretation (and there is a subsection on cost effectiveness), recommendations regarding research, resource impact, implementation and audit, related guidance and review of guidance.

So these sections are clearly laid out, but more useful is that after each of these sections there is a comments form for consultants (and others) to communicate back adding to the value of the website because of the facility to exchange information.

2. Specialist Libraries

Consultants need access to library materials in their fields. Much work is now online as a matter of convenience, cost and speed. Some are HTML pages in journal or other relevant form. Printed to file .PDF format documents produce a reliable "what you see is what you get" output, unlike even Word documents and most certainly unlike browser variable web pages.

The Mental Health area has a useful Help description:

http://libraries.nelh.nhs.uk/mentalhealth/default.asp?page=Help

Every topic has an introductory article written to allow fast reading introducing health professionals to a topic. These cover diagnosis, management, treatment, referral and information for the patient and family. The sitemap and its category tree is probably more useful for consultants going to their own specialities.

The principal method is searching (even via links). Records are matched and there is a tabbed interface on Guidance and Pathways, Evidence, Reference, Education/ professional development, Patient Information and News and Events.

http://rms.nelh.nhs.uk/mentalhealth/searchResponse.asp?categoryID=8603

This is deeper into dementia and the tabbed categories produce asp based urls that do not make identifying pages easy (they can be added to favourites by consultants).

http://rms.nelh.nhs.uk/mentalhealth/viewResource.asp?categoryID=8603&dg=178&uri=http%3A//libraries.nelh.nhs.uk/common/resources/%3Fid%3D79103

Taking the definition section, the bullet points are useful. What is more useful is if areas like this can be promoted to patients and their supporters so that more informed conversations can take place when consultants see patients. So although the website has a professional feel and full use of technical terms at all levels, a change in presentation could be useful from even the consultant's point of view in informing those who must be the focus of the work.

Providing Information Directly and Other Activity

The library assistant can help consultants find the relevant information they seek according to request. This may be necessary given that searches often provide high numbers of results and take some sifting. Clearly this is highly responsible action and needs accuracy according to a request for the place of information.

As regards other activity, there is a large overlap between facilitating in library information and facilitating in education. Assistance is best when it helps someone understand how to get the information, their time permitting, rather than just retrieving it. The information that becomes provided for all users should be regarded as important in its own right: important to learn the information and as a means of personal and career development, and ultimately in producing NHS clinicians. However, there is more to this than information (as in knowledge): as important is the argument employed and the presentation of argument. A student (for example) needs to know how to put information together and make the best of presentation. Such advice comes through teaching and facilitating skills.

My own approach to this is to answer any question put to me, either by my own understanding initially and in seeking out the information. It is also to assist, where relevant, how the information is used and presented.  The value of this is in learning itself, to which I have a particular commitment.


Adrian Worsfold

Differlearning/health/nhslibraryweb.html