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ASLIB BIOSCIENCES GROUP

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Aslib Biosciences Group Lecture - Knowledge Management in the NHS: Speaker: Margaret Haines (NHS Portfolio Director for KM)

The NHS has been undergoing major organisational change, which coupled with its highly pressured environment - involving a service which we rely on from birth - made this a compelling topic. Margaret took as her definition of knowledge the statement recorded in the preliminary document for the KM standard, "The capabilities by which communities within an organisation capture the knowledge that is critical to them, constantly improve it, and make it available in the most effective manner to those people who need it, so that they can exploit it creatively to add value as a normal part of their work" (Royal Dutch/Shell as reported in BSI, PAS 2001). By this definition the information recorded in people's heads is as vital to document as any recorded more traditionally, and even perhaps more vital, as it is more transient, as people move to other jobs or retire.

As part of the public sector, the NHS has been much influenced by other government initiatives, such as those coming from the Office of the e-Envoy which "is leading the drive to get the UK online, to ensure that the country, its citizens and its businesses derive maximum benefit from the knowledge economy." The NHS Plan (published in July 2000) and its modernisation agenda are also "patient-centred and knowledge based".

The NHS needs to take a wider view of KM to support the modernisation programme, to aid partnerships with Government, patients and the public and to enable sharing of explicit (written down) and tacit (in people's heads) knowledge to improve patient care. Margaret explained the role of KM in medical research and by contrast the role of research on KM itself. The KM strategy for the NHS Modernisation Agency is to share knowledge with the NHS about how to improve services and to provide staff with the right resources to do jobs properly.

To help NHS staff develop knowledge management skills, a "University" for the NHS is proposed. This is being developed by working with the Open University. It is also intended to include knowledge skills in a basic Induction Programme being planned for NHS staff which will include information on topics such as shared values and culture. Following the tragic events at Bristol the official report "Learning from Bristol" was responded to by the Government's Kennedy Report. The Kennedy Report stated the Government's intention to integrate NHS knowledge systems such as NHS Direct, NHS.uk, the National electronic Library for Health (NeLH), Department of Health websites, NHS Libraries etc., use partnerships with organisations such as the British Library and Higher Education, mobilise knowledge in the NHS, and create a National Knowledge Service.

The NHS needs to coordinate its activities and provide standards, manage its content, improve its infrastructure, information/knowledge skills, encourage knowledge sharing behaviours and support communities of practice. Challenges to be overcome include information overload, lack of protected time for learning, "initiative-weary troops", lack of a robust evidence base, multiple agency networks and the sheer size of the workforce - 1.1 million employees across the country.

Margaret's challenging role as NHS KM Portfolio Director is to lead a range of KM initiatives including; the KM Research and Development Programme, advise the Modernisation Agency (which was formed in April 2001 and is part of the Department of Health) on KM capacity development in the NHS, participate in the design and implementation of the National Health Service "University" (NHSU), coordinate the National Knowledge Service and contribute to the Department of Health's KM strategy. Sample initiatives given included the Orthopaedic Breakthrough Collaborative which concentrated on improving treatment and care for patients requiring hip replacement surgery.

Knowledge Management can help the NHS to focus on exploiting information and enabling knowledge sharing behaviours and can assist in levering investment in training, technology and resources. Knowledge Management will also show the expertise and "worth" of NHS staff. Knowledge facilitators will become very important in the future of the NHS in ensuring information harvesting, sharing and input from all the different stakeholders in the service, nurses, doctors, consultants and patients. KM needs to become part of the strategic planning process for the benefit of all.

Margaret's powerful presentation resulted in a number of questions from the delegates including the role of libraries in the future development of KM and the importance of health promotion.

Carol Gokce, Chair ASLIB Biosciences Group (Department of Information and Library Systems, The Natural History Museum)