How Do People Use Healthcare Libraries in the UK?

Collecting data on user experience helps healthcare librarians in the UK demonstrate their purpose and refine their services.

National Health Services Librarians use a multifaceted approach to track user experience.

I’ve now worked in healthcare librarianship for longer than I care to remember some days. Most of my career has been spent in the National Health Service (NHS) in England, but in a couple of other sectors too. In every library service, we’ve had to demonstrate our value. And that includes the impact on our users.

Over the years, I’ve seen trends change in how we evidence that impact. When I first started working in this sector, most of what we did to measure our activity relied on simple number crunching. The charts looked great but didn’t necessarily give much context, let alone evidence of actual impact.

The current approach is much more story-focused. This includes following data through to its final destination. In healthcare libraries, that can be anything from an academic article to a patient information leaflet or teaching session.

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Demonstrating service usage still includes quantitative data and simple figures; I have to confess at this point, I’ve always been a huge fan of using illustrations where possible. Give me a chart, and I’m happy!

  • We can track how many books are borrowed and renewed via our library management system. As we more or less follow the academic year, we often see a peak around assignment time in the spring and before our users move on to their next rotation, mostly in the summer. We can even see what time of day is busiest and which day of the week is most popular.
  • While there’s a perception amongst some users that e-books are less expensive than print books, that isn’t always the case. It’s very useful to analyse how our e-books are being used. As well as how many accesses have been made, in some cases we can also see how long a reader typically spends with a book.
  • In a healthcare library, one of the most popular services on offer relates to scientific articles since that’s where so much of the latest research is made available. We can keep tabs on how many articles are accessed online from our various collections, many of which are now provided with national funding from Health Education England — we can then work out “cost per download” and how much that would have cost our service to provide if we didn’t have access to these resources.
  • Most of these resources are accessed via a protocol called NHS Athens, and each month we can see how many new signups we’ve had, how many accounts have expired, and which resources are most popular. In my current service, Health Education England’s Knowledge and Library Hub is pulling ahead, but that varies month by month. UpToDate is often in pole position, neck and neck with the hub, or coming in at a very close second place.
  • UpToDate is what’s known as a point-of-care tool — not all NHS library services have this particular resource, and it’s not the only resource of its kind. Others include BMJ Best Practice, which is provided to NHS users throughout England. We can see which topics are proving most popular, which can then help us with the rest of our collection development.

Evidencing Impact

Increasingly, we’re being asked to demonstrate value by evidencing impact. NHS libraries are asked to contribute impact studies to a central repository. You can see the wide variety of studies, from clinical to healthcare education, at

In all the healthcare libraries I’ve worked for, the service has been asked to contribute information to annual reports and regular updates to senior management. Many senior managers in noneducation-focused organizations may not be aware that there even is a library, much less how we can contribute to the wider work of the organization or, indeed, why we’re needed at all.

Generally, in these cases, the more concise the presentation of our data, the better. Senior executives simply don’t have time to read through screeds of data.

Presenting Our Data

So, what do we use to get this data across succinctly?

  • Charts produced from numerical spreadsheet data
  • Infographics
  • Stories


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Alongside the books, computers, and e-resources, most healthcare libraries in the NHS also offer an evidence- or literature-searching service. Knowledge specialists retrieve and collate information on a particular topic to help users make evidence-based decisions. One of the ways we try to capture impact is by maintaining records, where available, of what that information has been used for. Our users might use the information we help them locate to:

  • Give presentations at a conference.
  • Incorporate information into peer teaching or patient education sessions.
  • Make clinical or management decisions.
  • Publish an article in an academic journal.
  • Contribute to systematic reviews of why a particular medication or treatment is suitable — or not, in some cases.
  • Keep their own knowledge up-to-date for the purposes of Continuing Professional Development (CPD) — physicians, nurses, and other clinical staff are required to record and demonstrate a certain level of CPD on a regular basis. 

In addition, all NHS libraries are required to regularly report back on their activity to Health Education England regularly. The data is then collated at a national level and reviewed at intervals.

We’re always looking for ways to both measure our activity and assess our impact, as well as new ways to present the data. We’re currently awaiting the delivery of a footfall counter, which will give us a snapshot of how many visitors we get in the library space. It won’t, however, tell us why our users are visiting the library space. 

They might be coming in to borrow or return a book, use one of the computers to complete e-learning or check their rota or their email, or ask us for articles or searches for evidence to help support their decisions.

The next step will probably be to try to capture the qualitative data, possibly by means of (short!) questionnaires, surveys, quizzes, or even interviews — which is where WordClouds are likely to have a part to play. At present, we can use those to track user comments and give us a quick impression of what books are proving most popular.

So, you know that saying about how a picture paints a thousand words? Well, combine it with a little numerical data, and it provides extremely useful insights into what’s going on at the local level — and how we can plan our next steps in a service and subject area that is constantly evolving.

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