I was invited to write about the development of health librarianship over the last 20 years from a national perspective. Handily, by June this year, I'll have been working in health libraries for 20 years, with 17 of those in a national organisation - it's like it's fate, or something!

My first role was as an outreach librarian working across the PCTs in Manchester and Stockport. At the time, databases were bought regionally (remember Aditus, anyone?), and I found some information about a website called the National Electronic Library for Health (NeLH - also known affectionately as Nellie) - which was the first version of a national health information resource. I built my training offering around these resources, with some information literacy and searching skills thrown in. I even included a session on searching Google - it was still a fairly new thing back then, and people just didn’t use it on a daily basis.

It was this role that first brought me into contact with David Stewart. I met him as part of my induction. I worked as part of an IT training team, rather than being part of a library service, and qualified as an ECDL trainer with them. David wanted to ensure all library staff were up to speed with IT, and I ended up delivering ECDL training to NHS library staff across the north-west. This was my first experience of a proper, joined-up, thought-out approach to librarian development.

I then joined the small team at NeLH as a training coordinator, working mostly with librarians. We established a national network of healthcare librarians (DLnet), who were all committed to promoting the use of digital resources. This period coincided with an increasing use of the internet in daily life – junior doctors now had smart phones in their pockets and could look things up on Wikipedia! Librarians were having to make changes to ways of working in response. DLnet was just one example of librarians’ willingness to share and collaborate to achieve this.

NeLH changed to National Library for Health (NLH), and then transferred to NICE in 2009, becoming first NHS Evidence and now NICE Evidence Search. I continued working within the service, in a variety of roles. I’ve seen initiatives come and go…. and come back again!

Over the years, there has been a change in the library leadership landscape, in terms of where support and direction were coming from. In the north, we’re lucky that we’ve had David and the Health care Libraries Unit (HCLU) team steering us through it all, providing a continuous reassuring presence. The current strategic leadership embedded within HEE has encouraged us to be much more vocal about the value and worth that our library services bring to the NHS.

What else has changed in health librarianship over the last 20 years?  The all-pervasiveness of technology and the sheer number of resources: people are now constantly connected to information in such a variety of ways. This obviously brings challenges to traditional ways of storing, sorting and finding information.  

The thing that strikes me most is that 20 years ago there was only a handful of sources providing guidelines and summaries of evidence. So people needed to search bibliographic databases to find the best evidence.  But there is a proliferation of resources now, where people have already done the work of retrieving and summarising the primary evidence. This changes the need for many people to search the databases. In an environment where everyone is under pressure, what they need is quick access to reliable resources that give them the best evidence. Our challenge, as librarians, is to help connect them to it wherever they are. This isn’t necessarily where we want or expect them to be. I think we need to be working on getting the evidence into where people are looking – whether that’s more initiatives like the Cochrane Wikipedia Partnership to improve the information that’s freely available, or plugging our content into web browsers so that people find it from within the usual places they search.

The COVID-19 pandemic has also highlighted challenges for us as a profession. People need to access information, and they need to be able to distinguish it from misinformation and disinformation. Our skills in information literacy, and in training and education, are needed now more than ever.

Some things have stayed the same over the last 20 years.  I’m thinking particularly about networking, support and sharing between librarians. I was welcomed into the LIHNN network 20 years ago, and still feel welcome now (despite being part of a national, rather than a northern organisation). Two other things haven’t gone away: health and social care staff's need to find good quality information; and a bunch of people who really want to help them to do that. We have to be ever-more creative in our approaches, but our ability to do that is what will keep us relevant for the next 20 years and beyond.

Fran Wilkie
NICE