1. Searching alternative sources
Document discovery in integrated care
Gill Foster
HLG Conference, June 2018
Gill – NHS Digital
Follow on from synthesising and summarising in 2017…. Service innovation and transformation

2. Searching “alternative” sources
Sources are mainstream but not alternative
Not clinical
NHS endorsed
Sources relate mostly to service improvement
Different ways of working
Do once and share
Alternative ways of searching
Document discovery
What do I mean by “alternative” sources
Not clinical evidence
Not evidence-based practice
Possibly clinical effectiveness
More usually practical case studies
NHS endorsed – not necessarily approved
Service improvement
Service reorganisation
Integrated working
Doing things differently
Do once and share
Document discovery – finding what is already there; not research, more discovery of what has been done
- Good quality information from good quality sources.

3. Why do we need different ways of searching?
Personalised Health & Care 2020
Evidence-based practice is too slow
Timescales/pressures
Efficiencies
Integrated health & social care
STPs
New models of care
We are all highly trained library & information professionals – so why do we have to use ‘different’/alternative ways of searching?
What are the drivers?
FYFV and 2020 Vision (2014) / Paperless 2020 (2015) – all VERY recent
Deadlines / budgets / MONEY / no time to wait for evidence to be published
Health & Social Care Act 2012
Sustainability and Transformation Partnerships – local govt, health, charity, voluntary AND multidisciplinary teams.
NHS England new models of care – pioneers, vanguards, pilots, global digital exemplars, now local health and care record exemplars, etc.

4. The NHS has changed Patient-focused
Self-care
Self management of long term conditions
Supporting people to be independent
Avoiding unplanned admissions
Services must support this new focus
Telehealth and technology
Integrated care
Still get – what is the best treatment for…… but the focus has changed:
Self-care – childhood ailments / rashes / pharmacy
Self management of long term conditions – COPD / diabetes
Supporting people to be independent – care in your own home / services/technology
Avoiding unplanned admissions – e.g. falls – Channel shift.
Every service in the NHS has nationally set priorities, targets and budget constraints, etc.
Increasingly, solutions are looking to technology, remote health care;
Systems that work together and multidisciplinary teams.

5. COPD example
Improving health and wellbeing & health inequalities in COPD through improving health literacy
Requester: A commissioner interested in reducing hospital admissions.
In a real-life scenario what does the enquirer want?
Practical NHS examples of interventions that work
Synthesising and summarising example:
Does the enquirer really want examples of health literacy improving COPD outcomes?
Look at the commissioner interests? Could it more broadly be:
What interventions are successful at reducing hospital admissions in people with COPD?
Is it just health literacy or improving self-management, treatment compliance and support in the community?
Does he/she want an evidence-based case study of 15 people from Australia saying that interventions are promising but further studies need to be done; or a study of 15 people with an intervention run by a GP surgery and outpatient clinic in Stoke-on-Trent?
This comes back to purpose.

6. My COPD results
NHS England Innovation & Technology Tariff 2017 to 2019: Web-based applications for COPD
myCOPD: NHS Innovation Accelerator case study
NIHR CLAHRC case studies:
Smart COPD, University of Sheffield
Rotherham Breathing Space Programme for COPD
SPACE for COPD, East Midlands
Health Foundation case study - RIPPLE Respiratory Innovation, University Hospitals Coventry & Warwickshire
NHS England case study - Lancashire Care COPD pathway
Sample search print out
This is evidence-based case study research in the NHS in England.

7. How do we search for service information?
Rarely through HDAS
Often through Google
To retrieve items from quality sources, e.g.
NHS England
AHSNs
To find someone who has done all or part of it before
Unless your service is the trailblazer
Looking for relevant experience and case studies.

8. Websites – service transformation
What’s going on in the NHS
Not exhaustive, e.g. royal colleges, e.g. guidance on photographs in remote consultation

9. Websites - innovations
Much of this is funding calls, other parts are small test studies, much is technical.
Most practical studies are then in the NHS.

10. Searching with Google Simple terms Phrase search “…”
(watch for Google notes when they try to help you)
Site restriction - site:nhs.uk
e.g. “flow management” site:nhs.uk
Verbatim - restricts results to just your search terms
type in search, click: Tools, All results, Verbatim
Google search help
How to search on Google
Google, especially, Verbatim and site: nhs.uk, gov.uk
Google search help – tricks, tips and filters:
Verbatim – type in search – click tools, All results, Verbatim cuts results to only your search terms
Site:… allows you to search specific sites only, e.g. site:nhs.uk gives results from nhs websites only

11. What is different in document discovery?
Documents have to be read
Searcher has to understand the topic
Searcher has to understand the research reason
Results need to be practical and actionable – more than just theoretical

12. Any questions? Gill Foster Clinical Information Specialist |
Contact details