Staff Ratio Policy: Frequently Asked Questions
Guidance on how to apply the NHS Knowledge for Healthcare recommendations to improve the staff ratio for the number of qualified library and knowledge specialists per member of NHS workforce.
FAQ’s
Q: Why should we employ professionally qualified knowledge and library staff?
A: You will be assured of the professional expertise for evidence-based practice and research delivered by knowledge and library staff who have a Chartered Institute of Library Information Professionals (CILIP) accredited degree and/or a period of professional experience evidenced by CILIP Professional Registration.
Their skills will enable your organisation to:
- fulfil duties under the Health and Care Act 2022 in respect of the use of evidence from research
- release the time of clinical and non-clinical staff, ensuring that all decisions are evidence-based
- realise the economic benefits evidenced by the Gift of Time report, and latest research1 indicating a cost-effectiveness ratio of 1:3.85 where knowledge and library services provide evidence searching and summarising services
1Edwards et al. Evidence Searches Undertaken by Knowledge and Library Specialists Save the Time of Health Care Professionals and Produce an Economic Benefit to the NHS in England
https://www.tandfonline.com/doi/full/10.1080/15323269.2022.2124772
Q: What is meant by professionally qualified knowledge and library specialists?
A: A professionally qualified knowledge and library specialist within the NHS is a member of staff who has either:
- Undertaken a Chartered Institute of Library and Information Professionals (CILIP) accredited programme of study at Undergraduate or Postgraduate Level
or
- Has professional recognition through the achievement of Chartership or Fellowship within CILIP including chartered knowledge manager and knowledge management fellow
Newly-qualified specialists can expect to be working in a Band 5 role progressing to a Band 6 or above, with the relevant experience in accordance with Agenda for Change role profiles.
Qualified and experienced knowledge and library managers will be employed at Band 7, 8a or above. See also question 3
Q: How do I ensure my organisation has the correct mix of roles, skills and experience required when applying the staff ratio?
A: To function effectively each NHS knowledge and library team needs the correct capacity and skills. As a minimum this can best be achieved by a team consisting of the following:
- A knowledge and library service manager who should be a qualified and experienced knowledge and library specialist working at Agenda for Change Band 7, 8a or above.
- A range of qualified knowledge and library specialists working at Agenda for Change Bands 5 and 6 or above.
- Administrative support – roles known as library assistants, library technicians, or paraprofessionals. These staff will usually be working at Agenda for Change Band 3 and 4.
Organisations may choose to work in partnership with neighbouring Trusts, or across an integrated care system (ICS), to develop effective knowledge and library teams.
Q: What is meant by an embedded knowledge and library specialist role?
A: Embedded roles in clinical and management teams provide decision-ready information. Aligned to multidisciplinary teams, embedded knowledge specialists release the time of health professionals by seeking out evidence and good practice. They are often asked to synthesise and summarise information, working with clinical and non-clinical team members as needed to deliver information that is decision ready. See 3.1 in the Policy for further details.
Q: Are there any other policy recommendations in the NHS Education Contract I should be aware of relating to my organisation’s knowledge and library service?
A: Yes. These are:
Ensures that all NHS workforce members are able to freely access library and knowledge services so that they can use the right knowledge and evidence to achieve excellent healthcare and health improvement.
Indicative guidance on minimum funding arrangements recommends that organisations commit a minimum of 2.4% of the placement fee paid by NHS England via the NHS Education Contract to the knowledge and library service and ensure that as a minimum, funding allocated from the placement fee is matched by an employer contribution.
Outlines the value of the learning environment and recommends that the library study and wellbeing space, managed and developed by qualified knowledge and library specialists, should be available to all staff, educators, and learners both during and outside the working hours of the knowledge and library services team.
Recommends that the psychological well-being of librarians and knowledge specialists working in clinical environments is considered and ensured by extending access to psychological well-being services available to the multi-disciplinary team.
Q: What do we mean by role redesign for knowledge and library specialists?
A: Role redesign includes reviewing the team’s capacity and skill mix based on organisational priorities. This involves reviewing job roles and job descriptions to take account of evolving needs and skills. The CILIP Professional Skills and Knowledge Base can be used to assist with this as outlined in the resources to assist in role redesign examples.
The national Knowledge and Library Services Team can advise organisations on role redesign. England.kfh@nhs.net
Q: Is there any evidence that organisations are using the staff ratio policy in a beneficial way?
A: Yes. Feedback from services shows that organisations have successfully used the recommendations to make changes to their knowledge and library team structures.
Q: If my organisation does not have a knowledge and library service, do these recommendations apply?
A: All organisations holding an NHS Education Contract are required to ensure access to proactive high-quality NHS knowledge and library services for all staff and learners.
If you have arranged access to knowledge and library services and specialists via an agreement with another organisation, it is your responsibility to ensure that sufficient funding is provided through the agreement to employ professionally qualified staff to fulfil the policy requirements.
Q: What happens if my organisation chooses not to invest in more knowledge and library specialists and does not meet the recommended staff ratio?
A: As an organisation with an NHS Education Contract (schedule 1 section 14), you are required to ensure there is a proactive high-quality knowledge and library service, with the right staff and funding. This is assured through the NHS Knowledge and Library Services Quality and Improvement Outcomes Framework.
With the right level of staffing the organisation will be able to leverage the economic benefits outlined in the “Gift of Time” report and latest research1 indicating a cost-effectiveness ratio of 1:3.85 where knowledge and library services provide evidence searching and summarising services.
1Edwards et al. Evidence Searches Undertaken by Knowledge and Library Specialists Save the Time of Health Care Professionals and Produce an Economic Benefit to the NHS in England
https://www.tandfonline.com/doi/full/10.1080/15323269.2022.2124772
Q: Has the average staff ratio changed since the original recommendation in 2020?
A: As of April 2023, the average staff ratio has changed from 1:1730 to 1:1900. Although the number of qualified knowledge and library staff has increased during this period, it has not kept pace with the overall increase in NHS staff numbers. As a result of this our recommended ratio of 1:1250 will remain in place.
Q: If you are already meeting the minimum staff ratio (1:1250) what else do you need to consider?
A: The policy recommends that the minimum staff ratio level should be at least 1 professionally qualified librarian or knowledge specialist per 1250 WTE NHS staff. If you are meeting this ratio, consider if your organisation has the right capacity and skill mix in the knowledge and library team to deliver on the priorities of the organisation. You can use the NHS Knowledge and Library Services Quality and Improvement Outcomes Framework to inform your thinking. To meet the ambitions of the NHS Long Term Workforce Plan and changing organisational needs you should keep your staff ratio under regular review.