Funding for NHS Knowledge and Library Services in England: indicative guidance

Placement providers receive a contribution to the cost of knowledge and library services from HEE as part of the placement fee.  The NHS Education Contract specifies that the Placement Provider will ensure that there is:

  • a proactive, high-quality knowledge and library service that is available to all staff and learners. (14.2)
  • an appropriate level of funding, both from education tariff and matched employer contributions, to support delivery of proactive, high-quality knowledge services. (14.8)

Agreed by HEE, these recommendations are offered as indicative guidance on minimum funding arrangements.  It is recommended that placement providers in every setting:

  1. facilitate and promote the use in the health service of evidence obtained from research, encouraging staff and learners to maximise the value of using the knowledge and library service to support learning and decision making
  2. commit a minimum of 2.4% of the placement fee paid by HEE to the knowledge and library service
  3. ensure that, as a minimum, funding allocated to the knowledge and library service from the placement fee paid by HEE is matched by an employer contribution
  4. engage with the knowledge and library service manager to ensure that the service has the right resources to offer proactive, high-quality knowledge and library services to all learners and staff
  5. encourage the knowledge and library service to work with other services, and with the national NHS knowledge and library service team, to achieve better value through more collaborative procurement.

For more information please see the frequently asked questions page

NHS Library and Knowledge Services in England Policy

Healthcare relies on knowledge to be successful. It is not enough to have the right teams with the right skills in the right place, working together to deliver high quality and efficient patient care. It is also essential that they use the right knowledge and evidence to make informed decisions about patient healthcare.

Health Education England (HEE) is committed to enabling all NHS staff to freely access library and knowledge services so that they can use the right knowledge and evidence to achieve high-quality, safe healthcare.

NHS bodies are encouraged to check that they have arrangements in place so that their staff can capitalise on the specialist expertise of healthcare librarians and knowledge specialists, ensuring that decision-making is underpinned by evidence derived from research. Organisations are invited to contact their Strategic Library and Knowledge Services Lead for help in setting up or strengthening these arrangements.

Library and knowledge services across health have a strong track-record of sharing expertise and working across boundaries. Resource sharing and collaboration are vital to implementing the framework we call Knowledge for Healthcare.

Agreed by the HEE Executive, our policy sets out for the first time our approach to delivering on our key objective of enabling access to knowledge and evidence for healthcare decision-makers.

The policy is supported by the new Knowledge for Healthcare Quality and Improvement Outcomes Framework for NHS-funded library and knowledge services. The Outcomes Framework is an integral element of HEE’s Quality Framework and it enables HEE to assure the quality of NHS-funded library and knowledge services and support delivery of the vision and aims of Knowledge for Healthcare and the HEE Quality framework.

HEE Library and Knowledge Staff Ratios Policy

The NHS requires proactive knowledge services as business-critical instruments of informed decision-making. Currently there is significant variation in the ratio of qualified librarians and knowledge specialists to healthcare staff, leading to inequitable service provision across England. This means that the Service is not uniformly able to draw on evidence for #MillionDecisions.

The introduction of a recommended staff ratio is a key action by Health Education England to enable individual organisations to identify and address that risk. For the first time this policy, agreed by the Health Education England Executive in November 2019, provides a set of recommendations from which trusts and arm’s length bodies may look to ensure, and where necessary continuously build, improved staffing levels.


1. To optimise the benefits for the NHS of the emerging new roles for librarians and knowledge specialists, HEE recommends that all NHS organisations:

(i) review regular reports of the positive impact of the library and knowledge service on outcomes

(ii) work with the local library service manager to prioritise allocation of clinical librarian, knowledge manager and other embedded roles to specialities

(iii) take incremental steps to improve the staff ratio between qualified librarians and knowledge managers per member of the NHS workforce, through role redesign and by expanding this specialist workforce.

2. HEE recommends that over time, all NHS organisations aspire to achieving a much-improved staffing ratio.

3. HEE recommends that those NHS organisations with a staffing ratio in the region of the current average of 1 qualified librarian to 1,730 or more healthcare staff, strive to achieve a ratio of at least 1 qualified librarian or knowledge specialist per 1,250 WTE NHS staff.

4. HEE commits to monitoring the staff ratios annually and to reviewing the recommended ratio in three years’ time.

Learning Space within NHS Knowledge and Library Services in England

Knowledge and library specialists play a business-critical role in informing learning, and workforce development, as well as professional practice, patient care, decision making and innovation. Providing a suitable library environment is equally critical, helping staff morale, staff recruitment and staff retention across the organisation. Physical library learning space is highly valued by staff, educators and learners, and it offers benefits aligned to delivery of NHS organisational priorities.

This policy outlines four key benefits showing that library learning space is essential for self-directed learning; as a health and wellbeing space for staff; to encourage collaborative working and learning and as a technology hub to develop digital skills and innovation.

HEE’s contract with placement and education providers sets out specific requirements including appropriate learning space. Organisations in partnership with their knowledge and library specialists can draw on internationally recognised standards and examples of best practice to provide equity of access and sustainably designed spaces.


  1. The library study and well being space should be available to all staff, educators and learners both during and outside the working hours of the knowledge and library services team.
  2. The library service space should be developed, managed by the knowledge and library services staff, to ensure value through enabling organisational innovation, and meeting the changing needs of healthcare staff, learners and educators in relation to study and reflection, health and well-being, collaboration, and as a technology hub.

Emotional support for embedded knowledge specialists working in clinical settings: Policy recommendations to NHS Employers

Increasingly, NHS organisations are deploying knowledge specialists within clinical settings to bring evidence to bear in the ward, and in primary and community care. Our expectation is that the number of embedded roles for knowledge specialists will grow. Thispolicy makes three recommendations to NHS provider organisations. Asking them to review and put in place appropriate mechanisms for psychological support for this specialist workforce to ensure their health and wellbeing.


  1. NHS organisations ensure that the psychological well-being of librarians and knowledge specialists working in clinical environments is considered.
  2. NHS organisations extend existing arrangements for the multi-disciplinary team to include clinical librarians and knowledge specialists.
  3. Access to psychological wellbeing services provided within the organisation is highlighted to embedded librarians and knowledge specialists working in clinical environments.