Developing e-resource licensing models for Academic Health Science Centres in England

Introduction

An initial five Academic Health Science Centres (AHSCs) were officially designated by government in England in March 2009, as formal partnerships between a university and healthcare providers (1):

• Cambridge University Health Partners
• Imperial College AHSC
• King's Health Partners
• Manchester AHSC
• UCL Partners.

Their aim is to deliver world-class research, education and patient care for the benefit of their local communities, then promote the application of their discoveries in the National Health Service (NHS) and across the world. Indeed, the centres were recognised as having the potential to compete globally, including with similar centres in the United States, Sweden and the Netherlands.

A report of a national review of NHS health library services in England identified that “there would be great advantages in the NHS and HE [Higher Education] working together on joint procurement” (2). Previous efforts to provide joint licensing of e-resources across the university-health service divide in England had met with varying degrees of success (3). However, one licensing model, as adopted by the London Medical Schools Group (LMSG), had produced benefits for the local constituencies over the previous decade. The consortium had been operating successfully for several years and had been reaching value-for-money agreements with a range of publishers over the provision of resources under beneficial licensing terms. The agreements in place had included full access to selected electronic resources for all HE members of the institutions as well as NHS users in 36 affiliated Trusts representing up to 56.7% of NHS staff in London. Access for users in both HE and the NHS was through their existing personal institutional or NHS ATHENS usernames and passwords, and no separate accounts had to be set up.

As anticipated by the author as early as November 2008 (4), with the links between the universities and affiliated NHS organisations becoming even stronger through AHSCs, the drive for LMSG-type licensing initiatives was unlikely to diminish. This was confirmed soon afterwards, at a meeting of key stakeholders in April 2009 convened by JISC Collections, the UK academic community e-content procurement and negotiation service. The London Medical Schools Group approach was identified as one that had produced results to date and it was suggested that the Academic Health Science Centres could be a model group in England. The role of JISC Collections to act as a neutral advisor and negotiator was also acknowledged. At a workshop with publishers in June 2010, the key objective of the AHSC representatives was presented, namely making research outputs available for the rapid translation of research findings into clinical practice and outcomes, and outline proposals were discussed. Following this, a year long pilot project was jointly established between JISC Collections, AHSCs and major STM publishers and database suppliers (5).

Objectives

As clearly specified at the outset of the project, the aim was to develop “sustainable models for enhanced provision of access to high quality e-content across NHS and academic staff” (5). Over the course of the project it was intended that all stakeholders would work together to review usage, administration, and licensing requirements arising from the pilot. It was anticipated that the pilot would contribute significantly towards the development of possible e-resource licensing models for Academic Health Science Centres in England.

Methods

Co-ordinated by JISC Collections, the proposal adopted for the pilot allowed the universities at the centre of the AHSCs to extend to their partner NHS organisations access to their subscribed content from Elsevier, Nature Publishing Group, Springer, Thomson Reuters and Wolters Kluwer Health. All five publishers granted this extended access at no additional cost for 2011 in the first instance.

Results

A series of challenges became obvious as the pilot developed:

• Identifying the content to be made available
  • in some cases, only sub-sets of the academic subscribed content was made available to NHS users
  • acquiring a definitive list of the journal titles was sometimes problematic
• Enabling access to the resources through NHS Athens
  • access to a first set of resources was enabled in December 2010; access to the last set was enabled in May 2011
• Enabling access via the NHS Link Resolver
  • a variety of different complications arose when attempting to match publisher-enabled sets of resources against the NHS Link Resolver knowledge base
• Deciding how to present the resources to users
  • not all pilot resources could be presented through the NHS Link Resolver (eg databases)
  • additionally signposting of resources using MyAthens was necessary
• Sharing the knowledge so that all pilot participant sites could benefit
  • not all local NHS Athens and NHS Link Resolver administrators were sufficiently skilled in all aspects requiring attention
  • guides were produced, so that expertise could be shared over issues arising in implementation
• Communicating with library site managers and NHS Athens and NHS Link Resolver administrators to ensure the pilot project would filter through to the end users
  • marketing and promotion ideas and template texts were shared, with a soft launch selected at first in the first half of 2011 and a more targeted promotion in August 2011 to coincide with a new cohort of doctors entering postgraduate training in the NHS
• Communicating with other AHSC-like organisations over the scope of the pilot and potential prospects
  • the relevance of the pilot (for both publishers and the NHS and HE communities more widely) required an approach that could be easily adapted and adopted beyond the immediate AHSC set-up

Despite all the above challenges and efforts to overcome these, some sites were still showing 0 usage at the end of 2011. Given the start-up delays, the pilot was extended to the end of May 2012 with four out of the five publishers continuing to participate, so as to allow sufficient usage data to be collected.

A first analysis of comparative usage data and other findings was initially undertaken in December 2011 and then again in March 2012. As anticipated, levels of use by NHS staff were demonstrably low throughout, especially when compared to HE levels of use.

Discussion

The AHSC pilot has been well received, even though opportunities to promote it widely were restricted by start-up delays. Nonetheless, there have been indirect benefits as the pilot has raised the visibility of library services provision within the participating AHSC NHS Trusts. Importantly, publishers are recognising the imperative behind the AHSC library services’ preferences for joint licences and are tentatively beginning to explore how such licences may be offered.

Initial feedback indicates that at least some publishers may be prepared to enter into licence extension agreements on a revenue neutral basis provided a usage data threshold is set. It is understood that any model that emerges should be scalable to other joint university / healthcare provider arrangements, such as teaching hospitals in England and elsewhere in the United Kingdom.

The pilot raised some interesting considerations:

• The academic institution at the centre of the AHSC would need to be fully engaged in the processes involved: licence extension would by definition need to be based on the existing licence of the academic institution.
• Publishers would need to be prepared to undertake some customisation to ensure seamless access to their resources via the NHS link resolver: simply enabling access via NHS Athens would not be sufficient; indeed, access through all routes that users expect to access the resources would be key for take-up.
• Library services supporting the AHSCs would also need to be prepared to take actions to establish seamless access for NHS users: workflows could be determined to implement access within an AHSC; once resources are enabled successfully, it is expected that no additional set-up should be required.

Specific findings from the AHSC pilot and possible implications for future e-resource licensing in England will be presented at the conference. Other work is also ongoing towards a national licensing agreement to enable access to research outputs and any progress in this area will also be reviewed.