Where do literacies fit into health libraries?
Ruth Murphy
Abstract
As the remit of health libraries has expanded to include lifelong learning and equity of access for all staff members, health library staff may now come into increased contact with users with literacies or basic skills needs. This article discusses how the North Glasgow University Hospitals Division Library and eLearning service has begun to provide literacy sessions for staff through a new project called Get Ahead. It also outlines how other NHS Trusts have dealt with staff literacies provision and concludes with some guidelines to libraries that wish to support staff with literacies needs.
Introduction
While information literacy concerns are topping the agendas of many health libraries, some librarians may overlook the fact that not all of their potential users will have a high level of writing and comprehension of written information. As the remit of health libraries has expanded to include lifelong learning and equity of access for all staff members, health library staff may now be coming into increased contact with users with literacies or basic skills needs.
The Scottish Executive defines literacies as "the ability to read, write and use numeracy, to handle information, to express ideas and opinions, to make decisions and solve problems, as family members, workers, citizens and lifelong learners"(1). In Scotland more than one in five adults "perform at the lowest level of a five-point scale measuring literacy" (2), a statistic also echoed in the rest of Britain. Low literacies can present barriers in all aspects of people's lives and exclude them from opportunities. Low literacies can also prevent access to library services as "literacy is the key to education and knowledge and to the use of library and information services"(3).
The North Glasgow University Hospitals Division Library and eLearning Service not only supports Divisional staff with literacies needs but provides literacies sessions through a new project called Get Ahead. The project began in October 2003 and is funded until 2006 by the Glasgow Community Learning Strategy Partnership with support from the Scottish Executive.
North Glasgow Division and workplace literacies
A 2003 report on Glasgow employers stated that the greatest number of adults with needs will be in employment. 20% of employees are likely to have literacy needs and 17% likely to have numeracy needs in Scotland(4). From over 14,700 staff employed by the North Glasgow Division, approximately 5000 are from staff groups that are most likely to have literacies needs(5). These consist of support staff such as healthcare assistants, domestics, porters, auxiliaries, catering, estates and maintenance staff, etc. All of these staff groups contribute directly or indirectly to patient care and the effective running of the Division. Despite this, many of these staff groups traditionally would not have the same level of access to the range of support and training available to professional clinical staff.
Before the Get Ahead initiative, there was some existing support at the North Glasgow University Hospitals Division. WEA (Workers Education Authority) Scotland, who delivers the Return to Learn programme for NHS staff, are available for literacies sessions but do not actively recruit learners within the Division. Ann Wales, the previous Library Service Manager who submitted the original project bid, identified a gap in the Trust training provision where dedicated literacies sessions were not being held in the workplace.
By making sessions available within the workplace there is a flexibility of time and place as well as ease of access to sessions, factors which can be crucial in encouraging someone to take the first step in addressing their basic skills needs. Protected time can also be negotiated if the learner is willing to allow the matter to be discussed with their supervisor or manager. Employers who provide a workplace basic education programme benefit from increased quality, increased ability to handle training on the job and quicker training results, increased retention of employees, improved labour-management relations and a better health and safety record(6).
Get Ahead Project and the Library Service
Three fulltime project staff are based in the Library Service and consist of a coordinator who has responsibility for the day-to-day running of the project and two facilitators who undertake the majority of the tutoring. Sessions take place mostly in the libraries but can run at any site in the Division. The existing facilities in the Library Service, which consist of four LearnDirect Scotland branded learning centres and private rooms, are used for literacies sessions. As there are a wide range of users and training sessions occurring each day in the libraries, the learners can have a degree of anonymity when they come for a session. We also encourage them to independently use the library resources and learning centres.
By being based in the Library Service, the Get Ahead project has benefited from the Service's reputation as an acknowledged source of quality training and information provision. Establishing the project has also been made easier with the support of the library staff and their experience in marketing and providing training within the Division. There is a regularly updated training programme sent throughout the Division and the project is able to host its own webpages on the library website (http://www.northglashealthinfo.org.uk/getahead). As NHS employees, the project team are able to use the internal channels of communication such as the Division newsletter, payslips messages and email noticeboard to market their service. The Big Plus campaign run by Learn Direct Scotland has also aided Get Ahead's efforts as the subject of literacies is very sensitive.
Existing learning and training activities in the Division such as the ECDL and professional development courses can provide internal exit pathways for further learner development. Get Ahead is also part of a wider network of support with the Glasgow Community Learning Strategy Partnership and we are seeking to develop partnerships with the literacy provider community in Glasgow. The project has also identified and supports training and learning programmes in the North Glasgow Division such as Cleanliness Champions, Return to Learn, eLearning and the Working for Health in Greater Glasgow (WHIGG) initiative which gives unemployed people training to prepare them to work for the NHS. While Get Ahead is still in the initial phase, it has already achieved a degree of success. Our most successful marketing tool has been outreach talks to the target staff groups. We are now currently investigating the possibility of patient literacy sessions in order to develop the project.
Literacies provision in the NHS
The Get Ahead project is unique by being based in the Library Service. Other NHS Trusts have addressed literacies needs in their staff in various ways. Training and Education departments have taken the responsibility for staff literacies provision, as found in Morecambe Bay Hospitals NHS Trust(7) and South London and Maudsley NHS Trust(8). Other Trusts, like Coventry and Warwickshire NHS Trust, have taken an alternative approach by contracting out provision to external agencies such as a local college(9). Also, Oxfordshire County Council has formed a partnership with the Oxford Radclffe Hospitals Trust to provide key skills training for staff(10). The NHSU in England has taken up the challenge of basic skills provision with the Skills Escalator but this has unfortunately not translated to Scotland as yet(11).
In the light of these examples, some would argue that providing literacies support may fall outside the domain of a health library service, and is something that is the concern of public libraries or their Trust's training department. Yet the Health Service Guidelines state that libraries are the key resource for education and training, all of which are crucial to the delivery of high quality healthcare(12). The development of the NHS as a learning organisation with the Learning Together policy means that the role of the health library includes the provision of lifelong learning opportunities. Literacies support and even provision is one of the additional services that a health library service could take responsibility for in order to facilitate and promote lifelong learning.
Providing literacies support
While establishing literacies provision may not be ideal for all libraries, there are some basic steps a library service could take to ensure their staff are literacies aware or support literacies provision.
In Scotland, Learning Connections can provide advice and support for libraries interested in literacies (http://www.lc.communitiesscotland.gov.uk). They will be able to give you contact information for the learning partnership and literacies providers such as local colleges or community initiatives in your area. WEA Scotland (http://www.weascotland.org.uk) or the Unison Learning representative in your hospital are also useful points of contact if a staff member approaches for help.
Get Ahead found awareness raising sessions to be particularly beneficial to ensure that all library staff were more informed and conscious of adults with literacies needs and the barriers they face in everyday life. These sessions also provided referral guidelines for library staff to deal with queries from potential learners. An awareness training pack is available to download free on the Learning Connections website. Interested staff could also attend the Introductory Training to Adult Literacies and Learning (ITALL)(13).
Literacy resources are readily available, even with a small budget. Graded readers and tutor workbooks are inexpensive and many of our fiction titles were donated by staff. Get Ahead has a range of resources such as tutor workbooks, picture dictionaries and graded readers purchased from recommended specialist publishers such as Avanti Books, the Basic Skills Agency, Axis Education as well as a range of audio books and fiction titles. Learning Connections also have resources libraries at their offices throughout Scotland that will lend materials to organisations. The project has also ordered literacy software covering literacies in ESOL, work skills and basic skills from CTAD, but websites such as the excellent BBC Skillswise (http://www.bbc.co.uk/skillswise) and the Irish literacy agency NALA (www.nala.ie) give free tutor/learner support, materials, games and online exercises.
In conclusion, literacies cannot be ignored as health libraries try to expand their learning activities and reach more non-traditional users. The Health Library at York NHS Trust is already running a nine month project with funding from the Workforce Development Confederation called 'Learning resource audit and needs analysis for support staff'. It is seeking to provide resources for support staff, including literacies resources because "lifelong learning in the NHS is a key issue in supporting changes and improvements in patient care" (14).
This article has identified the importance of an awareness of literacies issues. Library staff in general are particularly well placed to identify and refer people with literacies needs. As some people may experience difficulties in filling out forms or reading notices, library staff can use the Plain English Campaign free guides to ensure that these are readable and easy to use(15). The experience of Get Ahead is that literacies initiatives and support fit in well with the objectives of a health library and that there is a wide range of resources and support available to which people can be referred.
References
1. Scottish Executive. Adult Literacy and Numeracy in Scotland. [Online]. 2001 July 2 [cited 6 April 2004]; Available from: http://www.scotland.gov.uk/library3/lifelong/alan.pdf
2. Scottish Executive. Adult literacy in Scotland: analysis of data from the 1996 Adult Literacy Survey. Edinburgh: The Stationery Office, 2001. [Online]. 2001 November 2 [cited 6 April 2004]; Available from: http://www.scotland.gov.uk/library3/lifelong/alals.pdf
3. International Federation of Library Associations and Institutions. Guidelines for library-based literacy programs: some practical suggestions. [Online]. April 25 2003 [cited 6 April 2004]; Available from: http://www.ifla.org/VII/s33/project/literacy.htm
4. Inter-ed Ltd. Glasgow Employers: A study of literacy and numeracy need perceptions and responses for the Glasgow Community Learning Strategy Partnership March 2003. Unpublished report, 2003.
5. Scottish Executive. Adult Literacy and Numeracy in Scotland. [Online]. 2001 July 2 [cited 6 April 2004]; Available from: http://www.scotland.gov.uk/library3/lifelong/alan.pdf
6. NALA. Workplace Basic Education programmes in Ireland: Approaches and models for implementation - report. Final Draft. [Online]. 2002 March [cited 6 April 2004]; Available from: http://www.nala.ie/pubs/pubs_list.tmpl?_eqSKUdatarq=20021004164453
7. Pomphrey M. Lifelong learning. [Online]. [cited 6 April 2004]; Available from: http://www.dh.gov.uk/assetRoot/04/03/49/50/04034950.pdf
8. McCallion, H. Opening up educational routes for existing staff. [Online]. [cited 6 April 2004]; Available from: http://www.dh.gov.uk/assetRoot/04/03/51/59/04035159.pdf
9. Meeson, P. Email to Ruth Murphy. Title: Fw: workplace literacy project. Sent: 27 November 2003.
10. Bradell, A. Stepping stones. Basic Skills Bulletin 2002; 6: 9.
11. Derricks, J. Accessing the NHS Skills Escalator. Basic Skills Bulletin 2003; 11: 5.
12. Marriott, R. The only way is up: an enhanced role for library and information services within the NHS beckons. Library Review 1998; 47 (3): 66-70.
13. Learning Connections. Development and training. [Online]. 2004 April [cited 6 April 2004]; Available from: http://www.communitiesscotland.gov.uk/Web/Site/cl/al_development.asp
14. Davies, K. Email to Ruth Murphy. Title: Learning resources project. Sent: 3 March 2004.
15. Plain English Campaign. Free guides. [Online]. 2004 April [cited 6 April 2004]; Available from: http://www.plainenglish.co.uk/guides.html
Contact:
Ruth Murphy
Learning Skills Development Coordinator,
Library and eLearning Service,
North Glasgow University Hospitals Division,
Glasgow Royal Infirmary,
10 Alexandra Parade,
Glasgow G31 2ER.
Tel 0141 211 1239.
Email ruth.murphy@northglasgow.scot.nhs.uk