Building a centralised electronic National Knowledge Service, that will deliver focused clinical knowledge to clinicians when they need it, has become the key aim of NHS Connecting for Health’s (CfH) new Knowledge, Process and Safety Directorate.

The National Knowledge Service (NKS) will seek to ensure "that all decisions are based not only the best current knowledge but also on the needs and preferences of the individual patient".

According to the CfH directorate’s business plan, seen by E-Health Insider, the aim of the NKS is to "create a one-stop shop that provides the navigation and links to all government procured health and social care". By 2010 it says "all 10 million clinical decisions "will be supported by clinical knowledge"

The document estimates that the NHS currently wastes £100 million a year on clinical knowledge that is not used or not effective. It states that the various NHS organisations that generate or procure clinical knowledge currently only make "rudimentary" use of the NHS National Programme for IT.

The KPS directorate includes the National electronic Library for Health, Knowledge Management web services, together with disparate work on the development of clinical pathways and processes.

A key objective of the directorate will be to rationalise the sources of clinical knowledge the NHS procures, introducing stringent new standards and requirements. Knowledge procured will be organised and mobilised through the new National Library for Health.

CfH says that despite the NHS spending £100 million a year on buying in knowledge bases, together with its own investment in generating knowledge through agencies such as NICE, the National Patient Safety Agency and the R&D programme, there are currently "penetration deficiencies in the supply chain, at present running at 50% failure".

It estimates that less than half of the currently procured knowledge reaches the intended audience where and when they need it. "Thus about £100 million a year of knowledge is wasted".

In addition to working to build NKS the directorate will carry out work on 18 major projects focused on integrating knowledge with different aspects of clinical practice and process.

A copy of the business plan seen by EHI makes clear just how ambitious the NKS aims to be, setting out an extremely wide ranging action plan and series of development projects to begin or complete in 2005-2006.

Major clinical knowledge projects to be carried out range from developing clinical and nursing ‘National Clinical Toolboxes’; a National Library for Public Health; a ‘National Question Answering Service’ for clinicians; together with projects to evaluate voice recognition software and the most effective use of handheld devices.

Led by Sir Muir Gray, one of the prime movers behind the NHS Electronic Library for Health, the new NKS will procure best practice knowledge, organise it through the new National Library for Health and actively promote its effective use locally by teaching clinicians how to use knowledge more effectively.

In total the plan sets out 18 main projects:

  • The National Clinical Toolbox
  • Integrated Child Health Knowledge Platform
  • Nursing Knowledge Toolbox
  • National Library for Public Health
  • National Question Answering Service
  • National Knowledge Penetration Survey
  • Patient Decision Aids
  • Community Nurse Prescribers
  • Safer Handover
  • Constant Barcode
  • Patient Data Entry
  • Evaluation of Voice Recognition Software
  • Evaluation of Hand-held devices in Healthcare
  • Development of a Risk Minimisation Plan
  • Do Once and Share
  • National Library for Health
  • The Constant Patient