As the white paper proposals are increasing the involvement of primary care staff in planning and managing healthcare for their local populations, it is important that their access to good quality published information is improved.

The strategic importance of access to information has been recognised, and has led to the Librarian of the 21st Century programme in Anglia and Oxford region. The Primary Care Information Management Across Anglia (PRIMA) project is part of this, and addresses issues of information access for primary healthcare staff.

Currently, many practitioners based in the community have inadequate access to library services and, specifically, to such new information sources as Effective Health Care bulletins. When our pilot sites were questioned, hardly any primary care staff knew of such materials or thought they would be able to obtain copies. The Cochrane Library, with its useful range of databases, is also much less available to primary care staff than those in hospitals or health authorities. Critical appraisal skills training in some areas is less developed for community healthcare staff than for those based on hospital sites. Our experience in Anglia bears out the situation reported in a recent NHS Confederation research report, and also the issues reported in the Journal by Nick Summerton.1, 2

We hope that those responsible for planning information services following the new guidance (HSG(97)47) will treat the full range of primary and community healthcare staff as important users of the healthcare knowledge base, and address the issues of remote access to library services (by phone, fax and e-mail).3 Even more importantly, the Internet and worldwide web are of ever-increasing potential in providing distributed information services to even the smallest health centre or GP surgery, and librarians and information managers must work together to ensure effective exploitation of these services.

Nigel Starey,

PRIMA project manager;

Dorothy Husband,

PRIMA project officer,



1 Walshe K, Ham C. Acting on the

Evidence: progress in the NHS.

Birmingham: NHS Confederation, 1997.

2 Summerton N. Literacy criticism. Health Service J 1997; 107(5572): 27.

3 NHS Executive. HSG(97)47. Library and information services.

London: Department of Health, 1997.

In his otherwise excellent review of Amanda Scott's book, (Book Reviews, 27 November) Chris Wilson oddly assumes that hospitals and trusts will be setting up open-learning resource centres from scratch, ignoring the fact that virtually every hospital already has one. It is usually called the library.

Existing library services may fall short of the fully functioning learning centre Scott and Wilson both advocate, but upgrading an existing service to the right level will be a far more effective strategy than developing a new and competing resource within the trust.

I am reminded of the millions wasted by the NHS in the 1970s and 1980s developing 'nursing libraries' instead of upgrading the pre-existing 'medical libraries'.

HSG(97)47 on library and information services requires all trusts and health authorities to have library and information service strategies in place by next autumn. This is an ideal opportunity for trainers and human resource managers to advocate the need for active open-learning centres.

Michael Carmel,


South Thames Library and Information Service.