- SA Mathieson

How Coventy City Council works with a local NHS trust to provide advice on sexual health and cancer in its libraries.

This article titled “The libraries that offer sexual health services and cancer support” was written by SA Mathieson, for theguardian.com on Wednesday 23rd March 2016 09.44 UTC

You expect to see books in a library. You might not expect free sperm keyrings – available in classic white or translucent with red sparkles – along with the offer of sexual health advice and 60-second HIV tests.

That is why staff from the Coventry and Warwickshire partnership NHS trust’s integrated sexual health service set up a stand in Coventry’s Central Library every Thursday. “Being here, we get to the people who can’t get to us,” says Steven Clay, a senior sexual health nurse.

People who don’t want to visit a sexual health clinic after work can visit the library on their lunch break, where staff can carry out tests and provide advice in a private meeting room. “Some people say I’ve seen the sign but I don’t want to come over because I’m embarrassed. So I text back and say come straight to meeting room three,” says Clay.

Public library services are increasingly providing health information, but Coventry city council takes this further than most. It runs health-related events, with a women’s wellness and fun day held on International Women’s Day, including a Zumba class, sari-tying and a writer’s workshop. Regular ones include free over-40 health checks, a mental health drop-in service and support with breastfeeding.

The last event is held alongside Rhymetime, whose infant participants fill the library with Hokey Cokey. Sorrelle Clements, service development manager for Coventry’s libraries, says that some people with health worries rush to their GPs and demand attention, but “the people who are reticent, or don’t have English as a first language, or have so many multiple things going on in their lives that they put themselves last don’t have that option”.

However, they may visit Coventry’s Central Library to use its 50 free computers, to read books in 12 foreign languages or to bring their children or grandchildren to Rhymetime. “We use these events and opportunities to push life-changing messages,” Clements says, over the sound of Heads, Shoulders, Knees and Toes.

As well as the local NHS, Coventry is working with cancer support charity Macmillan. Last summer, the city installed Macmillan information points in five of its 17 libraries, providing leaflets and CDs, and has trained 73 of its library staff in effective listening and local cancer support services.

“We wanted to have that place in the community where people could access quality cancer support information, but also to provide training to library staff so they would be able to signpost on when the information needs were more complex,” says Ceri Brettle, the city’s Macmillan library services co-ordinator, whose 18-month post is funded by the charity.

Brettle moved from a training role at pub chain JD Wetherspoon, where she raised money for cancer charities. As well as setting up the training, she has worked on where to place Macmillan’s information in libraries. Central Library has two large stands and smaller displays within specific sections, including the library’s health and wellbeing zone and the children’s ‘Books to help with life’s up and downs’ section.

The foreign zone has leaflets from the charity on cancer symptoms in Arabic, Bengali, Chinese, Gujarati, Hindi, Punjabi and Urdu as well as details of its multilingual support line, which are unmissable in the middle of the library’s books in these languages. The city asked Macmillan to provide this information in Romanian following work with the local Roma community, and this is now available online. So far, 2,300 leaflets and CDs have been taken from the information points, with 90 enquiries or conversations.

Kim Diprose, information and support programme manager at Macmillan, says that about a dozen of its 200 information services are run with library services, with Glasgow city council having set up information points in all its 33 libraries and regular advice sessions in more than half. The charity is assessing their effectiveness.

Most of its information services are based in NHS buildings, but Diprose says libraries offer a useful alternative for those who are ending treatment and have seen enough of hospitals. “People tell us they want to be able to access information when they need it in the place that suits them,” she says. “Some people find it daunting to go into something that’s clearly a cancer-related environment, and sometimes libraries can be less intimidating.”

Coventry also uses books to boost users’ health. It provides books on prescription for mental health and dementia, and will soon add titles for children and teenagers. This is a national scheme in which 87% of public library authorities participate and through which GPs and other NHS staff can prescribe a book by printing and signing a form available locally on Coventry and Rugby clinical commissioning group’s GP Gateway intranet.

Clements says few people hand in the prescription form at a library, with many preferring to find the book anonymously; the titles, which are displayed in special stands, are borrowed a lot. The library service manages the stock carefully and if a title isn’t available on the shelf, “we’ll go to the ends of the earth to get it,” she says.

City library staff have also attended quarterly training days run by the clinical commissioning group for GPs to promote the service, but Clements says it can be difficult to make links with the NHS, particularly large organisations such as the local acute trust. “It’s like learning a new language for the library service and library professionals.”

She has found that it is useful to highlight specific books that professionals can recommend as support for patients who are ending a stage of treatment, “so they see their library almost as a support mechanism”.

“Librarians have the expertise to point you to quality information sources that meet your specific needs,” says Nick Poole, chief executive of the Chartered Institute of Library and Information Professionals. “They can’t offer diagnoses or offer tailored healthcare.” But there are big variations in health outcomes across the country that are not caused by the quality of local NHS services, he adds. “There’s an awful lot you can do prior to providing actual healthcare advice.”

Does using libraries for healthcare advice dilute their main purpose of providing access to reading? “People are always keen to paint this as an either/or,” says Poole. “What we’re finding is it’s cumulative.”

“Libraries are about the general health and wellbeing of the population,” says Peter Barnett, head of libraries, advice, health and information service at Coventry council. “We’re valuable as a neutral space that people don’t have any great hang-ups about. We can reach different people that the NHS won’t through its own locations.”

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