Let's stick together: collaborative purchasing of electronic journals in the National Health Service.

AIM: To describe the process and the lessons learned from the collaborative purchasing of electronic journals by National Health Service (NHS) libraries in the East Midlands, UK. RESULTS: The background to a successful joint purchasing initiative is described, including the methodology for selecting titles and the formula for dividing the payment. Factors that have a bearing on successful collaboration are discussed, including use of a Framework Agreement, licensing conditions and measuring impact. CONCLUSION: NHS librarians working together can leverage collective benefits for users through collaborative purchasing.

Access to learning resources for students on placement in the UK: what are the issues and how can we resolve them?

AIM: To compile a list of the issues regarding access to learning resources which affect students on placement in the UK and suggest some ways in which these can be resolved. RESULTS: Issues relating to PC access, network access, software, firewalls, disciplinary procedures, electronic information resources, virtual learning environments, service level agreements, physical access to libraries, book loans, reading lists and course committees are identified and discussed in relation to NHS libraries. CONCLUSIONS: Successful resolution of the IT and library issues, which are increasingly inter-linked, can help to ensure that students have a positive placement experience. Resolution will depend on close, regular liaison and can be assisted by negotiation of a clear Service Level Agreement.

Assessment and management of self-harm in older adults attending accident and emergency: a comparative cross-sectional study.

OBJECTIVE: Older people who undertake self-harm are at higher suicide risk than are younger patients. This study examines whether this greater risk is reflected in the assessment and after-care that older patients receive when they attend accident and emergency. METHOD: This cross-sectional study, set in the two accident and emergency departments in a large industrial city in Northern England, compared 141 consecutive attendances due to self-harm among older patients (aged 55 years and over) with a random sample of 125 attendances of younger people (aged 15-54) attending because of self-harm. Data were drawn from accident and emergency records and from psychiatric and general hospital casenotes. RESULTS: Compared with the younger group, older patients were significantly more likely to be admitted from accident and emergency to the general hospital, to receive a specialist assessment whilst at the hospital, and to be offered psychiatric after-care-either as a psychiatric in-patient or an out-patient. CONCLUSIONS: Fortunately, older people attending accident and emergency following self-harm seemed likely to receive psychosocial assessment from a mental health specialist, and they were much more likely than younger patients to be offered after-care. Hospitals will need to monitor accident and emergency and other records if they are to check that their services are responding to the high risks seen in older patients.