• evidence-based practice;
  • journals;
  • library circulation and loans;
  • National Health Service;
  • survey;
  • United Kingdom


Background:  NHS Library Services are utilised by NHS staff and junior trainees to locate scientific papers that provide them with the evidence base required for modern medical practice. The cost of accessing articles can be considerable particularly for junior trainees.

Objectives:  This survey looks at variations in cost of journal article loans and investigates access to particular orthopaedic journals across the country.

Methods:  A national survey of UK Health Libraries was performed. Access to and costs of journals and interlibrary loan services were assessed. Availability of five wide-reaching orthopaedic journals was investigated.

Results:  Seven hundred and ten libraries were identified. One hundred and ten libraries completed the questionnaire (16.7%). Of these, 96.2% reported free access to scientific journals for users. 99.1% of libraries used interlibrary loan services with 38.2% passing costs on to the user at an average of £2.99 per article. 72.7% of libraries supported orthopaedic services. Journal of Bone and Joint Surgery (British) had greatest onsite availability.

Conclusions:  The study demonstrates fluctuations in cost of access to interlibrary loan services and variation in access to important orthopaedic journals. It provides a reflection of current policy of charging for the acquisition of medical evidence by libraries in the UK.