APPENDIX 43
Memorandum from BioMed Central
HOW ACCESSIBLE IS NHS-FUNDED RESEARCH TO
THE GENERAL PUBLIC AND TO THE NHS'S OWN RESEARCHERS?
SUMMARY
1. We carried out a survey to estimate what
proportion of articles resulting from NHS centrally funded research
is accessible online (a) to the general public and (b) to NHS
researchers at a particular location (Derbyshire Royal Infirmary
and Derby City General Hospital).
2. Our results indicate that although the
majority (90%) of the resulting research articles now exist in
online full text form, less than a third (30%) of the online full
texts are accessible to the general public immediately upon publication.
Perhaps more surprisingly, despite the NHS's major recent program
of electronic journal procurement, only 40% of the online full
texts of these NHS-funded research articles are immediately accessible
to NHS staff at the hospital we studied. These preliminary results
suggest that the current system of scientific publishing is failing
to make NHS research fully accessible to those who could benefit
from it, including staff within the NHS.
3. We recommend that the government works
to improve the accessibility of the research that it funds by
encouraging UK researchers to publish in Open Access journals.
INTRODUCTION
4. The first question posed by the Inquiry
is:
`What impact do publishers' current policies
on pricing and provision of scientific journals, particularly
"big deal schemes", have on libraries and the teaching
and research communities they serve?'
In order to evaluate how effectively the current
system of scientific publication supports scientific communication
within the NHS and the UK community at large, we undertook a survey
of a sample of centrally funded NHS research projects. We investigated
what proportion of the publications resulting from these projects
are accessible online:
— to the UK population as a whole
This submission is a preliminary report on the
results of the survey. We plan to publish a more extensive and
detailed analysis in the near future.
METHODOLOGY
5. The NHS maintains a database known as
ReFeR (Research Findings electronic Register) 148. ReFeR holds
short summaries of the findings of all completed projects funded
by the NHS R&D Programme and the Department of Health Policy
Research Programme.
[148]
6. Our survey covered all 128 projects listed
in the ReFeR database for which the funding period ended during
2001. We chose to study the projects ending in 2001 as this allowed
a 2-3 year window for the research that resulted from the project
to have been submitted to a journal and published.
7. We emailed a questionnaire to the primary
contact for each of the relevant projects in the ReFeR database
on October 1st 2003, giving an initial deadline of November 1st
for responses. The questionnaire asked the recipients to provide
details of all published articles that had resulted directly from
the specific project listed in the ReFeR database.
8. We sent a series of email reminders over
the course of the next two months to those recipients who had
not completed their survey forms. The collection of responses
ceased on December 1st 2003.
9. In addition to published articles, we
also asked the participants to list details of "submitted",
"in press" and "rejected" articles. The analysis
below covers only the published articles, however. We also excluded
from this analysis meeting abstracts, book chapters and other
types of non-journal content so as to focus entirely on the issue
of journal article accessibility.
RESULTS
How many journal articles are published as a result
of NHS centrally funded research?
10. We received responses from 108 (85%)
of the 128 projects covered by the survey.
11. Collectively these projects had led
to the publication of 206 journal articles at the time of questionnaire
completion (Table 1).
12. For a breakdown of the journals in which
articles were published, see Annex.
13. A further 58 articles were described
as `submitted' or `in press'. These articles are not included
in the analysis below.
Table 1
|
| Projects covered by survey | 128
|
| Projects that responded | 108
|
| Response rate | 84%
|
| Total number of published articles reported
| 206 |
| Number of distinct journals in which articles were published
| 107 |
| Mean number of articles published per responding project
| 1.9 |
|
How accessible is NHS research to the general public?
14. The first part of our analysis investigated what
proportion of the research articles resulting from NHS-funded
research, during the period of the study, were accessible online
to the general public without requiring a subscription.
15. The results are shown in Figure 1. Although 186 articles
(90%) had online full text available, the full text was only freely
accessible immediately after publication for 54 articles (26%
of the total number, 30% of those that are online). A further
16 articles (eight% of the total) became available after an embargo
period of between six and 24 months. The majority of articles,
however, remain long term inaccessible to the general public.
16. It is noteworthy that more than half of the fully
Open Access online full text articles (31 articles) were publications
in the NHS's monograph series Health Technology Assessment (HTA)
[149]. These articles
are indexed in PubMed, and the PubMed record links directly to
the free online full text. This publication provides an excellent
example of how the results of NHS research can be published in
a way that makes them generally accessible.
17. The next largest set of Open Access articles were
those published in the British Medical Journal (11 articles).
It is worth noting that the BMJ has indicated that it does not
plan to retain its policy of full free online access beyond January
2005 (Tony Delamothe and Richard Smith, BMJ, 2003, 327:241-242)
[150]. It is still
considering whether or not to retain free access to all research
articles.
Figure 1
|
| Article accessibility | Number of articles
|
|
Free full text via PubMed
(HTA) |
31 |
Free full text via PubMed
(other) |
14 |
| Other free full text | 9
|
| Embargoed full text | 16
|
| Subscription full text | 116
|
| No online full text | 20
|
| Total | 206
|
|
Figure 2
|
| Article accessibility | Number of articles
|
|
Immediately accessible full
text |
76 |
| Embargoed full text | 14
|
| Inaccessible | 96
|
| (NHS does not subscribe) |
|
| No online full text | 20
|
| Total | 206
|
|
How accessible is NHS research to NHS researchers?
18. In the second part of our analysis, we examined the
accessibility of the online full texts of these NHS-funded research
articles to researchers within the NHS. For this initial study,
we looked at one specific NHS location: Derbyshire Royal Infirmary
and the Derby City General Hospital.
19. The NHS has three major tiers of online access provision:
National level
Electronic journals licensed by the Core Content project
Confederation level
Electronic journals licensed by the confederation
Local level
Electronic journals licensed by the individual NHS Trust
20. The NHS Core Content project[151]
provides access to more than more than 1000 journals, although
in some cases this access is subject to an embargo period of either
six months or 12 months.
21. Derbyshire Royal Infirmary and the Derby City General
Hospital belong to the Trent confederation, which holds a confederation-wide
licence for electronic access to 29 journals published by the
BMJ Publishing Group.
22. In addition, at the local level, Derbyshire Royal
Infirmary and the Derby City General Hospital hold online subscriptions
to 42 electronic journals (out of a total of 180 journal subscriptions
held). Since the purpose of this study was to examine online accessibility,
we did not include the print-only holdings when calculating accessibility
figures. But it is worth noting that even had we done so, it would
have made very little difference to the accessibility figures.
Most of the articles that were inaccessible online were not covered
by print holdings either.
23. Figure 2 shows the end result of these three tiers
of online access provision. It indicates the proportion of the
journal articles (reporting NHS-funded research) covered by this
study that are accessible to staff at Derbyshire Royal Infirmary
and the Derby City General Hospital.
24. Perhaps surprisingly, despite all the online access
procurement efforts and expenditure of the NHS, the online accessibility
of NHS-funded research to NHS staff at the location studied is
only marginally better than the accessibility of those articles
to the general public. Only 37% of the articles covered by the
study are available to these staff immediately on publication
(compared to a figure of 30% for the general public). A further
7% of the articles are accessible after a 6-12 month embargo period,
leaving 56% long-term inaccessible online. Since 90% of all the
articles do exist as online full texts, the major reason for this
lack of access is subscription barriers.
25. The Annex provides a journal-by-journal breakdown,
indicating how many of the articles covered by this study appeared
in each journal, and what the accessibility of that journal is
for the general public and for NHS staff at the location covered
by this study.
DISCUSSION
26. The web has changed the economics of scientific communication
by making the incremental cost of distributing additional copies
of research articles negligible, once the first copy has been
published online.
27. It is therefore now feasible that research results
should be openly accessible to anyone who has an interest in them.
From the point of view of the investigator carrying out the research,
and of the organization funding it, it is desirable that research
publications should have the widest possible distribution.
28. Unfortunately, traditional scientific publishers
have simply taken their existing business models, which derive
from the completely different economic imperatives of print publishing
and distribution, and transferred them to the online environment.
The result is that access to the scientific literature online
is subject to severe constraints, even though this is not economically
necessary, nor in the interests of science.
29. The results reported in this survey indicate that
there remains a significant gap between the status quo and a situation
in which all research is broadly accessible to the general population
online.
30. Even more striking is the limited online access that
NHS staff have to the published results of the NHS's own research.
Of course, due caution must be used in extrapolating from this
initial study. The study only covered centrally funded NHS research,
which constitutes a fairly small proportion of all the research
that takes place within the NHS. Also, the initial phase of the
study has only examined access at one location within the NHS.
Further research is clearly necessary, but we have no reason to
believe that the NHS location we studied was unusual or unrepresentative
of the NHS as a whole. In particular, it is our understanding
that across the NHS, the national Core Content collection is the
major source of online subscription access rights. This report
suggests that the Core Content collection still leaves a large
fraction of the NHS's own research publications inaccessible online,
to say nothing of the vast amount of research published by other
organizations that also remains inaccessible.
31. Defenders of the scientific publishing status quo
sometimes claim that researchers at major institutions effectively
already have open access to all the research that they really
need, thanks to institutional licensing deals. See, for example,
Kate Worlock's interview with Elsevier Science & Technology
division CEO Arie Jongejan, in "Open Access: A step back
in time?" (IMI Insights, October 2003, pp. 5-7), where Jongejan
disputes the fact that "traditional publishing models hinder
access to content" and instead asserts that "70% of
the audience which might be interested in accessing Elsevier's
scientific, technical and medical content can at present do so".
The results presented in the current report show that, from the
NHS's perspective at least, this argument does not hold water.
Subscription-barriers do significantly limit the access of NHS
researchers and staff to online research, even when that research
has been funded and carried out by the NHS.
32. It might be argued that the availability of all NHS
research (and other research) throughout the NHS is unnecessary,
since as long as specialists and specialist departments subscribe
to the particular journals they need, it might not be a major
problem that this access is not available in all parts of the
NHS. But the scientific literature is so large, the boundaries
between disciplines are so fuzzy, and interdisciplinary research
is so important that a specialist department still cannot possibly
subscribe to all the journals that it needs. Even if it wanted
to, publishers now primarily target their online offerings to
large institutions and consortiums, so individual departments
are forced to rely on print journals, rather than being able to
take advantage of the instant availability, searchability and
other benefits that online access provides.
33. Looking beyond the NHS, Jongejan's argument disregards
the right of the general public to have access to the results
of the latest medical research that their taxes have funded. The
quality of debate in the country on controversial issues such
as the MMR vaccine and BSE would greatly benefit from the accessibility
to all concerned (not least science and health journalists) of
the original peer-reviewed research articles themselves, rather
than second- or third-hand journalistic interpretations. It is
unjustifiably elitist to proclaim that none but those working
at major well-funded institutions have the capacity to benefit
from having access to the scientific literature.
34. The huge popularity with the general public of free
sites such as PubMed[152],
which indexes and makes freely available more than 11 million
medical research abstracts, indicates that there is a strong demand
amongst the general public for access to the latest medical research
findings.
CONCLUSIONS
35. It is clear that if the majority of NHS research
is to be accessible to the general public, the scientific publishing
industry will need to go through profound change. Although most
of the research now being published is being made available online,
it is trapped behind subscription barriers, and so one of the
key benefits that online publishing can deliver for science (a
near-zero marginal cost of distribution) is not being fully utilized.
The current system of science publishing leaves the vast majority
of full text research articles inaccessible to the majority of
the population.
36. Online access to the research literature for the
general public is desirable, but for medical professionals this
access is essential. It makes little sense to spend vast sums
on medical research, and then to surrender the fruits of that
research to the control of a few large publishers who then restrict
access. Doing so is an inefficient use of funding resources, since
a lack of access to previous research will act as a continuing
impediment to further research.
37. Comparing Figures 1 and 2, it can be seen that despite
significant expenditure by the NHS on online subscriptions, the
online accessibility of the NHS's own research to NHS staff is
currently only slightly better than the accessibility of that
research to the general public. This situation needs to be addressed.
RECOMMENDATIONS FOR
ACTION
38. We recommend that the government publicly expresses
support for Open Access journals[153]
and initiatives, such as those listed at the Directory of Open
Access Journals[154].
39. The NHS and the UK Research Councils should set out
a policy to ensure that, when considering funding proposals and
new scientific appointments, the quality of the applicant would
be judged directly on the merit of the research that they have
published. This policy would address the problem perceived by
many scientists that the current system is skewed by reliance
on "impact factors" and "journal reputation",
which serve to disadvantage those who publish high quality research
in new Open Access journals. These pioneers should be encouraged
rather than penalized.
ACKNOWLEDGEMENTS
40. The survey was carried out in collaboration with
Ron Stamp and Lesley Elliott at the Department of Health. Scott
Gibbens, Richard Marriott and Caroline White provided details
of NHS electronic subscriptions at the national, confederation
and local levels respectively, and Camilla Macdonell provided
assistance with collating survey responses.
148
http://www.doh.gov.uk/research/rd3/information/findings.htm Back
149
http://www.ncchta.org/index.htm Back
150
http://bmj.bmjjournals.com/cgi/content/full/327/7409/241 Back
151
http://www.sherpa.nhs.uk/Dbase/html-files/Database%20Registration.htm
Back
152
http://www.ncbi.nlm.nih.gov/PubMed/ Back
153
http://www.earlham.edu/¥peters/fos/bethesda.htm£definition
Back
154
http://www.doaj.org/ Back
| 
