Trip Database Blog

In the middle of last year I attempted to draw conclusions about the difference in costs between TRIP and NHS Evidence (click here for the full blog post).  Since then I’ve been trying to understand the costs of NHS Evidence and have managed to arrive at the following figures (NOTE: I’ve had to use Freedom of Information requests which are tedious see here & here.  I welcome NHS Evidence correcting any figures below):

• Total budget – £24,438,000
• Content costs (BNF, Cochrane) – £10,675,971
• Remaining costs (This includes the budget for the specialist collections which I understand is approximately £2,000,000 for all 34) – £13,762,029

Of those remaining costs, here’s a flavour of the spending:

• Consultants and other temporary staff – £2,813,258
• Staff costs (the 41 employees) – £2,863,742
• Marketing – £730,000

Using the same search figures as before = 15,811,716 searches at a cost of £13,762,029 (excluding content costs from the total budget).  BTW since I quoted that figure a few people have suggested that actual figure for number of searches is too high as it includes search figures for other databases managed by NHS Evidence.  However, a specific question, via Freedom of Information, refutes this – so I will use this higher figure.

Each search on NHS Evidence costs 87.04 pence

TRIP on the other hand has now reduced its costs (on the TRIP Database) and will this year run on a maximum of £35,000.  Using the same search figures as before (8,058,648) this equates to a cost per search of 0.43 pence per search.

Therefore, each search on NHS Evidence costs 202 times more than on TRIP.

Why does this bother me?  A number of reasons:

• The NHS is facing massive challenges to the budget yet NHS Evidence appears immune.
• NHS Evidence distorts the market and TRIP suffers. 
• NHS Evidence does not appears to be engaging with librarians (that’s certainly the feel I get from conversations and emails). The recent decision to give the specialist collections to non-librarian consortia reinforces this feeling.

But the main one is that I don’t feel they offer a superior service to TRIP.  I would go as far as to say that I feel TRIP is significantly better at supporting real, frontline clinical staff.  However, I still stand by my main conclusion of last year that search isn’t the answer to properly supporting clinicians to practice evidence-based healthcare.

With regard to these latter points I’d love to have the funds to test this.  NHS Evidence got any spare change?

UPDATE: We’ve had an email from someone who used to work on the predecessor of the NHS Evidence – the National Library for Health (NLH).  They point out that the old budget for the NLH was approximately £9,000,000.  The only significant difference between the two (in relation to funding content (is the £5,000,000 paid to the BNF.  So, comparing the old NLH and the new NHS Evidence there is a difference in funding level of around £10,000,000. They would like to know what does that extra money get you?

I’ve no idea, perhaps NHS Evidence can tell us?

UPDATE 2: I tweeted about this post and subsequently saw this tweet from Ben Goldacre (@bengoldacre) he of Bad Science fame:

A search on NHS Ev costs 200X one on TRIP: I find TRIP better

Below is a copy of an email I sent to one of the design teams we use, I’m hoping it’s self-explanatory.  Feel free to comment on the idea and possible approach.

In TRIP we add around 4-5,000 new articles per month and currently this gets added to the index. In a way this hides it. I feel we could make it much more visible and accessible.



I’m increasingly aware that to search you need to know what you’re looking for ie a known unknown. I want to create a space where people can browse for content without really knowing what they’re looking for, so more like unknown unknowns.

A few points:

• I’d like users to be able to select the time period (from 1 month to 12 months) perhaps some sort of visual system e.g. slider.
• I’d like them to be able to select the grade of evidence (we have the slider in the results filter, which could be used/aopted).
• I’d like to create some specialist areas e.g. view all the latest cardiology articles.
• But I’d also like them to be able to search e.g. show latest articles on cholesterol
• But I’d also like them to start with ALL latest evidence and burrow.

I’d hate for it to be a simple list – so boring. I want it to be immersive, I want them to enjoy exploring the data. I’d like it to be visual. I quite like the idea of using a word cloud to help navigate. But is that good? Old fashioned?

I’m still at very early stages of my thoughts and am quite keen to have some input from a design perspective.


Do you fancy doing a little bit of work on this? I’m not expecting proper designs, perhaps some outlines? I’m not saying this should be design led but I think it could help guide my thoughts on how/if it develops.

I hope everyone had a good new year.

In 2010 we added a number of blogs to TRIP, for instance:

• Clinical correlations
• Trust the Evidence
• National Prescribing Centre blog

We’re fairly selective about which blogs to include and have identified a few more to add in the near future.  However, we’re hoping to hear from users of TRIP with suggestions of any blogs to include.  A few – loose – criteria:

• High quality
• Content is clinically focused and clinically usable
• Aimed at health professionals

Let me know if you can think of any.

Also, we’re always looking out for high-quality content.  So, any non-blog sites you find useful, that fit the criteria above, then feel free to let me know.