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 or fairly easy access to published research papers; and a large majority said that access had improved over the past five years.

4.37. But many researchers—especially those in smaller and less research-intensive institutions—complain that they do not have access to a sufficiently-wide range of titles; and a significant minority (5%) describe their current level of access as ‘fairly’ or ‘very’ difficult. A similar-sized minority (5%) also reported a recent difficulty in securing access, the most frequent of which was the need to pay for the article they wanted. Since most were unwilling to pay, they adopted a range of coping strategies, the most frequent of which was to give up and move onto something else.

4.38. These findings should be set in a context, however, where levels of satisfaction with access to other kinds of information content, including conference papers, books, technical reports, trade publications, research data and theses—were very much lower; and the difficulties encountered in gaining access to relevant material much more frequent. In sum, levels of access to published research outputs are good in many universities, but far from comprehensive across the HE sector as a whole; there are particular problems with access to conference proceedings and monographs; and the restrictions on use and re-use imposed by publishers limit the ability of researchers to make use of journal contents to best effect.

4.39. Health. On the basis of the available data from the NHS, surveys undertaken by the Library and Information Statistics Unit (LISU), and estimates from publishers, the Open Road report in 2011 estimated that on average across the NHS, about a third of relevant journals were available free at the point of use. That includes core content in the form of full-text databases (not necessarily including current content) procured in England by NHS Evidence (part of the National Institute for Health and Clinical Excellence), as well as print and electronic content procured locally. The estimate should therefore be regarded as tentative.

4.40. Staff in the NHS show lower levels of satisfaction than staff in universities with their access to journal articles and other content; and universities with medical schools repeatedly report problems with different systems and levels of access for university and NHS staff. JISC Collections is leading a pilot programme to provide access to content from major publishers to five Academic Health Science Centres (AHSCs) that were established in London, Cambridge and Manchester in 2009. The programme allows the universities at the heart of the AHSCs to extend to their partner NHS organisations access to all their subscribed content from five major