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This paper aims to demonstrate the approach taken in delivering the quality and impact elements of Knowledge for Healthcare, the strategic development framework for National Health Service (NHS) library and knowledge services in England. It examines the work undertaken to enhance quality and demonstrate the value and impact of health library and knowledge services. It describes the interventions developed and implemented over a five-year period 2015–2020 and the move towards an outcome rather than process approach to impact and quality.

The case study illustrates a range of interventions that have been developed, including the outcomes of implementation to date. The methodology behind each intervention is informed by the evidence base and includes professional engagement.

The outcomes approach to the development and implementation of quality and impact interventions and assets provides evidence to demonstrate the value of library and knowledge staff to the NHS in England to both high-level decision-makers and service users.

The interventions are original concepts developed within the NHS to demonstrate system-wide impacts and change. The Evaluation Framework has been developed based on the impact planning and assessment (IPA) methodology. The interventions can be applied to other healthcare systems, and the generic learning is transferable to other library and knowledge sectors, such as higher education.

In June 2016, a clear majority of English voters chose to unilaterally take the United Kingdom out of the European Union (EU). According to many of the post-Brexit vote analyses, the single strongest motivating factor driving this vote was “immigration” in Britain, an issue which had long been the central mobilizing force of the United Kingdom Independence Party. The chapter focuses on how – following the bitter demise of multiculturalism – these Brexit related developments may now signal the end of Britain's postcolonial settlement on migration and race, the other parts of a progressive philosophy which had long been marked out as a proud British distinction from its neighbors. In successfully racializing, lumping together, and relabeling as “immigrants” three anomalous non-“immigrant” groups – asylum seekers, EU nationals, and British Muslims – UKIP leader Nigel Farage made explicit an insidious recasting of ideas of “immigration” and “integration,” emergent since the year 2000, which exhumed the ideas of Enoch Powell and threatened the status of even the most settled British minority ethnic populations – as has been seen in the Windrush scandal. Central to this has been the rejection of the postnational principle of non-discrimination by nationality, which had seen its fullest European expression in Britain during the 1990s and 2000s. The referendum on Brexit enabled an extraordinary democratic vote on the notion of “national” population and membership, in which “the People” might openly roll back the various diasporic, multinational, cosmopolitan, or human rights–based conceptions of global society which had taken root during those decades. This chapter unpacks the toxic cocktail that lays behind the forces propelling Boris Johnson to power. It also raises the question of whether Britain will provide a negative examplar to the rest of Europe on issues concerning the future of multiethnic societies.