Executive summary The aim was to provide an overview of the status of the Specialist Libraries around 12 months after the commissioning exercise of March 2003 that saw the creation of new Specialist Libraries, as well as the continuation of some that had been established for some years prior to 2003. The objectives were to answer the following questions: · Are the Specialist Libraries operating as intended? Are their differing management structures working well? · How are they acting as communities of practice? · How can their stage of development be assessed? · How is the community of information specialists operating to support the development of the Specialist Libraries? · What are the Specialist Libraries’ links with other organisations, such as professional associations and patient groups? Operation and management of the Specialist Libraries Structures are different but they work. Many Libraries see the need to reward contributors’ efforts through CPD points or payment. The RMS is working, and most Specialist Libraries appreciate the benefits of the links between the libraries, the ability to make use of RSS feeds, but the drawback is the difficulty in providing training and learning materials. Technical support has improved. Information specialists are taking on greater responsibilities for ensuring that their editorial boards, reference groups, and advisory groups are kept informed of developments. There is some uncertainty about the fit between the Specialist Libraries, and other national knowledge activities, particularly the Map of Medicine. Specialist Libraries as communities of practice Some Specialist Libraries wish to foster their' active' stage of development and move towards the 'engaged'stage by: · developing interaction with their communities online discussion forums, or question and answering services · providing more learning activities and materials. The evidence from the recent literature suggests that the Specialist Libraries will need to focus on: · dealing with differences between the professions represented in their communities on the way innovations are handled. · integrating primary care, and providing services that primary care appreciate (such as the question and answering services) Specialist Libraries may need to debate how to: · support learning, and link into existing CPD activities (such as journal clubs) · provide filtered access, to people with the knowhow about service improvement, for their specialist area.