Purpose Collaboration on procurement of e-content between health libraries in the National Health Service (NHS) and in higher education (HE) should have advantages in increasing their negotiating power to improve licence terms and avoiding unnecessary duplication of content. The aim of the paper is to examine some of the strategies for ensuring that collaboration across the two sectors works effectively. The paper is based on a report to the Joint Information Systems Committee of the Funding Councils (for higher and further education) in the UK, and the NHS Library and Knowledge Development Network, on research conducted in 2006. Design/methodology/approach The methods included interviews (n=39) with representatives from NHS and higher education bodies, representatives of independent health libraries, the National Library for Health, collective agencies, publishers and aggregators. Findings There were common interests in functionality/interfaces, open access, and better metrics for estimating usage that might contribute to discussions with publishers over the licence terms. There are differences in the type of resource each sector might deem core. The extent of existing collaboration on purchasing and related collection management activities varied considerably across the UK. Three possible paths for cooperative activity were identified: 1) sharing information and joint advocacy; 2) building the technical infrastructure; and 3) joint procurement. Mapping of the stages, roles, actors and stakeholders in some processes was done with 'use cases' (Unified Modeling Language) to help identify some of the risks involved. Research limitations/implications Poor response from online surveys limited the validity of the forecasting of user needs. Usage statistics were both difficult to obtain and compare. Practical implications The paper concludes that collaborative procurement of e-content activities should focus on health services research requirements, and open access needs across the sectors. More innovative analysis of usage statistics is required to profile usage and inform cost analyses of both the impact of new roles for health librarians, and cost analyses of e-resources on a life cycle basis. Originality/value The paper develops new ways of examining the business processes required for collaborative procurement.