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Important: please update your RDS app to version 4.7.3 Details with newsletter below.

Please update your RDS app to v4.7.3

We asked you in January to update to v4.7.2.  After the deployment planned for 27th February, this new update will be needed to ensure that you are able to download RDS toolkits even when the RDS website is not available. We will wait until as many users as possible have downloaded the new version before switching off the old system for app downloads and moving entirely to the new approach.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. 

To update to the latest release:

 On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Right Decision Service newsletter: February 2025

Welcome to the February 2025 update from the RDS team

1.     Next release of RDS

 

A new release of RDS is planned (subject to outcomes of current testing) for week beginning 24th February. This will deliver:

 

  • Fixes to mitigate the recurring glitches with the RDS admin area and the occasional brief user interface outages which have arisen following implementation of the new distributed technology infrastructure in December 2024.

 

  • Capability to embed content from Google calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream into RDS pages.

 

  • Capability to include simple multiplication in RDS calculators.

 

The release will also incorporate a number of small fixes, including:

  • Exporting of form within Medicines Sick Day Guidance in polypharmacy toolkit
  • Links to redundant content appearing in search in some RDS toolkits
  • Inclusion of accordion headers alongside accordion text in search result snippets.
  • Feedback form on mobile app.
  • Internal links on mobile app version of benzo tapering tool

 

We will let you know when the date and time for the new release are confirmed.

 

2.     New RDS developments

There is now the capability to publish toolkits on the web with left hand side navigation rather than tiles on the homepage. To use this feature, turn on the “Toggle navigation panel” option at the top of the Page settings menu at toolkit homepage level – see below. Please note that publication to downloadable mobile app for this type of navigation is still under development.

The Benzodiazepine tapering tool (https://rightdecisions.scot.nhs.uk/benzotapering) is now available as part of the RDS toolkit for the national benzodiazepine prescribing guidance developed by the Scottish Government Effective Prescribing team. The tool uses this national guidance developed with a wide-ranging multidisciplinary group. This should be used in combination with professional judgement and an understanding of the needs of the individual patient.

3.     Archiving and version control and new RDS Search and Browse interface

Due to the intensive work Tactuum has had to undertake on the new technology infrastructure has pushed back the delivery dates again and some new requirements have come out of the recent user acceptance testing. It now looks likely to be an April release for the search and browse interface. The archiving and version control functionality may be released earlier. We’ll keep you posted.

4.     Statistics

At the end of January, Olivia completed the generation of the latest set of usage statistics for all RDS toolkits. If you would like a copy of the stats for your toolkit, please contact Olivia.graham@nhs.scot .

 

5.     Review of content past its review date

We have now generated reports of all RDS toolkit content that has exceeded its review date by 6 months or more. We will be in touch later this month with toolkit owners and editors to agree the plan for updating or withdrawing out of date content.

 

6.     Toolkits in development

Some important toolkits in development by the RDS team include:

  • National CVD prevention pathways – due for release end of March 2025.
  • National respiratory pathways, optimal cancer diagnostic pathways and cancer prehabilitation pathways from the Centre for Sustainable Delivery. We will shortly start work on the national cancer referral pathways, first version due for release via RDS around end of June 2025.
  • HIS Quality of Care Review toolkit – currently in final stages of quality assurance.

 

The RDS team and other information scientists in HIS have also been producing evidence summaries for the Scottish Government Realistic Medicine team, to inform development of national guidance around Procedures of Limited Clinical Value. This guidance will in due course be translated into an RDS toolkit.

 

7. Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

  • Friday 28th February 12-1 pm
  • Tuesday 11th March 4-5 pm

 

To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)

 

To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form  - also available in End-user and Provider sections of the RDS Learning and Support area.   If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot  If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.

With kind regards

 

Right Decision Service team

Healthcare Improvement Scotland

 

 

Atopic eczema (Paediatric)

Not all treatment options may be listed in this guidance. Please refer to local formulary for a complete list.

Treatment/ therapy

Atopic eczema may present as cradle cap in babies, before spreading to face, skin creases and extensor limb surfaces  then  flexural sites .  Rapid and early control is beneficial to long term outlook. May improve with advancing age. 

 

Atopic eczema

 

Atopic eczema

 

Atopic eczema

  

Eczema Herpeticum 

consider if any acute vesicular and painful flare. 

 

Topical Steroids: 

  • Prescribe a mild (face) and moderate (body) steroid in ointment form. 
  • Consider potent topical steroid to body in over 2’s 
  • Advise on fingertip units . 
  • Simultaneous application of emollients and topical steroid may reduce potency of steroid , advise a delay before steroid 
  • Reduce topical steroid to twice weekly maintenance when improved. 

Emollients: 

Consider Prescribing  an ointment  to use in the evening (if steroid used, apply after a suitable interval ) and a cream  to use in the morning. Ointments may cause less ‘stinging’ in inflamed skin. Discuss with  patient/parent  which  he/she prefers and will use regularly. 

Prescribe adequate quantities of emollients for daily use 

Soap substitutes and bath emollients: 

Soaps, shower gels and bubble baths are very irritant and should ALWAYS be avoided. 

Prescribe a bath additive or shower emollient instead which can also be used to wash hair. 

  

Eczema Herpeticum 

  • Stop topical steroids/tacrolimus and urgent referral 
  • Urgent viral PCR swab if available. 
  • consider if any acute vesicular and painful flare. 

Referral Management

  • Eczema not controlled (2+flares per month) despite maintenance and flare treatment with hydrocortisone to face and moderately potent steroid (up to 1 year) or potent steroid (in 1 year+) to trunk/limbs. 
  • Eczema causing severe psychological or social difficulties 
  • Diagnosis uncertain 
  • History of GI symptoms with severe widespread eczema not responding to topical steroids start on extensively hydrolysed formula and refer. 
  • Eczema Herpeticum: 
  • Contact Dermatology department immediately for advice. 

Clinical tips

  • Systemic antibiotics are only indicated if patient is systemically unwell 
  • Reassure patients that topical steroids are safe and effective if used as described. 
  • Ointments are preferable to creams. 
  • The vast majority of children with mild-moderate eczema that respond to treatment do not have food allergy. 
  • Light cotton or silk garments are available on prescription and can prevent scratching, help treatments to soak in and avoid staining of bedding and clothing. 
  • consider eczema herpeticum where there is an acute blistering flare of eczema, pain, fever and patient is unwell. 

Patient information resources

1.NHS Inform: www.nhsinform.scot 

2. NHS24 Tel: 08454 242424 

3. Text Phone: 18001 08454 24 24 24 

Editorial Information

Author(s): Adapted from Dermatology Patient Pathways .

Co-Author(s): NHS Scotland, Scottish Dermatology Society.