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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

 

 

Viral Warts

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

Treatment/ therapy

Warts are caused by a common viral infection, the human papillomavirus (HPV). Most resolve spontaneously within a year or two. They may vary in appearance depending on the types of HPV, the anatomical site involved and the host immune response. They often have small black dots, representing coagulated capillaries, particularly evident on paring. 

Common hand warts 

Common Hand Warts

Deep plantar wart (verruca) 

  • May be tender on pressure 

Deep Plantar Wart

Mosaic plantar wart 

  • May be slow to resolve in comparison to other warts 

Mosaic Plantar Wart

Plane wart 

  • Flat topped pink or pale brown. Often on face or other sun exposed sites 

Plane Wart

Filiform facial wart 

Filiform Facial Wart

Most patients with viral warts can be managed in primary care. 

Consider no  treatment as warts usually resolve spontaneously 

Common hand warts 

  • Self treatment daily with salicylic acid (up to 26%) or glutaraldehyde paints or gels after paring the warts 
  • Continue treatment for at least three months then review 
  • Consider 3-weekly cryotherapy in non-responders, occlusion under waterproof plaster, and use in combination with topical therapy 
  • Cryotherapy may be distressing and therefore inappropriate for young children 

Deep plantar wart / mosaic plantar warts 

  • Self treatment with daily salicylic acid paint (up to 50%) 
  • Paring of plantar warts with single-use file enhances treatment response 
  • Consideration of cryotherapy three weekly for up to 10 treatments: single or double freeze thaw cycle(s) 
  • Patients with painful plantar warts can be treated with corn plasters 

Plane warts 

  • Plane warts often resolve spontaneously 
  • Avoid cryotherapy 
  • Apply topical retinoic acid if persistent 

Filiform facial warts 

  • Do not apply wart paints 
  • Treat filiform facial warts with careful cryotherapy for 5-10 seconds to the wart but avoid surrounding skin 
  • Repeat every 2 or 3 weeks 

Referral Management

  • Symptomatic warts persistent for at least two years and unresponsive to topical agents and cryotherapy 
  • Diagnostic uncertainty especially in the elderly 
  • Multiple recalcitrant warts in the immunosuppressed 
  • If you need support for a patient with anogenital warts, seek advice from your local genito-urinary medicine team 

Clinical tips

  • Do not use salicylic acid on the face 
  • Cryotherapy should be administrated by appropriately trained staff 
  • Diagnostic doubt over solitary wart: remove by curettage for histopathology 
  • Children with verrucae should not be banned from swimming pool but can wear verruca socks 

Patient information resources

Editorial Information

Author(s): Adapted from Dermatology Patient Pathways.

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