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  6. Young people common STIs and other genital infections in 13 to 15 year olds
  7. 2) The prophylaxis of specific sexually transmitted infections
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

 

 

2) The prophylaxis of specific sexually transmitted infections

a. Hepatitis B vaccination in the absence of a post exposure need

i. Use of adult vaccinations and adult schedules

No adult hepatitis B vaccinations are licensed for use as per adult schedules in young people less than 16 years of age, but their use in sexual health services is common place.

 

ii. Use of adult vaccines in licensed modified schedules in 13 to 15 years of age

Some services may adopt an alternative ‘2 dose’ schedule for young people aged 13 to 15 yrs (incl), using 2 doses of Engerix B  20 micrograms at 0 and 6 months, but this is only suitable when there is a low risk of hepatitis B during the vaccination course and when completion of the 2 dose course can be assured1.

The manufacturer of Engerix B also reports a reduced level of seroprotection at 42, 54 and 66 months in the 0, 6 schedule Engerix B 20microgram compared to 0,1,6 months of Engerix B 10 in 11 to 15 years old2.

 

iii. Use of licensed paediatric vaccines in licensed schedules in 13-15 years of age

Vaccine

Schedule Options1

Engerix B® 10 micrograms

0, 1 and 6 months

0, 1, 2 and 12 month 

HBVAXPRO Paediatric 5 micrograms,

0, 1 and 6 months

0, 1, 2 and 12 month

Twinrix® Paediatric

0, 1 and 6 months

  

b. Hepatitis B vaccination in the presence of a known or presumed exposure within the previous six weeks

The vaccine should be offered early, preferably within 24 hours, and as post-exposure prophylaxis. It may be offered up to six weeks, but there is little to evidence to support its effectiveness beyond 14 days.

BASHH1 recommends in young people that schedules can be:

  • 0, 7, 21 days with a 4th dose at 12 months
  • 0, 1, 2 months with a 4th dose at 12 months

The decision on the schedule should take into consideration the age of the child (super accelerated used extensively in sexual health services) and the risk of exposure.

Hepatitis B immunoglobulin should also be considered if the young person has been exposed to someone known to have hepatitis B and there are concerns they may be infectious. If indicated, hepatitis B immunoglobulin should ideally be given within 48 to 72 hours, but can be used for up to 7 days.

c. Human Immunodeficiency Virus (HIV)

I. Pre-exposure prophylaxis (PrEP)

Some young people will be identified of being at increased risk of HIV through sexual exposure, e.g. young MSM, and appropriate advice should be sought from clinicians experienced in the prescribing of PrEP.

 

II. Post exposure prophylaxis sexual exposure (PEPSE)

Likewise, PEPSE maybe indicated in young people and appropriate advice should be sought. Decision should be made according to criteria in the appropriate National BHIVA guidelines for adult and CHIVA guidelines. PEPSE must be initiated as soon as possible, ideally within one hour but at least within 72 hours, with input from a specialist experienced in the prescribing of PEPSE.

All young people who are started on PEPSE should be assessed for continuation of PrEP post PEPSE and discussed with a clinician experienced in the prescribing of PrEP.

References

    1. BASHH National Guideline on the Management of Sexually Transmitted Infections and Related Conditions in Children and Young People (2021) [accessed 9 July 2024]
    2. Engerix B 20 micrograms/1 ml Suspension for injection [accessed 9 July 2024]

Editorial Information

Last reviewed: 09/07/2024

Next review date: 16/09/2026

Author(s): West of Scotland Managed Clinical Network in Sexual Health Clinical Guidelines Group .

Version: 6.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health