Welcome to the Right Decision Service (RDS) newsletter for October 2024.
Development of the contingency solutions to maximise RDS resilience and minimise risk of future outages is in progress, aiming for completion by Christmas. As a reminder, these contingency arrangements are:
In the meantime, a gentle reminder to encourage users to download essential clinical toolkits to their mobile devices so that there is an offline version always available.
A new scheduled deployment with minor improvements drawn from support tickets, externally funded projects, information related to outages, and feature requests will take place in early December. Key improvements planned are:
We are also seeking approval to use the NHS Scotland logo and title for the RDS app on the app stores to help with audience engagement and clarity around the provenance of RDS.
We are still hopeful that user acceptance testing for at least the Search and browse enhancements can take place before Christmas. Thank you for your patience and understanding in waiting for these improvements. Timescales have been pushed back by old app migration challenges, work to address outages, and most recently implementing the contingency arrangements.
We are aware that there continue to be some issues around a number of RDS support tickets, in part due to constraints around visibility for the RDS team of the tickets in the existing support portal. We are investigating the potential to move to a new support ticket requesting system from early in the new year. We will organise the proposed webinar around support ticket processes once we have confirmed the way forward with the system.
There is a known issue with alterations in formatting of some RDS tables which seems to have arisen as a result of the 17 October deployment. Tactuum is working on a fix and on implementing additional regression testing to prevent this issue recurring.
Recently launched toolkits include:
NHS Lothian Infectious Diseases
Scottish Health Technologies Group – Technology Assessment recommendations
NHS Tayside Anaesthetics and Critical Care projects – an innovative toolkit which uses PowerAutomate to manage review and response to proposals for improvement projects.
If you would like to promote one of your new toolkits through this newsletter, please contact ann.wales3@nhs.scot
A number of toolkits are expected to go live before Christmas, including:
We have had a good response to the recent invitation to sign up to the new Teams channel for RDS editors. This provides a forum for editors to share learning, ideas and questions and we hope to hold regular webinars on topics of interest. The RDS team is in the process of joining participants to the channel and we’d encourage all editors to take part, using the registration form – available in Providers section of the RDS Learning and Support area.
The RDS team has worked with colleagues in NHS Grampian and the Digital Health & Care Innovation Centre to evaluate the impact of the Prevent the progress of diabetes web and mobile app in a small-scale pilot project. This app provides access to local and national resources and services targeted at people with prediabetes, a history of gestational diabetes, or candidates for remission. After just 8 weeks of using the app, 94% of patients reported increased their knowledge and understanding of diabetes, and 88% said it had increased their confidence and motivation to make lifestyle changes, highlighting specific behaviour changes. The learning from this project is informing development of a service model based on tailored support for patient groups with, high, medium and low digital self-efficacy.
Please contact ann.wales3@nhs.scot if you would like to know more about this project.
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
The Right Decision Service: the national decision support platform for Scotland’s health and care
Website: https://rightdecisions.scot.nhs.uk Mobile app download: Apple Android
The frailty assessment and interventions tool is designed to support community health and social care teams to identify and assess people living with frailty and those at risk of falling. It contains interventions to consider, depending on an individual's needs. The tool can be used to help signpost individuals to the right care and support within the community. It can also be used as a checklist to aid assessment of risk factors and prompts for interventions that can reduce risk and improve wellbeing.
Check |
| General health status and skin care |
| Recent decline in function or performance |
| History of recent falls |
| Increased hospital admissions or interaction with community services |
Consider |
| Comprehensive geriatric assessment |
| Multidisciplinary team case review |
| Health and wellbeing interventions (smoking cessation, alcohol, healthy eating, exercise) |
| Pressure ulcer assessment |
| Future care plan |
| Key worker |
| Adult support and protection |
Check |
| Informal support being provided |
| Opportunity for social activities or access |
| Current care package |
| Community connections |
| Willingness to consider lifestyle changes |
Consider |
| Welfare assessment and income maximisation |
| Carer's assessment |
| Community assets (befriending and active health classes) |
| Technology to support health and wellbeing |
| Referral to social work for home assessment |
| Key worker |
| Risk enablement |
| A Local Information System for Scotland (ALISS) |
Check |
| Changes in memory or mood |
| Cognitive assessment |
| Delirium (sudden confusion) |
| Fear of falling |
| Signs of infection |
| Recent medication changes |
| Loneliness and isolation |
Consider |
| Referral to community mental health teams or GP |
| Dementia services |
| Assistive technology assessment |
| Locality support (leisure and day services) |
| Advocacy |
| Counselling and wellbeing services |
| A Local Information System for Scotland (ALISS) |
Check |
| Transfers (bed, toilet and chair) |
| Safety on internal and external stairs |
| Lighting |
| Home hazards |
| Pathways around home are clear |
| Person's interaction with environment (risk taking and balance) |
| Whether housing meets needs |
Consider |
| Occupational therapy, social work and housing |
| Scottish Fire and Rescue Service home safety visit |
| Referral to advise and support around home adaptations and repairs from Care and Repair |
| Fuel poverty check |
| Telecare |
| Housing support |
Check |
| Weight and body mass index (BMI) |
| Dentition |
| Ability to make meals and functional ability to feed self |
| Food and drink normally consumed |
| Ability to swallow |
Consider |
| Carer support for preparing meals |
| Encourage hydration |
| Referral to dietitian for nutritional assessment, Malnutrition Universal Screening Tool (MUST) and supplementation if needed |
| Referral to dentist for issues relating to dentition |
| Vitamin D levels |
| Referral to a speech and language therapist if swallowing difficulty identified |
Check |
| Recent medication changes |
| Manual heart rate |
| Blood glucose |
| Lying and standing blood pressure |
Consider |
| Referral to practice or community nurse |
| Refer to GP if someone has experienced a loss of consciousness recently |
| Medication review |
| Discussing with specialist falls service |
| Telehealth and telecare |
Check |
| Any side effects, particularly dizziness, light-headedness, visual disturbance or hallucinations |
| Recent medication changes |
| Compliance with medication |
| Use of over-the-counter medication |
Consider |
| Seven steps to appropriate polypharmacy |
| Referral for compliance aids and telecare |
| Medication prompts |
| Influenza and Pneumococcal Pneumonia vaccine |
Check |
| Mobility and gait |
| Walking aid use and condition |
| Splints, prosthesis fitting and compliance |
| Foot pain, skin colour, sensation and movement |
| Footwear and trip hazards |
Consider |
| Community physiotherapy |
| Reablement |
| Occupational therapy |
| NHS strength and balance class or leisure class |
| Community connections |
| Assessment of balance |
| Podiatry and orthotics |
| Footwear and foot care advice |
| Encourage physical activity |
Check |
| Urinalysis |
| Clothing easy loosened |
| Catheter bags secured to leg |
| Changes to elimination habits |
| Taking diuretic medication |
Consider |
| Referral to community or practice nurse for continence assessment |
| Provision of commode |
| Fluid intake |
| Medication review |
Check |
| Symptoms of vertigo |
| Hearing aids fitted correctly and working |
| Wearing current prescription glasses |
| Good lighting |
Consider |
| Optometrist for eye check |
| Any domiciliary optometry service |
| Advice from optician on use of multifocal glasses |
| Referral to sensory impairment team |
| Practice nurse for ear assessment |
Focus on frailty