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May 2025 RDS newsletter now available. Expand this announcement to view.

Welcome to the May 2025 update from the RDS team

1.     RDS deployments

Three small-scale releases took place during April and May, including the following fixes and improvements:

  • Applying moderate severity security patch to Umbraco.
  • Fixes to:
    • Random ordering of tiles on mobile app
    • Simultaneous issuing of multiple copies of content review alerts
    • Content display on mobile app for the left hand menu navigation option
  • Whitelisting of Jotforms outcomes pages so that recommendations for action can be displayed following completion of a form or calculation.

2.     RDS performance

Two short outages took place on the mornings of 12th and 22nd May. Tactuum is still investigating the root cause and will report on this shortly.

3.     Redesign of Gentamicin and Vancomycin calculator interfaces

New designs have been produced which make the health board name and calculator title clear to the user on these calculator pages, with a warning message and link to ensure users access the right calculator for their board. These designs have been implemented in a test environment and are now under review.

4.     RDS Redesign, archiving and version control

We now plan to release at end of July 2025 the following major enhancements:  redesigned Right Decision Service homepage, new search and browse interface, upgraded archiving and version control, and capability to edit content adopted from the Shared Content Library. We will provide slides and demos in advance of the release to introduce users and editors to the new functionality.

5. Training sessions for RDS editors

Introductory webinars for RDS editors will take place on:

  • Monday 16 June 12.30-1.30 pm
  • Tuesday 24 June 3.45-4.45 pm

Running usage statistics reports using Google analytics

  • Wednesday 11th June: 2-3pm

 To book a place on any of these webinars, please contact Olivia.graham@nhs.scot providing your name, role, organisation, title and date of the webinar you wish to attend.

6.New RDS toolkits

The following toolkits were launched during March 2025:

7.New RDS developments

Work is progressing on a number of decision support systems that are part of the wider Right Decision Service platform, beyond the web and mobile apps:

  • The Patient Reported Outcome Measures system. A minimum viable product version will be available for functional testing by key stakeholders at end of July.
  • Pharmacogenomics decision support as an extension of the current high risk prescribing decision support integrated with primary care electronic health record systems. This is part of a European research and innovation project.
  • Planned Date of Discharge decision support system to be tested in NHS Lanarkshire. Will undergo user acceptance testing in July with a view to piloting from November.

8. Implementation projects

Public library services in Inverclyde, East Renfrewshire, Glasgow Life, Angus, Falkirk and Stirling have come forward to work with the RDS team, the Scottish Library and Information Council and local Realistic Medicine leads, to develop their role in engaging citizens in Realistic Medicine. This includes promoting the Being a partner in my care app: Realistic Medicine Together. This provides tools and resources to support conversations about what matters to the person,  shared decision-making and self-management.

 

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.

 

 

 

Indications for Obstetric Consultant Attendance in Labour Ward (595)

Please report any inaccuracies or issues with this guideline using our online form

Patient safety and quality of care is the priority.

The positive effect of direct consultant care is recognised. Consultant work patterns have been altered to facilitate their contribution to acute Obstetric care. There should be no hesitation to call Consultants to the Labour Ward area and Consultants should respond positively to requests for assistance.

A request to attend should be communicated clearly, in a structured way (e.g. by using SBAR). The request should be documented in the notes. If consultant input is required, this should happen before a management plan is discussed with the woman.

Attendance in person

In the following situations, the consultant should attend in person, whatever the level of the trainee:

  • Eclampsia
  • Maternal collapse (such as massive abruption, septic shock)
  • Life threatening maternal condition (such as amniotic fluid embolism)
  • Postpartum haemorrhage of more than 1.5 litres where the haemorrhage is continuing and a MOH protocol has been instigated
  • Return to theatre
  • Caesarean birth for major placenta praevia or placenta accreta spectrum (PAS) 
  • Vaginal twin births
  • Vaginal breech birth
  • Instrumental birth in women with BMI greater than 50
  • Caesarean birth in women with BMI greater than 50
  • Caesarean birth after intrauterine death has occurred
  • Caesarean birth for transverse lie
  • Caesarean birth at less than 30 weeks gestation
  • Uterine rupture
  • Fourth Degree perineal tear
  • Caesarean birth for any women declining blood products
  • Unexpected intrapartum stillbirth
  • When requested for any reason

Attendance in person or immediately available

For the procedures listed below, the consultant should attend in person or should be immediately available (i.e. present on labour ward) unless the trainee on duty is an ST7 and has been assessed by the unit and signed off, by OSATS where these are available, as competent for the procedure in question:

  • Full dilatation caesarean birth
  • Trial of forceps / vacuum
  • Rotational Forceps
  • Caesarean birth at 30-34 weeks gestation
  • Caesarean birth where the woman has had 3 or more previous caesarean sections
  • Third degree perineal tear (trainees at other levels who have been assessed to be competent may perform these unsupervised.)
  • Any woman who requires transfer to ITU

Situations where Consultants should be informed

In the following situations the consultant should be informed and a decision whether direct review or advice is appropriate should be made depending on each case. There should be a low threshold for attendance and direct contribution to care.

  • Severe maternal compromise (MEWS >7)
  • Any woman admitted to an Obstetric HDU or ITU
  • An intrauterine transfer (either out or in; discussion prior to decision)
  • Preterm labour less than 30 weeks
  • Severe pre-eclampsia – requiring IV therapy
  • Severe antepartum haemorrhage (evidence of maternal or fetal compromise)

Other factors

There will be times when consultant input is required due to high levels of clinical activity, rather than a single complex case. Where there are multiple factors present that overall increase the difficulty of a case the consultant should be called.

Senior midwifery staff or other medical staff should contact the consultant directly if it is considered that the clinical situation requires their input.

Consultants should be called for help if any clinical situation where their direct input to care would potentially improve the outcome for the mother and baby.

Editorial Information

Last reviewed: 27/02/2024

Next review date: 26/02/2029

Author(s): Ros Jamieson.

Version: 3

Approved By: Maternity Clinical Governance Group

Document Id: 595