Skip to main content
  1. Right Decisions
  2. GGC - Clinical Guidelines
  3. Maternity
  4. Back
  5. Orientation and support you will need (Maternity)
  6. Caring for a relative in pregnancy and labour (1164)
Announcements and latest updates

Right Decision Service newsletter: October 2024

Welcome to the Right Decision Service (RDS) newsletter for October 2024.

1.Contingency arrangements for RDS outages

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:

  • Optimising mobile app build process
  • Mobile app always to be downloadable.
  • Serialising builds to mobile app; separate mobile app build from other editorial and end-user processes
  • Load balancing – provides failover (also enables separation of editorial processes from other processes to improve performance.)

 

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.

 

2. New deployment with improvements.

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:

  • Deep-linking to individual toolkits within the RDS mobile app. Each toolkit will now have its own direct URL and QR code, both accessible from the app. These can be used to download the toolkit directly where users already have the RDS app installed. If the user does not yet have the RDS app installed, they will be taken to the app store to install the app and immediately afterwards the toolkit will automatically open and download. Note that this will go live a few days later than the improvements below due to the need to link up the mobile front end to the changes in the content management system.
  • Introducing an Announcement Header field to replace the hardcoded "Announcements and latest updates" text. This will enable users to see at a glance the focus of new announcements.
  • Automated daily emptying of the recycling bin (with a 30 day rolling grace period)  in the content management system. A bug preventing complete emptying of the recycling bin contributed to one of the outages earlier this year.
  • Supporting multiple passcodes (ticket 6079)
  • Expanding accordion section to show location of a search result rather than requiring user coming from a search result to manually open all sections and search again for the term.
  • Displaying first accordion section Content text as a snippet on the search results page as a fallback if default/main content is not provided
  • Displaying the context of each search result in the form of a link to the relevant parent tool/section. This will help users to choose which search result is most likely to be appropriate for their needs.
  • As part of release of the new national benzodiazepine quality prescribing guidance toolkit sponsored by Scottish Government Effective Prescribing and Therapeutics, a digital tool to support creation of benzodiazepine tapering/withdrawal schedules.

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.

3. RDS Search, Browse and Archive/Version control enhancements

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.

4. Support tickets

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.

Table formatting

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.

5. New RDS toolkits

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:

  • Focus on dementia
  • Highland Council Getting it Right for Every Child
  • Dumfries and Galloway Adult Support and Protection procedures
  • National Waiting Well toolkit
  • Fertility Scotland National Network
  • NHS Lothian postural care for care homes

6.Sign up to RDS Editors Teams channel

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.

 

7. Evaluation projects

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.

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

  • Friday 29th November 3-4 pm
  • Thursday 5 December 3.30 -4.30 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

 

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

 

 

Caring for a relative in pregnancy and labour (1164)

Warning

Objectives

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

As a professional you may be asked to provide care for a family member or close friend and whilst there may be no legal or regulatory reason why you may not do so, you should consider carefully the risks or benefits before entering into such an agreement

This is not a matter on which the NMC currently provide any guidance. Refer to the requirements of section 20.6 of the Code, which states that all NMC registrants must stay objective and maintain clear professional boundaries at all times with people in their care (including those who have been in their care in the past), their families and carers.

Key Messages

NHS Greater Glasgow and Clyde deems it to be undesirable and unacceptable and recommends that whenever possible employees should avoid providing care to anyone with whom there is a close personal relationship.

If during the course of staff employment, the staff member is asked to care for or treat a relative/family member or close friend or encounters a relative/family member or close friend in their area of work, advice and support should be sought immediately from the appropriate Line Manager. The principles may be applied to other situations where personal and professional boundaries may be compromised.

In practice, employees should not consider treating a relative or close friend unless in an emergency and it is absolutely unavoidable. If done, it should be for the shortest possible time until care can be handed over.

Policy

All midwives are accountable for their practice in whatever environment they are practicing. Midwives who care for their close friends, relatives or fellow colleagues during pregnancy, childbirth or in the postnatal period, need to consider that there is the potential for increased stress and emotional involvement that could possibly influence objective decision-making.

Midwives need to understand and acknowledge that potential conflicts could occur in such situations and that there may be a need for additional support and guidance.

Midwives should be able to decline the request if they are concerned with their ability to provide impartial proven evidence based advice or care.

When present on rostered time

The Royal College of Nursing advises that the following principles should be applied:

  • The first priority must be to the patient
  • The needs of the patient are paramount
  • The patient has a right to have his/her privacy protected.
  • Obligations to the patient, health care team and other members of staff must be met
  • Professional standards must be upheld e.g. accountability

If the member of staff wishes to continue working in an area where a relative/family member is being cared for or treated, this should be carefully considered and fully discussed with the line manager and the wider healthcare team as appropriate. Involvement in direct care should be avoided.

If staff are approached by a relative or friend to provide direct clinical care a discussion with your line manager must be arranged as soon as possible. Following discussion an individual supportive plan may be arranged.  This plan must have final agreement by the Lead Midwife and/or Director of Midwifery. Written confirmation of the plan must be uploaded on to the women’s Badger-Net record and a copy provided for the staff member and a copy for the HR personal file.

There can be situations where an employee is rostered or is required to work in a department where a family member or friend is being cared for. NHS Greater Glasgow and Clyde deems it undesirable in this situation and unacceptable that a midwife or other health professional is involved in their direct patient care. The issue of whether the employee continues to work in the general surrounding clinical area should be discussed fully, with consideration given to both the practitioner and family member. Redeployment to another clinical areas may be required.

Not on rostered time

The employee may choose to be present as a support to the relative/family member or close friend. In this instance they should not provide direct patient care or document in patient notes.

Consideration to employee roster commitments should be discussed with line manager to ensure working and/or cover arrangements. Support care given should ideally be outside of the midwife’s rostered hours.

Editorial Information

Last reviewed: 28/08/2024

Next review date: 28/08/2027

Author(s): Elaine Drennan.

Version: 1

Approved By: Maternity Governance Group

References

The NMC (2018) The Code: Professional standards of Practice and behaviour for Nurses, Midwives and nursing associates. Nursing and Midwifery Council, London.

The NMC (2012) Midwives rules and standards. Nursing and Midwifery Council, London.