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  4. Age and stage development - 0 to 18 years
  5. 12 - 14 years
Important: please update your RDS app to version 4.7.3

Welcome to the March 2025 update from the RDS team

1.     RDS issues - resolutions

1.1 Stability issues - Tactuum implemented a fix on 24th March which we believe has finally addressed the stability issues experienced over recent weeks.  The issue seems to have been related to the new “Tool export” function making repeated calls for content when new toolkit nodes were opened in Umbraco. No outages have been reported since then, and no performance issues in the logs, so fingers crossed this is now resolved.

1.2 Toolkit URL redirects failing– these were restored manually for the antimicrobial calculators on the 13th March when the issue occurred, and by 15th March for the remainder. The root cause was traced to adding a new hostname for an app migrated from another health board and made live that day. This led to the content management system automatically creating internal duplicate redirects, reaching the maximum number of permitted redirects and most redirects therefore ceasing to function.

This issue should not happen again because:

  • All old apps are now fully migrated to RDS. The large number of migrations has contributed to the high number of automated redirects.
  • If there is any need to change hostnames in future, Tactuum will immediately check for duplicates.

1.3 Gentamicin calculators – Incidents have been reported incidents of people accessing the wrong gentamicin calculator for their health board.  This occurs when clinicians are searching for the gentamicin calculator via an online search engine - e.g. Google - rather than via the health board directed policy route. When accessed via an external search engine, the calculator results are not listed by health board, and the start page for the calculator does not make it clearly visible which health board calculator has been selected.

The Scottish Antimicrobial Prescribing Group has asked health boards to provide targeted communication and education to ensure that clinicians know how to access their health board antimicrobial calculators via the RDS, local Intranet or other local policy route. In terms of RDS amendments, it is not currently possible to change the internet search output, so the following changes are now in progress:

  • The health board name will now be displayed within the calculator and it will be made clear which boards are using the ‘Hartford’ (7mg/kg) higher dose calculator
  • Warning text will be added to the calculator to advise that more than one calculator is in use in NHS Scotland and that clinicians should ensure they access the correct one for their health board. A link to the Right Decision Service list of health board antimicrobial prescribing toolkits will be included with the warning text. Users can then access the correct calculator for their Board via the appropriate toolkit.

We would encourage all editors and users to use the Help and Support standard operating procedure and the Editors’ Teams channel to highlight issues, even if you think they may be temporary or already noted. This helps the RDS team to get a full picture of concerns and issues across the service.

 

2.     New RDS presentation – RDS supporting the patient journey

A new presentation illustrating how RDS supports all partners in the patient journey – multiple disciplines across secondary, primary, community and social care settings – as well as patients and carers through self-management and shared decision-making tools – is now available. You will find it in the Promotion and presentation resources for editors section of the Learning and support toolkit.

3.     User guides

A new user guide is now available in the Guidance and tips section of Resources for providers within the Learning and Support area, explaining how to embed content from Google Calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream and Jotforms into RDS pages. A webinar for editors on using this new functionality is scheduled for 1 May 3-4 pm (booking information below.)

A new checklist to support editors in making all the checks required before making a new toolkit live is now available at the foot of the “Request a new toolkit” standard operating procedure. Completing this checklist is not a mandatory part of the governance process, but we would encourage you to use it to make sure all the critical issues are covered at point of launch – including organisational tags, use of Alias URLs and editorial information.

4.Training sessions for RDS editors

Introductory webinars for RDS editors will take place on:

  • Tuesday 29th April 4-5 pm
  • Thursday 1st May 4-5 pm

Special webinar for RDS editors – 1 May 3-4 pm

This webinar will cover:

  1. a) Use of the new left hand navigation option for RDS toolkits.
  2. b) Integration into RDS pages of content from external sources, including Google Calendar, Google Maps and simple Jotforms calculators.

Running usage statistics reports using Google analytics

  • Wednesday 23rd April 2pm-3pm
  • Thursday 22nd May 2pm-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.

5.New RDS toolkits

The following toolkits were launched during March 2025:

SIGN guideline - Prevention and remission of type 2 diabetes

Valproate – easy read version for people with learning disabilities (Scottish Government Medicines Division)

Obstetrics and gynaecology induction toolkit (NHS Lothian) – password-protected, in pilot stage.

Oral care for care home and care at home services (Public Health Scotland)

Postural care in care homes (NHS Lothian)

Quit Your Way Pregnancy Service (NHS GGC)

 

6.New RDS developments

Release of the redesign of RDS search and browse, archiving and version control functionality, and editing capability for shared content, is now provisionally scheduled for early June.

The Scottish Government Realistic Medicine Policy team is leading development of a national approach to implementation of Patient-Reported Outcome Measures (PROMs) as a key objective within the Value Based Health and Care Action Plan. The Right Decision Service has been commissioned to deliver an initial version of a platform for issuing PROMs questionnaires to patients, making the PROMs reports available from patient record systems, and providing an analytics dashboard to compare outcomes across services.  This work is now underway and we will keep you updated on progress.

The RDS team has supported Scottish Government Effective Prescribing and Therapeutics Division, in partnership with Northern Ireland and Republic of Ireland, in a successful bid for EU funding to test develop, implement and assess new integrated care pathways for polypharmacy, including pharmacogenomics. As part of this project, the RDS will be working with NHS Tayside to test extending the current polypharmacy RDS decision support in the Vision primary care electronic health record system to include pharmacogenomics decision support.

7. Implementation projects

We have just completed a series of three workshops consulting on proposed improvements to the Being a partner in my care: Realistic Medicine together app, following piloting on 10 sites in late 2024. This app has been commissioned by Scottish Government Realistic Medicine to support patients and citizens to become active partners in shared decision-making and encouraging personalised care based on outcomes that matter to the person. We are keen to gather more feedback on this app. Please forward any feedback to ann.wales3@nhs.scot

 

 

0 - 5   6 - 8   9 - 11   15 - 18   A - Z

Each child will be different and may not present as their chronological age because of past experiences or additional needs. (8) Therefore, you may need to use language and resources from other age/stage sections of this toolkit.

All children should learn about the changes at puberty for both boys and girls, to help understand what is happening to them and to their peers.

  • Most girls will have started puberty and most boys also start puberty now. Their testicles and penis begin to grow, as does their underarm and pubic hair. A growth spurt ensues. Their voice becomes deeper and facial hair starts to grow. Boys have their first ejaculation at the age of 13 (on average), which is a sign that they are sexually mature. 
  • Girls also continue to develop. They have already had a growth spurt and now develop underarm and pubic hair. The average age for girls to have their first menstrual period is 12 yrs, indicating that they are sexually mature and could become pregnant. 
  • Wet dreams may be experienced by both girls and boys. Masturbation may increase, for both boys and girls.  
  • Adolescents can be very unsure about the growth of their bodies: “is it normal?”, “are they developing too slowly compared with others the same age?” 
  • Adolescents have to get used to their “new body”, often feeling embarrassed and uncomfortable. 
  • Some young people consider their gender identity more at this stage and how they want to express this to others. Some young people will identify as transgender . See A-Z LGBTQ+ 
  • Puberty can be a distressing time for transgender and non-binary young people, who may feel even more out of place in their own body than they did before puberty changes started. In addition to open discussion and support from staff and carers, it may be helpful to have some discussion with a GP. Some young people will find peer support helpful; carers can connect them in with one of the support groups run by LGBT Youth. Go to Website: Groups and Support LGBT Youth
  • Changes occur in the “biological clock” during adolescence. As a result, teenagers have a natural tendency to fall asleep later and to wake up later. This is a contributing factor to feelings of tiredness during the day, which can increase during growth spurts. (4)
  • Young people develop a sexual self-image: they see themselves as someone who can have sex, which is why it is important for them to be attractive. Since they are often unsure about their own body, they are often equally unsure about how attractive they are (to a potential partner). 
  • Young people of this age are frequently very sensitive to the opinion of others: they can be influenced by their peers. 
  • They also start finding people of the same age sexually attractive. 
  • Young people gradually find out who they are attracted to and if they identify themselves as lesbian, gay, bisexual, straight (or other terms).
  • They often truly fall in love for the first time. 
  • They flirt with one another and have their first relationships. 
  • More experience with kissing and caressing; petting. 
  • 97% of children at this stage have a mobile phone and this is the main way they go online. (2)
  • By age 13, 50% of young people will have seen pornography. (3)

All children in Scotland should be getting Relationships Sexual Health and Parenthood (RSHP) lessons at school as part of the Health and Wellbeing curriculum. Individual schools can choose what resources to use but most will now use Go to website: rshp.scot, as it is the most up to date resource. All the content on this website is available for anyone to view and use.

These links take you to an overview of what children are learning at school and what you can do in the home setting to back this up.

Information from Go to website: rshp.scot:

All children need help from adults to distinguish between appropriate and inappropriate behaviour. Past trauma may mean that a child or young person displays inappropriate and sometimes sexualised behaviour. Be clear with everyone in the house or care setting about what is acceptable and about the need for personal privacy. (8)

Carers and staff should model respect for LGBTQ+ people. They should show they are welcoming and supportive of people coming out by talking positively about LGBT people in their life or in the media.

Puberty

  • Boys will need ongoing information and support about the physical and emotional changes that come with puberty.  See video clips in A-Z Puberty, and A-Z Anatomy which provide a good overview.  
  • Girls will need staff and carers to continue discussions about physical and emotional changes at puberty. If they haven’t started having periods yet, they will need support to prepare for their first period in terms of their feelings about this and on a practical level – choosing products they want to try from a full range of what is available, See A-Z Periods
  • At this stage young people don't all feel certain about their own identity and who they might be attracted to, or not, and its important that the adults in their lives don't make assumptions about this. It's more helpful for young people if we talk about attraction and relationships broadly, instead of being specific about a boyfriend or girlfriend.
  • At this stage it is also common for young people to not be very interested in romantic relationships yet/at all. 

Brain Development

  • All young people at this stage need staff and carers to help them understand some of the ongoing changes as a normal part of developing adolescence. Phases of physical growth and change cause tiredness and often align with changes in sleep patterns. Staff and carers can help young people to have a good sleep routine and should include a cut off time for use of phones/tablets and other electronic devices. 
  • This stage of life brings increased expectations of young people’s academic and social skills at a time of significant brain development - see NSPCC Our Brain's Air Traffic Control below, especially in relation to their executive functioning skills.
  • Most young people will struggle at some point to juggle the many demands on them from school, home and friends and will benefit from help to plan and/or manage their time well. They will need help with navigating friendships and relationships, risk taking, peer pressure and making healthy choices. 

Our Brain's Air Traffic Control (Executive Function) | NSPCC (3 min 43s) YouTube

 

Healthy Relationships and Consent

  • All young people need staff and carers to help them learn which behaviours within relationships are healthy, which aren’t, and support available. Young people will benefit from ongoing, short, chats about healthy relationships and consent throughout the teenage years.  It can be feel more comfortable for young people to use situations in films/TV/on social media to start discussions about this. These resources provide an overview of some useful key messages to include and an interactive game to play with young people 

Relationships - Red and Green Flags (3min 34s)

 

Go to website: Healthy Relationships and Consent: Key Messages for Young People

Healthy relationships and consent resource for professionals working with young people

  • Almost all young people will now have a smartphone and be using a range of social media for entertainment and to socialise. It is still important to have parental controls on their phone but equally important to have ongoing discussion about who they are socialising with online and what they are watching. Peer sharing of images is common and staff and carers need to talk with young people about what is ok and what is not. Sharing intimate images should be discussed, in general, as part of ongoing conversation about socialising online, not just in response to a situation where this has happened. These videos can help start conversations. 

Forever (1min 52s)

Send a Mole Rat Instead (1min 30s)

These are some key messages to use, that you can put into your own words. See P17 of Healthy Relationships and Consent Resource for Professionals working with Young People

  • Sexual harassment is any form of unwanted sexual behaviour. Many young people at this stage and older will experience some form of sexual harassment in a range of settings – school, in the street, online – and need staff and carers to talk with them about this and that it is not their fault if it happens. This is a helpful overview from Brook - Go to website: What is sexual harassment? This is a short video about Go to website: sexual harassment in Scottish schools - scroll to play video.
  • Much of the free and easily accessed pornography that this age group may see shows sexual violence, mostly carried out on women by men. Staff and carers need to talk to teenagers about this and be clear about the difference between consensual sexual activities that give people mutual pleasure and sexual violence.

Sexual Health

  • At the upper end of this stage, young people need to learn basic info about contraception, STIs, clinics and other helpful sources of information.

This tool has been developed by Stop it Now for parents, but is suitable for carers and staff to use. It describes behaviours that are developmentally expected and behaviours that are not healthy or safe.

Carers who are concerned about a child’s behaviour should share their concerns with the team around the child as a first action.

Staff should refer to their locality guidance and protocols.

Traffic Light Guide - Teenager