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  4. Age and stage development - 0 to 18 years
  5. 6 - 8 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   9 - 11   12 - 14   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.

  • Children have more contact with large groups of people at school. They increasingly learn how they “should” behave (social rules).They learn that adults disapprove if they expose themselves in public and touch themselves or someone else. This makes them less likely to walk around in the nude in public and touch their genitals. 
  • Exploring their own and other people’s bodies is expressed more in the context of playing at first openly but later often in secret, because they learn that being naked in public is not allowed.  
  • Children are discovering their boundaries. They notice that saying certain words provokes a reaction in people around them. This is exciting and fun, so they repeat those same words.
  • At this age children are very interested in reproduction and ask many questions, such as “where do children come from?” Most children start experiencing shyness in regard to their bodies and start do draw boundaries. 
  • Children start to recognise their own gender; for most this means that they know that they are boys or girls. 
  • They pick up messages from the world around them about “what a boy does” and “what a girl does” (gender stereotypes). 
  • Children make friends with other children: of both sexes or sometimes just with other boys or girls (members of their own sex). Children of this age often associate friendship and liking someone with “being in love”. For instance, they often say that they are in love with their mother, teacher or rabbit. This usually has nothing to do with feelings of sexuality and desire. It is simply their way of saying that they are fond of someone. 
  • From 8 years old some girls will be starting to experience emotional changes due to hormonal changes associated with puberty. For most children, emotional ups and downs caused by hormone changes are experienced up to 2 years before physical changes start. 

Gender stereotyping can limit children’s expectations for themselves and they need the adults in their lives to challenge this. It is important that caregivers help them learn that girls and boys are not limited by their gender. This can be done as part of day to day care by encouraging children to play with a range of toys, dressing up outfits etc and sharing stories about people that challenge gender stereotypes.

This video shows the impact of gender stereotypes on children’s ideas - Redraw the Balance (duration 2 minutes 07):

 

This story book - William's Doll by Charlotte Zolotow - is about a boy who wants a doll (duration 5 minutes 59):

 

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. 

Children aged 6-8 years old are usually in P2, P3 or P4, which is called First level.

This link takes you to an overview of what children are learning at school and what you can do in the home setting to back this up. Go to website: First Level – RSHP.

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)

  • Children need to be taught the accurate names for the private parts of their body – penis or vulva and bottom. They may use a range of other words e.g. flower, wee man etc. It’s ok if they use these, as long as they are also taught the correct words. 
  • Children will need to be reminded that they don’t touch the private parts of their body in public. (e.g. in school, when they are tired!) They should not look at or touch someone else’s private parts and no-one should touch theirs. 
  • Even though children are using the bathroom by themselves at home and at school, they will still need some guidance/reinforcement about privacy and hygiene – shutting the door of the bathroom or cubicle, flushing the toilet, making sure pants, tights, trousers are pulled up before leaving the cubicle etc. If boys haven’t used urinals before starting school, they will need help to learn or be encouraged to use a cubicle. 
  • Staff and carers should demonstrate that they respect children's right to ownership/ autonomy of their body. As with teaching social rules, this can done as part of everyday situations, for example, saying goodbye, asking ‘would you like a hug?’ instead of automatically hugging them.  
  • Children need adults to help them learn how to assert and articulate their right ​to bodily autonomy. For example, if another child picks them up or hugs them without asking, the adult can intervene: ‘I’m not sure that x wanted to be picked up/a hug. You need to ask them first’. This short video explains it well - Consent for kids (duration 2 minutes 43):

 

Girls who are taller or heavier than their peers are more likely to start puberty earlier than their peers. This can be as early as 8 years old with emotional ups and downs caused by hormone changes. For most children the emotional changes start to happen 1-2 years before any physical changes.

If you look after a girl who is experiencing this, she will need help to understand what is happening alongside reassurance that it is normal. Here is a short video to help discussion (duration 1 minute 46):

 

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.

Parents Protect: Helping you understand the sexual development of children aged 5-11