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  4. Age and stage development - 0 to 18 years
  5. 9 - 11 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   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.

Typical development 9 - 11 years old (1)

  • From about the age of 10, children become more interested in adult sexuality. They fantasise more about sexuality and hear and see all sorts of things online, on TV/films and watch or hear about things on social media which arouses their curiosity. Nevertheless, their response may be prudish or offhand if you try to talk to them about sexuality. 
  • The first steps towards love may be taken during this phase: young people start to have ‘crushes’ and make cautious advances towards one another (holding hands, kiss on the cheek, etc.) 
  • At the younger end of this stage, some children will have a phone and many won’t. This changes at the upper end of this age range. In 2022 Ofcom reported that 91% of 11 year olds owned a smartphone.(2)  
  • By age 11, 27% of children 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)

All children going through these changes need adults to help them understand that the emotions are part of puberty and that it is normal but that it can be unsettling as it can feel like you are not in control of your body. It’s important that children are not labelled as ‘moody’ or ‘grumpy’ but these feelings and behaviours are linked back to puberty and they are helped to manage their feelings. 

On average, girls are about 2 years ahead of boys in puberty development at this stage. However, some boys will be starting to experience these emotional fluctuations and need the same support and patience. 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.

  • The sex hormones become active, manifested in behaviour and physical development, but also in perception and emotional mood swings. All children will experience emotional changes, usually a year or two before physical changes. Girls usually reach puberty two years earlier than boys. Obvious physical changes include the growth of breasts and an increase in height. 

This document is an overview of changes that happen to all children/young people. It is suitable for children age 9-13yrs to read and discuss with you or for you to read together - Go to website: Puberty and your body | Childline

These videos are useful to support discussions:

Puberty: feeling depressed, happy and other emotions (duration 1 minute 45):

 

Early or delayed puberty – information about reasons Go to website: Early or delayed puberty - NHS (www.nhs.uk)

 

Puberty changes in boys age 10-13 years - Top signs boys are in puberty (duration 3 minutes 24):

 

 

Puberty, body odor and other changes for boys (duration 2 minutes 33):

 

 

Puberty changes girls aged 9-12 - Top signs girls are in puberty (duration 1 minute 57):

 

 

Breast development and worries about it.

This is a short video for a child/young person to watch and discuss with you - Does breast size really matter? (duration 3 minutes):

 

 

See also A-Z Periods and Periods below

Additional Support for Learning Needs – the national teaching resource has resources specifically designed for learners with additional needs: Go to website: Learners with Additional Support Needs (ASN) - RSHP

This website is specifically about puberty and has lots of interactive games to help your discussions if your young person has additional needs: Go to website: Planet Puberty.

Girls will need support to prepare for their first period in terms of their feelings about this and on a practical level. They will need in choosing products they want to try from the full range of what is available.

These short videos can help discussion: 

Menstruation: what to expect (duration 3 minutes 18) by amaze.org:

 

Tampons, Pads and Menstrual Cups (duration 2 minutes 9) by amaze.org: 

 

At this age children might be online more with less supervision, doing homework, chatting to friends, playing games or watching YouTube. It is helpful to talk with them about how being online is like being in a place, and wherever they are they need to be and feel safe. Children need help to learn about what information not to share and about coming to you if something they see or hear upsets them.

At this stage, it is recommended that parental controls are still used to restrict access to inappropriate content.

Go to website: InternetMatters.org Parental controls

Step by step parental controls guides to help you to set up the right controls and privacy settings on the networks, gadgets, apps, and sites they use to give them a safer online experience.

At the upper end of this stage some children will see pornography online. They are more likely to stumble across it than deliberately search for it and/or be shown images by a peer. The possibility of this should be covered as part of online safety discussions with 11-year-olds especially if they have, or are getting, a phone.

One of the safety rules needs to be that they tell you if someone shows them pornography or if they come across it online. Easily accessed online pornography presents a distorted view of sex that often shows sexual violence carried out on women and caregivers need to be able to talk about this with a child who has seen pornography.

The NSPCC have some Go to website: helpful guidance about how to do this.

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