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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

 

 

0 - 5   6 - 8   12 - 14   15 - 18   A - Z

Typical development 9 - 11 years old

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) 

What children should be learning at school and how to back it up at home

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:

 

Support and learning required from carers and staff

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)

Managing friendship ups and downs

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. 

Puberty

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.

Helping children prepare for periods

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: 

 

Online safety

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.

Pornography

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.

Behaviours that are not developmentally typical and how to respond

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