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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

 

 

Infectious Diseases Screening Tests in Late Bookers (357)

Warning Warning: This guideline is 709 day(s) past its review date.
Please report any inaccuracies or issues with this guideline using our online form

Late bookers are women who present for the first time on or after 24 weeks pregnancy. This is the stage at which the baby is potentially viable if early labour occurred.

The results of the infectious disease screening tests could affect the management at or after delivery, therefore all infectious diseases screening test results for a woman should be known prior to delivery and certainly before discharge.

If a woman presents to maternity services as a late booker i.e. on or after 24 weeks it is important to ensure that screening has been offered and results are received.

 

  • Seek informed consent for screening (HIV, Syphilis and hepatitis B)
  • Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
  • Ensure tests are recorded on the maternity electronic record.
  • Mark the  sample  as  URGENT  and  telephone  the  West of Scotland Specialist Virology Centre to let them know it is in the system. (0141 201 8722). Alternatively, email west.ssvc2@nhs.scot. State that the patient is a late booker, provide the lab with a contact phone number and state if you are want to receive the result on Clinical Portal or by phone.
  • Send the sample to the virus lab, via normal routine processes.
  • Ensure that the name and contact details of the person and a deputy who will be responsible for any positive results are clearly appended
  • Note that to view a result on portal a CHI number is essential

  • Seek informed consent for screening (HIV, Syphilis and hepatitis B)
  • Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
  • Ensure tests are recorded on the maternity electronic record at next                      
  • Mark the sample as ‘URGENT’ and telephone the West of Scotland Specialist Virology Centre before you send the sample.
  • In hours(9.00 – 17.00 Monday to Friday), telephone the lab on 0141 201 8722 and:-
    • Explain that an urgent sample is being sent;
    • Discuss the travel arrangements and
    • Arrange when and to whom the results will be communicated. You must provide the laboratory with adequate contact details to include the name and preferably two contact numbers of the main results recipient and a deputy.
    • Alternatively, in hours only, email west.ssvc2@nhs.scot, flag the email as urgent and state that the patient has a high risk of delivery. Provide the lab with a contact number. They will call you back within an hour.
  • Out of hours (including Saturday and Sunday).
    • Please telephone the on-call virologist via the Switchboard 0141 211 4000 and discuss the above. Do not email the lab out of hours or at the weekend. 
  • If the timing of the local transport systems does not facilitate urgent transfer order a taxi to ensure the sample reaches the laboratory. (see NHSGGC Amended Protocol Ordering and Use of Taxis and Couriers October 2011 [Staffnet link])  
  • In normal hours the lab is able to process and produce results within 1-2 hours of receipt. Note that reactive samples will need to be confirmed on the next day.
  • Note that to view a result on Clinical Portal, a CHI number is essential.

It is the responsibility of the labour ward staff to ensure that virology screening tests are offered and results received. Even intrapartum diagnosis can significantly, positively modify neonatal outcome therefore it is important to ensure women are offered screening tests no matter how late.

It is essential that you telephone the virology lab as soon as possible to discuss emergency testing of the woman.

  • Seek informed consent for screening (HIV, Syphilis and hepatitis B)
  • Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
  • Ensure tests are recorded on the maternity electronic record at next      
  • Mark the sample as ‘URGENT’ and telephone the West of Scotland Specialist Virology Centre before you send the sample.
  • In hours (9.00 – 17.00 Monday to Friday), telephone the laboratory on 0141 201 8722 and:-
    • Explain that an urgent sample is being sent;
    • Discuss the travel arrangements and
    • Arrange when and to whom the results will be communicated. You must provide the laboratory with adequate contact details to include the name and preferably two contact numbers of the main results recipient and a deputy.
  • Out of hours (including Saturday and Sunday) Please telephone the on-call virologist via the Switchboard 0141 211 4000 and discuss the above.
  • Order a taxi to ensure the sample reaches the laboratory. (see NHSGGC Amended Protocol Ordering and Use of Taxis and Couriers October 2011 [Staffnet link]) 
  • As with ALL emergency blood tests ensure results are followed up immediately they are available. In normal hours the lab is able to process and produce results within 1-2 hours of receipt.  
  • Communication with paediatricians is essential as their management may be significantly altered by these results however the responsibility for taking and sending these investigations and obtaining these results remains with the midwifery / obstetric team.

Editorial Information

Last reviewed: 20/03/2021

Next review date: 30/04/2023

Author(s): Gillian Penrice.

Version: 4

Approved By: Maternity Clinical Governance Group

Document Id: 357