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  6. Caring for a relative in pregnancy and labour (1164)
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

 

 

Caring for a relative in pregnancy and labour (1164)

Warning

Objectives

Please report any inaccuracies or issues with this guideline using our online form

As a professional you may be asked to provide care for a family member or close friend and whilst there may be no legal or regulatory reason why you may not do so, you should consider carefully the risks or benefits before entering into such an agreement

This is not a matter on which the NMC currently provide any guidance. Refer to the requirements of section 20.6 of the Code, which states that all NMC registrants must stay objective and maintain clear professional boundaries at all times with people in their care (including those who have been in their care in the past), their families and carers.

NHS Greater Glasgow and Clyde deems it to be undesirable and unacceptable and recommends that whenever possible employees should avoid providing care to anyone with whom there is a close personal relationship.

If during the course of staff employment, the staff member is asked to care for or treat a relative/family member or close friend or encounters a relative/family member or close friend in their area of work, advice and support should be sought immediately from the appropriate Line Manager. The principles may be applied to other situations where personal and professional boundaries may be compromised.

In practice, employees should not consider treating a relative or close friend unless in an emergency and it is absolutely unavoidable. If done, it should be for the shortest possible time until care can be handed over.

All midwives are accountable for their practice in whatever environment they are practicing. Midwives who care for their close friends, relatives or fellow colleagues during pregnancy, childbirth or in the postnatal period, need to consider that there is the potential for increased stress and emotional involvement that could possibly influence objective decision-making.

Midwives need to understand and acknowledge that potential conflicts could occur in such situations and that there may be a need for additional support and guidance.

Midwives should be able to decline the request if they are concerned with their ability to provide impartial proven evidence based advice or care.

When present on rostered time

The Royal College of Nursing advises that the following principles should be applied:

  • The first priority must be to the patient
  • The needs of the patient are paramount
  • The patient has a right to have his/her privacy protected.
  • Obligations to the patient, health care team and other members of staff must be met
  • Professional standards must be upheld e.g. accountability

If the member of staff wishes to continue working in an area where a relative/family member is being cared for or treated, this should be carefully considered and fully discussed with the line manager and the wider healthcare team as appropriate. Involvement in direct care should be avoided.

If staff are approached by a relative or friend to provide direct clinical care a discussion with your line manager must be arranged as soon as possible. Following discussion an individual supportive plan may be arranged.  This plan must have final agreement by the Lead Midwife and/or Director of Midwifery. Written confirmation of the plan must be uploaded on to the women’s Badger-Net record and a copy provided for the staff member and a copy for the HR personal file.

There can be situations where an employee is rostered or is required to work in a department where a family member or friend is being cared for. NHS Greater Glasgow and Clyde deems it undesirable in this situation and unacceptable that a midwife or other health professional is involved in their direct patient care. The issue of whether the employee continues to work in the general surrounding clinical area should be discussed fully, with consideration given to both the practitioner and family member. Redeployment to another clinical areas may be required.

Not on rostered time

The employee may choose to be present as a support to the relative/family member or close friend. In this instance they should not provide direct patient care or document in patient notes.

Consideration to employee roster commitments should be discussed with line manager to ensure working and/or cover arrangements. Support care given should ideally be outside of the midwife’s rostered hours.

Editorial Information

Last reviewed: 28/08/2024

Next review date: 28/08/2027

Author(s): Elaine Drennan.

Version: 1

Approved By: Maternity Governance Group

References

The NMC (2018) The Code: Professional standards of Practice and behaviour for Nurses, Midwives and nursing associates. Nursing and Midwifery Council, London.

The NMC (2012) Midwives rules and standards. Nursing and Midwifery Council, London.