Welcome to the Right Decision Service (RDS) newsletter for August 2024.
Following the recent RDS outages, Tactuum and the RDS team have been reviewing the learning from these incidents. We are committed to doing all we can to ensure a positive outcome by strengthening the RDS to make it fully robust and clinically resilient for the future.
We would like to invite you to a webinar on 26th September 3-4 pm on national and local contingency planning for future RDS outages. Tactuum and the RDS team will speak about our business continuity plans and the national contingency arrangements we are putting in place. This will also be a space to share local contingency plans, ideas and existing good practice. We would also like to gather your views on who we should send communications to in the event of future outages.
I have sent a meeting request for this date to all editors – please accept or decline to indicate attendance, and please forward on to relevant contacts. You can also contact Olivia.graham@nhs.scot directly to register your interest in participating.
2.National IV fluid prescribing calculator
This UK CA marked calculator is now live at https://righdecisions.scot.nhs.uk/ivfluids . It has been developed by a multiprofessional steering group of leads in IV fluids management, as part of the wider Modernising Patient Pathways Programme within the Centre for Sustainable Delivery. It aims to address a known cause of clinical error in hospital settings, and we hope it will be especially useful to the new junior doctors who started in August.
Please do spread the word about this new calculator and get in touch with any questions.
The following toolkits are now live;
We have updated and simplified this guidance within our standard operating procedures. We have clarified the guidance on how to determine whether an RDS tool is a medical device, and have provided an interactive powerpoint slideset to steer you through the process.
We have developed a guide to support editors and toolkit leads through the process of scoping, designing, delivering, quality assuring and implementing a new RDS toolkit. We hope this will help in project planning and in building shared understanding of responsibilities throughout the full development process. The guide emphasises that the project does not end with launch of the new toolkit. Implementation, communication and evaluation are ongoing activities throughout the lifetime of the toolkit.
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.)
7 Evaluation projects
Dr Stephen Biggart from NHS Lothian has kindly shared with us the results of a recent survey of use of the Edinburgh Royal Infirmary of Edinburgh Anaesthesia toolkit. This shows that the majority of consultants are using it weekly or monthly, mainly to access clinical protocols, with a secondary purpose being education and training purposes. They tend to find information by navigating by specialty rather than keyword searching, and had some useful recommendations for future development, such as access to quick reference guidance.
We’d really appreciate you sharing any other local evaluations of RDS in this way – it all helps to build the evidence base for impact.
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
Ailsa Stein - Programme Manager, SIGN. ailsa.stein@nhs.scot
Kirsty Littleallan - Administrative Officer, SIGN. kirsty.littleallan@nhs.scot
Co-chairs of SIGN Guideline Group:
Dr Selena Gleadow Ware, Consultant Perinatal Psychiatrist, NHS Lanarkshire, Selena.Gleadow-Ware@lanarkshire.scot.nhs.uk
Susan McConachie, Regional Perinatal Nurse Consultant, NHS Lothian, susan.mcconachie2@nhslothian.scot.nhs.uk
Senior responsible owner
Roberta James, SIGN Programme Lead.
Content has been checked for accessibility in line with the relevant RDS standard operating procedure.
The content in this toolkit has been developed by the SIGN guideline group for SIGN Guideline 169: Perinatal mental health conditions.
Content has been reviewed and approved in line with the SIGN editorial governance process.
Final content was signed off by SIGN Programme Lead.
The content will be considered for update 3 years from publication. Any minor updates brought to the attention will be dealt with on an "as needed" basis.
Updates will be reviewed and approved in line with the SIGN editorial governance process.
Content updates on the Right Decisions platform will be carried out by the SIGN team, with support from the Right Decision Service team when required.
RDS automated alerts when review is due will be sent to the Programme Manager responsible for the project, and the generic SIGN inbox, sign@sign.ac.uk .
Six months prior to the deadline for update (ie 3 years post publication) a scoping review will be conducted to identify new evidence which may change the recommendations in the toolkit. The results of the scoping review will be circulated to the original guideline development group for comment, and to identify any other new areas for inclusion. Their responses, along with the review results, are submitted to the work programme committee for consideration for update or revalidation.
Content will be updated using the guideline development processes outlined in the SIGN methodology manual, SIGN 50: a guideline developer's handbook.
Amendments will be developed by a multidisciplinary group of clinicians and people with lived experience, subject to peer review, and signed off by the SIGN editorial team.
The content was reviewed by the clinicians and people with lived experience on the guideline development group.
The SIGN guideline was available for peer review in June 2023. All comments received were addressed and responses published on the SIGN website. The guideline was reviewed by clinical experts from SIGN Council as part of the editorial process.
Copyright permission was obtained from the Australian government for use of recommendations from the Centre for Perinatal Excellence (COPE) guideline, Mental Health Care in the Perinatal Period: Australian Clinical Practice guideline, 2023.
Copyright permission was obtained from Professor Marie-Paule Austin, Adjunct Professor, School of Psychiatry, UNSW, to use the version of the Antenatal Risk Questionnaire (ANRQ) deployed in this toolkit..
The City Birth Trauma Scale is free to use in clinical practice or research under a Creative Commons licence. It was published by Ayers S, Wright DB and Thornton A (2018) in Development of a Measure of Postpartum PTSD: The City Birth Trauma Scale. Frontiers in Psychiatry, 9:409.
The authors of the Edinburgh Postnatal Depression Scale (EPDS) grant permission for reproduction. Copyright remains with the British Journal of Psychiatry, as detailed in Cox, J.L., Holden, J.M. and Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal
Depression Scale. British Journal of Psychiatry, 150, 782-786.
All icons are from Flaticon.com, accessed through the licence held Tactuum Ltd for the resources supported by the software platform it provides.
The content is based on robust evidence-based guidelines. Each recommendation was assessed for suitability for the Scottish healthcare context and acceptability to the patient population in Scotland.
The content of this toolkit was reviewed by the SIGN editorial team (October 2023) and signed off by the SIGN Programme Lead.
SIGN Council and the SIGN senior management team monitor the SIGN work programme, and SIGN methodology includes procedures for identifying when new evidence prompts an update to current guidance.
The email for the SIGN Programme Manager is available in the "Key contacts" section above and can be used to highlight any feedback or complaints.
Any messages received through the RDS Feedback form will also be forwarded to the Programme Manager.
The Programme Manager will address the feedback. If it requires significant amendments, it will be referred to the SIGN senior management team for consideration for the SIGN work programme.
The toolkit has been risk assessed, and mitigations put in place where required.
The toolkit was user tested by the group of clinicians and people with lived experience in the guideline development group throughout its development.
The toolkit was available for open consultation in June 2023. Responders were asked to comment on the ease of navigation, look and content of the toolkit. All comments were addressed and responses published on the SIGN website.
Mental health in pregnancy and after birth (SIGN)