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
Physiotherapy Department
Borders General Hospital
Melrose
TD6 9BS
Telephone 01896 826548
telephone 01896 826548
This information leaflet aims to help people with mechanical neck pain. It gives information and exercises so that you can make practical step to improving your symptoms.
"Information given on this site is not meant to take the place of a talk with your doctor or health worker."
There are different types of neck pain, which are described below. We will be focusing on mechanical neck pain, which is the most common type.
The picture below shows the main parts that make up your spine. There are 7 bones in your neck, which are also known as your cervical vertebrae. There are also ligaments and muscles around your neck. Together these allow the neck to move in lots of different directions.
1. Vertebral body
2. Disc
3. Spinosus process
4. Facet joint
This is the most common and can be caused by different things. Posture is often the most common cause,
especially for people who work at a desk or computer all day.
This is most commonly caused by a car accident or sporting injury.
This is sometimes called primary torticollis or ‘wry neck'. Often muscles on one side of the neck go into spasm either after small injury or poor sleeping posture. The pain and spasm often settle in a few days.
This is sometimes called cervical spondylosis. The spinal bones (vertebrae) and the discs degenerate. This is more common in older people.
This is when the nerve root is pressed on or injured as it comes out of the spinal cord. This causes pins and needles, numbness and weakness in parts of the arm and neck supplied by the nerve root.
Pain usually starts in the neck and sometimes spreads to the shoulders and bottom of the skull.
People often find moving the neck may make the pain worse. Pain may also spread down an arm towards the hand and fingers. This is usually due to irritation of the nerve at the neck.
If you get numbness or pins and needles in some or all of your arm, you should discuss these symptoms with your doctor. This may be a sign of a problem with a nerve at the neck.
If you have an acute or sudden onset of neck pain then the recovery is normally good. Pain will start to improve after a few days and is usually gone after a few weeks. However everyone is different and it may take longer for some people.
If you get more chronic symptoms, the pain might come and go and you have ‘flare-ups' from time to time.
It is important to follow the advice in this leaflet to try and reduce the length of these flare-ups.
The main advice is exercise, pain control and correct posture both sitting and lying. These are discussed below.
The pictures show poor sitting posture and correct sitting posture at the computer. As you can see from the poor sitting posture the person's neck is poking forward and over time this can cause increased muscle strain and lead to a painful neck.
By making some small changes to your seat height or monitor position you can decrease the strain on your neck and back.
Seating is also very important. Having support at the lower back can improve posture and stop your head
protruding or poking forward.
Often people feel that sleeping in a poor position caused their neck pain and they wake up with pain and
stiffness. It is important to try and sleep with your neck in a good position. Aim to keep your head in a straight line with your body. Your pillow is very important for this.
The pictures below show a couple of ways to support the hollow of your neck.
a. Put a foam roll or rolled up hand towel inside a pillowcase
b. Twist pillow to make a 'butterfly' pillow
Try to avoid sleeping on your stomach as this can increase the strain on your neck over time.
Your doctor will advise you on what is most suitable. Below is a list of some of the more common painkillers used.
Paracetamol is often enough to control the pain.
Anti-inflammatory painkillers - some people find these help more than paracetamol.
Stronger painkillers such as codeine can also be recommended
Muscle relaxant such as diazepam can be used to calm down muscle spasm in you neck.
This leaflet has been produced to help you get a better understanding about the problems with your neck. It is not a substitute for professional medical
Patient information leaflets