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  1. Right Decisions
  2. Prevent the progress of diabetes
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  4. I have been diagnosed with prediabetes
  5. Maintaining a healthy weight
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

 

 

Maintaining a healthy weight

Once you have lost weight, you want to keep it off and maintain a healthy weight. To prevent the weight creeping back on, you need to keep going with the healthy habits you’ve formed.

The basic rules of maintaining a healthy weight are to:

  1. Eat healthily
  2. Watch your portion sizes
  3. Be more active. 

 

Diabetes UK provides five key rules for keeping to a healthy weight when you have diabetes:

 

 

These top tips are based on Diabetes UK guidance.

1. Choose healthier carbohydrates with high fibre

Examples include:

  • whole grains like brown rice, buckwheat and whole oats
  • fruit
  • vegetables
  • pulses such as chickpeas, beans and lentils
  • dairy like unsweetened yoghurt and milk.

At the same time, it’s also important to cut down on carbohydrate foods that are low in fibre. Examples include  white bread, white rice and processed cereals.

Check food labels when you’re looking for foods high in fibre if you’re unsure.

2. Eat less salt

Eating lots of salt can increase your risk of high blood pressure, which in turn increases risk of heart diseases and stroke. When you have diabetes, you’re already more at risk of all of these conditions.

Try to limit yourself to a maximum of 6g (one teaspoonful) of salt a day. Lots of pre-packaged foods already contain salt so remember to check food labels and choose those with less salt.

Cooking from scratch will help you keep an eye on how much salt you’re eating. You can also get creative and swap out salt for different types of herbs and spices to add that extra flavour.

3. Eat less red and processed meat

This includes meats like ham, bacon, sausages, beef and lamb. These all have links with heart problems and cancers.

Try swapping with:

  • pulses such as beans and lentils
  • eggs
  • fish - especially oily fish like salmon and mackerel. These which contain an oil which protects your heart
  • poultry like chicken and turkey
  • unsalted nuts

4. Eat more fruit and veg

Eating fruit and vegetables will help you get the vitamins, minerals and fibre your body needs every day to help keep you healthy.

Fruits do contain sugar, but it’s natural sugar. This is different to the added sugar (also known as free sugars) that are in things like chocolate, biscuits and cakes.

Products like fruit juices also count as added sugar, so go for whole fruit instead. This can be fresh, frozen, dried or tinned in juice, not in syrup. 

5. Choose healthier fats

We all need fat in our diet because it gives us energy. 

Healthier fats are in foods like unsalted nuts, seeds, avocados, oily fish, olive oil, rapeseed oil and sunflower oil.

Some saturated fats can increase the amount of cholesterol in your blood, increasing your risk of heart problems. These are mainly found in animal products and prepared food like:

  • red and processed meat
  • butter
  • biscuits, cakes, pies and pastries.

Try to grill, steam or bake foods instead of frying.

6. Cut down on added sugar

Swapping sugary drinks, energy drinks and fruit juices with water, plain milk, or tea and coffee without sugar can be a good start.

Cutting out these added sugars can help you manage your blood glucose levels and help you manage your weight.

You can always try low or zero-calorie sweeteners to help you cut back. But, in the long term, try and reduce the overall sweetness in your diet.

7. Be smart with snacks

If you want a snack, choose yoghurts, unsalted nuts, seeds, fruits and vegetables instead of crisps, chips, biscuits and chocolates.

8. Drink alcohol sensibly

Alcohol is high in calories, so if you do drink and you’re trying to lose weight, think about cutting back. Try to keep to a maximum of 14 units a week. But spread it out to avoid binge drinking, and go several days a week without alcohol.

Diabetes UK: What’s your healthy weight when you have diabetes?

  • Advice on how to maintain a healthy weight when you have diabetes. Includes links to other diabetes UK pages with weight loss information and tips.

 

My Diabetes My Way: The Importance of Weight Management

  • Describes why it is important to maintain a healthy weight and the benefits of weight loss. Also includes links to resources on managing your weight.