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Right Decision Service newsletter: June 2024

Welcome to the Right Decision Service (RDS) newsletter for June 2024.

1.     Issues with RDS

Hopefully you all received the notification on Friday 28th June about the worldwide security vulnerability relating to use of code from the Polyfill.io code library – typically used to enable use of functionality in older browsers and operating systems. This vulnerability has now been addressed within RDS. Thanks to Tactuum for their prompt action on this.

This incident served as a useful reminder about the importance of making sure all devices and desktop/laptop computers have up to date anti-malware installed.

2.Redesign and improvements to RDS

The most recent information is that final fixes and developments will take place during July, with a view to user testing taking place in August 2024.

3.Evaluation

3.1 Usage statistics

We will be running the six-monthly usage statistics reports for all RDS toolkits during July. Please contact his.decisionsupport@nhs.scot if you would like to receive the usage report for your toolkit(s).

3.2 Palliative care

The Scottish Palliative Care Group is carrying out a value and impact survey of the national Palliative Care Guidelines toolkit on RDS. We would appreciate your help in circulating this survey, available at https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/evaluation-survey/ /

3.3 Standard evaluation survey form

The Palliative Care Guidelines toolkit is using an adapted version of a generic impact evaluation form which the RDS team now encourages all toolkit owners to apply 6-12 months after launch of their toolkit.  Please contact ann.wales3@nhs.scot if you would like to find out more.

4. Training and communications

The RDS Learning working group is in the final stages of developing and uploading new learning resources including:

  • Clinical and Care governance of RDS toolkits
  • The RDS toolkit development journey – from scoping to implementation and evaluation.
  • New 5-minute videos demonstrating key editorial functionality

 

We have also drafted a communication and training plan to support implementation of the redesigned RDS. The plan aims to reach both end-users and editors, who will benefit from new features such as the archiving and version control functionality.  

 

4.1 Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

  • Thursday 1 August 11 am – 12 pm
  • Wednesday 7 August 4-5 pm

 

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.)

 

4.2 Google analytics training

Remember that you can also organise 1-1 training sessions with Olivia on running Google Analytics reports if you want to look at data more frequently than the six-monthly reports.

5. New toolkits

The following RDS toolkits are now live:

  • SARCS (Sexual Assault Response Coordination Service)
  • Child protection procedures (North Lanarkshire)
  • NHS Lothian neonatal guidelines

 

The following toolkits are due to go live imminently:

  • NHS Grampian critical care
  • Care Inspectorate Safe Staffing guidance.

6. Toolkits in development

Some of the toolkits the RDS team is currently working on:

  • SIGN/NICE/BTS Asthma guideline – combination of old and new guidance.
  • New SIGN guideline around prevention and remission of type 2 diabetes
  • Updating of HIS national tissue viability guidance in collaboration with the and transfer to RDS as an extension to the Skin and wound care toolkit

 

Please contact his.decisionsupport@nhs.scot if you would like to learn more about a toolkit. The RDS team will put you in touch with the relevant toolkit lead.

7. Implementation projects

HIS is working with the Scottish Library and Information Council and the ALLIANCE to implement the second phase of the Collective Force for Health and Wellbeing Action Plan. This plan aims to strengthen the role of public, health and school libraries in empowering people to use digital tools and health information for self-management and choices about health and wellbeing. A key element of this new phase is supporting public libraries to promote the RDS citizen-facing apps for health and wellbeing.

We held a webinar on 28th June about the implementation challenge for health and wellbeing apps for citizens. This included an overview of the evidence base around implementation, the critical importance of health literacy skills, and the early findings from tests of change of implementing the Being a partner in my care app. Please contact his.decisionsupport@nhs.scot if you would like a copy of the slides or access to the recording of this webinar (NHS staff only.)

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

 

 

 

 

Risk factors

The key risk factors for developing type 2 fall into two categories:

Modifiable risk factors

These are risk factors that you can change and control. 

Non-modifiable risk factors

These are risk factors you cannot change yourself. However you can still reduce your risk of developing type 2 diabetes by acting on the modifiable risk factors such as weight loss.

Find out more about each of these types of risk factor by clicking on the links below.

 

Modifiable risk factors

1.Excess body weight

Bathroom scales        tape measure

Your weight plays a large role in developing  type 2 diabetes, especially if your extra weight is around your waist. 

What is a healthy weight to aim for?

This is about working out your Body Mass Index (BMI).  BMI uses your height and weight to work out if you're a healthy weight.  You can work your BMI out for yourself using this NHS tool  – it will show you your target range.

For many people living with obesity, aiming for a healthy BMI may not be realistic. Research shows that  even losing just 5% of extra weight will improve your health. The more weight you lose, the greater the health benefits.

What is a healthy waist size?

BMI  doesn’t look at how much fat you have around the middle. That is why you need to measure your waist too.

Healthy weight size all depends on your gender and ethnicity. For a healthy measurement you need to aim to be less than:

  • 80cm (31.5in) for all women
  • 94cm (37in) for most men
  • 90cm (35in) for South Asian men.

This video from Diabetes UK shows you how to measure your waist size.

2. Physical activity 

physical activity

 It is estimated that 1 in 3 women, and 1 in 4 men in the UK do not undertake enough activity to stay healthy.

It is recommended that we all undertake at least 150 minutes of moderate-intensity exercise, or 75 minutes of high-intensity exercise per week.

Being active can:

  • Contribute to weight loss
  • Increase the way your body uses insulin, reducing the period of time blood glucose levels remain high. 
  • Use fat for fuel in endurance exercise such as running or swimming. This reduces levels of fat around your waist.

Exercise videos

This playlist of short videos from Diabetes UK gives you lots of exercise options to choose from. They range from gentle arm and leg movements to dance and a full body workout.

3. Smoking

smoking

In the UK, 15% of people aged 18 years and over are said to be active smokers. This means that there are  some 7.2 million active smokers that are putting themselves at risk of type 2 diabetes.

Smokers are estimated to be 30% to 40% more likely to develop T2DM than nonsmokers. Cigarette smoke has been found to contain more than 7000 harmful chemicals, many of which can decrease the effectiveness of insulin as a result of  inflammation and damage cells as a consequence of oxidative stress.

Additionally, the nicotine from smoking can reduce the effectiveness of insulin, resulting in active smokers finding it harder to manage blood glucose levels. 

If you have prediabetes or a previous diagnosis of gestational diabetes, you already have an increased chance of developing cardiovascular disease, such as a heart attack, stroke or circulatory problems in the legs.

Combine this with smoking and you make the chances of developing these diseases and their complications even higher.

Help to stop smoking

NHS inform provides a suite of support and resources to help you to stop smoking. This includes the Quit your Way Scotland service. This is staffed by a team of trained advisors who will give you advice tailored to your needs.  

4. Stress 

 stress

Stress  hormones cause an increase in blood glucose levels and reduce the effectiveness of insulin. 

For some people, stress can also trigger overeating behaviours. The change in body chemicals resulting from eating “comfort foods'' can dampen stress related responses and emotions. Over time, this can lead to prolonged levels of comfort eating and, ultimately, an increase in body weight and the development of T2DM. 

Non-modifiable risk factors

1.Age

image of ageing

You’re more at risk of developing type 2 diabetes if you’re:

  • White and over 40 years old
  • African-Caribbean, Black African, or South Asian and over 25 years old.

As we age, our bodies naturally begin to function less efficiently than they did when we were younger. This includes our body becoming less efficient in producing insulin. That can increase our risk of developing type 2 diabetes as we get older. 

2.Genetics

image of DNA

  • You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.

The genetic risk comes from changes in the parts of our DNA that help to control our blood glucose levels. Some of these changes can reduce our body's ability to release insulin. This leads to increases in blood glucose levels. Over time, elevated levels of blood glucose increases the risk of developing T2DM. 

3.Ethnicity

image representing ethnic diversity

  • Type 2 diabetes is two to four times more likely in people of South Asian descent and African-Caribbean or Black African descent.

While the exact cause of this increased risk among different ethnicities is not fully understood, it is likely that our genetics that are passed down to us and determine who we are play a large role.