Welcome to the Right Decision Service (RDS) newsletter for October 2024.
Development of the contingency solutions to maximise RDS resilience and minimise risk of future outages is in progress, aiming for completion by Christmas. As a reminder, these contingency arrangements are:
In the meantime, a gentle reminder to encourage users to download essential clinical toolkits to their mobile devices so that there is an offline version always available.
A new scheduled deployment with minor improvements drawn from support tickets, externally funded projects, information related to outages, and feature requests will take place in early December. Key improvements planned are:
We are also seeking approval to use the NHS Scotland logo and title for the RDS app on the app stores to help with audience engagement and clarity around the provenance of RDS.
We are still hopeful that user acceptance testing for at least the Search and browse enhancements can take place before Christmas. Thank you for your patience and understanding in waiting for these improvements. Timescales have been pushed back by old app migration challenges, work to address outages, and most recently implementing the contingency arrangements.
We are aware that there continue to be some issues around a number of RDS support tickets, in part due to constraints around visibility for the RDS team of the tickets in the existing support portal. We are investigating the potential to move to a new support ticket requesting system from early in the new year. We will organise the proposed webinar around support ticket processes once we have confirmed the way forward with the system.
There is a known issue with alterations in formatting of some RDS tables which seems to have arisen as a result of the 17 October deployment. Tactuum is working on a fix and on implementing additional regression testing to prevent this issue recurring.
Recently launched toolkits include:
NHS Lothian Infectious Diseases
Scottish Health Technologies Group – Technology Assessment recommendations
NHS Tayside Anaesthetics and Critical Care projects – an innovative toolkit which uses PowerAutomate to manage review and response to proposals for improvement projects.
If you would like to promote one of your new toolkits through this newsletter, please contact ann.wales3@nhs.scot
A number of toolkits are expected to go live before Christmas, including:
We have had a good response to the recent invitation to sign up to the new Teams channel for RDS editors. This provides a forum for editors to share learning, ideas and questions and we hope to hold regular webinars on topics of interest. The RDS team is in the process of joining participants to the channel and we’d encourage all editors to take part, using the registration form – available in Providers section of the RDS Learning and Support area.
The RDS team has worked with colleagues in NHS Grampian and the Digital Health & Care Innovation Centre to evaluate the impact of the Prevent the progress of diabetes web and mobile app in a small-scale pilot project. This app provides access to local and national resources and services targeted at people with prediabetes, a history of gestational diabetes, or candidates for remission. After just 8 weeks of using the app, 94% of patients reported increased their knowledge and understanding of diabetes, and 88% said it had increased their confidence and motivation to make lifestyle changes, highlighting specific behaviour changes. The learning from this project is informing development of a service model based on tailored support for patient groups with, high, medium and low digital self-efficacy.
Please contact ann.wales3@nhs.scot if you would like to know more about this project.
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.)
To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form - also available in End-user and Provider sections of the RDS Learning and Support area. 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
The Right Decision Service: the national decision support platform for Scotland’s health and care
Website: https://rightdecisions.scot.nhs.uk Mobile app download: Apple Android
Chunk and check can be used alongside teach back to assist in promoting understanding. Break down the information you need to discuss into smaller chunks. In between each chunk use methods such as teach back to check for understanding.
Source: Health Literacy Place
Target audience: all health and social care staff
Access: free online resource
Firstly, we need to consider how information is ‘framed’. ‘Gain framing’ is where the focus is on the advantages of intervention e.g. 95 out of 100 people having this procedure will have a good outcome. ‘Loss framing’ focuses on the disadvantages e.g. 5 in every 100 will have a complication.
It’s also easier to be consistent about the ‘denominator’ – ideally 100 – and to say e.g. 5 in every 100 rather than 1 in 20; and rather than 1 in 4, say 25 in every 100.
Another way to express information in a helpful way is to talk about the ‘number needed to treat’. That is the number of people who need to have the intervention in order to have one positive outcome. In other words, if the number needed to treat is 23, this means that 23 people will need to have the treatment in order to have one good outcome. Conversely, the ‘number needed to harm’ is the number of people undergoing the treatment before a single harm occurs. If the number needed to harm is 200, this means that 200 people will have the intervention before one negative outcome occurs.
Source: NHS Greater Glasgow and Clyde
Teach back is a useful way to confirm that the information you have provided has been understood. Get people to "teach back" what has been discussed and what instructions have been given.
Source: Health Literacy Place
Target audience: all health and social care staff
Access: free online resource
Phrase to avoid: what are your preferences?
May be interpreted as: perhaps I can ask for anything
A better form of words: we need to think about your priorities and then what we can do to fit with that
Phrase to avoid: what are your goals?
May be interpreted as: are there targets I’m supposed to meet?
A better form of words: what are things that are important for you to be able to do?
Phrase to avoid: the test results are negative
May be interpreted as: oh dear, the results are not good
A better form of words: there are no signs of any tumour in the tests we carried out
Phrase to avoid: the ceiling of treatment is ..
May be interpreted as: there’s a point at which I may not be entitled to treatment that might help
A better form of words: there are things we can do but some treatments don’t work or help when someone has these health problems
Phrase to avoid: we are going to withdraw treatment
May be interpreted as: I am (or my relative is) being abandoned by the clinical team
A better form of words: we are continuing care that may help but stopping treatments that are not helping and may cause distress or discomfort
Source: NHS Greater Glasgow and Clyde
Use simple language and try to avoid using jargon and acronyms.
Source: Health Literacy Place
Target audience: all health and social care staff
Access: free online resource
Use pictures and visuals as an effective way to improve understanding when communicating new or complex ideas to people.
Source: Health Literacy Place
Target audience: all health and social care staff
Access: free online resource
A ‘pictogram’ such as this one from NICE guidelines showing the effect of stopping smoking on preventing a cardiovascular event.
Source: National Institute for Health and Clinical Excellence. Guideline development Group. Improving the experience of care for people using NHS services: summary of NICE guidance March 2012, BMJ (online) 344(mar16 1):d6422
Access: free online resource
Realistic Medicine - National toolkit for professionals