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
Selective dorsal rhizotomy brings improved mobility for boy with spastic cerebral palsy (University of Michigan Health)
Dr. Debbie Song at Gillette Children's Hospital, St Paul MN, USA describes the selective rhizotomy surgery procedure in detail. Includes footage of surgery and before-and-after examples of patients walking
Evidence-based recommendations on selective dorsal rhizotomy for spasticity in cerebral palsy. This involves cutting nerves in the lower spine that are responsible for muscle rigidity.
NHS England - Clinical Commissioning Policy: Selective Dorsal Rhizotomy (SDR) for the treatment of spasticity in Cerebral Palsy (children aged 3-9 years)
Selective dorsal rhizotomy is an operation used to reduce spasticity (muscle stiffness) in cerebral palsy. NHS England has carefully reviewed the evidence and concluded that there is enough evidence to make the treatment available at this time.
Great Ormond Street Children's Hospital - Selective Dorsal Rhizotomy clinical outcomes
GOSH established its Selective Dorsal Rhizotomy (SDR) service in 2013 and is one of five centres providing the service in England. SDR is an operation that reduces spasticity (muscle stiffness) in children with cerebral palsy who fulfil specific clinical criteria.
Alder Hey Children's Hospital Trust - Selective Dorsal Rhizotomy patient discharge information leaflet
This leaflet aims to provide information for parents and children about the care of their SDR wound.
Bristol Royal Hospital for Children SDR service - Information pages
Leeds General Infirmary SDR Neurosurgery site - Information pages
SCOPE - Advice & support: Selective Dorsal Rhizotomy (SDR) for muscle spasticity
Selective Dorsal Rhizotomy (SDR) is a surgical procedure aimed at reducing spasticity (tight and stiff muscle tone) in the lower limbs. It's mostly used for children with spastic diplegia (2 limbs affected). Around 1 in 4 children born with cerebral palsy (CP) have 2 limbs affected.
Selective Dorsal Rhizotomy - SDR