Welcome to the Right Decision Service (RDS) newsletter for April 2024.
Tactuum has been working hard to address the issues experienced during the last week. They have identified a series of three mitigation measures and put the first of these in place on Friday 3rd May. If this does not resolve the problems, the second mitigation will be actioned, and then the third if necessary.
Please keep a lookout for any slowing down of the system or getting locked out. Please email myself, mbuchner@tactuum.com and onivarova@tactuum.com if you experience any problems, and also please raise an urgent support ticket via the Support Portal.
Thank you for your patience and understanding while we achieve a full resolution.
A rotating carousel presenting some of the key RDS tools and capabilities, and an editable slideset, are now available in the Resources for RDS providers section of the Learning and Support toolkit.
The redesign of RDS Search and Browse is still on-track for delivery by mid-June 2024. We then plan to have a 3-week user acceptance testing phase before release to live. All editors and toolkit owners on this mailing list will be invited to participate in the UAT.
The archiving and version control functionality is also progressing well and we will advise on timescales for user acceptance testing shortly.
Tactuum is also progressing with the deep linking to individual toolkits within the mobile RDS app. There are several unknowns around the time and effort required for this work, which will only become clear as the work progresses. So we need to be careful to protect budget for this purpose.
These have all been compiled and effort estimated. Once the redesign work is complete, these will be prioritised in line with the remaining budget. We expect this to take place around late June.
Many thanks to those of you completed the value and impact survey we distributed in February. Here are some key findings from the 65 responses we received.
Figure 1: Impact of RDS on direct delivery of care
Key figures
Figure 2 shows RDS impact to date on delivery of health and care services
Key figures
These data show how RDS is already contributing to NHS reform priorities and supporting delivery of more sustainable care.
Saving time and money
Quality assurance and governance
Service innovation and workforce development
A few examples of toolkits published to live in the last month:
Some of the toolkits the RDS team is currently working on:
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.
Thanks to all of you who have responded to the retrospective quality audit survey and to the follow up questions. We still have some following up to do, and to work with owners of a further 23 toolkits to complete responses. An interim report is being presented to the HIS Quality and Performance Committee.
Eight clinical services and two public library services are undertaking tests of change to implement the Being a partner in my care app. This app aims to support patients and the public to become active participants in Realistic Medicine. It has a strong focus on personalised, person-centred care and a library of shared decision aids, as well as simple explanations and videoclips to help the public to understand the aims of Realistic Medicine. The tests of change will inform guidance and an implementation model around wider adoption and spread of the app.
With kind regards
Right Decision Service team
Healthcare Improvement Scotland
Bow-legs (genu varum) and knock-knees (genu valgum) are common reasons for referrals to paediatric orthopaedic clinics and are what we term “normal variants”. Bow-legs mean that there is a gap between the knees when the ankles are pressed together. Knock-knees are present when there is a gap between the malleoli when the knees are pressed together.
Usually no. There is a very famous study from Scandinavia in 1975 which demonstrated the changing alignment of children’s leg as they age. This is often remembered and shown in the Salenius Curve.
The Salenius curve shows that all children are born with bow legs and that these are usually present until about the age of 2. After this they become knock kneed. The degree of knock-knee is most obvious between ages of 3-4. The legs then gradually straighten reaching an adult shape by the age of 10-12. This is often a very small degree of valgus. Heavy children and children with loose ligaments stretch their knee joints and will appear to have greater deformity. Many babies have big calf muscles, which can make the leg seem quite bent even the bones are only slightly curved.
Symmetrical bow-legs before the age of two, and symmetrical knock-knees seen between the ages of 2 and 12 are termed “physiological” because these appearance are part of the normal growth and development. It should be remembered that we are all slightly different in appearance and this goes for leg shape too.
For physiological symmetrical bow-legs and knock-knees, no. It is helpful to explain the normal to the parents and it can be helpful to ask them to take photos 3 or 4 months apart which usually demonstrates to them that things are moving the way we would expect There is no place for physiotherapy, special shoes or braces as this is the normal development of lower limb alignment. Occasionally if there is an underlying cause this may require treatment. This is indicated with the presence of asymmetric, pain, progressive deformity out with the normal curve.
NHSL Guidelines