Pregnant women
- After 39 weeks gestation who has given consent.
- After previous caesarean birth if planning vaginal birth (VBAC). If a VBAC is the planned method of birth then a membrane sweep is not contraindicated.
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
This guideline covers the reasoning behind why a membrane sweep may be performed at term and the process of this procedure. It aims to give women the option to have membrane sweeping to possibly prevent prolonged pregnancy and reduce the need for mechanical or pharmacological induction of labour.
This procedure can be carried out, with informed consent, by healthcare professionals i.e. Midwives and Obstetricians.
Healthcare professionals
Pregnant women, their families and carers
Please report any inaccuracies or issues with this guideline using our online form
A membrane sweep can be discussed with the woman in the latter stages of the third trimester and offered from 39 weeks gestation and performed at the both community midwife led and obstetric led antenatal clinics. The woman should be informed of the advantages and disadvantages of a membrane sweep to allow them to make an informed decision whether to have the procedure. The procedure should be discussed and verbal consent must be gained, from the pregnant person, before carrying out the membrane sweep.
Research suggest membrane sweeps performed twice weekly after 39 weeks are more effective than once weekly or no membrane sweep. Clinical judgement and women’s choice should be considered when arranging subsequent follow up.
The pregnant person should be informed that they may experience some light vaginal bleeding or ‘Show’. If any heavy bleeding, painful contractions or waters breaking (SROM) maternity assessment unit should be contacted. A discussion regarding whether the woman would like additional membrane sweeping should take place if spontaneous labour does not occur after the first sweep.