Change Request
 

NHS Connecting for Health

NHS Data Model and Dictionary Service

Reference: Change Request 1090
Version No:1.0
Subject:NHS Data Model and Dictionary Modelling Changes - Questionnaires and Person Score
Effective Date:Immediate
Reason for Change:Change to Data Standards
Publication Date:18 January 2010

Background:

The NHS Data Model and Dictionary Service are currently working with the Department of Health and Information Centre for Health and Social Care to develop a number of Data Sets.

During the business analysis stage, it has been identified that these Data Sets cover a number of common areas which are either not currently in the NHS Data Model and Dictionary or amendments are required to make the current information suitable for use in these Data Sets.

This Data Set Change Notice adds the common data items and associated data modelling changes for "Questionnaires and Person Score" into the NHS Data Model and Dictionary in preparation for these Data Sets. The changes are detailed in the "Summary of changes" below.

The primary purpose is to introduce a new “Person Score” and "Questionnaire or Rating” Class into the NHS Data Model to support the new data sets currently under development. This will enable the new data sets to use the generic data items and codes for reporting the results of questionnaires completed by a person and the related scores.

Note: “HONOS Score for Person” has been retired and replaced by a new NHS Business Definition to ensure all Questionnaires are represented in a consistent manner in the NHS Data Model.

These changes do not need to be implemented in end-user systems until the Data Set Change Notices for the specific data sets come into effect. Other specific items will be added to the Data Sets during development.

Summary of changes:

Diagrams
PERSON AND PERSON PROPERTY   Changed Diagram
 
Supporting Information
HEALTH OF THE NATION OUTCOME SCALE (WORKING AGE ADULTS)   New Supporting Information
MENTAL HEALTH MINIMUM DATA SET OVERVIEW   Changed Description
 
Class Definitions
HONOS SCORE FOR PERSON (RETIRED) renamed from HONOS SCORE FOR PERSON   Changed Name, status to Retired
PERSON   Changed Relationships
PERSON PROPERTY   Changed Description
PERSON SCORE   New Class
QUESTIONNAIRE OR RATING SCALE   New Class
 
Attribute Definitions
PERSON SCORE   New Attribute
QUESTIONNAIRE OR RATING SCALE QUESTION NUMBER   New Attribute
QUESTIONNAIRE OR RATING SCALE TYPE   New Attribute
 
Data Elements
HONOS RATING (BEST IN LAST TWELVE MONTHS)   Changed Description, linked Attribute
HONOS RATING (FIRST IN MHCS)   Changed Description, linked Attribute
HONOS RATING (MOST RECENT IN MHCS)   Changed Description, linked Attribute
HONOS RATING (WORST EVER RECORDED)   Changed Description, linked Attribute
HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS)   Changed Description
HONOS SCORE DATE (FIRST IN MHCS)   Changed Description
HONOS SCORE DATE (MOST RECENT IN MHCS)   Changed Description
HONOS SCORE DATE (WORST EVER RECORDED)   Changed Description
QUESTIONNAIRE OR RATING SCALE COMPLETION DATE   New Data Element
 
Packages
H   New Package
 

Date:18 January 2010
Sponsor:Ken Lunn, Director of Data Standards and Products, NHS Connecting for Health

Note: New text is shown with a blue background. Deleted text is crossed out. Retired text is shown in grey. Within the Diagrams deleted classes and relationships are red, changed items are blue and new items are green.

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PERSON AND PERSON PROPERTY

Change to Diagram: Changed Diagram

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HEALTH OF THE NATION OUTCOME SCALE (WORKING AGE ADULTS)

Change to Supporting Information: New Supporting Information

The Health of the Nation Outcome Scale (Working Age Adults) (HoNOS (Working Age Adults)) is a type of QUESTIONNAIRE OR RATING SCALE.

The Health of the Nation Outcome Scale (Working Age Adults) is a means of measuring the health and social functioning of people of working age with severe mental illness.

It is assessed by a CARE PROFESSIONAL or Mental Health Care Team Member.

For further information on Health of the Nation Outcome Scale (Working Age Adults), see the Royal College of Psychiatrists website.

 

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MENTAL HEALTH MINIMUM DATA SET OVERVIEW

Change to Supporting Information: Changed Description

The Mental Health Minimum Data Set was introduced by DSCN20/19/P13 in April 2000 in response to the lack of national clinical data collection in the mental health arena, in line with the information requirements of the emerging National Service Framework for Mental Health.

Since April 2003 (DSCN 49/2002) it has been a mandatory requirement that all Providers of specialist adult, including elderly, mental health services submit central Mental Health Minimum Data Set returns on a quarterly basis, with an additional annual submission.

The Mental Health Minimum Data Set facilitates the collection of person-focussed clinical data and the sharing of such data to underpin the delivery of mental health care. It is structured around the clinical process and includes an outcome assessment (Health of the Nation Outcome Scales, or HoNOS). It is structured around the clinical process and includes an outcome assessment (Health of the Nation Outcome Scale (Working Age Adults), or HoNOS (Working Age Adults)). It records the key role played by partner agencies, particularly social services.

The Mental Health Minimum Data Set describes Mental Health Care Spells. These comprise all interventions made for a PATIENT by a specialist Mental Health Care Team from initial REFERRAL REQUEST to final discharge. For some individuals the Mental Health Care Spell will comprise a short Consultant Out-Patient Episode; for others it may extend over many years and include hospital, community, out-patient and day care episodes.

Information is collected relating to various stages in the journey of the PATIENT, including activity such as Hospital Provider Spells, Consultant Out-Patient Episodes, community care, and NHS day care episodes; mental health reviews and assessments including Care Programme Approach (CPA) and Health of the National Outcome Scales (HoNOS); contacts with mental health professionals such as care co-ordinators, psychiatric NURSES and CONSULTANTS; and also any diagnosis and treatment.Information is collected relating to various stages in the journey of the PATIENT, including activity such as Hospital Provider Spells, Consultant Out-Patient Episodes, community care, and NHS day care episodes; mental health reviews and assessments including Care Programme Approach (CPA) and Health of the Nation Outcome Scale (Working Age Adults) contacts with mental health professionals such as care co-ordinators, psychiatric NURSES and CONSULTANTS; and also any diagnosis and treatment.

The prime purpose of the Mental Health Minimum Data Set is to provide local clinicians and managers with better quality information for clinical audit, and service planning and management.

Central collection provides improved national information, facilitating feedback to Trusts, and the setting of benchmarks. It will also allow the delivery of the National Service Framework for Mental Health priorities to be monitored.

The Mental Health Minimum Data Set data is collected from NHS Trusts and submitted via the "Mental Health Minimum Data Set Assembler" to the Secondary Uses Service for storage, analysis and reporting by a variety of stakeholders including the Department of Health, Care Quality Commission, and the Health and Social Care Information Centre.

The Mental Health Minimum Data Set is transmitted to the Secondary Uses Service using Mental Health Minimum Data Set Message Schema Versions

Please note that the collection of the Mental Health Minimum Data Set does not replace any other collection of mental health data such as the Admitted Patient Care Commissioning Data Set Type Detained and/or Long Term Psychiatric Census, which should continue to be collected.

For further information on the Mental Health Minimum Data Set, please view the following Health and Social Care Information Centre website:

http://www.ic.nhs.uk/services/mental-health/mental-health-minimum-dataset-mhmds

Mental Health Minimum Data Set Version History

Version
 
Date Issued
 
Summary of Changes
 
DSCN
 
Implementation Date
 
1.0November 1999Introduction of Mental Health Minimum Data SetDSCN 20/99/P13April 2000
1.1June 2002Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)DSCN 27/2002April 2003
1.2September 2002Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)DSCN 29/2002April 2003
1.3October 2002Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)DSCN 48/2002April 2003
2.0October 2002Mental Health Minimum Data Set - Mandatory Central returns. This version of the data set incorporates changes defined in DSCN 27/2002, 29/2002 and 48/2002.DSCN 49/2002April 2003
2.1November 2007Introduction of Mental Health Minimum Data Set Version 2.1DSCN 37/2007November 2007
3.0February 2008Introduction of Mental Health Minimum Data Set Version 3.0 - incorporating changes required for Mental Health Act 2007 and Public Service Agreement Delivery Agreement 16 (Social Exclusion)DSCN 06/2008April 2008

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HONOS SCORE FOR PERSON (RETIRED)  renamed from HONOS SCORE FOR PERSON

Change to Class: Changed Name, status to Retired

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PERSON

Change to Class: Changed Relationships

Each PERSON
must be the user of one or more PERSON NAME
must be the owner of one or more PERSON ORGAN
may be registered as one and only one CARE PROFESSIONAL
may be contacted via one or more COMMUNICATION CONTACT INFORMATION
may be born in one and only one COUNTRY
may be recorded as one or more EMPLOYEE
may be supervisor of one or more EMPLOYEE SUPERVISOR
may be classified by one or more NATIONALITY OR RESIDENCY
may be registered as one and only one PATIENT
may be the subject of one or more PERSON DEATH DETAILS
may be related to one or more PERSON OR ORGANISATION ADDRESS
may be the reporter of one or more PERSON PROPERTY
may be the recorder of one or more PERSON PROPERTY
may be the owner of one or more PERSON PROPERTY
may be the observer of one or more PERSON PROPERTY
may be the second party in one or more PERSON RELATIONSHIP
may be the first party in one or more PERSON RELATIONSHIP
may be holder of one or more PROFESSIONAL REGISTRATION
may be required to complete one or more QUESTIONNAIRE OR RATING SCALE
may be the recipient of one or more TISSUE TRANSPLANT

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PERSON PROPERTY

Change to Class: Changed Description

This item is being updated for development purposes and the changes have not yet been assured by the Information Standards Board for Health and Social Care. 

Subtypes of PERSON PROPERTY include:

CANCER STAGING
CARDIAC ARREST
CATEGORY VALUED PERSON OBSERVATION
DIABETES ROUTINE REVIEW RESULT
EDUCATIONAL ASSESSMENT
EMPLOYMENT
HONOS SCORE FOR PERSON
MEASURED PERSON OBSERVATION
ORGAN DONATION CONSENT
PATIENT DIAGNOSIS
PERSON SCORE
REPERFUSION
SECURE ACCOMMODATION REQUIREMENT
SKIN CANCER LESION
TEXT VALUED PERSON OBSERVATION
THROMBOLYTIC THERAPY
TOBACCO USAGE
TREATMENT RELATED MORBIDITY

A condition or state associated with a PERSON. PERSON PROPERTIES are collected as a result of an ACTIVITY

PERSON PROPERTIES for a PATIENT do not include information about a treatment or intervention. The observation may be a clinical diagnosis. The observer may be a related PERSON or a CARE PROFESSIONAL. Observations may be recorded during, or as a result of, a course of treatment.

PERSON PROPERTIES include:

 

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PERSON SCORE

Change to Class: New Class

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

A subtype of PERSON PROPERTY.

A PERSON SCORE is the outcome of a QUESTIONNAIRE OR RATING SCALE completed by a PERSON.

This could be for an individual question within a QUESTIONNAIRE OR RATING SCALE, a subtotal or total score.

 

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PERSON SCORE

Change to Class: New Class

Attributes of this Class are:
HONOS RATING DESCRIPTION
HONOS SCORE
PERSON SCORE

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PERSON SCORE

Change to Class: New Class

Each PERSON SCORE
may be the result of one or more QUESTIONNAIRE OR RATING SCALE

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QUESTIONNAIRE OR RATING SCALE

Change to Class: New Class

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

A type of questionnaire or assessment tool used to measure and evaluate specific aspects of a PERSON's or family needs or their experiences.

A QUESTIONNAIRE OR RATING SCALE results in a PERSON SCORE or outcome rating.

 

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QUESTIONNAIRE OR RATING SCALE

Change to Class: New Class

Attributes of this Class are:
QUESTIONNAIRE OR RATING SCALE QUESTION NUMBER
QUESTIONNAIRE OR RATING SCALE TYPE

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QUESTIONNAIRE OR RATING SCALE

Change to Class: New Class

Each QUESTIONNAIRE OR RATING SCALE
must be completed by one and only one PERSON
may be resultant in one or more PERSON SCORE

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PERSON SCORE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

The score taken from the appropriate QUESTIONNAIRE OR RATING SCALE.

This could be for an individual question within a QUESTIONNAIRE OR RATING SCALE, a subtotal or total score.

The purpose of the PERSON SCORE is to measure changes in health and wellbeing.

 

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QUESTIONNAIRE OR RATING SCALE QUESTION NUMBER

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

The number of a question in a QUESTIONNAIRE OR RATING SCALE.

 

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QUESTIONNAIRE OR RATING SCALE TYPE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

A type of QUESTIONNAIRE OR RATING SCALE.

National Codes:

01Health of the Nation Outcome Scale (Working Age Adults)
 

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HONOS RATING (BEST IN LAST TWELVE MONTHS)

Change to Data Element: Changed Description, linked Attribute

Format/length:an13
HES item: 
National Codes: 
Default Codes: 

Notes:
At each Care Programme Approach Review of a Care Programme Approach Episode within a Mental Health Care Spell, an HONOS SCORE FOR PERSON should be recorded.At each Care Programme Approach Review of a Care Programme Approach Episode within a Mental Health Care Spell, a Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE should be recorded.

For purposes of the Mental Health Minimum Data Set collection record, HONOS RATING (BEST IN LAST TWELVE MONTHS) is the best Honos Rating of all the HONOS SCORES FOR PERSONS recorded in the period of the last twelve months for the PATIENT regardless of which Mental Health Care Spell it was recorded within. Where more than one HONOS SCORE FOR PERSON has the same best Honos Rating, then the first recorded one should be used.For purposes of the Mental Health Minimum Data Set, HONOS RATING (BEST IN LAST TWELVE MONTHS) is the best rating of all the Health of the Nation Outcome Scales (Working Age Adults) PERSON SCORES recorded in the period of the last twelve months for the PATIENT regardless of which Mental Health Care Spell it was recorded within. Where more than one Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has the same best rating, then the first recorded one should be used. The twelve month period should be calculated from the REPORTING PERIOD END DATE of the REPORTING PERIOD.

This is an optional data element in the Mental Health Minimum Data Set collection record and should only be present if an HONOS SCORE FOR PERSON has been recorded during the calculated twelve month period.This is an optional data element in the Mental Health Minimum Data Set and should only be present if a Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has been recorded during the calculated twelve month period.

 

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HONOS RATING (BEST IN LAST TWELVE MONTHS)

Change to Data Element: Changed Description, linked Attribute

HONOS RATING (BEST IN LAST TWELVE MONTHS)
 
Attribute:
HONOS SCORE

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HONOS RATING (FIRST IN MHCS)

Change to Data Element: Changed Description, linked Attribute

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HONOS RATING (FIRST IN MHCS)

Change to Data Element: Changed Description, linked Attribute

HONOS RATING (FIRST IN MHCS)
 
Attribute:
HONOS SCORE

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HONOS RATING (MOST RECENT IN MHCS)

Change to Data Element: Changed Description, linked Attribute

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HONOS RATING (MOST RECENT IN MHCS)

Change to Data Element: Changed Description, linked Attribute

HONOS RATING (MOST RECENT IN MHCS)
 
Attribute:
HONOS SCORE

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HONOS RATING (WORST EVER RECORDED)

Change to Data Element: Changed Description, linked Attribute

Format/length:an13
HES item: 
National Codes: 
Default Codes: 

Notes:
At each Care Programme Approach Review of a Care Programme Approach Episode within a Mental Health Care Spell, a Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE should be recorded.

At each Care Programme Approach Review of a Care Programme Approach Episode within a Mental Health Care Spell, an HONOS SCORE FOR PERSON should be recorded.For purposes of the Mental Health Minimum Data Set, HONOS RATING (WORST EVER RECORDED) is the worst rating of all the Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORES ever recorded for the PATIENT regardless of which Mental Health Care Spell it was recorded within. Where more than one Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has the same worst rating, then the first recorded one should be used.

For purposes of the Mental Health Minimum Data Set collection record, HONOS RATING (WORST EVER RECORDED) is the worst Honos Rating of all the HONOS SCORES FOR PERSONS ever recorded for the PATIENT regardless of which Mental Health Care Spell it was recorded within. Where more than one HONOS SCORE FOR PERSON has the same worst Honos Rating, then the first recorded one should be used.

 

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HONOS RATING (WORST EVER RECORDED)

Change to Data Element: Changed Description, linked Attribute

HONOS RATING (WORST EVER RECORDED)
 
Attribute:
HONOS SCORE

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HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS)

Change to Data Element: Changed Description

Format/length:see DATE 
HES item: 
National Codes: 
Default Codes: 

Notes:
HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS) is the same as attribute PERSON PROPERTY RECORDED DATE for the HONOS SCORE FOR PERSON.HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS) is the same as attribute PERSON PROPERTY RECORDED DATE for the Health of the Nation Outcome Scale (Working Age Adults).

The date of an HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS) is the date of the best HONOS SCORE FOR PERSON recorded in the period of the last twelve months for the PATIENT. Where more than one HONOS SCORE FOR PERSON has the same best Honos Rating within the period, then the date of the first recorded one should be used.The date of an HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS) is the date of the best Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE recorded in the period of the last twelve months for the PATIENT. Where more than one Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has the same best rating within the period, then the date of the first recorded one should be used.

This is an optional data element in the Mental Health Minimum Data Set collection record and should only be present if an HONOS SCORE FOR PERSON has been recorded during the calculated twelve month period.This is an optional Data Element in the Mental Health Minimum Data Set and should only be present if a Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has been recorded during the calculated twelve month period.

 

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HONOS SCORE DATE (FIRST IN MHCS)

Change to Data Element: Changed Description

Format/length:see DATE 
HES item: 
National Codes: 
Default Codes: 

Notes:
HONOS SCORE DATE (FIRST IN MHCS) is the same as attribute PERSON PROPERTY RECORDED DATE for the HONOS SCORE FOR PERSON.HONOS SCORE DATE (FIRST IN MHCS) is the same as attribute PERSON PROPERTY RECORDED DATE for the Health of the Nation Outcome Scale (Working Age Adults).

The date of an HONOS SCORE DATE (FIRST IN MHCS) is the date of the first HONOS SCORE FOR PERSON recorded within the Mental Health Care Spell whether or not the PERSON PROPERTY RECORDED DATE is within the REPORTING PERIOD.The date of an HONOS SCORE DATE (FIRST IN MHCS) is the date of the first Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE recorded within the Mental Health Care Spell whether or not the PERSON PROPERTY RECORDED DATE is within the REPORTING PERIOD.

 

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HONOS SCORE DATE (MOST RECENT IN MHCS)

Change to Data Element: Changed Description

Format/length:see DATE 
HES item: 
National Codes: 
Default Codes: 

Notes:
HONOS SCORE DATE (MOST RECENT IN MHCS) is the same as attribute PERSON PROPERTY RECORDED DATE for the HONOS SCORE FOR PERSON.HONOS SCORE DATE (MOST RECENT IN MHCS) is the same as attribute PERSON PROPERTY RECORDED DATE for the Health of the Nation Outcome Scale (Working Age Adults).

The date of an HONOS RATING (MOST RECENT IN MHCS) and is the date of the latest HONOS SCORE FOR PERSON recorded within the Mental Health Care Spell whether or not the PERSON PROPERTY RECORDED DATE is within the REPORTING PERIOD.The date of an HONOS RATING (MOST RECENT IN MHCS) and is the date of the latest Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE recorded within the Mental Health Care Spell whether or not the PERSON PROPERTY RECORDED DATE is within the REPORTING PERIOD.

 

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HONOS SCORE DATE (WORST EVER RECORDED)

Change to Data Element: Changed Description

Format/length:see DATE 
HES item: 
National Codes: 
Default Codes: 

Notes:
HONOS SCORE DATE (WORST EVER RECORDED) is the same as attribute PERSON PROPERTY RECORDED DATE for the HONOS SCORE FOR PERSON.HONOS SCORE DATE (WORST EVER RECORDED) is the same as attribute PERSON PROPERTY RECORDED DATE for the Health of the Nation Outcome Scale (Working Age Adults).

The date of an HONOS SCORE DATE (WORST EVER RECORDED) is the date of the worst HONOS SCORE FOR PERSON ever recorded for the PATIENT. Where more than one HONOS SCORE FOR PERSON has the same worst Honos Rating then the date of the first recorded one should be used.The date of an HONOS SCORE DATE (WORST EVER RECORDED) is the date of the worst Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE ever recorded for the PATIENT. Where more than one Health of the Nation Outcome Scale (Working Age Adults) PERSON SCORE has the same worst rating then the date of the first recorded one should be used.

 

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QUESTIONNAIRE OR RATING SCALE COMPLETION DATE

Change to Data Element: New Data Element

Format/Length:see DATE
HES Item: 
National Codes: 
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care. 

Notes:
The date the QUESTIONNAIRE OR RATING SCALE was completed.

 

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H

Change to Package: New Package

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For enquiries about this Data Set Change Notice, please email datastandards@nhs.net