Change Request
 

NHS Connecting for Health

NHS Data Model and Dictionary Service

Reference: Change Request 1213
Version No:1.0
Subject:Update Patch
Effective Date:Immediate
Reason for Change:Patch
Publication Date:22 November 2010

Background:

This patch updates the NHS Data Model and Dictionary as follows:

Summary of changes:

Diagrams
ACTIVITY DIAGRAM   Changed Diagram
PATIENT PATHWAY DIAGRAM   Changed Diagram
 
Supporting Information
CANCER CARE PLAN   Changed Description
CANCER CARE SPELL   Changed Description
DRUG DOSAGE AND ADMINISTRATION renamed from DRUG DOSAGE AND ADMINISTRATION   Changed Name, Aliases
ENDOCRINE THERAPY   Changed Description
FEV1 PERCENTAGE   Changed Description
FIRST DEFINITIVE TREATMENT   Changed Description
PLANNED CANCER TREATMENT   Changed Description
 
Class Definitions
CARE CONTACT   Changed Attributes
REFERRAL TO TREATMENT PERIOD   Changed Attributes
 
Attribute Definitions
ADMISSION METHOD   Changed Description
CANCER TREATMENT EVENT TYPE   Changed Description
CARE PLAN TYPE   Changed Description
CATEGORY VALUED PERSON OBSERVATION TYPE   Changed Description
CLINICAL INTERVENTION TYPE   Changed Description
CONSULTATION MEDIUM USED   Changed Description
PERFORMANCE STATUS CODE FOR ADULTS   Changed Description
PLANNED TREATMENT CHANGE REASON   Changed Description
SEXUAL ORIENTATION CODE   Changed Description
WAITING TIME MEASUREMENT TYPE   Changed Description
 
Data Elements
CANCER CARE SETTING (TREATMENT)   Changed Description
CANCER DENTAL ASSESSMENT DATE   Changed Description
CANCER REFERRAL TO TREATMENT PERIOD START DATE   Changed Description
CANCER TREATMENT EVENT TYPE   Changed Description, Aliases
CANCER TREATMENT PERIOD START DATE   Changed Description
DELAY REASON (CONSULTANT UPGRADE)   Changed Description
DELAY REASON (DECISION TO TREATMENT)   Changed Description
DELAY REASON COMMENT (CONSULTANT UPGRADE)   Changed Description
DELAY REASON COMMENT (DECISION TO TREATMENT)   Changed Description
DELAY REASON COMMENT (FIRST SEEN)   Changed Description
DELAY REASON COMMENT (REFERRAL TO TREATMENT)   Changed Description
DELAY REASON REFERRAL TO TREATMENT (CANCER)   Changed Description
EXCISION MARGIN   Changed Description
NUTRITIONAL SUPPORT PROVIDED (CANCER)   Changed Description
ORGANISATION CODE (CODE OF COMMISSIONER)   Changed Description
ORGANISATION CODE (PCT OF RESIDENCE)   Changed Description
PRIMARY TUMOUR STATUS   Changed Description
SKIN CANCER SUBSEQUENT DIAGNOSIS DATE   Changed Description
TREATMENT START DATE (CANCER)   Changed Description
TREATMENT TYPE (CANCER MORBIDITY)   Changed Description
 

Date:22 November 2010
Sponsor:Richard Kavanagh, 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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ACTIVITY DIAGRAM

Change to Diagram: Changed Diagram

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PATIENT PATHWAY DIAGRAM

Change to Diagram: Changed Diagram

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CANCER CARE PLAN

Change to Supporting Information: Changed Description

Cancer Care Plan is a CARE PLAN.A Cancer Care Plan is a CARE PLAN.

A CARE PLAN developed within a Cancer Care Spell. There should be at least one Planned Cancer Treatment recorded within a Cancer Care Plan.

References:
National Cancer Dataset

 

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CANCER CARE SPELL

Change to Supporting Information: Changed Description

Cancer Care Spell is an ACTIVITY GROUP.A Cancer Care Spell is an ACTIVITY GROUP.

The period of time during which a PATIENT who has been diagnosed as suffering from a single site primary cancer or, in the case of particular skin cancers, one or more lesions may receive care. The Cancer Care Spell starts on the date of the REFERRAL REQUEST from whatever source to the specialist team. It ends when the PATIENT dies.

A recurrence of the original primary cancer at a secondary site is part of the same Cancer Care Spell.

If a PATIENT has another primary cancer this will be a new Cancer Care Spell with the following exceptions.

A PATIENT may have many skin cancer basal cell carcinomas diagnosed at the same time, or consecutively during follow-up, or by re-referral. All these skin cancer basal cell carcinomas will be treated under one Cancer Care Spell.

For skin cancer squamous cell carcinoma (this includes atypical fibroxanthoma, merkel cell tumour and all epidermal cell derived invasive malignancies except basal cell carcinoma), most PATIENTS have a single lesion at presentation, but a significant number will get more primaries over a period of time. All these squamous cell carcinomas will be treated under one Cancer Care Spell.

For each kaposi's sarcoma, malignant melanoma and cutaneous lymphoma diagnosed there will be one Cancer Care Spell.

The Cancer Care Spell may only involve diagnostic procedures leading to a diagnosis, for example in cases where the PATIENT refuses treatment, or it may include treatment and follow-up.

The Cancer Care Spell may be the context for one or more Anti-Cancer Drug Programmes and may involve one or more Cancer Clinical Status Assessments, Endocrine Therapies and PATIENT CLINICAL TRIAL STATUSES.

Information recorded for a Cancer Care Spell includes:

CANCER OR SYMPTOMATIC BREAST REFERRAL PATIENT STATUS
DIAGNOSTIC ROUTE   O
QUALITY OF LIFE
Specialist Palliative Care Date   O
Symptoms First Noted Date   O

References:
National Cancer Dataset

 

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DRUG DOSAGE AND ADMINISTRATION  renamed from DRUG DOSAGE AND ADMINISTRATION

Change to Supporting Information: Changed Name, Aliases


ENDOCRINE THERAPY

Change to Supporting Information: Changed Description

Endocrine Therapy is a CLINICAL INTERVENTION.

A record of the type of endocrine therapy given to the PATIENT as part of a Cancer Care Spell.A record of the type of Endocrine Therapy given to the PATIENT as part of a Cancer Care Spell.

References: National Cancer Dataset

 

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FEV1 PERCENTAGE

Change to Supporting Information: Changed Description

FEV1 Percentage is a MEASURED PERSON OBSERVATION.

The forced expiratory volume of the lungs in 1 second as a percentage of the predicted value.FEV1 Percentage is the forced expiratory volume of the lungs in 1 second as a percentage of the predicted value.

References:
National Cancer Dataset Version 1.3_ISB October 2002

 

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FIRST DEFINITIVE TREATMENT

Change to Supporting Information: Changed Description


First Definitive Treatment is the first CLINICAL INTERVENTION intended to manage a PATIENT's disease, condition or injury and avoid further CLINICAL INTERVENTIONS. What constitutes First Definitive Treatment is a matter of clinical judgement in consultation with others, where appropriate, including the PATIENT.

Further guidance on ending REFERRAL TO TREATMENT PERIODS and first treatments.

Undertaking a procedure is not necessarily in itself the end of a REFERRAL TO TREATMENT PERIOD. For example, outpatient or day case diagnostic CARE ACTIVITIES prior to admission for treatment do not represent the end of the period and, in these cases, are part of the diagnostic process rather than the start of treatment.

Commencement of medication as an outpatient can be the end of a REFERRAL TO TREATMENT PERIOD, if it is intended as the First Definitive Treatment. However, CARE PROFESSIONALS often begin to manage a PATIENT's condition in advance of the first actual treatment taking place, for example by giving pain relief before a surgical procedure takes place. In these cases, the REFERRAL TO TREATMENT PERIOD END DATE is when the First Definitive Treatment (in this example, surgery) has started.

Other CARE ACTIVITIES that may end a REFERRAL TO TREATMENT PERIOD as First Definitive Treatment include:

-the fitting of a medical device where a CONSULTANT decides that treatment consists of fitting a medical device. This is the date of the actual fitting of the device rather than the point at which the PATIENT is measured for the device.
 
-the date of a therapeutic procedure where it is intended as diagnostic but the CARE PROFESSIONAL makes a decision to undertake a therapeutic procedure at the same time. In this example, it may count as a start of treatment and as such, the period will end.
 
-the date for less intensive treatment and medical management such as palliative care that may be attempted before moving on to invasive procedures and treatment or may be the only treatment. In such cases, the first treatment that is intended to manage a PATIENT's disease, condition or injury will end that particular REFERRAL TO TREATMENT PERIOD. Should the PATIENT at some later stage require more 'aggressive' treatment then the decision to treat would start a new REFERRAL TO TREATMENT PERIOD.
 

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PLANNED CANCER TREATMENT

Change to Supporting Information: Changed Description

Planned Cancer Treatment is a PLANNED ACTIVITY.

The identification of a type of treatment to be provided within a Cancer Care Plan.Planned Cancer Treatment is the identification of a type of treatment to be provided within a Cancer Care Plan.

There may be more than one type of treatment in a planned sequence within a Cancer Care Plan.

References:
National Cancer Dataset

 

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CARE CONTACT

Change to Class: Changed Attributes

Attributes of this Class are:
A and E ARRIVAL MODE
A and E ATTENDANCE CATEGORY
A and E ATTENDANCE DISPOSAL
A and E INITIAL ASSESSMENT TRIAGE CATEGORY
A and E STREAM
ACUTE HOME-BASED TELEPHONE CONTACT
ANTENATAL OR POSTNATAL INDICATOR
BREAST CANCER NURSE SEEN
CARE ACTIVITY INFORMATION
CARE CONTACT SUBJECT
CARE CONTACT TYPE
COLPOSCOPY PRIME PROCEDURE TYPE
CONSULTATION MEDIUM USED
CONTRACEPTIVE SERVICE TYPE
CPA REVIEW OUTCOME
DENTAL HAEMORRHAGE SERVICE TYPE
DENTAL REFERRAL INDICATOR
ELIGIBILITY OUTCOME
EMERGENCY TREATMENT FEE
EMERGENCY TREATMENT TYPE
FIRST ATTENDANCE
GENITOURINARY CONTACT TYPE CODE
HEALTH PROMOTION STAFF GROUP
HOME HELP USE
INITIAL CONTACT
INITIAL CONTACT WITHIN FIVE DAYS
IUD APPLICATION DATE
MARKER RESPONSE STATUS
MATERNITY MEDICAL SERVICE TYPE
MATERNITY VISIT CALL REASON
MEDICAL STAFF TYPE SEEING PATIENT
METASTATIC STATUS
NODAL STATUS
NON-NHS COMMUNITY BED USE
NON-NHS DAY CARE FACILITY USE
OUTCOME OF ATTENDANCE
PATIENT INFORMED OF OUTCOME DATE
PATIENT REPORTED SYMPTOMS INDICATOR
PATIENT REPORTED WAIT
PATIENT TRIAL STATUS
PAYMENT FROM PATIENT RECEIVED
POSTNATAL CARE INDICATOR
PRIMARY TUMOUR STATUS
REVIEW TYPE
SETTLED ACCOMMODATION INDICATOR
SHELTERED WORK FACILITY USE
SIGHT TEST DOMICILIARY VISIT TYPE
SIGHT TEST FORM COMPLETED
SIGHT TEST PERSON SUBSIDY TYPE
SKIN TUMOUR STATUS
STATUTORY ASSESSMENT TYPE
SURVEILLANCE RESULT

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REFERRAL TO TREATMENT PERIOD

Change to Class: Changed Attributes

Attributes of this Class are:
KREFERRAL TO TREATMENT PERIOD START DATE
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR
REFERRAL TO TREATMENT PERIOD END DATE

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ADMISSION METHOD

Change to Attribute: 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.

The method of admission to a Hospital Provider Spell. A detailed definition of Elective Admission is given in ELECTIVE ADMISSION TYPE.

National Codes:

Elective Admission, when the DECISION TO ADMIT could be separated in time from the actual admission:
11Waiting list
12Booked
13Planned
Note that this does not include a transfer from another Hospital Provider (see 81 below).

Emergency Admission, when admission is unpredictable and at short notice because of clinical need:
21Accident and emergency or dental casualty department of the Health Care Provider 
22GENERAL PRACTITIONER: after a request for immediate admission has been made direct to a Hospital Provider, i.e. not through a Bed bureau, by a GENERAL PRACTITIONER or deputy
23Bed bureau
24Consultant Clinic, of this or another Health Care Provider 
25Admission via Mental Health Crisis Resolution Team
25Admission via Mental Health Crisis Resolution Team **
28Other means, examples are:
- admitted from the Accident And Emergency Department of another provider where they had not been admitted
- transfer of an admitted PATIENT from another Hospital Provider in an emergency
- baby born at home as intended

Maternity Admission, of a pregnant or recently pregnant woman to a maternity ward (including delivery facilities) except when the intention is to terminate the pregnancy
31Admitted ante-partum
32Admitted post-partum

Other Admission not specified above
82The birth of a baby in this Health Care Provider 
83Baby born outside the Health Care Provider except when born at home as intended.
81Transfer of any admitted PATIENT from other Hospital Provider other than in an emergency

Note: The classification has been listed in logical sequence rather than alphanumeric order.

 ** Note that these codes have not yet been assured by the Information Standards Board for Health and Social Care.

 

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CANCER TREATMENT EVENT TYPE

Change to Attribute: Changed Description

A classification of the stage of treatment reached during a Cancer PATIENT PATHWAY for primary, recurrent or metastatic cancer.A classification of the stage of treatment reached during a Cancer PATIENT PATHWAY for primary, recurrent or metastatic cancer.

National Codes:

01First Definitive Treatment for a new primary cancer
02Second or subsequent treatment for a new primary cancer
03Treatment for a local recurrence of a primary cancer
04Treatment for a regional recurrence of cancer
05Treatment for a distant recurrence of cancer (metastatic disease)
06Treatment for multiple recurrence of cancer (local and/or regional and/or distant)
07First treatment for metastatic disease following an unknown primary
08Second or subsequent treatment for metastatic disease following an unknown primary
09Ttreatment for relapse of primary cancer (second or subsequent)
10Treatment for progression of primary cancer (second or subsequent)
01First Definitive Treatment for a new primary cancer
02Second or subsequent treatment for a new primary cancer
03Treatment for a local recurrence of a primary cancer
04Treatment for a regional recurrence of cancer
05Treatment for a distant recurrence of cancer (metastatic disease)
06Treatment for multiple recurrence of cancer (local and/or regional and/or distant)
07First treatment for metastatic disease following an unknown primary
08Second or subsequent treatment for metastatic disease following an unknown primary
09Ttreatment for relapse of primary cancer (second or subsequent)
10Treatment for progression of primary cancer (second or subsequent)
 

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CARE PLAN TYPE

Change to Attribute: Changed Description

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

A type of CARE PLAN.

National Codes:

01Cancer Care Plan
02Child Protection Plan
02Child Protection Plan **
 ** Note that these codes have not yet been assured by the Information Standards Board for Health and Social Care.

 

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CATEGORY VALUED PERSON OBSERVATION TYPE

Change to Attribute: 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.

A classification of a CATEGORY VALUED PERSON OBSERVATION.

National Codes:

01ALCOHOL STATUS 
02ASPIRIN THERAPY LOCATION 
03BLEED COMPLICATION 
04ETHNIC CATEGORY 
05JOINT REPLACEMENT REVISION CLASSIFICATION 
06LANGUAGE CLASSIFICATION 
07MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION 
08PATIENT CLINICAL GROUP 
09PERFORMANCE STATUS 
10PERSON GENDER 
11PERSON MARITAL STATUS 
12SARCOMA PREDISPOSING CONDITION 
13SKIN LYMPHOMA MORPHOLOGY 
14ACCOMMODATION 
15SEXUAL ORIENTATION 
16RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION 
17RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION GROUP 
18CONTRACEPTION
19DISABILITY 
20DISABILITY SEVERITY 
19DISABILITY **
20DISABILITY SEVERITY **
 ** Note that these codes have not yet been assured by the Information Standards Board for Health and Social Care.

 

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CLINICAL INTERVENTION TYPE

Change to Attribute: Changed Description

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CONSULTATION MEDIUM USED

Change to Attribute: 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.

Identifies the communication mechanism used to relay information between the CARE PROFESSIONAL and the PERSON who is the subject of the consultation, during a CARE ACTIVITY.

The telephone or telemedicine consultation should directly support diagnosis and care planning and must replace a face to face Out-Patient Attendance Consultant, Clinic Attendance Nurse or Clinic Attendance Midwife, types of CARE ACTIVITY. A record of the telephone or telemedicine consultation must be retained in the PATIENT's records.

Telephone contacts solely for informing PATIENTS of results are excluded.

National Codes:

01Face to face communication
02Telephone
03Telemedicine web camera
04Talk type for a PERSON unable to speak
05Email
06Short Message Service (SMS) - Text Messaging
05Email **
06Short Message Service (SMS) - Text Messaging **
 ** Note that these codes have not yet been assured by the Information Standards Board for Health and Social Care.

 

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PERFORMANCE STATUS CODE FOR ADULTS

Change to Attribute: 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.This item has been renamed for development purposes and the changes have not yet been assured by the Information Standards Board for Health and Social Care.

A World Health Organisation classification indicating a PERSON's status relating to activity / disability.

Note: see PERFORMANCE STATUS FOR YOUNG PEOPLE for codes for a young person of 16 years and under.

National Codes:

0Able to carry out all normal activity without restriction
1Restricted in physically strenuous activity, but able to walk and do light work
2Able to walk and capable of all self care, but unable to carry out any work. Up and about more than 50% of waking hours
3Capable of only limited self care, confined to bed or chair more than 50% of waking hours
4Completely disabled. Cannot carry on any self care. Totally confined to bed or chair
 

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PLANNED TREATMENT CHANGE REASON

Change to Attribute: Changed Description

An indicator of whether the treatment within an Anti-Cancer Drug Programme was completed as planned, and if not, the reason why.

National Codes:

Treatment completed
0Treatment completed as prescribe

Treatment not completed
0Treatment completed as prescribed
Treatment not completed
1PATIENT died
2Progressive disease during chemotherapy
3Acute chemotherapy toxicity
4Technical or organisational problems
5PATIENT choice (stopped or interrupted treatment)

References:
National Cancer Dataset Version 1.3_ISB October 2002

 

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SEXUAL ORIENTATION CODE

Change to Attribute: Changed Description

This item is being updated for development purposes. Codes "4" and "Z" have not yet been assured by the Information Standards Board for Health and Social Care.

The SEXUAL ORIENTATION of a PATIENT.

National codes:

1Heterosexual
2Homosexual
3Bi-sexual
4PERSON asked and does not know or is not sure  *
ZNot Stated (PERSON asked but declined to provide a response)  *


Note:
Code not to be used for the Genitourinary Medicine Clinic Activity Data Set.

 These codes have not yet been assured by the Information Standards Board for Health and Social Care. 

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WAITING TIME MEASUREMENT TYPE

Change to Attribute: Changed Description

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 type of waiting time measurement methodology which may be applied during a PATIENT PATHWAY.  The methodology applied may be for one part of a PATIENT PATHWAY, such as the measurement of a REFERRAL TO TREATMENT PERIOD, or other parts of the PATIENT PATHWAY according to Department of Health policy.

National Codes:

01Referral To Treatment Period Included In 18 Weeks Target
02Allied Health Professional Referral To Treatment Measurement
09Other Referral To Treatment Measurement Type
 

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CANCER CARE SETTING (TREATMENT)

Change to Data Element: Changed Description

Format/length:an2
HES item: 
Format/Length:an2
HES Item: 
National Codes: 
Default Codes:99 - unknown


Notes:


CANCER CARE SETTING (TREATMENT) is the type of care setting where the cancer care relating to the TREATMENT START DATE (CANCER) took place.

This is the type of care setting where the cancer care relating to the TREATMENT START DATE (CANCER) took place.

Where the care is delivered during a Hospital Provider Spell, distinction is made between care delivered as part of an ordinary admission (where the PATIENT CLASSIFICATION is National Code 1 - Ordinary Admission) and a day case admission (where PATIENT CLASSIFICATION is National Code 2 - Day case admission).

National codesNational Codes:

01Cancer treatment delivered as part of a Hospital Provider Spell (where PATIENT CLASSIFICATION is National code 1 - Ordinary admission)
02Cancer treatment delivered as part of a Hospital Provider Spell (where PATIENT CLASSIFICATION is National Code 2 - Day case admission)
03Cancer treatment delivered in an Out-patient setting
04Cancer treatment delivered in another care setting
01Cancer treatment delivered as part of a Hospital Provider Spell (where PATIENT CLASSIFICATION is National code 1 - Ordinary admission)
02Cancer treatment delivered as part of a Hospital Provider Spell (where PATIENT CLASSIFICATION is National Code 2 - Day case admission)
03Cancer treatment delivered in an Out-patient setting
04Cancer treatment delivered in another care setting
 

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CANCER DENTAL ASSESSMENT DATE

Change to Data Element: Changed Description

Format/length:see DATE
HES item: 
Format/Length:See DATE
HES Item: 
National Codes: 
Default Codes: 

Notes:
The date on which a pre-treatment dental assessment was done for a Head And Neck Cancer Care Spell.

CANCER DENTAL ASSESSMENT DATE is the same as ACTIVITY DATE of ACTIVITY DATE TIME where the ACTIVITY DATE TIME TYPE is National Code 04 'Cancer Dental Assessment Date'.CANCER DENTAL ASSESSMENT DATE is the same as ACTIVITY DATE of ACTIVITY DATE TIME where the ACTIVITY DATE TIME TYPE is National Code 04 'Cancer Dental Assessment Date'.

 

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CANCER REFERRAL TO TREATMENT PERIOD START DATE

Change to Data Element: Changed Description

Format/length:see DATE
HES item: 
Format/Length:See DATE
HES Item: 
National Codes: 
Default Codes: 


Notes:
This is the same as attribute CANCER REFERRAL TO TREATMENT PERIOD START DATE.

CANCER REFERRAL TO TREATMENT PERIOD START DATE is the same as attribute CANCER REFERRAL TO TREATMENT PERIOD START DATE. 

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CANCER TREATMENT EVENT TYPE

Change to Data Element: Changed Description, Aliases

Format/length:an2
HES item: 
National Codes:Click on the attribute tab to display the attribute that contains the National Codes.
Format/Length:an2
HES Item: 
National Codes:See CANCER TREATMENT EVENT TYPE
Default Codes: 


Notes:
This is the same as attribute CANCER TREATMENT EVENT TYPE.

CANCER TREATMENT EVENT TYPE is the same as attribute CANCER TREATMENT EVENT TYPE. 

 

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CANCER TREATMENT EVENT TYPE

Change to Data Element: Changed Description, Aliases


CANCER TREATMENT PERIOD START DATE

Change to Data Element: Changed Description

Format/length:see DATE
HES item: 
National Codes:Click on the attribute tab to display the attribute that contains the National Codes.
Format/Length:See DATE
HES Item: 
National Codes: 
Default Codes: 


Notes:

This is the same as attribute CANCER TREATMENT PERIOD START DATE.

 CANCER TREATMENT PERIOD START DATE  is the same as attribute CANCER TREATMENT PERIOD START DATE. 

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DELAY REASON (CONSULTANT UPGRADE)

Change to Data Element: Changed Description

Format/length:an2
HES item: 
National codesClick on the attribute tab to display the attribute that contains the National Codes.
Format/Length:an2
HES Item: 
National codesSee DELAY REASON TO TREATMENT (CANCER)
Default codes 


Notes:
This is the same as attribute DELAY REASON TO TREATMENT (CANCER).

DELAY REASON COMMENT (CONSULTANT UPGRADE) is the same as attribute DELAY REASON TO TREATMENT (CANCER).

 A DELAY REASON (DECISION TO TREATMENT) must be present in the National Cancer Waiting Times Monitoring Data Set where a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) exists.

 

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DELAY REASON (DECISION TO TREATMENT)

Change to Data Element: Changed Description

Format/length:n2
HES item: 
National codesClick on the attribute tab to show the attribute that contains the National Codes
Format/Length:n2
HES Item: 
National codesSee DELAY REASON TO TREATMENT (CANCER)
Default codes 


Notes:
This is the same as the attribute DELAY REASON TO TREATMENT (CANCER).

DELAY REASON (DECISION TO TREATMENT) is the same as the attribute DELAY REASON TO TREATMENT (CANCER).

A DELAY REASON (DECISION TO TREATMENT) must be present in the National Cancer Waiting Times Monitoring Data Set where a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) exists. 

This data can also be recorded locally for prospective PATIENTS where a full histological diagnosis confirming cancer is not yet available.

 

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DELAY REASON COMMENT (CONSULTANT UPGRADE)

Change to Data Element: Changed Description

Format/length:an255
HES item: 
National codes 
Default codes 


Notes:


DELAY REASON COMMENT (CONSULTANT UPGRADE) is the same as attribute DELAY REASON COMMENT

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set.  It is applicable and must be recorded if the existing 62 day standard (for referral to treatment) has been breached (after any days adjustments allowed in WAITING TIME ADJUSTMENT (TREATMENT) have been removed).  It is the free text comment that describes why there was a delay experienced between the Consultant Upgrade Date and the TREATMENT START DATE (CANCER).

If DELAY REASON (CONSULTANT UPGRADE) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (CONSULTANT UPGRADE) must explain the full reason for the delay.

 

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DELAY REASON COMMENT (DECISION TO TREATMENT)

Change to Data Element: Changed Description

Format/length:an255
HES item: 
National codes 
Default codes 


Notes:
This is the same as the attribute DELAY REASON COMMENT.

DELAY REASON COMMENT (DECISION TO TREATMENT) is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing 31-day standard (for referral to treatment) has been breached (after any days adjustments allowed in WAITING TIME ADJUSTMENT (TREATMENT) have been removed).  It is the free text comment that describes why the maximum 31 day wait from CANCER TREATMENT PERIOD START DATE to TREATMENT START DATE (CANCER) could not be met. 

If DELAY REASON (DECISION TO TREATMENT) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (DECISION TO TREATMENT) must explain the full reason for the delay.

 

 

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DELAY REASON COMMENT (FIRST SEEN)

Change to Data Element: Changed Description

Format/length:an255
HES item: 
National codes 
Default codes 


Notes:
DELAY REASON COMMENT (FIRST SEEN) is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the maximum two week wait fromCANCER REFERRAL TO TREATMENT PERIOD START DATE to DATE FIRST SEEN (less WAITING TIME ADJUSTMENT (FIRST SEEN)) could not be met.

See DATE FIRST SEEN for guidance on determining the appropriate first seen date.

If DELAY REASON REFERRAL TO FIRST SEEN (CANCER OR BREAST SYMPTOMS) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (FIRST SEEN) must explain the full reason for the delay.

 

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DELAY REASON COMMENT (REFERRAL TO TREATMENT)

Change to Data Element: Changed Description

Format/length:an255
HES item: 
National codes 
Default codes 


Notes:
DELAY REASON COMMENT (REFERRAL TO TREATMENT) is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the specified maximum 62 day wait from CANCER REFERRAL TO TREATMENT PERIOD START DATE to the TREATMENT START DATE (CANCER), less any adjustments recorded by WAITING TIME ADJUSTMENT (FIRST SEEN) and WAITING TIME ADJUSTMENT (DECISION TO TREAT) and WAITING TIME ADJUSTMENT (TREATMENT), could not be met.

 

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DELAY REASON REFERRAL TO TREATMENT (CANCER)

Change to Data Element: Changed Description

Format/length:n2
HES item: 
National codes 
Format/Length:n2
HES Item: 
National codesSee DELAY REASON TO TREATMENT (CANCER)
Default codes 

Notes:
See attribute DELAY REASON TO TREATMENT (CANCER) for the National Codes used for recording the DELAY REASON REFERRAL TO TREATMENT (CANCER).DELAY REASON REFERRAL TO TREATMENT (CANCER) is the same as attribute DELAY REASON TO TREATMENT (CANCER).

It is an optional data element and should only be present if a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) has been recorded where the DELAY REASON INDICATOR is classification b. 'delay between urgent GP referral and date of first definitive treatment'.

Cancer Care Spell Delay is a REFERRAL DELAY where REFERRAL DELAY TYPE is National Code 01 'Cancer Care Spell Delay'.

 

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EXCISION MARGIN

Change to Data Element: Changed Description

Format/length:n2
HES item: 
National Codes:See EXCISION MARGIN
Default Codes:98 - Not applicable
 99 - Not known

Notes:
EXCISION MARGIN is the same as attribute EXCISION MARGIN.

An indication of whether the Pathology Laboratory Investigation excision margin finding was clear of the tumour and if so, by how much.

Pathology Laboratory Investigation is a CLINICAL INTERVENTION where CLINICAL INTERVENTION TYPE is National Code 24 'Pathology Laboratory Investigation'.

References:
National Cancer Dataset

 

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NUTRITIONAL SUPPORT PROVIDED (CANCER)

Change to Data Element: Changed Description

Format/length:an1
HES item: 
Format/Length:an1
HES Item: 
National Codes: 
Default Codes: 

Notes:
NUTRITIONAL SUPPORT PROVIDED (CANCER) is derived from the presence of NUTRITIONAL SUPPORT PROVIDED TYPE.

This is derived from the presence of NUTRITIONAL SUPPORT PROVIDED TYPE.National Codes:

National codes:

NNo
YYes

References:
National Cancer Dataset Version 1.3_ISB October 2002

 

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ORGANISATION CODE (CODE OF COMMISSIONER)

Change to Data Element: Changed Description

Format/length:an3 or an5
HES item:PURCODE
National Codes:See ORGANISATION CODE 
ODS Default Codes:VPP00 - Private PATIENTS / Overseas Visitor liable for charge
 XMD00 - Commissioner Code for Ministry of Defence (MoD) Healthcare
 YDD82 - Episodes funded directly by the National Commissioning Group for England

Notes:
This is the ORGANISATION CODE of the ORGANISATION commissioning health care.

This should always be the ORGANISATION CODE of the original commissioner for Commissioning Data Sets to support Payment by Results.

The Department of Health document "Who pays? Establishing the Responsible Commissioner" sets out a framework for establishing responsibility for commissioning an individual's care within the NHS, (i.e. determining who pays for a PATIENT’s care.) The guidance is set out in three sections:

  1. Section 1: Establishing who pays - sets out the key principles
  2. Section 2: Applying the key principles - gives further details about a number of services and situations where further clarification of how the key principles are applied may be helpful
  3. Section 3: Exceptions to the key principles - outlines the exceptions to the key principles e.g. prisoners, continuing care arrangements.

This following sections, provides guidance as to which code(s) should be used as the ORGANISATION CODE (CODE OF COMMISSIONER).

General Medical Practitioner Practice Registration (England):

General Medical Practitioner Practice Registration (Wales, Scotland and Northern Ireland):

PATIENTS from the Channel Islands:

Overseas PATIENTS: charge-exempt:

PATIENTS - liable for charges (Overseas and Private):

VPP00 'Private PATIENTS / Overseas Visitor liable for charge' should be used as the ORGANISATION CODE (CODE OF COMMISSIONER) for these PATIENTS.

Prisoners:

  • Since April 2003, GP Practice registration (if any) is disregarded for PERSONS who are detained in prison in England. The Primary Care Trust or Care Trust in which the prison is located is responsible for commissioning NHS services for those prisoners, including NHS dental services.
  • For those usually resident outside the United Kingdom, the responsible commissioner will be the Primary Care Trust or Care Trust in which the prison is located.
  • PERSONS usually resident overseas held in English prisons are exempt from charges for NHS hospital treatment. There is no centrally held budget for this group and costs should be borne by the Primary Care Trust or Care Trust in which the prison is located.

Ministry of Defence:

  • Upon enlistment, Primary Care Trusts and Care Trusts are required to de-register members of the British Armed Forces from their General Medical Practitioner Practice registration list and they should not be able to re-register until they have been discharged. During this time, the Ministry of Defence is responsible for their primary medical services which has specific contractual and entitlement arrangements with the NHS.
  • This does not apply to dependants of British Armed Forces members, who can remain registered with a General Medical Practitioner Practice.
  • XMD00 'Commissioner Code for Ministry of Defence (MoD) Healthcare' should be used as the ORGANISATION CODE (CODE OF COMMISSIONER) for members of British Armed Forces (not dependants).

Specialised Commissioning (England):

 

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ORGANISATION CODE (PCT OF RESIDENCE)

Change to Data Element: Changed Description

Format/length:an3
HES item:PCTR
National Codes:See ORGANISATION CODE 
ODS Default Codes:Q99 - Primary Care Trust of residence not known.
Note: this code must not be used in the Commissioning Data Set (CDS) header. It is not a default Commissioner code.
 X98 -Primary Care Trust code not applicable (e.g. Overseas Visitors, Wales, Scotland or Northern Ireland). 
Note: this code must not be used in the Commissioning Data Set (CDS) header. It is not a default Commissioner code.

Notes:
This is the ORGANISATION CODE derived from the PATIENT's POSTCODE OF USUAL ADDRESS, where they reside within the boundary of a:

ORGANISATION CODES can be downloaded from the Organisation Data Service website or through the online Terminology Reference Data Update Distribution Service (TRUD). For further information, see Organisation Data Service.

For PATIENTS who are Overseas Visitors: Organisation Data Service Default Code X98 'Primary Care Trust code not applicable (e.g. Overseas Visitors, Wales, Scotland or Northern Ireland)' should be reported.
Note: A review of Organisation Data Service Default Codes is planned to be carried out and this default code will be updated as part of that.

For the purposes of sending Commissioning Data Set messages to the Secondary Uses Service (regardless of how local systems hold the data), it is essential at present to continue using a 3 character field, using the first 3 characters of the ORGANISATION CODE (PCT OF RESIDENCE) and following the same update rules relating to Prime Recipient as are currently in place. This is necessary, primarily to preserve the integrity of the current Commissioning Data Set message and the CDS PRIME RECIPIENT IDENTITY which is derived from the ORGANISATION CODE (PCT OF RESIDENCE).

The Organisation Data Service provides postcode files which link postcodes to the Primary Care Trust. See NHS Postcode Directory.

 

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PRIMARY TUMOUR STATUS

Change to Data Element: Changed Description

Format/length:n1
HES item: 
National Codes:Click on the attribute tab to display the attribute that contains the National Codes.
Format/Length:n1
HES Item: 
National Codes:See PRIMARY TUMOUR STATUS
Default Codes: 
 Notes:
PRIMARY TUMOUR STATUS is the same as attribute PRIMARY TUMOUR STATUS. 

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SKIN CANCER SUBSEQUENT DIAGNOSIS DATE

Change to Data Element: Changed Description

Format/length:see DATE
HES item: 
Format/Length:See DATE
HES Item: 
National Codes: 
Default Codes: 
 Notes:
SKIN CANCER SUBSEQUENT DIAGNOSIS DATE is the same as attribute SKIN CANCER SUBSEQUENT DIAGNOSIS DATE. 

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TREATMENT START DATE (CANCER)

Change to Data Element: Changed Description

Format/length:see DATE
HES item: 
Format/Length:See DATE
HES Item: 
National Codes: 
Default Codes: 

Notes:
This is the same as attribute TREATMENT START DATE (CANCER).

Notes: 

TREATMENT START DATE (CANCER) is the same as attribute TREATMENT START DATE (CANCER). 

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TREATMENT TYPE (CANCER MORBIDITY)

Change to Data Element: Changed Description

Format/length:n1
HES item: 
National Codes: 
Format/Length:n1
HES Item: 
National Codes:See TREATMENT TYPE
Default Codes: 

TREATMENT TYPE (CANCER MORBIDITY) is the same as attribute TREATMENT TYPE.

 

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