DIAGRAM OVERVIEW Person_DIAGRAM OVERVIEW

This shows the subtype of PERSON PROPERTY with the set of predetermined values. See Person and Person Property diagram for a fuller explanation.

USING THE DIAGRAM

By clicking on a class box on the diagram opposite, the selected class definition will be displayed.

Any text within the displayed definition which is in blue and uppercase, is the name of a class or an attribute and if clicked on will display the definition for the class or attribute.

To redisplay the full diagram again just click on the diagram name again in the content list, and this will remove the right hand frame. Alternatively, you can resize the right hand frame by moving your mouse pointer over the middle scroll bar and when the pointer icon changed into a double ended icon (pointing left and right) click on the left mouse button and drag the middle scroll bar either left or right.

PRINTING THE DIAGRAM

To print the diagram first click on the 'Print Window' button, positioned just under the title bar, which will open a new window that will only display the diagram and header bar and exclude the superfluous navigation and content links. The diagram page can then be printed using your internet browsers standard printing functionality (e.g. CTRL+P).

The diagrams can also be printed by copying the diagram images into Word, and then printing them from a Word document. This can be done by right-clicking over the diagram and selecting 'copy'. Next open up MS Word (or any other word processing software) and create a new document and then 'paste' the diagram image into the document. The diagram can then be printed using the normal Word print functionality.

DIAGRAMMING CONVENTIONS

• information requirements of national and local performance management, planning and clinical governance
• assurance of the quality of health and social care services
• the monitoring of National Service Frameworks (NSFs)

The information in the Central Return Data Sets is transmitted at aggregate level.

Some of these Central Return Data Sets are transmitted to Unify2.
Unify2 is the data collection system used by the Knowledge and Intelligence team in the Department of Health to collect a wide range of performance information.The Unify2 homepage can be found at the following address:
http://nww.

The Unify2 homepage can be found at the following address: http://nww.unify2.dh.nhs.uk/unify/interface/homepage.aspx  

Note: access to this address requires a Unify2 account and password. Any queries about the site can be addressed to the Unify2 helpdesk by emailing STEIS-Helpdesk@dh.gsi.gov.uk or calling 0113 254 5278 Any queries about the site can be addressed to the Unify2 helpdesk by:

• emailing STEIS-Helpdesk@dh.gsi.gov.uk or
• calling 0113 254 5278.

The Department of Health uses the information gathered from Central Returns to monitor service provision at a high level and to support trend analysis for health service activity and health needs assessment. In addition, the returns support the monitoring of progress in the achievement of overall objectives for the NHS and contribute towards the development of policy and the process of funding allocation.

Each Central Return contained within this publication has an image of the Central Return form itself and provides guidance on its content and completion. The guidance also describes how data items held in the NHS Data Dictionary are used to derive the information required for Central Returns. The guidance also describes how data items held in the NHS Data Model and Dictionary are used to derive the information required for Central Returns. Physical definitions of data items, such as the code values, are included.

Important Notes

1. Some of the Central Return Forms covered in this publication are under review. Changes arising from these reviews are not covered in this publication as they were not available in time for publishing. Users should therefore use this publication in conjunction with relevant change notifications as they are published. These were issued as Data Set Change Notices (DSCNs) at time of writing, but the Information Standards Board for Health and Social Care may use a different notification system.

2. Not all mandated Central Return Forms are contained within this publication. For those returns not yet covered, please consult the Notes for Completion provided with the form for detailed information requirements.

• Change Request Log
• Approved New Items Log
• Deleted Items Log
• Change Request Log
• Data Set Change Notice Website

Children's Home is an ORGANISATION SITE.

An establishment registered with the National Care Standards Commission as a children's home which provides care and accommodation wholly or mainly for children.An establishment registered with the National Care Standards Commission as a Children's Home which provides care and accommodation wholly or mainly for children.

An establishment is not a children's home merely because a child is cared for and accommodated there by a parent or relative or by a foster parent.An establishment is not a Children's Home merely because a child is cared for and accommodated there by a parent or relative or by a foster parent.

A school may be registered as a children's home if accommodation is provided for children at the school for more than 295 days during a twelve month period.A school may be registered as a Children's Home if accommodation is provided for children at the school for more than 295 days during a twelve month period.

References:
National Care Standards Commission registration April 2002.

Childrens Home Registration is an ORGANISATION REGISTRATION.

An establishment registered with the National Care Standards Commission as a children's home which provides care and accommodation wholly or mainly for children.An establishment registered with the National Care Standards Commission as a Children's Home which provides care and accommodation wholly or mainly for children.

An establishment is not a children's home merely because a child is cared for and accommodated there by a parent or relative or by a foster parent.An establishment is not a Children's Home merely because a child is cared for and accommodated there by a parent or relative or by a foster parent.

A school may be registered as a children's home if accommodation is provided for children at the school for more than 295 days during a twelve month period.A school may be registered as a Children's Home if accommodation is provided for children at the school for more than 295 days during a twelve month period.

References:
National Care Standards Commission registration April 2002.

Contextual Overview

• The Department of Health requires performance management information on utilisation of the NHS Connecting for Health Choose and Book System.
• This central information collection requirement is commissioner based and is the aggregation of commissioned PATIENT activity delivered by provider NHS Trusts and provider Primary Care Trusts
• The collection is for all PATIENTS given an APPOINTMENT and added to the Out-Patient Waiting List within the REPORTING PERIOD arising from a GENERAL PRACTITIONER referral processed using the NHS Connecting for Health Choose and Book System.
• The NHS Connecting for Health Choose and Book system during the booking process issues a unique booking reference number when a PATIENT is offered one or more APPOINTMENT DATE OFFERED of an APPOINTMENT OFFER.

• When the PATIENT accepts an APPOINTMENT DATE OFFERED, the unique booking reference number is considered to be 'converted' i.e. an APPOINTMENT is created and recorded; and the PATIENT is placed on an Out-Patient Waiting List even if subsequently the PATIENT does not attend or cancels the APPOINTMENT.

  The APPOINTMENT BOOKING SYSTEM TYPE of the APPOINTMENT records the type of booking system used and UNIQUE BOOKING REFERENCE NUMBER (CONVERTED) records the 'converted' reference number.

Class Definitions Introduction

The classes and their definitions appearing within the NHS data standards logical data model are listed in alphabetical order.

Each listed class contains a 'Description' tab that link to its nationally agreed definition, an 'Attributes' tab that links to a list of its attributes and a 'Relationship' tab that links to a list of its relationships it has with other classes.

The 'Where Used' tab provides a list of all the diagrams that the class is included in. Each diagram is a sub-set of the logical data model but does not contain an exclusive set of classes. Thus the same class can appear in more than one diagram.

Each attribute name or class name which appears in the definition text, attribute list or relationships is in uppercase. Where the name also appears in blue indicates that it is clickable and if clicked on will display the definition for that class or attribute.

The following information may be shown against a class attribute:

The following information is shown for each class relationship:

Although this may seem complicated, it is necessary both to form a coherent logical model and to relate physical information such as that which flows on the messages (elements) to the logical model. Every physical item should be represented logically in the Dictionary. However, the scope of the logical model is greater than the physical information it holds and therefore not all logical information has a physical existence.

The classes, attributes and relationships are logical model components. The classes are comprised of attributes and the Attribute 'tab' is the way of displaying these. An attribute can only belong to one class (although the Where Used 'tab' will show every class or other object where it is referenced). The relationships identify any optional links or mandatory dependencies between classes. The relationship 'tab' is the way of displaying the relationships associated with a class.

Elements are physical model components. They represent information on the messages or in some cases Central Returns. Identifying how this information maps to the logical model is essential if the information stored on the attributes, classes and relationships is to be utilised with respect to the physical item.

Classes

Classes are shown in diagrams as in the example below:

Class Relationships

Relationships between classes are shown in diagrams with a line connecting the classes as in the example below:Relationships between Classes are shown in diagrams with a line connecting the Classes as in the example below:

Information concerning the relationship is conveyed by the number at the top and bottom of the connecting line, known as Relationship Cardinality.Information concerning the relationship is conveyed by the number at the top and bottom of the connecting line, known as Relationship Cardinality.

Introduction

• information requirements of national and local performance management, planning and clinical governance
• assurance of the quality of health and social care services
• the monitoring of National Service Frameworks (NSFs)

Clinic Attendance Consultant is a CARE CONTACT.

An Out-Patient Attendance Consultant.

An attendance or contact at which a PATIENT is seen by or in contact with a CONSULTANT, or member of the CONSULTANTS firm, at a Consultant Clinic.

A PATIENT attending or being contacted by a clinic will always be given an Out-Patient Appointment Consultant (even when arriving with no prior notice), but appointments will not always result in an attendance or contact.A PATIENT attending or being contacted by a clinic will always be given an Out-Patient Appointment Consultant (even when arriving with no prior notice), but APPOINTMENTS will not always result in an attendance or contact.

If an appointment time was given, the time seen should be recorded.If an APPOINTMENT TIME was given, the time seen should be recorded.

Information recorded for a Clinic Attendance Consultant includes:

Clinic Attendance Midwife is a CARE CONTACT.

A Clinic Attendance Non-Consultant.

An appointment and/or attendance at a Midwife Clinic or an appointment and/or contact with a Midwife Clinic.An APPOINTMENT and/or attendance at a Midwife Clinic or an appointment and/or contact with a Midwife Clinic.

The total number of attendances or contacts in a period is required for central returns.

Where both mother and baby attend a postnatal clinic together this is to count as one attendance.

Information recorded for a Clinic Attendance Midwife includes:

Clinic Attendance Non-Consultant is a CARE CONTACT.

An attendance at or contact with a Nurse Clinic, Midwife Clinic or Family Planning Clinic. This may have been as a result of an Out-Patient Appointment Non-Consultant.

If the PATIENT is currently subject to a Mental Health Care Spell and the nurse they are in contact with during the attendance or contact is their allocated Care Programme Approach care coordinator then a Face To Face Contact CPA Care Coordinator should also be recorded.

Note: Attendances or contacts at clinics run by Paramedics are Professional Staff Group Contact.

If an appointment time was given, the time seen should be recorded.If an APPOINTMENT TIME was given, the time seen should be recorded.

Information recorded for a Clinic Attendance Non-Consultant includes:

An Educational Establishment providing further education after statutory school age for qualifications such 'A' levels or National Vocational Qualifications. This includes sixth form Colleges.

This definition describes the function of the establishment rather than the name of the establishment as the term 'College' can be used in the name for a number of different types of Educational Establishments including Schools or Universities.This definition describes the function of the establishment rather than the name of the establishment as the term 'College' can be used in the name for a number of different types of Educational Establishments including Schools or Universities.

The primary purpose of national data sets is to enable conformant health information to be generated across the country, independent of the ORGANISATION or system that maintains it. In achieving this, the Health and Social Care Information Centre will enable healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals and ORGANISATIONS. In achieving this, the Health and Social Care Information Centre will enable healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals and ORGANISATIONS.

Information Requirements

• monitor and manage Service Agreements;
• develop commissioning plans;
• support the Payment By Results processes;
• support NHS Comparators;
• monitor Health Improvement Programmes;
• underpin clinical governance;
• understand the health needs of the population.

Information on care provided for all PATIENTS by NHS Hospitals and Primary Care Trusts and Independent Sector Providers (for NHS PATIENTS only) is specified in the Commissioning Data Sets and must be submitted to the Secondary Uses Service according to issued guidelines.

Independent Sector Treatment Centres (TC) are responsible for providing Admitted Patient Care and Out-Patient Attendance Commissioning Data Sets and may submit this data on their own behalf or via a third party. Other Independent Sector activity for NHS PATIENTS is the responsibility of the NHS commissioning body for the provision of the appropriate central returns and data sets.

The Department of Health requires accurate data of all PATIENTS admitted to or treated as out-patients, or treated as an Accident And Emergency Attendance by NHS Hospital Providers and Primary Care Trusts, including PATIENTS receiving private treatment. The data also includes NHS PATIENTS treated electively in the independent sector and overseas. These Hospital Episode Statistics (HES) are derived from the Admitted Patient Care, Out-Patient Attendance and Accident and Emergency Attendance Commissioning Data Sets as stored in the Secondary Uses Service. This data provides information about hospital and PATIENT management, epidemiological data on PATIENT DIAGNOSES and OPERATIVE PROCEDURES.

Commissioning Data Set Data Flow Definitions

CDS TYPES

The Commissioning Data Set is the basic structure used for the submission of commissioning data to the Secondary Uses Service and is designed to be capable of individually conveying many different Commissioning Data Set structures encompassing Accident and Emergency Attendances, Out-Patient Attendances, Future Attendances, Admitted Patient Care and Elective Admission List data etc.

Commissioning Data Set Messages have been defined in specific components known as a CDS TYPE. Each Commissioning Data Set Type as configured into the Commissioning Data Set Message carries only one specific Commissioning Data Set Type, an examples being the Finished Consultant Episode Commissioning Data Set Type etc.

Consultant Clinic is a CLINIC OR FACILITY.

An Out-Patient Clinic.

An administrative arrangement enabling PATIENTS to see a CONSULTANT, the CONSULTANT's staff and associated health professionals. The holding of a clinic provides the opportunity for consultation, investigation and treatment. PATIENTS normally attend by prior appointment. PATIENTS normally attend by prior APPOINTMENT. Although a CONSULTANT is in overall charge, the CONSULTANT may not be present on all occasions that the clinic is held. However, a member of the CONSULTANT's firm or locum for such a member, must always be present. An individual CONSULTANT may run more than one clinic in the same or different locations. This also includes clinics run by GENERAL PRACTITIONERS acting as CONSULTANT (see definition of 'CONSULTANT'). This also includes clinics run by GENERAL PRACTITIONERS acting as CONSULTANT (see definition of 'CONSULTANT').

For shared clinics the Shared Care Out-Patient Consultant should be recorded.

Clinics not controlled by a CONSULTANT (or GENERAL PRACTITIONER) should not be included, e.g. those run by midwives (see Midwife Clinic). Consultant Clinic Sessions are actual occurrences of Consultant Clinics.

Information recorded for a Consultant Clinic includes:

Data Elements Introduction

Data elements are used to identify or indicate the content of:

In addition, data elements can contain text providing guidance, support, values or other information concerning the data element and its use with the above.

The data elements are listed in alphabetical order. Click on a letter in the Data Element Bookmarks to display the list of data element names for that letter in the right hand screen frame. To display the content of a specific data element, click on the data element name. The content of the data element replaces the list of data element names in the rightmost screen frame.

Each attribute name, class name or data element name which appears in the data element content text is in uppercase, any business definition will appear in Title Case. Where the name also appears in blue, this indicates that it is a clickable link and if clicked on will display the definition for that class, attribute, business definition or the content of the data element. In the same way, if a 'definition' tab is present and clicked on, the attribute containing the definition of that data element will be displayed (this may contain National Codes relevant to that data element).

The following information may be shown within a data element:

Although this may seem complicated, it is necessary both to form a coherent logical model and to relate physical information such as that which flows on the messages (elements) to the logical model. Every physical item should be represented logically in the Dictionary. However, the scope of the logical model is greater than the physical information it holds and therefore not all logical information has a physical existence.

The classes, attributes and relationships are logical model components. The classes are comprised of attributes and the Data Attribute 'tab' is the way of displaying these. An attribute can only belong to one class (although the Where Used 'tab' will show every class or other object where it is referenced). The relationships identify any optional links or mandatory dependencies between classes. The relationship 'tab' is the way of displaying the relationships associated with a class.

Elements are physical model components. They represent information on the messages or in some cases Central Returns. Identifying how this information maps to the logical model is essential if the information stored on the attributes, classes and relationships is to be utilised with respect to the physical item.

Contextual Overview

In achieving this the Health and Social Care Information Centre will be enabling healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals.In achieving this the Health and Social Care Information Centre will be enabling healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals.

The primary purpose of national data sets is to enable the same health information to be generated across the country independent of the ORGANISATION or system that captures it.

In achieving this, the Health and Social Care Information Centre will be enabling healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals.In achieving this, the Health and Social Care Information Centre will be enabling healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals.

• Diagrams
  
• Classes
• Class Relationships
• Relationship Cardinality
• Supertypes & Subtypes
• Supertypes and Subtypes
• Mutually Exclusive Relationships
• Reduced Arc - Mutually Exclusive Relationships
• Mutually Exclusive Relationships - Reduced Arc
• Recursive Relationships
• Model Cross-References

DIAGRAMS

The NHS Data Model and Dictionary has a small set of diagrams which represent parts of the NHS Data Model. The diagrams show the relationships between the classes and the relationship cardinality.

The list of these diagrams is located on the left.

Elective Admission provides further guidance for classifying an admission to hospital via an ELECTIVE ADMISSION LIST.

An elective admission is one that has been arranged in advance.An Elective Admission is one that has been arranged in advance. It is not an emergency admission, a maternity admission or a transfer from a bed in another provider. The period that the PATIENT has to wait for admission depends on the demand on hospital resources and the facilities available to meet this demand.

Electronic Staff Record (ESR) is the Human Resource and Payroll IT system for the NHS in England and Wales.Electronic Staff Record (ESR) is the Human Resource and Payroll IT system for the NHS in England and Wales.

A data warehouse has been developed, the Electronic Staff Record Data Warehouse, which is populated by extracts from Electronic Staff Record to provide for national and other supra-Trust level reporting.

Event Time is an ACTIVITY DATE TIME TYPE.

The time when an activity event started or was planned to be started.The time when an ACTIVITY event started or was planned to be started.

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:

Fraction is a CLINICAL INTERVENTION.Fraction is a CLINICAL INTERVENTION.

A set of exposures delivered or intended to be delivered to a PATIENT in the course of one visit to a radiotherapy room. The HELD OR CANCELLED indicator records those fractions for which appointments have been made, but which did not take place.

Note: For technical reasons the radiotherapy MACHINE TYPE actually used for each EXPOSURE may differ from that indicated when the fraction was planned.Note: For technical reasons the radiotherapy MACHINE TYPE actually used for each EXPOSURE may differ from that indicated when the Fraction was planned.

The Department of Health requires this data set from NHS providers of specialised services, where the primary function of the specialist clinical multidisciplinary team is concerned with the provision of screening, diagnosis and management of sexually transmissible infections and related genital medical conditions. In line with the national strategy for sexual health, Human Immunodeficiency Virus (HIV), genitourinary medicine services are represented as level three providers. This information is collected via the Genitourinary Medicine Access Monthly Monitoring Data Set.

The Genitourinary Medicine Access Monthly Monitoring Data Set provides essential information for:

• monitoring the 48 hour access target
• assurance of validity and veracity of the achievement of the target
• support for local service modernisation, performance management and commissioning required to assure 48 hour access on an on-going basis

Collection and Submission of the Genitourinary Medicine Access Monthly Monitoring Data Set

• The Genitourinary Medicine Access Monthly Monitoring Data Set is a monthly provider based return.
• Provider returns must be submitted by the 18th (or next working day) for the previous calendar month. Commissioner returns are due by the 25th or nearest next working day.
• The data is submitted via Unify2, the Department of Health online data collection system. NHS providers enter their data onto Unify2 using an upload.

1. REPORTING PERIOD, ORGANISATION CODE (CODE OF PROVIDER), ORGANISATION CODE (CODE OF COMMISSIONER) and SITE CODE (OF TREATMENT)
2. Attendances
3. First APPOINTMENTS Missed
4. First APPOINTMENTS offered within 2 days (excludes bank holidays & weekends)
5. PATIENTS reporting symptoms
6. FIRST ATTENDANCES seen after 2 days (excludes bank holidays & weekends)
7. Human immunodeficiency virus (HIV) clinic attendances
8. PATIENT perspective
9. PATIENTS registered but not seen

The Glossary lists commonly used terms in alphabetical order. These terms are not defined and therefore do not have a class or attribute. Each entry in the Glossary is shown with its related class and attribute where appropriate.

For example 'Booked Admission' is shown as relating to the class ELECTIVE ADMISSION LIST ENTRY. ELECTIVE ADMISSION LIST ENTRY has an attribute ELECTIVE ADMISSION TYPE and reference to the attribute definition will identify that 'Booked Admission' is one of the national code classifications of ELECTIVE ADMISSION TYPES.

The Health and Social Care Information Centre is an NHS Special Health Authority that collects, analyses and distributes national statistics on health and social care.The Health and Social Care Information Centre is an NHS Special Health Authority that collects, analyses and distributes national statistics on health and social care.

It also underpins regulation, health research, education and training. Health, social care, government and education bodies trust information from the Health and Social Care Information Centre, which is reliable, up-to-date, independent and trustworthy. Health, social care, government and education bodies trust information from the Health and Social Care Information Centre, which is reliable, up-to-date, independent and trustworthy.

The Health and Social Care Information Centre collection systems make it quick and easy for frontline staff to provide data with minimum impact on the delivery of care.The Health and Social Care Information Centre collection systems make it quick and easy for frontline staff to provide data with minimum impact on the delivery of care.

NHS frontline management, clinicians, information and care professionals, policy makers, patients and the media rely on the Health and Social Care Information Centre for their information needs.NHS frontline management, clinicians, information and care professionals, policy makers, PATIENTS and the media rely on the Health and Social Care Information Centre for their information needs.

The Health and Social Care Information Centre is also referred to as the Information Centre for health and social care or the Information Centre (IC).The Health and Social Care Information Centre is also referred to as the Information Centre for health and social care or the Information Centre (IC).

Further information on the Health and Social Care Information Centre can be found on their website.

DIAGRAM OVERVIEW

This shows the HEALTH PROGRAMME and its relation to PATIENTS and ACTIVITIES.

USING THE DIAGRAM

By clicking on a class box on the diagram opposite, the selected class definition will be displayed.

Any text within the displayed definition which is in blue and uppercase, is the name of a class or an attribute and if clicked on will display the definition for the class or attribute.

To redisplay the full diagram again just click on the diagram name again in the content list, and this will remove the right hand frame. Alternatively, you can resize the right hand frame by moving your mouse pointer over the middle scroll bar and when the pointer icon changed into a double ended icon (pointing left and right) click on the left mouse button and drag the middle scroll bar either left or right.

PRINTING THE DIAGRAM

To print the diagram first click on the 'Print Window' button, positioned just under the title bar, which will open a new window that will only display the diagram and header bar and exclude the superfluous navigation and content links. The diagram page can then be printed using your internet browsers standard printing functionality (e.g. CTRL+P).

The diagrams can also be printed by copying the diagram images into Word, and then printing them from a Word document. This can be done by right-clicking over the diagram and selecting 'copy'. Next open up MS Word (or any other word processing software) and create a new document and then 'paste' the diagram image into the document. The diagram can then be printed using the normal Word print functionality.

DIAGRAMMING CONVENTIONS

The Health Protection Agency is an independent body that protects the health and well-being of the population. The Health Protection Agency plays a critical role in protecting people from infectious diseases and in preventing harm when hazards involving chemicals, poisons or radiation occur. The Health Protection Agency also prepares for new and emerging threats, such as a bio-terrorist attack or virulent new strain of disease.

For more information on the Health Protection Agency please see their website http://www.hpa.org.uk

Height is a MEASURED PERSON OBSERVATION.

The height of a PERSON on a given date.The Height of a PERSON on a given date. The unit of measurement is metres.

Home Leave is a type of LEAVE.

Home Leave occurs when a PATIENT who is not liable to be detained under Part II of the Mental Health Act 1983 and who is using a bed in a WARD or care home spends a period of time outside hospital/care home, usually at home, with the intention of returning to the same type of WARD or care home to continue the same Consultant Episode (Hospital Provider), Midwife Episode or Nursing Episode.

A PATIENT liable to be detained in hospital under Part II of the Mental Health Act 1983 and as amended by the Mental Health (Patients in the Community) Act 1985, should be granted Mental Health Leave Of Absence instead of Home Leave.

For a PATIENT under a Nursing Episode or a Midwife Episode the period of time is at the discretion of the responsible NURSE OR MIDWIFE. The period of time for all other PATIENTS should be a maximum of Saturday, Sunday, NHS, bank and public holidays plus another three days. If a PATIENT does not return on the day specified and has failed to make alternative arrangements with hospital/care home staff, such a PATIENT should be considered discharged from that day. The date on which a PATIENT leaves the WARD to go on Home Leave closes the preceding Ward Stay. The date on which a PATIENT leaves the WARD to go on Home Leave closes the preceding Ward Stay.

Information recorded for a Home Leave includes:

A Health Care Provider providing services from:-

Hospital Provider Spell is an ACTIVITY GROUP.

The total continuous stay of a PATIENT using a bed on premises controlled by a Health Care Provider during which medical care is the responsibility of one or more CONSULTANTS, or the PATIENT is receiving care under one or more Nursing Episodes or Midwife Episodes in a WARD. During Nursing Episodes and Midwife Episodes general medical care is the responsibility of their own GENERAL MEDICAL PRACTITIONER, who is not acting as a CONSULTANT. The Hospital Provider Spell may be as a result of an ELECTIVE ADMISSION LIST ENTRY.

During the Hospital Provider Spell, the PATIENT may be subject to more than one ADMINISTRATIVE CATEGORY PERIODS. The PATIENT may be subject to one or more CRITICAL CARE PERIODS.

The Hospital Provider Spell starts when a CONSULTANT, NURSE or MIDWIFE assumes responsibility for care following the decision to admit the PATIENT. This may be before formal admission procedures have been completed and the PATIENT transferred to a WARD. For example, if a PATIENT is brought into hospital as an emergency and dies in the operating theatre before being transferred to a ward, the PATIENT would have started a Hospital Provider Spell.

In some circumstances a PATIENT may take Home Leave, or Mental Health Leave Of Absence for a period of 28 days or less, or have a current period of Mental Health Absence Without Leave of 28 days or less, which does not interrupt the Hospital Provider Spell, Consultant Episode (Hospital Provider), Nursing Episode, Midwife Episode or Hospital Stay.

Each admission as part of a series of regular day/night admissions generates a separate Hospital Provider Spell and Consultant Episode (Hospital Provider). An admission is the start of the PATIENT's Hospital Provider Spell and the first Consultant Episodes (Hospital Provider), Midwife Episode or Nursing Episode within the spell. If the PATIENT is on a Hospital Site the admission will also start the first Hospital Stay and, unless the PATIENT has to spend time as a LODGED PATIENT, the admission will also start the first Ward Stay within that Hospital Provider Spell. If the PATIENT is in a care home the admission will start the first Care Home Stay (Consultant Care) within the Hospital Provider Spell. Any admission of a PERSON liable to be detained under the Mental Health Act 1983 cannot be in a care home and must be a Hospital Provider Spell.

A discharge will be the end of the last Consultant Episode (Hospital Provider), Midwife Episode or Nursing Episode, and the end of the last Care Home Stay (Consultant Care) or Hospital Stay and Ward Stay within that Hospital Provider Spell.

If there is any time spent as a LODGED PATIENT before transfer to a WARD this is included in the Hospital Provider Spell.

A Hospital Provider Spell starts with a HOSPITAL PROVIDER ADMISSION and ends with a HOSPITAL PROVIDER DISCHARGE.A Hospital Provider Spell starts with a Hospital Provider admission and ends with a Hospital Provider discharge.

Contextual Overview

The Department of Health requires summary details from Primary Care Trusts to monitor the implementation and effectiveness of the Human Papillomavirus (HPV) Immunisation Programme.

The Human Papillomavirus Vaccination Programme for England will commence in September 2008, the first TARGET POPULATION being for females born between 1st September 1995 and 31st August 1996. This will be the first HEALTH PROGRAMME STAGE for what will then be a routine annual Immunisation Programme for all 12-13 year old females.

There will be catch-up HEALTH PROGRAMME STAGES in 2008/09 for 17-18 year olds, 2009/10 for 16-18 year old females and one in 2010/11 for 15-17 year old females.

It is recommended for the vaccine delivery to be in Schools/Colleges but Primary Care Trusts are responsible for implementing the programme according to their local needs.

Each Primary Care Trust will collect and return data on the females in a particular TARGET POPULATION. Primary Care Trusts are recommended to run a Schools-based programme, but some may choose not to. The ANNUAL TARGET DENOMINATOR (HUMAN PAPILLOMAVIRUS VACCINE) will either be Schools based or non-Schools based.

The Human Papillomavirus vaccine requires 3 separate doses to complete a full course. It is recommended that this full course is given within a 6 month period, but it may be given in a period of up to a 12 months. However, to allow for those that missed one or more doses in their TARGET POPULATION year, summary data will be collected every year for each TARGET POPULATION until those PERSONS reach 18 years old. This is because the Human Papillomavirus vaccine is most effective before an individual becomes sexually active.

Although data is collected monthly in the HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Set, it is recognised that Primary Care Trusts may not be aware of the number of other females they are responsible for at the start of the HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Set campaign year. However by the end of the School Year, Primary Care Trusts will have had opportunity to complete vaccinations for any others they are responsible for and these will be included in the HPV Immunisation Programme Vaccine Monitoring Annual Minimum Data Set together with the HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Sets.

The HPV Immunisation Programme Vaccine Monitoring Annual Minimum Data Set requires information on number of doses administered as well as the administration LOCATION TYPES.

Collection and Submission of the HPV Immunisation Programme Vaccine Monitoring Annual Minimum Data Set

• The HPV Immunisation Programme Vaccine Monitoring Annual Minimum Data Set is the School Year end annual return from Primary Care Trusts.
• The return must be submitted within 20 working days after the previous School Year end of 31st August.
• The data is submitted via a web form on the Health Protection Informatics website

1. Primary Care Trust, HEALTH PROGRAMME STAGE NUMBER (HUMAN PAPILLOMAVIRUS VACCINE), REPORTING PERIOD and ANNUAL TARGET DENOMINATOR (HUMAN PAPILLOMAVIRUS VACCINE)
2. Doses administered (by each of the three doses)
3. Doses administered by LOCATION TYPE.

Contextual Overview

The Department of Health requires summary details from Primary Care Trusts to monitor the implementation and effectiveness of the Human Papillomavirus (HPV) Immunisation Programme.

The Human Papillomavirus Vaccination Programme for England will commence in September 2008. The first TARGET POPULATION will be for females born between 1st September 1995 and 31st August 1996. This will be the first HEALTH PROGRAMME STAGE for what will then be a routine annual Immunisation Programme for all 12-13 year old females.

There will be catch-up HEALTH PROGRAMME STAGES in 2008/09 for 17-18 year olds, 2009/10 for 16-18 year old females and one in 2010/11 for 15-17 year old females.

It is recommended for the vaccine delivery to be in Schools/Colleges but Primary Care Trusts are responsible for implementing the programme according to their local needs.

The Department of Health will provide each Primary Care Trust with a monthly denominator for each TARGET POPULATION. The monthly denominator will be fixed for all monthly surveys for the School Year of the TARGET POPULATION and will be notified to the Primary Care Trust in advance. The denominator will not need to be entered each month on the on-line survey form as it will already be held on the Health Protection Informatics website.

The Human Papillomavirus vaccine requires 3 separate doses to complete a full course. It is recommended that this full course is given within a 6 month period, but it may be given in a period of up to a 12 months. However, to allow for those that missed one or more doses in their TARGET POPULATION year, summary data will be collected every year for each TARGET POPULATION until those PERSONS reach 18 years old. This is because the Human Papillomavirus vaccine is most effective before an individual becomes sexually active.

The HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Set requires the number of doses administered and information on vaccine supply and usage.

Collection and Submission of the HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Set

• The HPV Immunisation Programme Vaccine Monitoring Monthly Minimum Data Set is a monthly return from Primary Care Trusts.
• The data will be collected from Primary Care Trusts every month commencing October 2008.
• The return must be submitted within 10 working days for the previous calendar month.
• The data is submitted via a web form on the Health Protection Informatics website.

1. Primary Care Trust, HEALTH PROGRAMME STAGE NUMBER (HUMAN PAPILLOMAVIRUS VACCINE), REPORTING PERIOD and ANNUAL TARGET DENOMINATOR (HUMAN PAPILLOMAVIRUS VACCINE)
2. Doses administered (by each of the three doses). Monthly figures are cumulative i.e. the data is always the number of vaccinations from 1st September for that School Year.
3. Vaccine supply, usage and stock levels. These figures are not cumulative - they refer to the month in question only.

NHS DATA MODEL AND DICTIONARY

Version 3

What's New: December 2008What's New: March 2009

The NHS Data Model and Dictionary provides a reference point for assured information standards to support health care activities within the NHS in England. It has been developed for everyone who is actively involved in the collection of data and the management of information in the NHS. The NHS Data Model and Dictionary is maintained and published by the NHS Data Model and Dictionary Service and all changes are assured by the Information Standards Board for Health and Social Care and published as Data Set Change Notices.  Classes are shown in Dark Red Text, Attributes are shown in Purple, Data Elements are shown in Green, Data Sets are shown in Aqua Blue, Central Return Forms are shown in Dark Pink and other pages are shown in Blue. About the NHS Data Model and Dictionary Version 3 and Meta Model Menu

The NHS Data Model and Dictionary provides a reference point for assured information standards to support health care activities within the NHS in England. It has been developed for everyone who is actively involved in the collection of data and the management of information in the NHS. The NHS Data Model and Dictionary is maintained and published by the NHS Data Model and Dictionary Service and all changes are assured by the Information Standards Board for Health and Social Care and published as Data Set Change Notices.  Classes are shown in Red Text, Attributes are shown in Purple, Data Elements are shown in Green, Data Sets are shown in Aqua Blue, Central Return Forms are shown in Pink and other pages are shown in Blue.

Labour And Delivery is a CLINICAL INTERVENTION.

The processes of labour and delivery, or process of delivery only if a caesarean section is carried out before the onset of labour, which result in one or more REGISTERABLE BIRTH.The processes of Labour And Delivery, or process of delivery only if a caesarean section is carried out before the onset of labour, which result in one or more REGISTERABLE BIRTH.

DIAGRAM OVERVIEW

This shows WAITING LISTS and PRIOR NOTIFICATION LISTS FOR CYTOLOGIES and their relationships to ORGANISATIONS, PATIENTS and ACTIVITIES.

USING THE DIAGRAM

By clicking on a class box on the diagram opposite, the selected class definition will be displayed.

Any text within the displayed definition which is in blue and uppercase, is the name of a class or an attribute and if clicked on will display the definition for the class or attribute.

To redisplay the full diagram again just click on the diagram name again in the content list, and this will remove the right hand frame. Alternatively, you can resize the right hand frame by moving your mouse pointer over the middle scroll bar and when the pointer icon changed into a double ended icon (pointing left and right) click on the left mouse button and drag the middle scroll bar either left or right.

PRINTING THE DIAGRAM

To print the diagram first click on the 'Print Window' button, positioned just under the title bar, which will open a new window that will only display the diagram and header bar and exclude the superfluous navigation and content links. The diagram page can then be printed using your internet browsers standard printing functionality (e.g. CTRL+P).

The diagrams can also be printed by copying the diagram images into Word, and then printing them from a Word document. This can be done by right-clicking over the diagram and selecting 'copy'. Next open up MS Word (or any other word processing software) and create a new document and then 'paste' the diagram image into the document. The diagram can then be printed using the normal Word print functionality.

DIAGRAMMING CONVENTIONS

For information on how to read the diagrams the please click this link:: Diagramming Conventions.

Lung Capacity is a PERSON PROPERTY.

The lung capacity of a PERSON.The Lung Capacity of a PERSON. This is made up of FEV1 Absolute Amount and FEV1 Percentage.

References:
National Cancer Dataset Version 1.3_ISB October 2002

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Mental Health Minimum Data Set Overview

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 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.

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, Healthcare Commission, and the Health and Social Care Information Centre.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, Healthcare 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: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/mentalhealth/mhmds

Mental Health Minimum Data Set Version History

Attribute Definitions Introduction

The attributes of classes appearing in the NHS data standards meta data model are listed in alphabetical order. Click on a letter in the Attribute Bookmarks to display the list of attribute names for that letter. To display the definition for a specific attribute, click on the attribute name.

Each listed attribute contains its nationally agreed definition.

Each attribute, data element or class name which appears in the definition text is in uppercase and each business definition name is in Title Case. Where the name appears in blue, this indicates that this is a clickable link and if clicked on will display the definition for that attribute, class or business definition. In the same way, if a data element link is present and clicked on, then the information for a data element will be displayed.

The classes, attributes and relationships are meta model components. The classes are comprised of attributes and the Attribute 'tab' is the way of displaying these. An attribute can only belong to one class (although the Where Used 'tab' will show every class or other object where it is referenced). The relationships identify any optional links or mandatory dependencies between classes. The relationship 'tab' is the way of displaying the relationships associated with a class.

Class Definitions Introduction

The classes and their definitions appearing within the NHS data standards meta data model are listed in alphabetical order.

Each listed class contains a 'Description' tab that link to its nationally agreed definition, an 'Attributes' tab that links to a list of its attributes and a 'Relationship' tab that links to a list of its relationships it has with other classes.

The 'Where Used' tab provides a list of all the diagrams that the class is included in. Each diagram is a sub-set of the meta data model but does not contain an exclusive set of classes. Thus the same class can appear in more than one diagram.

Each attribute name or class name which appears in the definition text, attribute list or relationships is in uppercase. Where the name also appears in blue indicates that it is clickable and if clicked on will display the definition for that class or attribute.

The following information may be shown against a class attribute:

The following information is shown for each class relationship:

The classes, attributes and relationships are logical model components. The classes are comprised of attributes and the Attribute 'tab' is the way of displaying these. An attribute can only belong to one class (although the Where Used 'tab' will show every class or other object where it is referenced). The relationships identify any optional links or mandatory dependencies between classes. The relationship 'tab' is the way of displaying the relationships associated with a class.

DIAGRAMS

The meta model is based on a small set of rationalised diagrams. The list of these diagrams is located on the left.

The purpose of the meta model is to cohesively support the development and maintenance of NHS data standards in a consistent and integrated manner, that also supports the business process within and across the NHS, and with other non-NHS organisations involved with the care of patients.

The meta data model will form the underpinning common structure which can be used by all future datasets related to patients and care activity whether they be 'administrative', 'clinical', 'management' etc.

A full review of the NHS Data Dictionary has been done in order to bring existing information into line with the Meta Data Model. This is to facilitate support of legacy data standards and alignment with NPfIT. This will therefore enable both legacy data standards and new data standards to be supported during the implementation of and migration to NPfIT. There may be further pieces of work which follow to ensure consistency of the NHS Data Dictionary with the National Programme and other evolving data standards.

Midwife Episode is an ACTIVITY GROUP.

A continuous period of time a client (PATIENT) uses a bed or delivery facility as part of a Hospital Provider Spell or Care Home Stay (Midwife Care), under the direct care of a MIDWIFE. This may be during a Pregnancy Episode or Labour And Delivery for the mother but may also be for a baby following a REGISTERABLE BIRTH.

The MIDWIFE with overall responsibility for a Midwife Episode must be identified. If the responsible MIDWIFE changes then a new Midwife or Consultant Episode (Hospital Provider) begins. If the responsible MIDWIFE changes then a new Midwife Episode or Consultant Episode (Hospital Provider) begins.

General medical care during the Midwife Episode is the responsibility of the PATIENTS own GMP who is acting as a CONSULTANT.General medical care during the Midwife Episode is the responsibility of the PATIENTS own GENERAL MEDICAL PRACTITIONER who is acting as a CONSULTANT.

Information recorded for a Midwife Episode includes:

Mutually Exclusive Relationships

In some situations, relationships may be mutually exclusive, i.e. either one or other relationship may be present, but not both. For example, a particular HOME LEAVE may only relate to either a WARD or, if the PATIENT is not in a hospital, an ORGANISATION SITE, such as a Care Home, but not both as the PATIENT can only be in one place from which the HOME LEAVE is taken. This 'either/or' situation is shown by a line spanning the relationships in question.In some situations, Relationships may be Mutually Exclusive, i.e. either one or other Relationship may be present, but not both.

An example of mutually exclusive relationships in diagrams is given below:For example, a particular SERVICE REQUEST may relate to either a CARE PROFESSIONAL ORGANISATION or a SERVICE POINT not both at the same time.

This 'either/or' situation is shown by a line spanning the Relationships in question.

An example of Mutually Exclusive Relationships in diagrams is given below:

Reduced Arc - Mutually Exclusive Relationships

In some diagrams only one of the mutually exclusive relationships may be present, the other, being not applicable to the diagram, being omitted. For example, a particular diagram is concerned with WARDS and requires the inclusion of HOME LEAVE however, the second mutually exclusive relationship to ORGANISATION SITE is not germane to the diagram and can be left out. This omission is indicated by the straight line (arc) which normally spans the two relationships being displayed in a reduced manner.In some diagrams only one of the Mutually Exclusive Relationships may be present, the other, being not applicable to the diagram, being omitted.

An example of a reduced mutually exclusive relationship arc in diagrams is given below:For example, a particular diagram is concerned with SERVICE REQUESTS and requires the inclusion of SERVICE POINT, however, the second Mutually Exclusive Relationship to CARE PROFESSIONAL ORGANISATION is not relevant to the diagram and can be left out.

This omission is indicated by the straight line (arc) which normally spans the two Relationships being displayed in a reduced manner.

An example of a Reduced Mutually Exclusive Relationship Arc in diagrams is given below:

Scope:

This takes account of related definitions which have been developed for the Maternity and Child Health data sets which are currently being drafted by the Health and Social Care Information Centre.This takes account of related definitions which have been developed for the Maternity and Child Health data sets which are currently being drafted by the Health and Social Care Information Centre.

The scope of the Neonatal Critical Care Minimum Data Set is:

If one or more of these CRITICAL CARE ACTIVITIES apply to a PATIENT, then the PATIENT would be counted as receiving Neonatal Critical Care at the level of Intensive Care, High Dependency Care or Special Care depending on the CRITICAL CARE ACTIVITIES which apply.

Except in very exceptional circumstances, CRITICAL CARE ACTIVITIES 01 to 16 will only occur in a Neonatal Intensive Care Unit environment where all PATIENTS are covered by Neonatal Critical Care Minimum Data Set regardless of treatment. Care on WARDS with a CRITICAL CARE UNIT FUNCTION of 'Facility for Babies on a Neonatal Transitional Care Ward' or 'Facility for Babies on a Maternity Ward' will only be in respect of CRITICAL CARE ACTIVITIES 22 to 29 unless very exceptional circumstances apply. This does not prevent these WARDS recording CRITICAL CARE ACTIVITIES 01 to 16 on the Neonatal Critical Care Minimum Data Set if they occur. However, it does mean that such settings will in practice be dealing with a much shorter list of CRITICAL CARE ACTIVITIES which would determine whether the Neonatal Critical Care Minimum Data Set applied or not.

Each NHS Business Definition consists of freestanding text which describes an aspect of NHS activity. The text starts by identifying which generic class encompasses the activity. This is followed by an outline of the business rules which should be applied to the activity.

The NHS Business Definitions are separate from the logical data model and allow specific business areas to be defined in greater detail. The names of NHS Business Definitions are distinguished from the classes, attributes and data elements by appearing in Title Case rather than CAPITALS (see below).

An example of an NHS Business Definition is a Hospital Provider Spell, which is related to the logical class ACTIVITY GROUP.

The NHS Data Dictionary and the NHS Data Manual were originally published separately. The elements of both these publications have been consolidated into one browsable integrated publication called the NHS Data Model and Dictionary.

NHS Data Standards

The NHS Data Model and Dictionary gives common definitions and guidance to support the sharing, exchange and comparison of information across the NHS. The common definitions, known as data standards, are used in commissioning and make up the base currency of Commissioning Data Sets. On the monitoring side, they support comparative data analysis, preparation of performance tables, and data returned to the Department of Health. NHS data standards also support clinical messages, such as those used for pathology and radiology. NHS data standards are presented as a logical data model, ensuring that the standards are consistent and integrated across all NHS business areas.

NHS data standards should not just be seen as supporting the collection of data on a consistent basis throughout the NHS. They also have an important role in supporting the flow and quality of information used in different parts of the NHS so that health care professionals are presented with the relevant information where and when it is required. An example of this is the linking of all records about a patient collected in different parts of the NHS, to be available to a health care professional wherever the patient attends to be seen for treatment, thus facilitating the Electronic Patient Record. Changes to NHS data standards are still being published as Data Set Change Notices at the time of publication. The Information Standards Board for Health and Social Care may eventually use a different form of change notification, but the principles of regulated changes will still apply. An example of this is the linking of all records about a PATIENT collected in different parts of the NHS, to be available to a health care professional wherever the PATIENT attends to be seen for treatment, thus facilitating the Electronic Patient Record. Changes to NHS Data Standards are published as Data Set Change Notices by the Information Standards Board for Health and Social Care.

See the Information Standards Board for Health and Social Care.

The NHS Data Model and Dictionary Elements

The NHS Data Model and Dictionary Items