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

A Learning Disability (formerly known as a Mental Handicap and referred to as an Intellectual Disability) is a type of DISABILITY.

A Learning Disability usually has a significant impact on a PERSON's life. A PERSON with a Learning Disability finds it harder than others to learn, understand and communicate.

People with Profound and Multiple Learning Disabilities (PMLD) need full-time help with every aspect of their lives, including eating, drinking, washing, dressing and toileting etc.

Someone is considered to have a Learning Disability when they function at a level of intellectual ability which is significantly lower than their chronological age. This is usually considered to be equivalent to having an Intelligence Quotient (IQ) of seventy or less:

• Mild Learning Disability (roughly equivalent to an IQ of fifty to seventy) is comparable to the educational term 'Moderate Learning Difficulty'. It is usually caused by a combination of restricted learning and social opportunities plus a high rate of low to average intellectual ability and Learning Disability in close relatives.
  
  
• Moderate-to-profound Learning Disability (roughly equivalent to an IQ below fifty) is comparable to the educational term 'Severe Learning Difficulty'. It usually has a specific biological cause.
• Mild Learning Disability (roughly equivalent to an IQ of fifty to seventy) is comparable to the educational term 'Moderate Learning Difficulty'. It is usually caused by a combination of restricted learning and social opportunities plus a high rate of low to average intellectual ability and Learning Disability in close relatives.
  
  
• Moderate-to-profound Learning Disability (roughly equivalent to an IQ below fifty) is comparable to the educational term 'Severe Learning Difficulty'. It usually has a specific biological cause.

Note: A Learning Difficulty is a type of Special Education Need which affects areas of learning, such as reading, writing, spelling, mathematics etc.Note: A Learning Difficulty is a type of Special Education Need which affects areas of learning, such as reading, writing, spelling, mathematics etc.

Further information on Learning Disabilities, can be found on the internet, for example:

• Mencap website
• Contact a Family website etc.

 

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 type of PERSON PROPERTY.

Observations made regarding a PERSON. These observations do not include information about a treatment or intervention.

CATEGORY VALUED PERSON OBSERVATION allows coded classifications of observations about a PERSON and includes:

• ACCOMMODATION
• ALCOHOL STATUS
• ASPIRIN THERAPY LOCATION
• BLEED COMPLICATION
• DISABILITY
• DISABILITY SEVERITY
• ETHNIC CATEGORY
• JOINT REPLACEMENT REVISION CLASSIFICATION
• LANGUAGE CLASSIFICATION
• LANGUAGE FLUENCY
• LEGAL STATUS CLASSIFICATION
• PATIENT CLINICAL GROUP
• PERFORMANCE STATUS
• PERSON GENDER
• PERSON MARITAL STATUS
• REFUGEE OR ASYLUM SEEKER
• RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION
• RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION GROUP
• SARCOMA PREDISPOSING CONDITION
• SEXUAL ORIENTATION
• SKIN LYMPHOMA MORPHOLOGY

Note: MEASURED PERSON OBSERVATION allows for recording of measurements about a PERSON and OTHER PERSON OBSERVATION is where the PERSON states, for example, when they first experienced symptoms, the number of days on which alcohol has been consumed etc.Note: MEASURED PERSON OBSERVATION allows for recording of measurements about a PERSON and OTHER PERSON OBSERVATION is where the PERSON states, for example, when they first experienced symptoms, the number of days on which alcohol has been consumed etc.

 

Attributes of this Class are:

K		NHS NUMBER
		CARER PERMISSION DATE
		CARER SUPPORT INDICATOR
		CHRONICALLY SICK OR DISABLED
		DRUG MISUSE DATABASE NUMBER
		DRUG MISUSER INJECTED EVER
		DRUG MISUSER SHARED NEEDLE EVER
		ENLISTMENT DATE
		INJECTED IN LAST 4 WEEKS
		INTERPRETER REQUIRED INDICATOR
		LAST DISCHARGE DATE
		NHS NUMBER OLD
		OVERSEAS VISITOR UK ARRIVAL DATE
		REFUGEE OR ASYLUM SEEKER INDICATOR
		SHARED NEEDLE OR SYRINGE IN LAST 4 WEEKS
		YEAR OF FIRST KNOWN PSYCHIATRIC CARE

The date when a PERSON PROPERTY became effective for a PATIENT. Examples may be the date when the PATIENT experienced a symptom or gave up smoking.

 Examples may be the date when the PATIENT experienced a symptom or gave up smoking.

 

Format/length:	n1
HES item:
National Codes:	Click on the attribute tab to display the attribute that contains the National Codes.
National Codes:	See ATTENDED OR DID NOT ATTEND
Default Codes:

Notes:
For Commissioning Data Set and XML Schema version 6, this Data Element will be recognised as ATTENDANCE STATUS.

Use in the Future Outpatient CDS:
Where the attendance is in the future (and has not been cancelled) use value 0 (zero) - not applicable - APPOINTMENT occurs in the future.

Where the future attendance has been cancelled, use the appropriate value from the national codes (see ATTENDED OR DID NOT ATTEND)Where the future attendance has been cancelled, use the appropriate value from the national codes (see ATTENDED OR DID NOT ATTEND).

 

Attribute:

ORGANISATION CODE

Attribute:

ORGANISATION CODE

Format/length:	an5
HES item:
National Codes:	See ORGANISATION CODE
Default Codes:

Notes:
This is the identity of the ORGANISATION acting as the Sender of a Commissioning Data Set submission and is represented by that ORGANISATION's ORGANISATION CODE.

Definition:
See ORGANISATION CODE.

Usage:
The CDS SENDER IDENTITY is the mandatory 5-character NHS ORGANISATION CODE of the organisation acting as the physical Sender of Commissioning Data Set submissions.The CDS SENDER IDENTITY is the mandatory 5-character NHS ORGANISATION CODE of the ORGANISATION acting as the physical Sender of Commissioning Data Set submissions. The Commissioning Data Set Sender must make sure that the Commissioning Data Set extraction and submission facilities and processes differentiate correctly between:

• The ORGANISATION CODE (CDS SENDER IDENTITY) as carried in the CDS Transaction Header Group for every Commissioning Data Set,
• and
• The ORGANISATION CODE (CODE OF PROVIDER) as carried in the Service Agreement details which are part of the Episode/Attendance details.

Once associated with the a Commissioning Data Set record and submitted to the Secondary Uses Service, the CDS SENDER IDENTITY should not be changed unless great care is taken to delete the original Commissioning Data Set records before any resubmission is undertaken.

Usually, the CDS SENDER IDENTITY is never altered once assigned. 

Attribute:

ORGANISATION CODE

Format/length:	n1
HES item:	DELPLACE
National Codes:	See ACTUAL DELIVERY PLACE
Default Codes:

Notes:
DELIVERY PLACES TYPE (ACTUAL) is the same as attribute ACTUAL DELIVERY PLACE.DELIVERY PLACE TYPE (ACTUAL) is the same as attribute ACTUAL DELIVERY PLACE. 

Attribute:

OFFERED FOR ADMISSION DATE

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	See EMPLOYEE ABSENCE CATEGORY CODE
Default Codes:

Notes:
This is the same as attribute EMPLOYEE ABSENCE CATEGORY CODE.

A high level classification of the reason for an EMPLOYEE ABSENCE

 

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	See EMPLOYEE ABSENCE SICKNESS REASON CODE
Default Codes:	99 - Not known

Notes:
This is the same as attribute EMPLOYEE ABSENCE SICKNESS REASON CODE.

The reason given for the EMPLOYEE ABSENCE where the EMPLOYEE ABSENCE TYPE CODE is National Code 08 'Sickness'.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYEE ABSENCE TYPE CODE
Default codes

Notes:
This is the same as attribute EMPLOYEE ABSENCE TYPE CODE.

The sub classification of an EMPLOYEE ABSENCE.

 

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	EMPLOYEE DISABILITY STATUS CODE
Default Codes:	97 - Not recorded 98 - Not applicable 99 - Not known

Notes:
This is the same as attribute EMPLOYEE DISABILITY STATUS CODE.

An indicator to denote whether or not an EMPLOYEE considers that they are disabled.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYEE INTERNATIONAL RECRUIT INDICATOR
Default codes

Notes:
This is the same as attribute EMPLOYEE INTERNATIONAL RECRUIT INDICATOR.

An indicator of whether or not an EMPLOYEE was recruited from outside the United Kingdom.

The value is derived from EMPLOYMENT HISTORY RECRUITMENT SOURCE CODE.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYEE RESIDENCY STATUS
Default codes

Notes:
This is the same as attribute EMPLOYEE RESIDENCY STATUS.

This indicates whether an EMPLOYEE who is not a national of the United Kingdom has the right to stay and work permanently in the UK.

The Electronic Staff Record will hold the residency status classifications as advised by the Immigration and Nationality Department (IND). The item was previously collected in the Medical and Dental Workforce Census but is no longer a required item. Its use for all staff is recommended, however, as it is extremely helpful in planning for replacement of staff without permanent rights of residence in the UK.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYMENT CONTRACT NATURE CODE
Default codes

Notes:
This is the same as attribute EMPLOYMENT CONTRACT NATURE CODE.

The nature of an EMPLOYMENT CONTRACT for an EMPLOYEE.

 

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	See EMPLOYMENT CONTRACT SESSION TYPE CODE
Default Codes:	97 - Not recorded 99 - Not known

Notes:
This is the same as attribute EMPLOYMENT CONTRACT SESSION TYPE CODE.

A description of the type of session specified in an EMPLOYMENT CONTRACT.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYMENT CONTRACT TYPE CODE
Default codes

Notes:
This is the same as attribute EMPLOYMENT CONTRACT TYPE CODE.

The type of EMPLOYMENT CONTRACT applicable to an ASSIGNMENT for an EMPLOYEE.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYMENT HISTORY EXIT INTERVIEW INDICATOR
Default codes	97 - Not recorded 99 - Not known

Notes:
This is the same as attribute EMPLOYMENT HISTORY EXIT INTERVIEW INDICATOR.

An indicator to denote whether or not an Exit Interview has taken place prior to an EMPLOYEE leaving employment with an NHS ORGANISATION.

 

Format/length:	n2
HES item:
National codes	Click on the Attribute tab to display the attribute that contains the National Codes
National codes	See EMPLOYMENT HISTORY EXIT QUESTIONNAIRE INDICATOR
Default codes	97 - Not recorded 99 - Not known

Notes:
This is the same as attribute EMPLOYMENT HISTORY EXIT QUESTIONNAIRE INDICATOR.

An indicator to denote whether or not an EMPLOYEE has completed an Exit Questionnaire prior to leaving employment with an NHS ORGANISATION.

 

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	See EMPLOYMENT HISTORY LEAVING DESTINATION CODE
Default Codes:	98 - Unknown

Notes:
This is the same as attribute EMPLOYMENT HISTORY LEAVING DESTINATION CODE.

The destination of an EMPLOYEE on termination of their employment with the NHS ORGANISATION.

 

Format/length:	n2
HES item:
National Codes:	Click on the Attribute tab to display the attribute that contains the National Codes
National Codes:	See EMPLOYMENT HISTORY LEAVING REASON CODE
Default Codes:

Notes:
This is the same as attribute EMPLOYMENT HISTORY LEAVING REASON CODE.

The reason given for an EMPLOYEE to be leaving their employment with an ORGANISATION.

 

Format/length:	an1
HES item:
National Codes:	Click on the attribute tab to display the attribute that contains the National Codes.
National Codes:	See ENDOCRINE THERAPY TYPE
Default Codes:

 Notes:
ENDOCRINE THERAPY TYPE is the same as attribute ENDOCRINE THERAPY TYPE.

Format/length:	an2
HES item:	ETHNOS
National Codes:	See the attribute ETHNIC CATEGORY CODE
National Codes:	See ETHNIC CATEGORY CODE
Default Codes:	99 - Not known

Notes:
ETHNIC CATEGORY is the same as attribute ETHNIC CATEGORY CODE.

The 16+1 ethnic data categories defined in the 2001 census is the national mandatory standard for the collection and analysis of ethnicity.

The national code must be transmitted as the first character in the 2 character field. The second character is optional for use locally. It must, however, be able to be grouped consistently with the 16 main categories.

The information recorded about ETHNIC CATEGORIES must be obtained by asking the PATIENT.

National code Z should be used where the PERSON has been given the opportunity to state their ETHNIC CATEGORY but chose not to.  Default code 99 should be used where the PERSON's ETHNIC CATEGORY is not known.

 

Format/length:	n1
HES item:
National Codes:	Click on the attribute tab to display the attribute that contains the National Codes.
National Codes:	See IMAGE GUIDED SURGERY INDICATOR
Default Codes:

Notes:
IMAGE GUIDED SURGERY INDICATOR is the same as attribute IMAGE GUIDED SURGERY INDICATOR.

References:
National Joint Registry Data Set: v.1: 24th March 2003

 

Format/length:	an50
HES item:
Default Codes:

Notes:
IMPLANT BATCH OR LOT NUMBER is the same as attribute IMPLANT BATCH OR LOT NUMBER.

References:
National Joint Registry Dataset: v.1: 24th March 2003

 

Format/length:	an100
HES item:
National Codes:
Default Codes:

Notes:
IMPLANT CATALOGUE NUMBER is the same as attribute IMPLANT CATALOGUE NUMBER.

References:
National Joint Registry Dataset: v.1: 24th March 2003

 

Attribute:

ORGANISATION SITE CODE

Format/length:	n3
HES item:
National Codes:	See LANGUAGE CLASSIFICATION CODE for National Codes.
National Codes:	See LANGUAGE CLASSIFICATION CODE
Default Codes:

Notes:
LANGUAGE is the same as the attribute LANGUAGE CLASSIFICATION CODE.

 

Format/length:	n2
HES item:
National Codes:	Click on the attribute tab to display the attribute that contains the National Codes.
National Codes:	See LANGUAGE USAGE
Default Codes:

Notes:
LANGUAGE USAGE is the same as the attribute LANGUAGE USAGE.

 

Format/length:	n1
HES item:	BIRSTATE
National Codes:	Click on the attribute tab to display the attribute that contains the National Codes.
National Codes:	See LIVE OR STILL BIRTH
Default Codes:

Notes:
LIVE OR STILL BIRTH is the same as the attribute LIVE OR STILL BIRTH.

If born dead before 24 weeks, it would be a spontaneous abortion.

 

Format/length:	see POSTCODE
HES item:	HOMEADD
National Codes:
Default Codes:

Notes:
This is a type of POSTCODE.

The POSTCODE of the ADDRESS nominated by the PATIENT with ADDRESS ASSOCIATION TYPE 'Main Permanent Residence' or 'Other Permanent Residence'.

If a PATIENT has no fixed abode this should be recorded with the appropriate code (ZZ99 3VZ).

For overseas visitors the POSTCODES OF USUAL ADDRESS field must show the relevant country pseudo postcode commencing ZZ99 plus space followed by a numeric, then an alpha character, then a Z. For example, ZZ99 6CZ is the pseudo-postcode for India. Pseudo-Country postcodes can be found in the NHS Postcode Directory.

The 8 characters field allows a space to be inserted to differentiate between the inward and outward segments of the code, enabling full use to be made of Royal Mail postcode functionality.  See NHS Postcode Directory and Contact Details.

The e-Government Interoperability Framework (e-GIF-GIF) standard POSTCODE should be used for all new and developing systems and for XML messages.The e-Government Interoperability Framework (e-GIF) standard POSTCODE should be used for all new and developing systems and for XML messages.

References:
The e-GIF version approved for use in NHS England is:
Government Data Standards Catalogue: (GDSC), Version 2.1, Agreed 1 September 2002.
GDSC: http://www.cabinetoffice.gov.uk/govtalk/schemasstandards/e-gif/datastandards.aspx.

 

Format/length:	an8
HES item:	REFERRER
National Codes:
Default Codes:	C9999998 - Consultant General Medical Council (GMC) number not known
	CD999998 - Dental Consultant: General Medical Council (GMC) number/ General Dental Council (GDC) number not known
Default Codes:	C9999998 - CONSULTANT GENERAL MEDICAL COUNCIL REFERENCE NUMBER not known
	CD999998 - Dental CONSULTANT: GENERAL MEDICAL COUNCIL REFERENCE NUMBER / GENERAL DENTAL COUNCIL REGISTRATION NUMBER not known
	D9999998 - Dentist, Dental Practice Board (DPB) number not known
	R9999981 - Referrer other than General Medical Practitioner, General Dental Practitioner or Consultant
	X9999998 - Not applicable, e.g. patient has self-presented or not known
	R9999981 - Referrer other than GENERAL MEDICAL PRACTITIONER, GENERAL DENTAL PRACTITIONER or CONSULTANT
	X9999998 - Not applicable, e.g. PATIENT has self-presented or not known

Notes:
This requires the code of the PERSON making the referral. This will normally be a CARE PROFESSIONAL - a GENERAL MEDICAL PRACTITIONER or a CONSULTANT.

The intention is for this item to reflect the actual (true) referrer. For example, following a GENERAL MEDICAL PRACTITIONER referral, a CONSULTANT may subsequently refer the PATIENT to another CONSULTANT within the Hospital Provider Spell. The code of the CONSULTANT making the referral and the CONSULTANTS ORGANISATION should be recorded in the Commissioning Data Set (CDS) rather than the code of the GENERAL MEDICAL PRACTITIONER referrer. This also applies where a CONSULTANT refers an NHS PATIENT to another doctor for NHS-commissioned treatment at another NHS Trust, a non-NHS provider, or an overseas provider. Where the CONSULTANT CODE is not known, the default value C9999998 should be used.

In all other cases, the code of the referring GENERAL MEDICAL PRACTITIONER should be recorded, if applicable. When a locum refers, use the code of the GENERAL PRACTITIONER for whom the locum is acting. See GENERAL MEDICAL PRACTITIONER PPD CODE.

See CONSULTANT CODE and GENERAL MEDICAL PRACTITIONER (SPECIFIED) for the codes available for CONSULTANTS and GENERAL MEDICAL PRACTITIONERS and GENERAL DENTAL PRACTITIONERS and Ministry of Defence (MoD) Doctors.

If the REFERRER CODE is not known or not applicable e.g., the PATIENT has self-presented, the default code (X9999998) should be used.

Hospital Provider Spell is an ACTIVITY GROUP where ACTIVITY GROUP TYPE is National Code 21 'Hospital Provider Spell'.

 

Format/length:	see ORGANISATION SITE CODE
HES item:	SITETRET
National Codes:
Default Codes:	R9998 - Not a hospital site (for use on Out-Patient CDS)
	89999 - Non-NHS UK Provider where no Organisation Site Code has been issued
	89997 - Non-UK Provider where no Organisation Site Code has been issued
	89999 - Non-NHS UK Provider where no ORGANISATION SITE CODE has been issued
	89997 - Non-UK Provider where no ORGANISATION SITE CODE has been issued

Notes:
SITE CODE (OF TREATMENT) is the ORGANISATION SITE CODE for the ORGANISATION SITE where the PATIENT was treated. Note that the SITE CODE (OF TREATMENT) should always identify an ORGANISATION SITE where activity managed by the treating organisation takes place, i.e. it should enable the treating organisation to be identified.

Note that the SITE CODE (OF TREATMENT) should always identify an ORGANISATION SITE where ACTIVITY managed by the treating ORGANISATION takes place, i.e. it should enable the treating ORGANISATION to be identified.

This identifies the site within the ORGANISATION on which the PATIENT was treated, since facilities may vary on different hospital sites. The code recorded should always be the national code; if the treatment is sub-commissioned to another provider, the site code used should be that of the provider actually carrying out the work.

Each ORGANISATION has a unique ORGANISATION CODE. However, where an ORGANISATION has more than one site from which it provides services then each site is uniquely identified. These sites are ORGANISATION SITES and are uniquely identified by ORGANISATION SITE CODE. The ORGANISATION SITE CODE contains the first 3 digits of the ORGANISATION CODE with the last two digits being the site identifier.

Example:

RA700	ORGANISATION CODE of the ORGANISATION
RA701	ORGANISATION SITE CODE of the first identified ORGANISATION SITE within the ORGANISATION
RA702	ORGANISATION SITE CODE of the second identified ORGANISATION SITE within the ORGANISATION

Where treatment for an NHS PATIENT is sub-commissioned to an independent UK provider the appropriate ORGANISATION SITE CODE should be used. Where treatment is sub-commissioned to an overseas provider the default code 89997 is applicable.

For out-patients, activity may take place outside the hospital, such as in the PATIENT'S home; in such cases, raising a site code is impractical.For out-patients, ACTIVITY may take place outside the hospital, such as in the PATIENT'S home; in such cases, raising a site code is impractical. LOCATION CLASS is used in the Commissioning Data Set (CDS) message to indicate the classification of the physical LOCATION within which the ACTIVITY occurred.

Use in the Future Outpatient CDS:
If the intended site code of treatment is not known, this data element should be omitted.If the INTENDED SITE CODE (OF TREATMENT) is not known, this data element should be omitted.