Change Request: CR1371

NHS Connecting for Health

NHS Data Model and Dictionary Service

Type:	Patch
Reference:	1371
Version No:	1.0
Subject:	March 2013 Release Patch
Effective Date:	Immediate
Reason for Change:	Patch
Publication Date:	27 March 2013

Background:

This patch updates the NHS Data Model and Dictionary in preparation for the March 2013 Release and includes:

What's New amended to include Change Requests incorporated since the last version of the NHS Data Model and Dictionary was published
Missing hyperlinks added
Website links updated
Html format corrected.

To view a demonstration on "How to Read an NHS Data Model and Dictionary Change Request", visit the NHS Data Model and Dictionary help pages at: http://www.datadictionary.nhs.uk/Flash_Files/changerequest.htm.

Note: if the web page does not open, please copy the link and paste into the web browser.

Summary of changes:

Data Set
CANCER OUTCOMES AND SERVICES DATA SET - CENTRAL NERVOUS SYSTEM	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - CHILDREN TEENAGERS AND YOUNG ADULTS	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - COLORECTAL	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - CORE	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - GYNAECOLOGICAL	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - HAEMATOLOGY	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - HEAD AND NECK	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - LUNG	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - SARCOMA	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - SKIN	Changed Description
CANCER OUTCOMES AND SERVICES DATA SET - UROLOGY	Changed Description
CHILD AND ADOLESCENT MENTAL HEALTH SERVICES SECONDARY USES DATA SET	Changed Description
CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES DATA SET	Changed Description
HIV AND AIDS REPORTING DATA SET	Changed Description
MATERNITY SERVICES SECONDARY USES DATA SET	Changed Description

Central Return Forms
KC53 1	Changed Description
KC63 1	Changed Description

Supporting Information
CHILD AND ADOLESCENT MENTAL HEALTH SERVICES SECONDARY USES DATA SET OVERVIEW	Changed Description
HARS DATA SET SUBMISSION REQUIREMENTS	Changed Description
INDEPENDENT HEALTH CARE SERVICE PLAN	Changed Description
MAINTENANCE	Changed Description
MENTAL HEALTH MINIMUM DATA SET OVERVIEW	Changed Description
METADATA FILES	Changed Description
NATIONAL CANCER WAITING TIMES MONITORING DATA SET OVERVIEW	Changed Description
NHS HEALTH CHECKS DATA SET MESSAGE VERSIONS renamed from NHS HEALTH CHECKS DATA SET MESSAGE VERSIONS	Changed Name
WHAT'S NEW: MARCH 2013 renamed from WHAT'S NEW: FEBRUARY 2013	Changed Description, Name

Data Elements
BLOOD SPOT CARD COMPLETION DATE	Changed Description
ESTIMATED GLOMERULAR FILTRATION RATE	Changed Description

XML Schema Constraint
CANCER OUTCOMES AND SERVICES DATA SET XML SCHEMA CONSTRAINTS	Changed Description
COMMISSIONING DATA SET VERSION 6-2 XML SCHEMA CONSTRAINTS	Changed Description
DIAGNOSTIC IMAGING DATA SET XML SCHEMA CONSTRAINTS	Changed Description
HIV AND AIDS REPORTING DATA SET XML SCHEMA CONSTRAINTS	Changed Description
NHS HEALTH CHECKS DATA SET XML SCHEMA CONSTRAINTS	Changed Description
SYSTEMIC ANTI-CANCER THERAPY DATA SET XML SCHEMA CONSTRAINTS	Changed Description

Date:	27 March 2013
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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CANCER OUTCOMES AND SERVICES DATA SET - CENTRAL NERVOUS SYSTEM

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

IMAGING - CENTRAL NERVOUS SYSTEM

To carry imaging details for Central Nervous System (CNS) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	LESION LOCATION (RADIOLOGICAL)
R	NUMBER OF LESIONS (RADIOLOGICAL)
R	LESION SIZE (RADIOLOGICAL)
R	LARGEST LESION FEATURES (RADIOLOGICAL) Multiple occurrences of this item are permitted
R	PRINCIPAL DIAGNOSTIC IMAGING TYPE

CANCER CARE PLAN - CENTRAL NERVOUS SYSTEM

To carry cancer care plan details for Central Nervous System (CNS) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PRIMARY DIAGNOSIS (ICD RADIOLOGICAL)
M	PROVISIONAL DIAGNOSIS (ICD)

SURGERY AND OTHER PROCEDURES - CENTRAL NERVOUS SYSTEM

To carry surgery and other procedures details for Central Nervous System (CNS) cancer. One occurrence of this data group is permitted per treatment.
M/R/O/X	Data Set Data Elements
R	ASA PHYSICAL STATUS CLASSIFICATION SYSTEM CODE
R	TUMOUR LOCATION (SURGICAL)
R	EXCISION TYPE

RADIOSURGERY - CENTRAL NERVOUS SYSTEM

To carry radiosurgery details for Central Nervous System (CNS) cancer. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	RADIOSURGERY PERFORMED INDICATOR
R	PROCEDURE DATE (RADIOSURGERY)

PATHOLOGY - CENTRAL NERVOUS SYSTEM

To carry pathology details for Central Nervous System (CNS) cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	MOLECULAR DIAGNOSTIC CODE Multiple occurrences of this item are permitted
R	HORMONE EXPRESSION TYPE Multiple occurrences of this item are permitted
R	WORLD HEALTH ORGANISATION CENTRAL NERVOUS SYSTEM TUMOUR GRADE

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CANCER OUTCOMES AND SERVICES DATA SET - CHILDREN TEENAGERS AND YOUNG ADULTS

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

REFERRALS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry referral details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	CARE PROFESSIONAL MAIN SPECIALTY CODE (CANCER REFERRAL)

DIAGNOSIS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry diagnosis details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PRIMARY DIAGNOSIS (CANCER COMMENT)
R	SECONDARY DIAGNOSIS (ICD) Multiple occurrences of this item are permitted
R	SECONDARY DIAGNOSIS (CANCER COMMENT)
M	FAMILIAL CANCER SYNDROME INDICATOR
R	FAMILIAL CANCER SYNDROME COMMENT
R	CARE PROFESSIONAL MAIN SPECIALTY CODE (DIAGNOSIS)
R	CHILDREN TEENAGERS AND YOUNG ADULTS AGE CATEGORY (CONSULTANT AT DIAGNOSIS)

CANCER CARE PLAN - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry care plan details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	CHILDREN TEENAGERS AND YOUNG ADULTS AGE CATEGORY (MULTIDISCIPLINARY TEAM) Multiple occurrences of this item are permitted

STEM CELL TRANSPLANTATION - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry stem cell transplantation details for Children Teenagers and Young Adults (CTYA) cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	PROCEDURE DATE (STEM CELL INFUSION)
R	STEM CELL INFUSION SOURCE CODE
R	STEM CELL INFUSION DONOR TYPE

CHEMOTHERAPY - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry chemotherapy details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	CHILDREN TEENAGERS AND YOUNG ADULTS AGE CATEGORY (CONSULTANT PRESCRIBING CHEMOTHERAPY)

ACUTE LYMPHOCYTIC LEUKAEMIA (ALL) - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Acute Lymphocytic Leukaemia (ALL) details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements

ACUTE LYMPHOCYTIC LEUKAEMIA (ALL) AND ACUTE MYELOID LEUKAEMIA (AML) - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Acute Lymphocytic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	EXTRAMEDULLARY DISEASE SITE
R	WHITE BLOOD CELL COUNT (HIGHEST PRETREATMENT)
R	CYTOGENETIC RISK CODE (ACUTE LYMPHOCYTIC LEUKAEMIA AND ACUTE MYELOID LEUKAEMIA)
R	CYTOGENETIC FINDINGS COMMENT

NON HODGKIN LYMPHOMA (NHL) - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Non Hodgkin Lymphoma (NHL) details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	MURPHY ST JUDES STAGE
R	ALK-1 STATUS

HODGKIN LYMPHOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Hodgkin Lymphoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	ANN ARBOR STAGE
R	ANN ARBOR SYMPTOMS INDICATOR
R	ANN ARBOR EXTRANODALITY INDICATOR

NEUROBLASTOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Neuroblastoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	INTERNATIONAL NEUROBLASTOMA PATHOLOGY CLASSIFICATION CODE
R	CYTOGENETIC RISK CODE (NEUROBLASTOMA)
R	INTERNATIONAL NEUROBLASTOMA STAGING SYSTEM STAGE

RENAL TUMOURS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry renal tumour details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	WILMS TUMOUR STAGE
R	PATHOLOGICAL RISK CLASSIFICATION CODE (AFTER NEPHRECTOMY)
R	PATHOLOGICAL RISK CLASSIFICATION CODE (AFTER PREOPERATIVE CHEMOTHERAPY)

RHABDOMYOSARCOMA AND OTHER SOFT TISSUE SARCOMA (STS) - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Rhabdomyosarcoma and Other Soft Tissue Sarcoma (STS) details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	INTERGROUP RHABDOMYOSARCOMA STUDY POST-SURGICAL GROUPING SYSTEM STAGE
R	CYTOGENETIC PRESENCE TYPE (RHABDOMYOSARCOMA)
R	RHABDOMYOSARCOMA SITE PROGNOSIS CODE
M	SARCOMA TUMOUR SITE (SOFT TISSUE)
R	SARCOMA TUMOUR SUBSITE (SOFT TISSUE)

OSTEOSARCOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Osteosarcoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PRIMARY TUMOUR SIZE (RADIOLOGICAL)
R	TUMOUR NECROSIS
R	SARCOMA SURGICAL MARGIN

EWINGS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Ewings details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	TUMOUR VOLUME AT DIAGNOSIS CODE
R	CYTOGENETIC ANALYSIS CODE

OSTEOSARCOMA AND EWINGS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Osteosarcoma and Ewings details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	SARCOMA TUMOUR SITE (BONE)
R	SARCOMA TUMOUR SUBSITE (BONE)

GERM CELL CENTRAL NERVOUS SYSTEM (CNS) TUMOURS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Germ Cell Central Nervous System (CNS) Tumours details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	ALPHA FETOPROTEIN (CEREBROSPINAL FLUID)
R	BETA HUMAN CHORIONIC GONADOTROPIN (CEREBROSPINAL FLUID)

GERM CELL NON CENTRAL NERVOUS SYSTEM (CNS) TUMOURS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Germ Cell Non Central Nervous System (CNS) Tumours details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	TNM STAGE GROUPING (NON CENTRAL NERVOUS SYSTEM GERM CELL TUMOURS)

GERM CELL CENTRAL NERVOUS SYSTEM (CNS) AND NON CENTRAL NERVOUS SYSTEM (CNS) TUMOURS - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Germ Cell Germ Cell Central Nervous System (CNS) Tumours and Germ Cell Non Central Nervous System (CNS) Tumours details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	BETA HUMAN CHORIONIC GONADOTROPIN (MAXIMUM AT DIAGNOSIS)

GERM CELL CENTRAL NERVOUS SYSTEM (CNS), GERM CELL NON CENTRAL NERVOUS SYSTEM (CNS) TUMOURS, HEPATOBLASTOMA AND HEPATOCELLULAR CARCINOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Germ Cell Central Nervous System (CNS) Tumours, Germ Cell Non, Central Nervous System (CNS) Tumours, Hepatoblastoma and Hepatocellular carcinoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	ALPHA FETOPROTEIN (MAXIMUM AT DIAGNOSIS)

MEDULLOBLASTOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Medulloblastoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	CHANG STAGING SYSTEM STAGE

HEPATOBLASTOMA - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry Hepatoblastoma details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	PRETEXT STAGING SYSTEM STAGE
R	PRETEXT STAGING SYSTEM STAGE (OUTSIDE LIVER)

CHEMOTHERAPY - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry chemotherapy details for Children Teenagers and Young Adults (CTYA) cancer. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	CHILDREN TEENAGERS AND YOUNG ADULTS AGE CATEGORY (CONSULTANT PRESCRIBING CHEMOTHERAPY)

PATHOLOGY: RENAL - CHILDREN, TEENAGERS AND YOUNG ADULTS

To carry renal pathology details for Children Teenagers and Young Adults (CTYA) cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	TUMOUR RUPTURE INDICATOR
R	ANAPLASTIC NEPHROBLASTOMA TYPE
R	TUMOUR INVASION INDICATOR (PERIRENAL FAT)
R	TUMOUR INVASION INDICATOR (RENAL SINUS)
R	RENAL VEIN TUMOUR INDICATOR
R	VIABLE TUMOUR INDICATOR
R	TUMOUR LOCAL STAGE

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CANCER OUTCOMES AND SERVICES DATA SET - COLORECTAL

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

REFERRALS - COLORECTAL

To carry referral details for Colorectal cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
X	CANCER SCREENING STATUS

IMAGING - COLORECTAL

To carry imaging details for Colorectal cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PROCEDURE DATE (CT SCAN)
R	PROCEDURE DATE (FIRST MRI SCAN)
R	PROCEDURE DATE (SECOND MRI SCAN)
R	PROCEDURE DATE (ENDOANAL ULTRASOUND)

DIAGNOSIS - COLORECTAL

To carry diagnosis details for Colorectal cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	SYNCHRONOUS TUMOUR INDICATOR (CAECUM)
R	SYNCHRONOUS TUMOUR INDICATOR (APPENDIX)
R	SYNCHRONOUS TUMOUR INDICATOR (ASCENDING COLON)
R	SYNCHRONOUS TUMOUR INDICATOR (HEPATIC FLEXURE)
R	SYNCHRONOUS TUMOUR INDICATOR (TRANSVERSE COLON)
R	SYNCHRONOUS TUMOUR INDICATOR (SPLENIC FLEXURE)
R	SYNCHRONOUS TUMOUR INDICATOR (DESCENDING COLON)
R	SYNCHRONOUS TUMOUR INDICATOR (SIGMOID COLON)
R	SYNCHRONOUS TUMOUR INDICATOR (RECTOSIGMOID)
R	SYNCHRONOUS TUMOUR INDICATOR (RECTUM)
R	TUMOUR HEIGHT ABOVE ANAL VERGE

CANCER CARE PLAN - COLORECTAL

To carry cancer care plan details for Colorectal cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	BODY MASS INDEX

STAGING - COLORECTAL

To carry staging details for Colorectal cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	MODIFIED DUKES CLASSIFICATION CODE

SURGERY AND OTHER PROCEDURES - COLORECTAL

To carry surgery and other procedure details for each surgery for Colorectal cancer. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
R	SURGICAL ACCESS TYPE

PATHOLOGY - COLORECTAL

To carry pathology details for Colorectal cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	MARGIN INVOLVED INDICATION CODE (POSITIVE PROXIMAL OR DISTAL RESECTION MARGIN)
R	DISTANCE TO CLOSEST NON PERITONEALISED RESECTION MARGIN
R	DISTANCE TO DISTAL RESECTION MARGIN
R	PERFORATIONS OR SEROSAL INVOLVEMENT INDICATION CODE
R	PLANE OF SURGICAL EXCISION TYPE
R	DISTANCE FROM DENTATE LINE
R	DISTANCE BEYOND MUSCULARIS PROPRIA
R	PREOPERATIVE THERAPY RESPONSE TYPE
R	MARGIN INVOLVED INDICATION CODE (CIRCUMFERENTIAL MARGIN)
R	DISTANCE TO CIRCUMFERENTIAL EXCISION MARGIN

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CANCER OUTCOMES AND SERVICES DATA SET - CORE

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

LINKAGE - CORE

To carry patient identity details for linkage. One occurrence of this group is required.
M/R/O/X	Data Set Data Elements
M	NHS NUMBER and/or LOCAL PATIENT IDENTIFIER
M	NHS NUMBER STATUS INDICATOR CODE
R	PERSON BIRTH DATE
M	ORGANISATION CODE (CODE OF PROVIDER)

To carry diagnostic details for linkage. One occurrence of this group is required.
M/R/O/X	Data Set Data Elements
M	PRIMARY DIAGNOSIS (ICD)
M	DATE OF DIAGNOSIS (CANCER CLINICALLY AGREED) and/or DATE OF RECURRENCE (CANCER CLINICALLY AGREED)

DEMOGRAPHICS - CORE

To carry patient demographic details. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
X	PATIENT PATHWAY IDENTIFIER
X	ORGANISATION CODE (PATIENT PATHWAY IDENTIFIER ISSUER)
M	PERSON FAMILY NAME
M	PERSON GIVEN NAME
M	PATIENT USUAL ADDRESS (AT DIAGNOSIS) - ADDRESS STRUCTURED or PATIENT USUAL ADDRESS (AT DIAGNOSIS) - ADDRESS UNSTRUCTURED
M	POSTCODE OF USUAL ADDRESS (AT DIAGNOSIS)
M	PERSON GENDER CODE CURRENT
R	GENERAL MEDICAL PRACTITIONER (SPECIFIED)
M	GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
X	ORGANISATION CODE (RESPONSIBLE PCT)
R	PERSON FAMILY NAME (AT BIRTH)
M	ETHNIC CATEGORY

REFERRALS AND FIRST STAGE OF PATIENT PATHWAY - CORE

To carry patient referral details to the Trust that receives the first referral. These details include information relating to the first stage of the Patient Pathway. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
X	TWO WEEK WAIT CANCER OR SYMPTOMATIC BREAST REFERRAL TYPE
X	DECISION TO REFER DATE (CANCER OR BREAST SYMPTOMS)
M	SOURCE OF REFERRAL FOR OUT-PATIENTS
X	PRIORITY TYPE CODE
M	REFERRAL TO TREATMENT PERIOD START DATE
M	DATE FIRST SEEN
M	CONSULTANT CODE
M	CARE PROFESSIONAL MAIN SPECIALTY CODE
M	SITE CODE (OF PROVIDER FIRST SEEN)
X	CANCER REFERRAL TO TREATMENT PERIOD START DATE
M	DATE FIRST SEEN (CANCER SPECIALIST)
M	SITE CODE (OF PROVIDER FIRST CANCER SPECIALIST)
X	CONSULTANT UPGRADE DATE
X	SITE CODE (OF PROVIDER CONSULTANT UPGRADE)
X	WAITING TIME ADJUSTMENT (FIRST SEEN)
X	WAITING TIME ADJUSTMENT REASON (FIRST SEEN)
X	DELAY REASON COMMENT (FIRST SEEN)
X	DELAY REASON REFERRAL TO FIRST SEEN (CANCER OR BREAST SYMPTOMS)
M	CANCER OR SYMPTOMATIC BREAST REFERRAL PATIENT STATUS
R	CANCER SYMPTOMS FIRST NOTED DATE

IMAGING - CORE

To carry imaging details. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	SITE CODE (OF IMAGING)
M	PROCEDURE DATE (CANCER IMAGING)
M	IMAGING CODE (NICIP) and/or CANCER IMAGING MODALITY and IMAGING ANATOMICAL SITE and ANATOMICAL SIDE (IMAGING)
R	IMAGING REPORT TEXT
R	LESION SIZE (RADIOLOGICAL)

DIAGNOSIS - CORE

To carry diagnostic details. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
X	DATE OF DIAGNOSIS (CANCER REGISTRATION) or DATE OF RECURRENCE (CANCER REGISTRATION)
M	TUMOUR LATERALITY
M	BASIS OF DIAGNOSIS (CANCER)
M	MORPHOLOGY (SNOMED) and/or MORPHOLOGY (ICD-O)
R	TOPOGRAPHY (ICD-O)
R	GRADE OF DIFFERENTIATION (AT DIAGNOSIS)
R	METASTATIC SITE
R	CANCER RECURRENCE CARE PLAN INDICATOR

CANCER CARE PLAN - CORE

To carry cancer care plan details. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	MULTIDISCIPLINARY TEAM DISCUSSION INDICATOR
R	MULTIDISCIPLINARY TEAM DISCUSSION DATE (CANCER)
R	CANCER CARE PLAN INTENT
R	PLANNED CANCER TREATMENT TYPE Multiple occurrences of this item are permitted
R	NO CANCER TREATMENT REASON
R	ADULT COMORBIDITY EVALUATION - 27 SCORE
R	PERFORMANCE STATUS (ADULT)
M	CLINICAL NURSE SPECIALIST INDICATION CODE

CLINICAL TRIALS - CORE

To carry clinical trial details for a patient who is eligible for a cancer clinical trial. Only one instance will be recorded for each diagnosis. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	PATIENT TRIAL STATUS (CANCER)
R	CANCER CLINICAL TRIAL TREATMENT TYPE

STAGING - CORE

To carry the staging details at the time that the first cancer care plan is agreed. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	T CATEGORY (FINAL PRETREATMENT)
R	N CATEGORY (FINAL PRETREATMENT)
R	M CATEGORY (FINAL PRETREATMENT)
R	TNM STAGE GROUPING (FINAL PRETREATMENT)
R	T CATEGORY (INTEGRATED STAGE)
R	N CATEGORY (INTEGRATED STAGE)
R	M CATEGORY (INTEGRATED STAGE)
R	TNM STAGE GROUPING (INTEGRATED)
R	TNM EDITION NUMBER

TREATMENT - CORE

To carry the cancer treatment details. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
X	SITE CODE (OF PROVIDER CANCER DECISION TO TREAT)
M	CANCER TREATMENT EVENT TYPE
M	TREATMENT START DATE (CANCER)
M	CANCER TREATMENT MODALITY
M	SITE CODE (OF PROVIDER CANCER TREATMENT START DATE)
X	CANCER TREATMENT PERIOD START DATE
X	CANCER CARE SETTING (TREATMENT)
X	CLINICAL TRIAL INDICATOR
X	DELAY REASON COMMENT (DECISION TO TREATMENT)
X	DELAY REASON (DECISION TO TREATMENT)
X	WAITING TIME ADJUSTMENT (TREATMENT)
X	WAITING TIME ADJUSTMENT REASON (TREATMENT)
X	DELAY REASON COMMENT (REFERRAL TO TREATMENT)
X	DELAY REASON REFERRAL TO TREATMENT (CANCER)
X	DELAY REASON COMMENT (CONSULTANT UPGRADE)
X	DELAY REASON (CONSULTANT UPGRADE)
M	CONSULTANT CODE
M	CARE PROFESSIONAL MAIN SPECIALTY CODE

SURGERY AND OTHER PROCEDURES - CORE

To carry surgery and other procedures details, including interventional radiology, laser treatment, endoscopies, photo-dynamic procedures, supportive care etc. One occurrence of this group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	CANCER TREATMENT INTENT
M	PROCEDURE DATE
M	PRIMARY PROCEDURE (OPCS)
R	PROCEDURE (OPCS) Multiple occurrences of this item are permitted
R	DISCHARGE DATE (HOSPITAL PROVIDER SPELL)
R	DISCHARGE DESTINATION CODE (HOSPITAL PROVIDER SPELL)

RADIOTHERAPY - CORE

To carry radiotherapy details. One occurrence of this group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
X	RADIOTHERAPY PRIORITY
X	RADIOTHERAPY INTENT
X	ANATOMICAL TREATMENT SITE (RADIOTHERAPY)
X	RADIOTHERAPY TOTAL DOSE
X	RADIOTHERAPY TOTAL FRACTIONS
R	BRACHYTHERAPY TYPE

CHEMOTHERAPY AND OTHER DRUGS - CORE

To carry details of chemotherapy and/or other anti-cancer and/or supportive drugs given to the patient during their treatment. One occurrence of this group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
X	DRUG TREATMENT INTENT
X	DRUG REGIMEN ACRONYM

ACTIVE MONITORING - CORE

To carry active monitoring details. One occurrence of this group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	MONITORING INTENT

PATHOLOGY - CORE

To carry pathology details. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
M	SERVICE REPORT IDENTIFIER
M	SERVICE REPORT STATUS
R	CARE PROFESSIONAL CODE (PATHOLOGY TEST REQUESTED BY)
R	SITE CODE (OF PATHOLOGY TEST REQUEST)
R	SAMPLE COLLECTION DATE
M	SAMPLE RECEIPT DATE
M	ORGANISATION CODE (OF REPORTING PATHOLOGIST)
M	CONSULTANT CODE (PATHOLOGIST)
M	SPECIMEN NATURE
R	TOPOGRAPHY (SNOMED)
R	MORPHOLOGY (SNOMED)
R	PRIMARY DIAGNOSIS (ICD PATHOLOGICAL)
M	TUMOUR LATERALITY (PATHOLOGICAL)
M	PATHOLOGY INVESTIGATION TYPE
R	PATHOLOGY REPORT TEXT
R	LESION SIZE (PATHOLOGICAL)
R	GRADE OF DIFFERENTIATION (PATHOLOGICAL)
R	CANCER VASCULAR OR LYMPHATIC INVASION
R	EXCISION MARGIN
R	SYNCHRONOUS TUMOUR INDICATOR
R	NUMBER OF NODES EXAMINED
R	NUMBER OF NODES POSITIVE
R	T CATEGORY (PATHOLOGICAL)
R	N CATEGORY (PATHOLOGICAL)
R	M CATEGORY (PATHOLOGICAL)
R	TNM STAGE GROUPING (PATHOLOGICAL)
R	NEOADJUVANT THERAPY INDICATOR

CANCER RECURRENCE / SECONDARY CANCER - CORE

To carry cancer recurrence and secondary cancer details. One occurrence of this group is permitted where applicable.
M/R/O/X	Data Set Data Elements
R	SOURCE OF REFERRAL (CANCER RECURRENCE)
M	KEY WORKER SEEN INDICATOR (CANCER RECURRENCE)
M	PALLIATIVE CARE SPECIALIST SEEN INDICATOR (CANCER RECURRENCE)

DEATH DETAILS - CORE

To carry death details. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	PERSON DEATH DATE
R	DEATH LOCATION TYPE
X	DEATH CAUSE IDENTIFICATION METHOD
X	DEATH CAUSE ICD CODE (IMMEDIATE)
X	DEATH CAUSE ICD CODE (CONDITION)
X	DEATH CAUSE ICD CODE (UNDERLYING)
X	DEATH CAUSE ICD CODE (SIGNIFICANT)

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CANCER OUTCOMES AND SERVICES DATA SET - GYNAECOLOGICAL

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

REFERRAL - GYNAECOLOGICAL

To carry referral details for Gynaecological cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
X	CANCER SCREENING STATUS

SURGERY AND OTHER PROCEDURES - GYNAECOLOGICAL

To carry surgery and other procedure details for Gynaecological cancer. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	CARE PROFESSIONAL SENIOR OPERATING SURGEON GRADE (CANCER)

STAGING - GYNAECOLOGICAL

To carry staging details for Gynaecological cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	FINAL FIGO STAGE

PATHOLOGY - GYNAECOLOGICAL

To carry pathology details for Gynaecological cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	MICROSCOPIC INVOLVEMENT INDICATION CODE (FALLOPIAN TUBE)
R	MICROSCOPIC INVOLVEMENT INDICATION CODE (OVARIAN)
R	MICROSCOPIC INVOLVEMENT INDICATOR (SEROSA)
R	OMENTUM INVOLVEMENT INDICATION CODE

To carry Fallopian Tube, Ovarian, Epithelial and Primary Peritoneal pathology details for Gynaecological cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	CAPSULE STATUS
R	OVARY SURFACE INVOLVEMENT INDICATOR
R	TUMOUR GRADE (GYNAECOLOGY)
R	PERITONEAL CYTOLOGY RESULT CODE
R	PERITONEAL INVOLVEMENT INDICATOR

To carry endometrial pathology details for Gynaecological cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	BACKGROUND ENDOMETRIUM ABNORMALITY INDICATION CODE
R	DISTANCE TO SEROSA
R	MICROSCOPIC INVOLVEMENT INDICATOR (CERVICAL STROMA)
R	MICROSCOPIC INVOLVEMENT INDICATOR (CERVICAL SURFACE OR GLANDS)
R	MYOMETRIAL INVASION IDENTIFICATION CODE
R	MICROSCOPIC INVOLVEMENT INDICATOR (PARAMETRIUM)
R	PERITONEAL WASHINGS IDENTIFIED

To carry cervical pathology details for Gynaecological cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	CERVICAL GLANDULAR INTRAEPITHELIAL NEOPLASIA PRESENCE AND GRADE
R	CERVICAL INTRAEPITHELIAL NEOPLASIA PRESENCE AND GRADE
R	SMILE INDICATION CODE
R	RESECTION MARGIN INVOLVEMENT INDICATOR
R	INVASIVE THICKNESS
R	PARACERVICAL OR PARAMETRIAL INVOLVEMENT INDICATOR
R	UNINVOLVED CERVICAL STROMA THICKNESS
R	MICROSCOPIC INVOLVEMENT INDICATOR (VAGINAL)

To carry vulval pathology details for Gynaecological cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	INVASIVE THICKNESS

To carry nodes pathology details for Gynaecological cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	CERVICAL NODE STATUS
R	NUMBER OF NODES EXAMINED (PARA-AORTIC)
R	NUMBER OF NODES POSITIVE (PARA-AORTIC)
R	NUMBER OF NODES EXAMINED (PELVIC)
R	NUMBER OF NODES POSITIVE (PELVIC)
R	NUMBER OF NODES EXAMINED (INGUINO-FEMORAL)
R	NUMBER OF NODES POSITIVE (INGUINO-FEMORAL)
R	EXTRANODAL SPREAD INDICATOR

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CANCER OUTCOMES AND SERVICES DATA SET - HAEMATOLOGY

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

LABORATORY RESULTS: VARIOUS - HAEMATOLOGY

To carry laboratory results, for various Haematological diseases, as specified. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PLATELETS COUNT
R	WHITE BLOOD CELL COUNT (HIGHEST PRETREATMENT)
R	HAEMOGLOBIN CONCENTRATION
R	KARYOTYPE TEST OUTCOME
R	BONE MARROW BLAST CELLS PERCENTAGE
R	NEUTROPHIL COUNT
R	ALBUMIN LEVEL
R	BETA2 MICROGLOBULIN LEVEL
R	BLOOD LYMPHOCYTE COUNT
R	LACTATE DEHYDROGENASE LEVEL
R	BLOOD MYELOBLASTS PERCENTAGE
R	BLOOD BASOPHILS PERCENTAGE
R	BLOOD EOSINOPHILS PERCENTAGE
R	CYTOGENETIC RISK CODE (ACUTE MYELOID LEUKAEMIA)

CANCER CARE PLAN: VARIOUS - HAEMATOLOGY

To carry cancer care plan details, specifically nodal details, for various Haematological diseases, as specified. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	NUMBER OF ABNORMAL NODAL AREAS
R	PRIMARY EXTRANODAL SITE
R	NUMBER OF EXTRANODAL SITES CODE

To carry cancer care plan details specific to Chronic Myeloid Leukaemia (CML). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	SPLEEN BELOW COSTAL MARGIN
R	CHRONIC MYELOID LEUKAEMIA INDEX SCORE (HASFORD)
R	CHRONIC MYELOID LEUKAEMIA INDEX SCORE (SOKAL)

To carry cancer care plan details specific to Myelodysplasia. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	INTERNATIONAL PROGNOSTIC SCORING SYSTEM SCORE

To carry cancer care plan details specific to Chronic Lymphoid Leukaemia (CLL). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	HEPATOMEGALY INDICATOR
R	SPLENOMEGALY INDICATOR
R	NUMBER OF LYMPHADENOPATHY AREAS
R	RAI STAGE
R	BINET STAGE

To carry cancer care plan details specific to Follicular Lymphoma. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	FOLLICULAR LYMPHOMA INTERNATIONAL PROGNOSTIC INDEX SCORE

To carry cancer care plan details specific to Diffuse Large B-Cell Lymphoma (DLBCL). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	REVISED INTERNATIONAL PROGNOSTIC INDEX SCORE

To carry cancer care plan details specific to Myeloma. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	INTERNATIONAL STAGING SYSTEM STAGE

To carry cancer care plan details specific to Hodgkin Lymphoma. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	HASENCLEVER INDEX SCORE

To carry cancer care plan details specific to Acute Lymphocytic Leukaemia (ALL). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	EXTRAMEDULLARY DISEASE SITE

STAGING - HAEMATOLOGY

To carry staging details, for Ann Arbor Staging Details (for Follicular Lymphoma, Diffuse Large B-Cell Lymphoma (DLBCL), Other Lymphomas, and Hodgkin Lymphoma). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	ANN ARBOR STAGE
R	ANN ARBOR SYMPTOMS INDICATOR
R	ANN ARBOR EXTRANODALITY INDICATOR
R	ANN ARBOR BULK INDICATOR

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CANCER OUTCOMES AND SERVICES DATA SET - HEAD AND NECK

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

PRE-TREATMENT ASSESSMENT - HEAD AND NECK

To carry pre-treatment assessment details for Head and Neck cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	OBSERVATION DATE (HEIGHT)
R	PERSON HEIGHT IN METRES
R	OBSERVATION DATE (WEIGHT)
R	PERSON WEIGHT
M	CANCER DENTAL ASSESSMENT DATE
R	CARE CONTACT DATE (DIETICIAN INITIAL)
R	SURGICAL VOICE RESTORATION COMMUNICATION METHOD (PLANNED POST OPERATIVE)

POST TREATMENT ASSESSMENT - HEAD AND NECK

To carry post treatment assessment details for Head and Neck cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	CLINICAL STATUS ASSESSMENT DATE (CANCER)
R	PERSON HEIGHT IN METRES
R	PERSON WEIGHT
R	PRIMARY TUMOUR STATUS
R	NODAL STATUS
R	METASTATIC STATUS
R	SURGICAL VOICE RESTORATION COMMUNICATION METHOD (PRIMARY)
R	SPEECH AND LANGUAGE ASSESSMENT DATE

PATHOLOGY: GENERAL - HEAD AND NECK

To carry general pathology details for Head and Neck cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER

PATHOLOGY: VARIOUS - HEAD AND NECK

To carry pathology details for various Head and Neck cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	MAXIMUM DEPTH OF INVASION
R	BONE INVASION INDICATION CODE
R	CARTILAGE INVASION INDICATION CODE
R	ANATOMICAL SIDE (NECK DISSECTION)

PATHOLOGY: SALIVARY TUMOUR - HEAD AND NECK

To carry pathology salivary tumour details for Head and Neck cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	HISTOLOGICAL TUMOUR GRADE (SALIVARY)
R	MACROSCOPIC EXTRAGLANDULAR EXTENSION INDICATION CODE

PATHOLOGY: GENERAL AND SALIVARY TUMOUR - HEAD AND NECK

To carry general pathology and salivary tumour details for Head and Neck cancer. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	ANATOMICAL SIDE (POSITIVE NODES)
R	LARGEST METASTASIS (LEFT NECK)
R	LARGEST METASTASIS (RIGHT NECK)
R	EXTRACAPSULAR SPREAD INDICATION CODE

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CANCER OUTCOMES AND SERVICES DATA SET - LUNG

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

IMAGING (CT SCAN) - LUNG

To carry imaging details for Computerised Tomography (CT) scans for Lung Carcinoma (to be captured once only for each care pathway). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PROCEDURE DATE (CT SCAN)
R	SCAN PERFORMED INDICATOR (CT)

IMAGING (PET SCAN) - LUNG

To carry imaging details for Positron Emission Tomography (PET) scans for Lung Carcinoma (to be captured once only for each care pathway). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PROCEDURE DATE (PET SCAN)
R	SCAN PERFORMED INDICATOR (PET)

CANCER CARE PLAN - LUNG

To carry cancer care plan details for Lung Carcinoma. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	FORCED EXPIRATORY VOLUME IN 1 SECOND (PERCENTAGE)
R	FORCED EXPIRATORY VOLUME IN 1 SECOND (ABSOLUTE AMOUNT)
R	SMOKING STATUS CODE
R	MEDIASTINAL SAMPLING INDICATOR

BRONCHOSCOPY - LUNG

To carry Bronchoscopy details for Lung Carcinoma (which informed management of the patient at the time of the Multidisciplinary Meeting). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	PROCEDURE DATE (BRONCHOSCOPY)
R	BRONCHOSCOPY PERFORMED INDICATOR

BIOMARKERS - LUNG

To carry Biomarker details for Lung Carcinoma. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	EPIDERMAL GROWTH FACTOR RECEPTOR MUTATIONAL STATUS

PATHOLOGY - LUNG

To carry Pathology details for Lung Carcinoma (only applicable where patients have had a surgical resection). Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	TUMOUR PROXIMITY TO CARINA
R	EXTENT OF ATELECTASIS
R	EXTENT OF PLEURAL INVASION
R	TUMOUR INVASION INDICATOR (PERICARDIUM)
R	TUMOUR INVASION INDICATOR (DIAPHRAGM)
R	TUMOUR INVASION INDICATOR (GREAT VESSELS)
R	TUMOUR INVASION INDICATOR (HEART)
R	MALIGNANT PLEURAL EFFUSION INDICATOR
R	SATELLITE TUMOUR NODULES LOCATION

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CANCER OUTCOMES AND SERVICES DATA SET - SARCOMA

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

DIAGNOSIS - SARCOMA

To carry diagnosis details for Sarcoma - for both Bone and Soft Tissue. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	SARCOMA TUMOUR SITE (BONE)
R	SARCOMA TUMOUR SUBSITE (BONE)
M	SARCOMA TUMOUR SITE (SOFT TISSUE)
R	SARCOMA TUMOUR SUBSITE (SOFT TISSUE)
R	MULTIFOCAL OR SYNCHRONOUS TUMOUR INDICATOR

PATHOLOGY - SARCOMA

To carry pathology details for Sarcoma - for both Bone and Soft Tissue. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	HISTOPATHOLOGICAL TUMOUR GRADE
R	GENETIC CONFIRMATION INDICATOR

To carry pathology details for Sarcoma - specific to Bone. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	TUMOUR BREACH IDENTIFIER
R	TUMOUR NECROSIS
R	TISSUE TYPE AT NEAREST MARGIN

To carry pathology details for Sarcoma - specific to Soft Tissue. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	TUMOUR DEPTH

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CANCER OUTCOMES AND SERVICES DATA SET - SKIN

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

STAGING - SKIN

To carry staging details for Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Malignant Melanoma (MM). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	AMERICAN JOINT COMMITTEE ON CANCER STAGE

GENERAL - BASAL CELL CARCINOMAS (BCC), SQUAMOUS CELL CARCINOMA (SCC), MALIGNANT MELANOMA (MM) - SKIN

To carry general details for Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Malignant Melanoma (MM). Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER
R	SKIN CANCER LESION NUMBER
R	CARE PROFESSIONAL SURGEON GRADE (CANCER)
M	SKIN SPECIMEN SITE CODE
R	SKIN CANCER LESION DIAGNOSIS

PATHOLOGY: BASAL CELL CARCINOMAS (BCC) AND SQUAMOUS CELL CARCINOMA (SCC) - SKIN

To carry pathology details for Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	PERINEURAL INVASION INDICATOR (SKIN)
M	LESION DIAMETER GREATER THAN 20MM INDICATOR
R	TUMOUR INVASION INDICATOR (PT3)
R	TUMOUR INVASION INDICATOR (PT4)

PATHOLOGY: SQUAMOUS CELL CARCINOMA (SCC) - SKIN

To carry pathology details for Squamous Cell Carcinoma (SCC). One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	CLARKS LEVEL IV INDICATOR
M	LESION VERTICAL THICKNESS GREATER THAN 2MM INDICATOR

PATHOLOGY: MALIGNANT MELANOMA (MM) - SKIN

To carry pathology details for Malignant Melanoma (MM). One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	ULCERATION INDICATOR
R	MITOTIC RATE
R	MICROSATELLITE OR IN-TRANSIT METASTASIS INDICATOR
R	TUMOUR REGRESSION INDICATOR
R	BRESLOW THICKNESS
R	TUMOUR INFILTRATING LYMPHOCYTE TYPE
M	FINAL EXCISION MARGIN AFTER WIDE LOCAL EXCISION
M	NUMBER OF SENTINEL NODES SAMPLED
M	NUMBER OF SENTINEL NODES POSITIVE
R	NUMBER OF SENTINEL NODES SAMPLED (POST SENTINEL NODE COMPLETION LYMPHADENECTOMY)
R	NUMBER OF SENTINEL NODES POSITIVE (POST SENTINEL NODE COMPLETION LYMPHADENECTOMY)

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CANCER OUTCOMES AND SERVICES DATA SET - UROLOGY

Change to Data Set: Changed Description

Cancer Outcomes and Services Data Set Overview

The Mandatory, Required, Optional or Not included in the COSDS Message (M/R/O/X) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes
X = Not included in the COSDS Message: Cancer Registries obtain the data from another source, or the item is submitted under another Standard and is included here for reference only.

For guidance on submission of the data set, see theCancer Outcomes and Services Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the Cancer Outcomes and Services Data Set XML Schema Constraints.

CANCER CARE PLAN - UROLOGY

To carry cancer care plan details for Urology cancer. One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
R	~~ESTIMATED GLOMERULAR FILTRATION RATE dog~~
R	ESTIMATED GLOMERULAR FILTRATION RATE
R	HYDRONEPHROSIS CODE
R	LACTATE DEHYDROGENASE LEVEL (NORMAL UPPER LIMIT)
R	S CATEGORY CODE
R	S CATEGORY (ALPHA FETOPROTEIN)
R	S CATEGORY (HUMAN CHORIONIC GONADOTROPIN)
R	S CATEGORY (LACTATE DEHYDROGENASE)
R	PROSTATE SPECIFIC ANTIGEN (DIAGNOSIS)

STAGING: TESTICULAR - UROLOGY

To carry staging details for Urology cancer (Testicular). One occurrence of this group is permitted.
M/R/O/X	Data Set Data Elements
M	STAGE GROUPING (TESTICULAR CANCER)
R	EXTENT OF METASTATIC SPREAD Multiple occurrences of this item are permitted
R	LUNG METASTASES SUB-STAGE GROUPING

TREATMENT: BLADDER - UROLOGY

To carry treatment details for Urology cancer for bladder. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	INTRAVESICAL CHEMOTHERAPY RECEIVED INDICATOR or INTRAVESICAL IMMUNOTHERAPY RECEIVED INDICATOR

TREATMENT: PROSTATE - UROLOGY

To carry cancer treatment details for Urology cancer for prostate. One occurrence of this data group is permitted per treatment where applicable.
M/R/O/X	Data Set Data Elements
M	PROSTATE SPECIFIC ANTIGEN (PRE-TREATMENT)

PATHOLOGY - UROLOGY

To carry general pathology details for Urology cancer. Multiple occurrences of this group are permitted.
M/R/O/X	Data Set Data Elements
M	INVESTIGATION RESULT DATE
R	SERVICE REPORT IDENTIFIER

To carry pathology details for Urology cancer for bladder. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	DETRUSOR MUSCLE PRESENCE INDICATION CODE

To carry pathology details for Urology cancer for kidney. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	TUMOUR NECROSIS INDICATOR
R	TUMOUR INVASION INDICATOR (PERINEPHRIC FAT)
R	TUMOUR INVASION INDICATOR (ADRENAL)
R	RENAL VEIN TUMOUR INDICATOR
R	TUMOUR INVASION INDICATOR (GEROTAS FASCIA)

To carry pathology details for Urology cancer for penis. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	TUMOUR INVASION INDICATOR (CORPUS SPONGIOSUM)
R	TUMOUR INVASION INDICATOR (CORPUS CAVERNOSUM)
R	TUMOUR INVASION INDICATOR (URETHRA OR PROSTATE)

To carry pathology details for Urology cancer for prostate. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	GLEASON GRADE (PRIMARY)
R	GLEASON GRADE (SECONDARY)
R	GLEASON GRADE (TERTIARY)
R	PERINEURAL INVASION INDICATOR (UROLOGY)
R	ORGAN CONFINED INDICATOR
R	TUMOUR INVASION INDICATOR (SEMINAL VESICLES)
R	TURP TUMOUR PERCENTAGE

To carry pathology details for Urology cancer for bladder. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
M	TUMOUR GRADE (UROLOGY)

To carry pathology details for Urology cancer for testicular. One occurrence of this data group is permitted per pathology report where applicable.
M/R/O/X	Data Set Data Elements
R	TUMOUR INVASION INDICATOR (RETE TESTIS)

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CHILD AND ADOLESCENT MENTAL HEALTH SERVICES SECONDARY USES DATA SET

Change to Data Set: Changed Description

Child and Adolescent Mental Health Services Secondary Uses Data Set Overview

~~The~~ ~~Child and Adolescent Mental Health Services Secondary Uses Data Set~~ ~~has been incorporated early to allow users to see the changes, but please note that the mandated from date is~~ ~~1 April 2013~~.

The Mandatory or Required (M/R) column indicates the recommendation for the inclusion of data:

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element.

DEMOGRAPHICS, BACKGROUND AND MEDICATION

Master Patient Index and Risk Indicators: To carry the demographic and background details for the patient. One occurrence of this group is required.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	ORGANISATION CODE (LOCAL PATIENT IDENTIFIER)
M	ORGANISATION CODE (CODE OF PROVIDER)
M	ORGANISATION CODE (CODE OF COMMISSIONER)
R	NHS NUMBER
R	NHS NUMBER STATUS INDICATOR CODE
R	POSTCODE OF USUAL ADDRESS
R	PERSON BIRTH DATE
R	PERSON GENDER CODE CURRENT
R	ETHNIC CATEGORY
R	RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION GROUP CODE
R	DFES ESTABLISHMENT NUMBER
R	GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
R	ATTEMPTED SUICIDE WITH INTENT INDICATOR
R	YOUNG CARER INDICATOR
R	CHILD PROTECTION PLAN INDICATOR
R	ORGANISATION CODE (RESPONSIBLE LOCAL AUTHORITY)
R	LOOKED AFTER CHILD INDICATOR
R	LEARNING DISABILITY INDICATOR
R	LEARNING DIFFICULTY INDICATOR

Accommodation Status: To carry details of the accommodation status of the patient. Multiple occurrences of this group are required, one for each accommodation status recorded.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	ACCOMMODATION STATUS DATE
M	ACCOMMODATION STATUS (MENTAL HEALTH)

Family: To carry details of the people with whom the patient is living. Multiple occurrences of this group are permitted, one for each person with whom the patient is living.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	RELATIONSHIP TO PERSON FOR CHILDREN AND YOUNG PEOPLE

Medication: To carry details of any medication prescribed. Multiple occurrences of this group are permitted, one for each type of prescribed medication.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	PRESCRIPTION DATE
M	PRESCRIBED MEDICATION TYPE (CHILD AND ADOLESCENT MENTAL HEALTH)

LEGAL STATUS

Mental Health Act Event Episode: To carry the Mental Health Act Event Episodes of the patient. Multiple occurrences of this group are permitted, one for each Mental Health Act Event Episode that the patient is subject to.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
M	START TIME (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
R	EXPIRY DATE (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
R	EXPIRY TIME (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
R	END DATE (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
R	END TIME (MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION)
R	MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION CODE
R	MENTAL HEALTH ACT 2007 MENTAL CATEGORY

Supervised Community Treatment: To carry the details of each separate period of Supervised Community Treatment for the patient. Multiple occurrences of this group are permitted, one for each period of Supervised Community Treatment for the patient.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (SUPERVISED COMMUNITY TREATMENT)
R	EXPIRY DATE (SUPERVISED COMMUNITY TREATMENT)
R	END DATE (SUPERVISED COMMUNITY TREATMENT)
R	SUPERVISED COMMUNITY TREATMENT END REASON

Supervised Community Treatment Recall: To carry the details of each separate period of recall into hospital for a patient on Supervised Community Treatment. Multiple occurrences of this group are permitted, one for each period of recall into hospital for the patient.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (SUPERVISED COMMUNITY TREATMENT RECALL)
M	START TIME (SUPERVISED COMMUNITY TREATMENT RECALL)
R	END DATE (SUPERVISED COMMUNITY TREATMENT RECALL)
R	END TIME (SUPERVISED COMMUNITY TREATMENT RECALL)

Leave of Absence: To carry the details of each separate period of Mental Health Leave of Absence involving an overnight stay for the patient Multiple occurrences of this group are permitted, one for each period of Mental Health Leave of Absence for the patient.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (MENTAL HEALTH LEAVE OF ABSENCE)
R	END DATE (MENTAL HEALTH LEAVE OF ABSENCE)
R	LEAVE OF ABSENCE END REASON

Absence Without Leave: To carry the details of each separate period of Mental Health Absence Without Leave for the patient. Multiple occurrences of this group are permitted, one for each period of Mental Health Absence Without Leave for the patient.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (MENTAL HEALTH ABSENCE WITHOUT LEAVE)
R	END DATE (MENTAL HEALTH ABSENCE WITHOUT LEAVE)
R	ABSENCE WITHOUT LEAVE END REASON

CAMHS REFERRAL AND DISCHARGE FROM SERVICE

CAMHS Referral: To carry details of the referral to and discharge from the Child and Adolescent Mental Health Service. One occurrence of this group is permitted.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	LOCAL PATIENT IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	REFERRAL REQUEST RECEIVED DATE
R	SOURCE OF REFERRAL FOR MENTAL HEALTH
R	CLINICAL RESPONSE PRIORITY TYPE
R	APPOINTMENT DATE (FIRST OFFERED)
R	APPOINTMENT DECLINED INDICATOR
R	DISCHARGE DATE (MENTAL HEALTH SERVICE)
R	DISCHARGE REASON (MENTAL HEALTH SERVICE)

Service Type Requested on Referral: To carry details of the type of service requested from the Child and Adolescent Mental Health Service. Multiple occurrences of this group are required, one for each type of requested service.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	SERVICE TYPE REQUESTED (CHILD AND ADOLESCENT MENTAL HEALTH)

Status of Service Request: To carry the status of the service request to the Child and Adolescent Mental Health Service. Multiple occurrences of this group are required, one for each service request status.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	SERVICE REQUEST STATUS DATE (MENTAL HEALTH)
M	STATUS OF SERVICE REQUEST (MENTAL HEALTH)

CAMHS ENCOUNTERS

CAMHS Contact: To carry details of contacts with the Child and Adolescent Mental Health Service. Multiple occurrences of this group are permitted, one for each contact with the patient.
M/R	Data Set Data Elements
M	ATTENDANCE IDENTIFIER
M	APPOINTMENT DATE
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
R	CLINICAL CONTACT DURATION OF APPOINTMENT
R	APPOINTMENT PURPOSE (CHILD AND ADOLESCENT MENTAL HEALTH)
R	ACTIVITY LOCATION TYPE CODE
R	SITE CODE (OF APPOINTMENT)
R	ATTENDED OR DID NOT ATTEND CODE

Care Professional at CAMHS Contact: To carry details of the care professionals contact at each contact. Multiple occurrences of this group are permitted, one for each care professional.
M/R	Data Set Data Elements
M	ATTENDANCE IDENTIFIER
M	APPOINTMENT DATE
M	SERVICE REQUEST IDENTIFIER
M	CARE PROFESSIONAL GROUP TYPE (CHILD AND ADOLESCENT MENTAL HEALTH)
R	DATE FIRST ENCOUNTERED PATIENT

Intervention at CAMHS Contact: To carry details of the type of Intervention at each contact. Multiple occurrences of this group are permitted, one for each care professional.
M/R	Data Set Data Elements
M	ATTENDANCE IDENTIFIER
M	APPOINTMENT DATE
M	SERVICE REQUEST IDENTIFIER
M	INTERVENTION TYPE (CHILD AND ADOLESCENT MENTAL HEALTH)

CARE PLANNING

Care Programme Approach (CPA) Care Episode: To carry details of Care Programme Approach Care episodes for the patient. Multiple occurrences of this group are permitted, one for each Care Programme Approach Care Episode.
M/R	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER
M	START DATE (CARE PROGRAMME APPROACH CARE)
R	END DATE (CARE PROGRAMME APPROACH CARE)

CAMHS Care Team: To carry details of Child and Adolescent Mental Health Care Teams responsible for the patients care. Multiple occurrences of this group are permitted, one for each Child and Adolescent Mental Health Care Team taking responsibility for the patient's care.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	CHILD AND ADOLESCENT MENTAL HEALTH CARE TEAM TYPE
M	CARE PROFESSIONAL TEAM START DATE
R	CARE PROFESSIONAL TEAM END DATE
R	CHILD AND ADOLESCENT MENTAL HEALTH TIER OF SERVICE

OUTCOMES

Strengths and Difficulties Questionnaire: To carry details of Strengths and Difficulties Questionnaire (SDQ) outcome measures. Multiple occurrences of this group are permitted, one for each Strengths and Difficulties Questionnaire (SDQ) outcome measure recorded.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	ASSESSMENT TOOL COMPLETION DATE
R	STRENGTHS AND DIFFICULTIES QUESTIONNAIRE VERSION
R	ASSESSMENT TOOL COMPLETION POINT
R	STRENGTHS AND DIFFICULTIES HYPERACTIVITY SCALE SCORE
R	STRENGTHS AND DIFFICULTIES EMOTIONAL PROBLEMS SCALE SCORE
R	STRENGTHS AND DIFFICULTIES CONDUCT PROBLEMS SCALE SCORE
R	STRENGTHS AND DIFFICULTIES PEER PROBLEMS SCALE SCORE
R	STRENGTHS AND DIFFICULTIES PROSOCIAL BEHAVIOUR SCALE SCORE
R	STRENGTHS AND DIFFICULTIES TOTAL IMPACT SCORE

Experience of Service Questionnaire: To carry details of Experience of Service Questionnaire (ESQ) outcome measures. Multiple occurrences of this group are permitted, one for each Experience of Service (ESQ) outcome measure recorded.
M/R	Data Set Data Elements
M	ORGANISATION CODE (CODE OF PROVIDER)
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	ASSESSMENT TOOL COMPLETION DATE
R	EXPERIENCE OF SERVICE QUESTIONNAIRE VERSION
R	ASSESSMENT TOOL COMPLETION POINT
R	EXPERIENCE OF SERVICE QUESTION 1 SCORE
R	EXPERIENCE OF SERVICE QUESTION 2 SCORE
R	EXPERIENCE OF SERVICE QUESTION 3 SCORE
R	EXPERIENCE OF SERVICE QUESTION 4 SCORE
R	EXPERIENCE OF SERVICE QUESTION 5 SCORE
R	EXPERIENCE OF SERVICE QUESTION 6 SCORE
R	EXPERIENCE OF SERVICE QUESTION 7 SCORE
R	EXPERIENCE OF SERVICE QUESTION 8 SCORE
R	EXPERIENCE OF SERVICE QUESTION 9 SCORE
R	EXPERIENCE OF SERVICE QUESTION 10 SCORE
R	EXPERIENCE OF SERVICE QUESTION 11 SCORE
R	EXPERIENCE OF SERVICE QUESTION 12 SCORE

Health of the National Outcome Scale for Child and Adolescent: To carry details of Health of the Nation Outcome Scale - Child and Adolescent (HONOS-CA) outcome measures. Multiple occurrences of this group are permitted, one for each Health of the Nation Outcome Scale - Child and Adolescent (HONOS-CA) outcome measure recorded.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	ASSESSMENT TOOL COMPLETION DATE
R	HONOS-CA VERSION
R	ASSESSMENT TOOL COMPLETION POINT
R	HONOS-CA RATING 1 SCORE
R	HONOS-CA RATING 2 SCORE
R	HONOS-CA RATING 3 SCORE
R	HONOS-CA RATING 4 SCORE
R	HONOS-CA RATING 5 SCORE
R	HONOS-CA RATING 6 SCORE
R	HONOS-CA RATING 7 SCORE
R	HONOS-CA RATING 8 SCORE
R	HONOS-CA RATING 9 SCORE
R	HONOS-CA RATING 10 SCORE
R	HONOS-CA RATING 11 SCORE
R	HONOS-CA RATING 12 SCORE
R	HONOS-CA RATING 13 SCORE
R	HONOS-CA RATING B14 SCORE
R	HONOS-CA RATING B15 SCORE

Children's Global Assessment Scale Outcome: To carry details of Children's Global Assessment Scale (CGAS) outcome measures. Multiple occurrences of this group are permitted, one for each Children's Global Assessment Scale (CGAS) outcome measure recorded.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	ASSESSMENT TOOL COMPLETION DATE
R	ASSESSMENT TOOL COMPLETION POINT
R	CHILDRENS GLOBAL ASSESSMENT SCALE SCORE
R	CHILDRENS GLOBAL ASSESSMENT SCALE SCORE RANGE CODE

Other Assessment Tool: To carry details of other types of assessment tool completed during the Child and Adolescent Mental Health Care Spell. Multiple occurrences of this group are permitted, one for each assessment tool type completed.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	OTHER ASSESSMENT TOOL TYPE COMPLETED
M	ASSESSMENT TOOL COMPLETION DATE
R	ASSESSMENT TOOL COMPLETION POINT

INTERVENTIONS

Intervention Episode: To carry details of the Child and Adolescent Mental Health Clinical Intervention Episodes delivered to the patient. Multiple occurrences of this group are permitted, one for each episode delivered.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	INTERVENTION TYPE (CHILD AND ADOLESCENT MENTAL HEALTH)
M	START DATE (CHILD AND ADOLESCENT MENTAL HEALTH CLINICAL INTERVENTION EPISODE)
R	END DATE (CHILD AND ADOLESCENT MENTAL HEALTH CLINICAL INTERVENTION EPISODE)

HOSPITAL PROVIDER SPELLS

Hospital Provider Spell: To carry details of Hospital Provider Spells. Multiple occurrences of this group are permitted, one for each Hospital Provider Spell.
M/R	Data Set Data Elements
M	HOSPITAL PROVIDER SPELL NUMBER
M	SERVICE REQUEST IDENTIFIER
M	ORGANISATION CODE (CODE OF COMMISSIONER)
M	START DATE (HOSPITAL PROVIDER SPELL)
R	CHILD AND ADOLESCENT MENTAL HEALTH ADMISSION SETTING
R	DISCHARGE DATE (HOSPITAL PROVIDER SPELL)
R	DISCHARGE METHOD CODE (HOSPITAL PROVIDER SPELL)
R	DISCHARGE DESTINATION CODE (HOSPITAL PROVIDER SPELL)

Ward Stay: To carry details of Ward Stays during each Hospital Provider Spell. Multiple occurrences of this group are permitted, one for each Ward Stay within the Hospital Provider Spell.
M/R	Data Set Data Elements
M	HOSPITAL PROVIDER SPELL NUMBER
M	START DATE (WARD STAY)
R	END DATE (WARD STAY)
R	SITE CODE (OF TREATMENT)
R	SEX OF PATIENTS CODE
R	INTENDED AGE GROUP
R	INTENDED CLINICAL CARE INTENSITY CODE (MENTAL HEALTH)
R	WARD SECURITY LEVEL

DIAGNOSES

Provisional Diagnosis: To carry details of provisional diagnoses made. Multiple occurrences of this group are required, one for each provisional diagnosis made.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	PROVISIONAL DIAGNOSIS DATE
M	PROVISIONAL DIAGNOSIS (ICD)

Primary Diagnosis: To carry details of the primary diagnoses made. One occurrence of this group is required.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	DIAGNOSIS DATE
M	PRIMARY DIAGNOSIS (ICD)

Secondary Diagnosis: To carry details of any secondary diagnoses made. Multiple occurrences of this group are required, one for each secondary diagnosis made.
M/R	Data Set Data Elements
M	SERVICE REQUEST IDENTIFIER
M	DIAGNOSIS DATE
M	SECONDARY DIAGNOSIS (ICD)

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CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES DATA SET

Change to Data Set: Changed Description

Children and Young People's Health Service Secondary Uses Data Set Overview

~~The~~ ~~Children and Young People's Health Service Secondary Uses Data Set~~ ~~has been incorporated early to allow users to see the changes, but please note that the implementation date is~~ ~~1 April 2013~~.

The Mandatory, Required or Optional (M/R/O) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes.

In addition to the information detailed below, each Data Set submission contains the following Data Set Rows:

Data Set File Header Row
Data Set Segment Row(s)
Data Set File Footer Row

For guidance on the content of the Data Set Rows, see the Maternity and Childrens Data Sets Submission Requirements.

PERSONAL AND DEMOGRAPHIC DETAILS

Child's or Young Person's details: To carry the personal details of the child or young person. One occurrence of this group is required.
M/R/O	Data Set Data Elements
R	NHS NUMBER
M	NHS NUMBER STATUS INDICATOR CODE
M	PERSON GENDER CODE AT REGISTRATION
R	PERSON BIRTH DATE
R	LOCAL PATIENT IDENTIFIER
R	ORGANISATION CODE (LOCAL PATIENT IDENTIFIER)
R	POSTCODE OF USUAL ADDRESS
R	ORGANISATION CODE (PCT OF RESIDENCE)
R	LANGUAGE
R	ETHNIC CATEGORY

Child's or Young Person's Death: To carry details in the event of the death of the child or young person. One occurrence of this group is required.
M/R/O	Data Set Data Elements
M	PERSON DEATH DATE AND TIME

Child's or Young Person's GP Practice: To carry details of the GP Practice Registration of the child or young person. One occurrence of this group is required for each change.
M/R/O	Data Set Data Elements
R	GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
R	START DATE (GMP PATIENT REGISTRATION)
R	END DATE (GMP PATIENT REGISTRATION)
R	ORGANISATION CODE (PCT OF GP PRACTICE)

SOCIAL AND PERSONAL CIRCUMSTANCES

Child's or Young Person's Accommodation: To carry the accommodation details of the child's or young person's accommodation. One occurrence of this group is required for each assessment.
M/R/O	Data Set Data Elements
R	ACCOMMODATION STATUS CODE

Child's or Young Person's Social Services Status: To carry details of social services care plans. One occurrence of this group is required for each change.
M/R/O	Data Set Data Elements
R	LOOKED AFTER CHILD INDICATOR

Child's or Young Person's Education Assessment details: To carry details of the child's or young person's education assessment. One occurrence of this group is required for each change.
M/R/O	Data Set Data Elements
R	EDUCATIONAL ASSESSMENT OUTCOME (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)
R	SPECIAL EDUCATIONAL NEED TYPE

Child's or Young Person's Child Protection details: To carry details when the child is subject to a child protection plan. One occurrence of this group is required for each plan.
M/R/O	Data Set Data Elements
O	CHILD PROTECTION PLAN REASON CODE
O	CARE PLAN START DATE (CHILD PROTECTION PLAN)
O	CARE PLAN END DATE (CHILD PROTECTION PLAN)

Child's or Young Person's Safeguarding Concern details: To carry details when the child is subject to any safeguarding concerns. One occurrence of this group is required for each safeguarding concern.
M/R/O	Data Set Data Elements
O	SAFEGUARDING VULNERABILITY FACTORS INDICATOR
O	SAFEGUARDING VULNERABILITY FACTORS TYPE

RELATIONSHIPS AND HOUSEHOLD

Child's or Young Person's Carer's details: To carry details of the main carer(s) of the child or young person. One occurrence of this group is required and on any change in circumstances.
M/R/O	Data Set Data Elements
R	PERSON RELATIONSHIP (MAIN CARER)

Child's or Young Person's Mother's details: To carry details of the mother of the child/young person. One occurrence of this group is required.
M/R/O	Data Set Data Elements
R	NHS NUMBER (MOTHER)
M	NHS NUMBER STATUS INDICATOR CODE (MOTHER)

BREASTFEEDING AND NUTRITION

Child's Breastfeeding details: To capture a child's breastfeeding details. One occurrence of this group is required whenever observed.
M/R/O	Data Set Data Elements
R	BREASTFEEDING STATUS
R	OBSERVATION DATE (BREASTFEEDING STATUS)

CARE EVENTS

Child's or Young Person's Care Activity: To carry the details of any care activity attended by or undertaken on behalf of a child or young person. One occurrence of this group is required for each activity.
M/R/O	Data Set Data Elements
M	REFERRAL REQUEST RECEIVED DATE
M	ACTIVITY DATE (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)
M	CARE CONTACT TYPE (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)
M	CARE CONTACT SERVICE TYPE (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)
M	CONSULTATION MEDIUM USED
M	ORGANISATION CODE (CODE OF PROVIDER)
R	SITE CODE (OF TREATMENT)
R	ACTIVITY LOCATION TYPE CODE
R	POSTCODE OF LOCATION OF CARE ACTIVITY
R	ATTENDED OR DID NOT ATTEND CODE
R	FOLLOW UP CONTACT ATTEMPTED INDICATOR
R	OUTCOME OF ATTENDANCE (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)
R	INTERPRETER REQUIRED INDICATOR

Child's or Young Person's Immunisation Activity: To carry the details of any Immunisation activity given to a child or young person. One occurrence of this group is required for each activity.
M/R/O	Data Set Data Elements
M	CHILDHOOD IMMUNISATION TYPE Multiple occurrences of this item are permitted
M	IMMUNISATION DATE Multiple occurrences of this item are permitted
M	ORGANISATION CODE (IMMUNISATION RESPONSIBLE ORGANISATION) Multiple occurrences of this item are permitted

Newborn Hearing Screening Follow Up: To carry the details of how concerns following newborn hearing screening are followed up. One occurrence of this group is required if concerns are identified.
M/R/O	Data Set Data Elements
M	NEWBORN HEARING SCREENING OUTCOME
M	SERVICE REQUEST DATE (NEWBORN HEARING AUDIOLOGY)
R	NEWBORN HEARING AUDIOLOGY OUTCOME

6- 8 Week Physical Examination: To carry the details of the 6- 8 week physical examination. One occurrence of this group is required.
M/R/O	Data Set Data Elements
M	SCREENING DATE (6 - 8 WEEK PHYSICAL EXAMINATION)
R	GESTATION LENGTH (AT 6 - 8 WEEK PHYSICAL EXAMINATION)
R	6 - 8 WEEK PHYSICAL EXAMINATION RESULT (HIPS)
R	6 - 8 WEEK PHYSICAL EXAMINATION RESULT (HEART)
R	6 - 8 WEEK PHYSICAL EXAMINATION RESULT (EYES)
R	6 - 8 WEEK PHYSICAL EXAMINATION RESULT (TESTES)
R	BREASTFEEDING STATUS (6 - 8 WEEK)

Child's or Young Person's Urgent Care Activity: To carry the details of any urgent care required by a child or young person. One occurrence of this group is required for each urgent care activity.
M/R/O	Data Set Data Elements
R	URGENT CARE SERVICE ACCESSED TYPE
M	URGENT CARE SERVICE ACCESSED DATE AND TIME
R	INCIDENT TYPE
R	INJURY TYPE (CHILDREN AND YOUNG PEOPLE'S HEALTH SERVICE SECONDARY USES)

Newborn Blood Spot Tests Follow Up: To carry the details of activities following newborn blood spot tests. One occurrence of this group is required if concerns are identified.
M/R/O	Data Set Data Elements
R	NEWBORN BLOOD SPOT TEST OUTCOME STATUS CODE (PHENYLKETONURIA)
R	NEWBORN BLOOD SPOT TEST OUTCOME STATUS CODE (SICKLE CELL DISEASE)
R	NEWBORN BLOOD SPOT TEST OUTCOME STATUS CODE (CYSTIC FIBROSIS)
R	NEWBORN BLOOD SPOT TEST OUTCOME STATUS CODE (CONGENITAL HYPOTHYROIDISM)
R	NEWBORN BLOOD SPOT TEST OUTCOME STATUS CODE (MEDIUM CHAIN ACYL-COA DEHYDROGENASE DEFICIENCY)

ADMITTED PATIENT CARE

Child's or Young Person's Care Inpatient Admission: To carry the details of any inpatient care admission of a child or young person. One occurrence of this group is required for each activity.
M/R/O	Data Set Data Elements
M	ORGANISATION CODE (CODE OF PROVIDER)
M	HOSPITAL PROVIDER SPELL NUMBER
M	START DATE (HOSPITAL PROVIDER SPELL)
R	START TIME (HOSPITAL PROVIDER SPELL)

Child's or Young Person's Care Inpatient Discharge: To carry the details of any inpatient discharges of a child or young person. One occurrence of this group is required for each admission.
M/R/O	Data Set Data Elements
M	HOSPITAL PROVIDER SPELL NUMBER
R	DISCHARGE DATE (HOSPITAL PROVIDER SPELL)
R	PRIMARY DIAGNOSIS (ICD)
R	SECONDARY DIAGNOSIS (ICD) Multiple occurrences of this item are permitted

Child's or Young Person's Care Procedure: To carry the details of any procedure during a Hospital Provider Spell carried out on a child or young person. One occurrence of this group is required for each procedure.
M/R/O	Data Set Data Elements
M	HOSPITAL PROVIDER SPELL NUMBER
R	PRIMARY PROCEDURE (OPCS)
R	PRIMARY PROCEDURE DATE

OBSERVATIONS

Child's or Young Person's Observations: To carry the details of observations of a child or young person. One occurrence of this group is required for each observation.
M/R/O	Data Set Data Elements
R	PERSON OBSERVATION DATE AND TIME
R	PERSON WEIGHT
R	PERSON HEIGHT IN METRES
R	BODY MASS INDEX

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HIV AND AIDS REPORTING DATA SET

Change to Data Set: Changed Description

HIV and AIDS Reporting Data Set Overview

~~The~~ ~~HIV and AIDS Reporting Data Set~~ ~~has been incorporated early to allow users to see the changes, but please note that the implementation date is~~ ~~1 April 2013~~.

The Mandatory, Required or Optional (M/R/O) column indicates the recommendation for the inclusion of data.

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element
O = Optional: the inclusion of this data element is optional as required for local purposes.

For guidance on submission of the data set, see the HARS Data Set Submission Requirements.

For guidance on the XML Schema constraints, see the HIV and AIDS Reporting Data Set XML Schema Constraints.

PERSONAL AND DEMOGRAPHIC

To carry personal and demographic details for the patient. One occurrence of this group is required.
M/R/O	Data Set Data Elements
M	LOCAL PATIENT IDENTIFIER (EXTENDED)
R	GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
R	PATIENT CONSENT OBTAINED INDICATOR (CARE PROFESSIONAL CONTACT)
M	PERSON SURNAME SOUNDEX CODE
R	PERSON INITIAL (FIRST)
R	PERSON BIRTH DATE
M	PERSON GENDER CODE AT REGISTRATION
M	GENDER IDENTITY CODE (HIV)
R	ETHNIC CATEGORY
R	COUNTRY CODE (BIRTH)
M	LOWER LAYER SUPER OUTPUT AREA (RESIDENCE)
R	PRISONER INDICATOR
R	SEX WORKER INDICATOR
R	DISABILITY CODE Multiple occurrences of this item are permitted

SERVICE INFORMATION

To carry service information details for the patient. One occurrence of this group is permitted.
M/R/O	Data Set Data Elements
M	ORGANISATION CODE (CODE OF PROVIDER)
M	SITE CODE (OF TREATMENT)
M	PATIENT HIV CARE STATUS
R	SITE CODE (OF PREVIOUS HIV CARE)
R	SITE CODE (REFERRED TO FOR HIV CARE)

HIV CLINIC ATTENDANCE

To carry clinic attendance details for the patient. One occurrence of this group is required.
M/R/O	Data Set Data Elements
R	CONSULTATION MEDIUM USED
R	CLINIC ATTENDANCE PURPOSE CODE (HIV)
M	ATTENDANCE DATE

DIAGNOSIS

To carry diagnosis details for the patient. One occurrence of this group is required.
M/R/O	Data Set Data Elements
M	NEW HIV DIAGNOSIS IN UNITED KINGDOM INDICATOR
R	DIAGNOSIS DATE IN UNITED KINGDOM (HIV)
O	YEAR OF DIAGNOSIS OUTSIDE UNITED KINGDOM (HIV)
M	DATE FIRST SEEN
M	PATIENT EXPOSURE TO HIV
R	COUNTRY CODE (HIV INFECTION)
R	YEAR OF UK ENTRY
R	INITIAL DIAGNOSIS CARE SETTING (HIV)
R	PREVIOUS NEGATIVE HIV TEST IN UNITED KINGDOM INDICATOR
R	YEAR AND MONTH OF LAST NEGATIVE HIV TEST IN UNITED KINGDOM
R	PATIENT DIAGNOSIS INDICATOR (SEROCONVERSION ILLNESS)
R	TEST OF RECENT INFECTION RESULT (HIV)
O	NUMBER OF HIV CONTACTS
O	NUMBER OF HIV CONTACTABLE CONTACTS
O	NUMBER OF HIV CONTACTABLE CONTACTS TESTED FOR HIV

TREATMENT

To carry treatment details for the patient. One occurrence of this group is permitted.
M/R/O	Data Set Data Elements
M	FIRST ANTIRETROVIRAL THERAPY IN UNITED KINGDOM INDICATOR
R	YEAR AND MONTH FIRST STARTED ANTIRETROVIRAL THERAPY
R	START DATE (ANTIRETROVIRAL THERAPY AT CURRENT PROVIDER)
R	POST AND/OR PRE EXPOSURE PROPHYLAXIS CODE
R	ANTIRETROVIRAL THERAPY DRUG PRESCRIBED CODE Multiple occurrences of this item are permitted
M	ANTIRETROVIRAL THERAPY GROUP CODE
R	ANTIRETROVIRAL THERAPY HOME DELIVERY INDICATOR
R	CLINICAL TRIAL INDICATOR

CLINICAL INFORMATION

To carry clinical information details for the patient. One occurrence of this group is required.
M/R/O	Data Set Data Elements
M	CD4 CELL COUNT PERFORMED INDICATOR
R	CD4 CELL COUNT
M	VIRAL LOAD COUNT PERFORMED INDICATOR
R	VIRAL LOAD COUNT
R	AIDS DEFINING ILLNESS TYPE Multiple occurrences of this item are permitted
M	TUBERCULOSIS TREATMENT INDICATOR (HIV)
M	CHRONIC VIRAL LIVER DISEASE INDICATOR (HIV)
M	HEPATITIS B INFECTION INDICATOR
M	HEPATITIS C INFECTION INDICATOR
M	MALIGNANCY TREATMENT INDICATOR (HIV)
M	PATIENT DIAGNOSIS INDICATOR (HIV END ORGAN DISEASE)
M	PSYCHIATRIC CARE INDICATOR (HIV)
M	PREGNANCY INDICATOR (HIV)
M	SOCIAL WORKER CARE INDICATOR (HIV)

DEATH

To carry death details for the patient. One occurrence of this group is permitted.
M/R/O	Data Set Data Elements
R	PERSON DEATH DATE
R	DEATH CAUSE ICD CODE (CONDITION) Multiple occurrences of this item are permitted

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MATERNITY SERVICES SECONDARY USES DATA SET

Change to Data Set: Changed Description

Maternity Services Secondary Uses Data Set Overview

~~The~~ ~~Maternity Services Secondary Uses Data Set~~ ~~has been incorporated early to allow users to see the changes, but please note that the implementation date is~~ ~~1 April 2013~~.

The Mandatory or Required (M/R) column indicates the recommendation for the inclusion of data:

M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present
R = Required: NHS business processes cannot be delivered without this data element

In addition to the information detailed below, each Data Set submission contains the following Data Set Rows:

Data Set File Header Row
Data Set Segment Row(s)
Data Set File Footer Row

For guidance on the content of the Data Set Rows, see the Maternity and Childrens Data Sets Submission Requirements.

BOOKING AND DATING SCAN

Mother's Demographics: To carry the demographic details of the mother's Maternity Episode. One occurrence of this group is permitted.
M/R	Data Set Data Elements
M	NHS NUMBER (MOTHER)
M	NHS NUMBER STATUS INDICATOR CODE (MOTHER)
M	PERSON BIRTH DATE (MOTHER)
M	ETHNIC CATEGORY (MOTHER)
R	LOCAL PATIENT IDENTIFIER (MOTHER)
M	ORGANISATION CODE (LOCAL PATIENT IDENTIFIER (MOTHER))
M	POSTCODE OF USUAL ADDRESS (MOTHER)
M	GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION (MOTHER))

Mother's Booking Appointment Details: To carry the personal, social and other details of the mother at the formal antenatal booking appointment. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PHYSICAL DISABILITY STATUS INDICATOR (MOTHER AT BOOKING)
R	FIRST LANGUAGE ENGLISH INDICATOR (MOTHER AT BOOKING)
R	EMPLOYMENT STATUS (MOTHER AT BOOKING)
R	SUPPORT STATUS (MOTHER AT BOOKING)

Partner's Demographics at Booking: To carry the personal, social and other details of the mother's partner at the formal antenatal booking appointment. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	EMPLOYMENT STATUS (PARTNER AT BOOKING)

Previous Pregnancies Summary: To carry the totals of previous pregnancies. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PREGNANCY PREVIOUS CAESAREAN SECTIONS
R	PREGNANCY TOTAL PREVIOUS LIVE BIRTHS
R	PREGNANCY TOTAL PREVIOUS STILLBIRTHS
R	PREGNANCY TOTAL PREVIOUS LOSSES LESS THAN 24 WEEKS

Pregnancy: To carry details of the mother's contact with the NHS for antenatal care. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PREGNANCY FIRST CONTACT DATE
R	CARE PROFESSIONAL TYPE CODE (PREGNANCY FIRST CONTACT)
R	LAST MENSTRUAL PERIOD DATE
R	APPOINTMENT DATE (FORMAL ANTENATAL BOOKING)
M	ESTIMATED DATE OF DELIVERY (AGREED)
R	ESTIMATED DATE OF DELIVERY METHOD (AGREED)

Mother's Health Observations at Booking: To carry observations of the mother at formal antenatal booking appointment. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	SUBSTANCE USE STATUS (MOTHER AT BOOKING)
R	SMOKING STATUS (MOTHER AT BOOKING)
R	CIGARETTES PER DAY (MOTHER AT BOOKING)
R	WEEKLY ALCOHOL UNITS (MOTHER AT BOOKING)
R	STATUS OF FOLIC ACID SUPPLEMENT (MOTHER AT BOOKING)
R	MENTAL HEALTH PREDICTION AND DETECTION INDICATOR (MOTHER AT BOOKING)

BMI Observations at Booking: To carry the details of the mother's antenatal observations. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	ANTENATAL OBSERVATION (MATERNAL WEIGHT)
R	ANTENATAL OBSERVATION (MATERNAL HEIGHT)
R	OBSERVATION DATE (ANTENATAL)

Mother's Medical History: To carry the pre-pregnancy medical history of the mother. One or more occurrences of this group are permitted, one for each diagnosis type applicable.
M/R	Data Set Data Elements
R	MATERNITY COMPLICATING MEDICAL DIAGNOSIS TYPE (MOTHER AT BOOKING)

Mother's Sexually Transmitted Infections History: To carry the mother's pre-pregnancy medical history of sexually transmitted infections. One or more occurrences of this group are permitted, one for each of the diagnoses.
M/R	Data Set Data Elements
R	MATERNITY COMPLICATING SEXUALLY TRANSMITTED INFECTION DIAGNOSIS (MOTHER AT BOOKING)

Previous Pregnancies Obstetric Diagnosis: To carry the details of a diagnosis that was a complication in a previous pregnancy. One or more occurrences of this group are permitted, one for each diagnosis within each previous pregnancy.
M/R	Data Set Data Elements
R	MATERNITY PREVIOUS COMPLICATING OBSTETRIC DIAGNOSIS TYPE (MOTHER AT BOOKING)

Family History: To carry the details of family history of medical and obstetric diagnoses. One or more occurrences of this group are permitted, one for each of the diagnoses.
M/R	Data Set Data Elements
R	MATERNITY FAMILY HISTORY DIAGNOSIS TYPE (AT BOOKING)

Dating Scan: To carry details of the first ultrasound (dating) scan during the current Maternity Episode. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	OFFER STATUS (DATING ULTRASOUND SCAN)
R	PROCEDURE DATE (DATING ULTRASOUND SCAN)
R	GESTATION (DATING ULTRASOUND SCAN)
R	NUMBER OF FETUSES (DATING ULTRASOUND SCAN)
R	ABNORMALITY DETECTED (DATING ULTRASOUND SCAN)

INFECTIOUS DISEASES AND INHERITED BLOOD DISORDERS

Screening at Booking - ABO Blood Group and Rhesus: To carry details of blood grouping and rhesus screening during the current Maternity Episode. One occurrence of this group is permitted for each sample.
M/R	Data Set Data Elements
R	BLOOD TEST SAMPLE DATE (MOTHER BLOOD GROUP AND RHESUS STATUS)
R	BLOOD GROUP (MOTHER)
R	RHESUS GROUP (MOTHER)
R	INVESTIGATION RESULT (MOTHER RHESUS ANTIBODIES BOOKING)

Screening at Booking - Rubella Susceptibility: To carry details of Rubella Antibodies screening during the current Maternity Episode. One or more occurrences of this group are permitted, one for the first offer status and one for each blood sample.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER RUBELLA SUSCEPTIBILITY)
R	BLOOD TEST SAMPLE DATE (SCREENING MOTHER RUBELLA SUSCEPTIBILITY)
R	INVESTIGATION RESULT (SCREENING MOTHER RUBELLA SUSCEPTIBILITY)

Screening at Booking - Hepatitis B: To carry details of Hepatitis B Antibodies screening during the current Maternity Episode. One or more occurrences of this group are permitted, one for the first offer status and one for each blood sample.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER HEPATITIS B)
R	BLOOD TEST SAMPLE DATE (SCREENING MOTHER HEPATITIS B)
R	INVESTIGATION RESULT (SCREENING MOTHER HEPATITIS B)

Screening at Booking - Syphilis: To carry details of Syphilis screening during the current Maternity Episode. One or more occurrences of this group are permitted, one for the first offer status and one for each blood sample.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER SYPHILIS)
R	BLOOD TEST SAMPLE DATE (SCREENING MOTHER SYPHILIS)
R	INVESTIGATION RESULT (SCREENING MOTHER SYPHILIS)

Screening at Booking - HIV: To carry details of Human Immunodeficiency Virus screening during the current Maternity Episode. One or more occurrences of this group are permitted, one for the first offer status and one for each blood sample.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER HUMAN IMMUNODEFICIENCY VIRUS)
R	BLOOD TEST SAMPLE DATE (SCREENING MOTHER HUMAN IMMUNODEFICIENCY VIRUS)
R	INVESTIGATION RESULT (SCREENING MOTHER HUMAN IMMUNODEFICIENCY VIRUS)

Screening at Booking - Asymptomatic Bacteriuria: To carry details of Asymptomatic Bacteriuria screening during the current Maternity Episode. One occurrence of this group is permitted for each offer status.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER ASYMPTOMATIC BACTERIURIA)

Screening at Booking - Haemoglobinopathy: To carry details of antenatal haemoglobinopathy screening during the current Maternity Episode. One or more occurrences of this group are permitted, one for the first offer status and one for each blood sample.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING MOTHER HAEMOGLOBINOPATHY)
R	BLOOD TEST SAMPLE DATE (SCREENING MOTHER HAEMOGLOBINOPATHY)
R	INVESTIGATION RESULT (SCREENING MOTHER HAEMOGLOBINOPATHY)

ANTENATAL

Maternity Care Plans: To carry the details of a Care Plan during the current Maternity Episode. At least one occurrence of this group is required for each Care Plan, and repeated for each change made to each Care Plan.
M/R	Data Set Data Elements
R	MATERNITY CARE PLAN DATE
R	MATERNITY CARE PLAN TYPE
R	LEAD CARE PROFESSIONAL TYPE (MATERNITY)
R	SITE CODE (OF INTENDED PLACE OF DELIVERY)
R	DELIVERY PLACE TYPE CODE (INTENDED)
R	DELIVERY PLACE TYPE (INTENDED MIDWIFERY UNIT TYPE)
R	DELIVERY PLACE CHANGE REASON CODE

Down's Syndrome Screening Offer Status: To carry details of an antenatal downs syndrome screening offer during the current Maternity Episode. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	MATERNITY SCREENING TESTS BOOKLET GIVEN DATE
R	OFFER STATUS (SCREENING DOWNS SYNDROME)

Down's Syndrome Screening Blood Sample: To carry details of antenatal downs syndrome screening sample during the current Maternity Episode. One or more occurrences of this group are permitted.
M/R	Data Set Data Elements
R	BLOOD TEST SAMPLE DATE (SCREENING DOWNS SYNDROME)

Down's Syndrome Screening Result: To carry details of antenatal downs syndrome screening result during the current Maternity Episode. One or more occurrences of this group are permitted, one for each Fetus.
M/R	Data Set Data Elements
R	INVESTIGATION RISK RATIO RESULT (SCREENING DOWNS SYNDROME)

Fetal Anomaly Screening Test: To carry details of a fetal anomaly scan in the pregnancy. One or more occurrences of this group are required for each fetus, one for each scan and repeated for each abnormality.
M/R	Data Set Data Elements
R	OFFER STATUS (ULTRASOUND FETAL ANOMALY SCREENING)
R	PROCEDURE DATE TIME (ULTRASOUND FETAL ANOMALY SCREENING)
R	FETAL ORDER (ULTRASOUND FETAL ANOMALY SCREENING)
R	INVESTIGATION RESULT (ULTRASOUND FETAL ANOMALY SCREENING)

Antenatal Contacts: To carry details of antenatal contacts occurring in the current Maternity Episode other than the formal antenatal booking appointment. One or more occurrences of this group are permitted, one for each contact.
M/R	Data Set Data Elements
R	ACTIVITY DATE (ANTENATAL APPOINTMENT)

Medical Conditions in Current Pregnancy: To carry details of diagnoses of infectious diseases in the current Maternity Episode. One or more occurrences of this group are permitted, one for each diagnosis.
M/R	Data Set Data Elements
R	MATERNITY MEDICAL DIAGNOSIS TYPE (CURRENT PREGNANCY)

Sexually Transmitted Infections in Current Pregnancy: To carry details of diagnoses of sexually transmitted infections in the current Maternity Episode. One or more occurrences of this group are permitted, one for each diagnosis.
M/R	Data Set Data Elements
R	MATERNITY SEXUALLY TRANSMITTED INFECTION DIAGNOSIS (CURRENT PREGNANCY)

Obstetric Conditions in Current Pregnancy: To carry details of obstetric conditions diagnosed in the current Maternity Episode. One or more occurrences of this group are permitted, one for each diagnosis.
M/R	Data Set Data Elements
R	MATERNITY OBSTETRIC DIAGNOSIS TYPE (CURRENT PREGNANCY)

Antenatal Admissions: To carry details of antenatal hospital admissions and discharges. This includes admissions during labour and/or for delivery. One or more occurrences of this group are permitted, one for each admission.
M/R	Data Set Data Elements
R	START DATE (HOSPITAL PROVIDER SPELL ANTENATAL)
R	DISCHARGE DATE (HOSPITAL PROVIDER SPELL ANTENATAL)

LABOUR AND DELIVERY

Medical Induction Method: To carry details of medical interventions for induction and augmentation of labour. At least one occurrence of this group is required, and repeated for each method used.
M/R	Data Set Data Elements
R	MEDICAL INDUCTION OF LABOUR METHOD

Oxytocin: To carry details of medical interventions by administration of Oxytocin. One or more occurrences of this group are permitted, one for each instance oxytocin is administered.
M/R	Data Set Data Elements
R	OXYTOCIN ADMINISTERED DATE TIME

Rupture of Membranes: To carry details of rupture of membranes. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	RUPTURE OF MEMBRANES DATE TIME
R	RUPTURE OF MEMBRANES METHOD
R	ARTIFICIAL RUPTURE OF MEMBRANES REASON

Labour and Delivery Process: To carry details of events in labour. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PRESENTATION AT ONSET OF LABOUR
R	ONSET OF ESTABLISHED LABOUR DATE TIME
R	ONSET OF SECOND STAGE OF LABOUR DATE TIME
R	END OF THIRD STAGE OF LABOUR DATE TIME
R	DELIVERY OF PLACENTA METHOD
R	DATE TIME OF DECISION TO DELIVER

Pain Relief in Labour and Delivery: To carry details of pain relief using during labour and delivery. At least one occurrence of this group is required, and repeated for each pain relief type used.
M/R	Data Set Data Elements
R	PAIN RELIEF TYPE IN LABOUR AND DELIVERY

Anaesthesia Type in Labour and Delivery: To carry details of anaesthesia using during labour and delivery. At least one occurrence of this group is required, and repeated for each anaesthesia type used.
M/R	Data Set Data Elements
R	ANAESTHESIA TYPE IN LABOUR AND DELIVERY

Caesarean Section: To carry details of caesarean section. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PROCEDURE DATE TIME (CAESAREAN SECTION)

Maternal Critical Incidents: To carry details of critical incidents during labour and delivery. One or more occurrences of this group are permitted, one for each incident.
M/R	Data Set Data Elements
R	MATERNAL CRITICAL INCIDENT
R	MATERNAL CRITICAL INCIDENT DATE TIME

Genital Tract: To carry details of any trauma to the genital tract in delivery. One or more occurrences of this group are permitted, one for each trauma.
M/R	Data Set Data Elements
R	TRAUMATIC LESION OF GENITAL TRACT

Episiotomy: To carry details of episiotomy. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	EPISIOTOMY PERFORMED REASON

BABY

Fetus Outcome: To carry the details of the pregnancy outcome for the fetus. One or more occurrences of this group are permitted, one for each fetus identified at the dating scan.
M/R	Data Set Data Elements
M	PREGNANCY OUTCOME (CURRENT FETUS)

Baby's Demographics: To carry the details of the Baby's Demographics. At least one occurrence of this group is required, one for each baby.
M/R	Data Set Data Elements
M	NHS NUMBER (BABY)
R	NHS NUMBER STATUS INDICATOR CODE (BABY)
R	DATE TIME OF BIRTH (BABY)
R	LOCAL PATIENT IDENTIFIER (BABY)
R	ORGANISATION CODE (LOCAL PATIENT IDENTIFIER (BABY))

Birth: To carry the details of the birth. One or more occurrences of this group are permitted, one for each baby.
M/R	Data Set Data Elements
R	BIRTH ORDER (MATERNITY SERVICES SECONDARY USES)
R	PERSON GENDER CODE AT REGISTRATION
R	BIRTH WEIGHT
R	GESTATIONAL AGE (AT BIRTH)
R	DELIVERY METHOD (CURRENT BABY)
R	DELIVERED IN WATER INDICATOR
R	APGAR SCORE (5 MINUTES)
R	SITE CODE (OF ACTUAL PLACE OF DELIVERY)
R	DELIVERY PLACE TYPE CODE (ACTUAL)
R	DELIVERY PLACE TYPE (ACTUAL MIDWIFERY UNIT TYPE)

Complication at Birth: To carry the details of any complications for the baby that may occur at birth. One or more occurrences of this group are permitted, one for each complication for each baby delivered.
M/R	Data Set Data Elements
R	BABY COMPLICATION AT BIRTH

Initiation of Feeding: To carry details of actions to initiate breastfeeding. One or more occurrences of this group are permitted, one for each baby.
M/R	Data Set Data Elements
R	SKIN TO SKIN CONTACT WITHIN ONE HOUR
R	BABY FIRST FEED DATE TIME
R	BABY FIRST FEED BREAST MILK STATUS

Neonatal Resuscitation Method: To carry the details of methods used during neonatal resuscitation. One or more occurrences of this group are permitted, one for each method used for each baby delivered.
M/R	Data Set Data Elements
R	NEONATAL RESUSCITATION METHOD

Neonatal Resuscitation Drugs and Fluids: To carry the details of drugs or fluids used during neonatal resuscitation. One or more occurrences of this group are permitted, one for each drug or fluid used for each baby delivered.
M/R	Data Set Data Elements
R	NEONATAL RESUSCITATION DRUG OR FLUID

Neonatal Unit Admission: To carry the details of transfers to neonatal units. One or more occurrences of this group are permitted, one for each Ward Stay for each baby transferred.
M/R	Data Set Data Elements
R	TRANSFER START DATE TIME (NEONATAL UNIT)
R	SITE CODE (OF ADMITTING NEONATAL UNIT)

Feeding at Discharge: To carry the details of the baby's feeding at discharge. One occurrence of this group is permitted for each baby.
M/R	Data Set Data Elements
R	BABY BREAST MILK STATUS (AT DISCHARGE FROM HOSPITAL)

Neonatal Diagnosis: To carry the details of diagnoses made. One or more occurrences of this group are permitted, one for each diagnosis for each baby.
M/R	Data Set Data Elements
R	NEONATAL DIAGNOSIS

Neonatal Critical Incidents: To carry details of neonatal critical incidents. One or more occurrences of this group are permitted, one for each incident.
M/R	Data Set Data Elements
R	NEONATAL CRITICAL INCIDENT

Newborn Physical Screening: To carry the details of Newborn Physical Screening. One or more occurrences of this group are permitted, one for each baby.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING NEWBORN PHYSICAL EXAMINATION)
R	SCREENING DATE (NEWBORN PHYSICAL EXAMINATION)
R	NEWBORN PHYSICAL EXAMINATION RESULT (HIPS)
R	NEWBORN PHYSICAL EXAMINATION RESULT (HEART)
R	NEWBORN PHYSICAL EXAMINATION RESULT (EYES)
R	NEWBORN PHYSICAL EXAMINATION RESULT (TESTES)

Newborn Hearing Screening: To carry the details of Newborn Hearing Screening. One or more occurrences of this group are permitted, one for each baby.
M/R	Data Set Data Elements
R	OFFER STATUS (SCREENING NEWBORN HEARING)
R	PROCEDURE DATE (SCREENING NEWBORN HEARING)
R	NEWBORN HEARING SCREENING OUTCOME (MATERNITY)

Newborn Blood Spot Screening: To carry the details of newborn blood spot screening. One or more occurrences of this group are permitted, one for each Newborn Blood Spot Test for each baby.
M/R	Data Set Data Elements
R	BLOOD SPOT SCREENING OFFER STATUS (PHENYLKETONURIA)
R	BLOOD SPOT SCREENING OFFER STATUS (SICKLE CELL DISEASE)
R	BLOOD SPOT SCREENING OFFER STATUS (CYSTIC FIBROSIS)
R	BLOOD SPOT SCREENING OFFER STATUS (CONGENITAL HYPOTHYROIDISM)
R	BLOOD SPOT SCREENING OFFER STATUS (MEDIUM CHAIN ACYL COA DEHYDROGENASE DEFICIENCY)
R	BLOOD SPOT CARD COMPLETION DATE
R	LABORATORY IDENTIFIER (NEWBORN BLOOD SPOT SCREENING)
R	BLOOD SPOT SCREENING STATUS (PHENYLKETONURIA)
R	BLOOD SPOT SCREENING STATUS (SICKLE CELL DISEASE)
R	BLOOD SPOT SCREENING STATUS (CYSTIC FIBROSIS)
R	BLOOD SPOT SCREENING STATUS (CONGENITAL HYPOTHYROIDISM)
R	BLOOD SPOT SCREENING STATUS (MEDIUM CHAIN ACYL COA DEHYDROGENASE DEFICIENCY)

Neonatal Death: To carry the death details for a baby. One or more occurrences of this group are permitted, one for each baby.
M/R	Data Set Data Elements
R	PERSON DEATH DATE TIME (BABY)

POSTPARTUM

Postpartum Demographics and Discharge. To carry the details of the personal, social and other details for the mother. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	DISCHARGE DATE TIME (MOTHER POST DELIVERY HOSPITAL PROVIDER SPELL)
R	DISCHARGE DATE (MOTHER MATERNITY SERVICES)
R	SMOKING STATUS (MOTHER AT END OF PREGNANCY)

Postpartum Readmissions: To carry the details of postpartum readmissions to hospital. One or more occurrences of this group are permitted, one for each admission.
M/R	Data Set Data Elements
R	START DATE (HOSPITAL PROVIDER SPELL POSTPARTUM)

Maternal Death: To carry the details of the mother's death. One occurrence of this group is permitted.
M/R	Data Set Data Elements
R	PERSON DEATH DATE TIME (MOTHER)

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KC53 1

Change to Central Return Form: Changed Description

Central Return Form Guidance

KC53: Adult Screening Programmes: Cervical Screening

This return is in development by the NHS Cancer Screening Programme, therefore the information should not be used.
For the latest version of the form and further details, please see the Health and Social Care Information Centre website.

Contextual Overview
The Department of Health, NHS Cervical Screening Programme (NHSCSP) and Strategic Health Authorities require information from Primary Care Trusts on Cervical Screening.
The information helps to monitor the process of achieving the Government's target to reduce the incidence of invasive cervical cancer and to ensure that the screening programme is managed effectively. It is used to monitor coverage by the cervical screening programme of the eligible Primary Care Trust responsible population.
Information on the return is also used in Public Expenditure Survey (PES) negotiations, resource allocation to the NHS and Departmental accountability.
Information based on the KC53 return is published annually by the Department in the Statistical Bulletin `Cervical Screening Programme'.
Completing Return KC53: Cervical Screening Programme
The Cervical Screening Programme is a programme to deliver services within a 'structured framework' to a defined target population, planned by a Primary Care Trust. The services provided to the population under this programme may be carried out by one or more Health Care Providers - NHS Trust, general medical practitioner (GMP), private or voluntary organisation or any combination of these.
Information on Cervical Screening should be readily available from the call and recall service's computerised call and recall system. A standard computer programme is provided by NHS Connecting for Health.
Information on Cervical Screening should be readily available from the call and recall service's computerised call and recall system.
The return requires the ORGANISATION CODE and ORGANISATION NAME of the Primary Care Trust. It requires information about women (PERSONS) on the lists of GPs in the Primary Care Trust and women from the unregistered population who live in the geographical area for which the Primary Care Trust is responsible at 31 March. It is completed annually and submitted within two months of this date.

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KC63 1

Change to Central Return Form: Changed Description

Central Return Form Guidance

KC63 - Adult Screening Programmes: Breast Screening, Resident Based

~~Contextual Overview~~
- Contextual Overview
- The NHS Breast Screening Programme (NHSBSP) and Regional Offices require information from Primary Care Trusts on the breast cancer screening status of their residents.
- The information is used to assess performance. Quality targets for breast screening are monitored and poor performances identified and followed up via performance management.
- Information on screening is used to monitor progress towards achieving the Government's target of a reduction in the death rate in the population invited for screening.
- Information on the return is also used in Public Expenditure Survey (PES) negotiations, resource allocation to the NHS and Departmental accountability.
- Information based on the KC63 return is published annually by the Department of Health in the Statistical Bulletin `Breast Screening Programme'.
  Completing Return KC63 - Adult Screening Programmes: Breast Screening
- The Breast Screening Programme is a structured programme by a Strategic Health Authority which is directed towards detecting specific diseases and conditions in a specific target group. The services provided to the population under this programme are carried out by a breast screening centre or Unit.
  A Screening Programme is a HEALTH PROGRAMME where the HEALTH PROGRAMME TYPE is National code 'Screening Programme'. A breast screening centre is type of a SERVICE POINT.
- ~~Information on Breast Screening should be readily available from the~~ ~~Primary Care Trust's computerised call and recall system designed for breast cancer screening. A standard computer program is provided by NHS Connecting for Health.~~
- Information on Breast Screening should be readily available from the Primary Care Trust's computerised call and recall system designed for breast cancer screening.
- The return must be submitted by Primary Care Trusts in respect of women resident in the Primary Care Trust at 31 March. It is completed annually and submitted by the end of October following the end of the financial year to which the return relates.
- The KC63 return requires the ORGANISATION CODE and ORGANISATION NAME of the Primary Care Trust as well as the name of a contact and the contact telephone number.
- Detailed information about compilation of the KC63 is contained in the NHS Connecting for Health publication `KC63 Statistics: Table definitions'.

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CHILD AND ADOLESCENT MENTAL HEALTH SERVICES SECONDARY USES DATA SET OVERVIEW

Change to Supporting Information: Changed Description

Contextual Overview

The Maternity and Children’s Data set including Child and Adolescent Mental Health Services has been developed as a key driver to achieving better outcomes of care for mothers, babies and children. The data set will provide comparative, mother and child-centric data that will include information on incidence and care that can be used to improve clinical quality and service efficiency; and to commission services in a way that improves health and reduces inequalities. The Child and Adolescent Mental Health Services element of the data set will for the first time:

allow maternal and child health data to be linked so that vital information can be used to improve services
provide comparative data (demographics, equalities, interventions and outcomes from birth through childhood) so that health services can be directed to those with most need
improve accountability, making it easier for the public to access comparative information to support them in making decisions about type and place of care
provide activity data on which to base mandatory tariffs for Child and Adolescent Mental Health Services (CAMHS)
underpin the improvement of local information systems to meet data set standards
for example in the case of Attention Deficit Hyperactivity Disorder (ADHD), the data set will provide the first opportunity to link data on a PATIENT’s demographics and where they access services, and a clinical assessment of problems with attention and concentration, with information on the prescribing of a methyl phenidate (e.g. Ritalin).

Data Collection

The Child and Adolescent Mental Health Services Secondary Uses Data Set provides the definitions for data:

to be lodged in the data warehouse regularly and routinely e.g. monthly. Extracts for Hospital Episode Statistics (HES) and other reports will be taken at prearranged intervals for publication as currently with the process for Commissioning Data Sets;
to be assembled, compiled and to flow into a secondary uses data warehouse;
to provide timely, pseudonymised patient-based data and information for purposes other than direct clinical care, e.g. planning, commissioning, public health, clinical audit, performance improvement, research, clinical governance.

This standard is intended to facilitate electronic data recording and reporting but it is not intended to create clinical records for Child and Adolescent Mental Health or to enable other systems to interoperate with other clinical systems.

Submission information

The Child and Adolescent Mental Health Services Secondary Uses Data Set is collected from NHS funded providers of Child and Adolescent Mental Health Services. ~~It is submitted via an intermediate database uploaded to the Bureau Services Portal provided by the Systems and Services Delivery (SSD) team at NHS Connecting For Health.~~

The Bureau Service processes submissions and produces local extracts for provider and commissioner ORGANISATIONS and a national pseudonymised extract for the Health and Social Care Information Centre, for analysis and reporting.

Further guidance

Further guidance has been produced by the Health and Social Care Information Centre and is available at Child and Adolescent Mental Health Services (CAMHS) Secondary Uses Data Set.

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HARS DATA SET SUBMISSION REQUIREMENTS

Change to Supporting Information: Changed Description

The HIV and AIDS Reporting Data Set is submitted to the Health Protection Agency (HPA) using the HARS Data Set Message.

Supporting documentation for each version of the message is available as a downloadable zip file from the HIV and AIDS Reporting Data Set Message Versions page.

In addition, further guidance for submissions is provided by the Health Protection Agency on the Health Protection Agency website.

A HIV and AIDS Reporting Data Set submission must only contain data relating to one ORGANISATION CODE (CODE OF PROVIDER) for one REPORTING PERIOD.

HARS Submission Header

The HARS submission header contains data items which are used by the Health Protection Agency to manage data upon receipt.

The Mandatory, Required or Optional (M/R/O) column indicates the requirements for inclusion of data:

M = this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present.

For guidance on the XML Schema constraints, see the HIV and AIDS Reporting Data Set XML Schema Constraints.

HARS SUBMISSION HEADER

M/R/O	Data Set Data Elements
M	HARS SUBMISSION IDENTIFIER
M	HARS SUBMISSION RECORD COUNT
M	REPORTING PERIOD START DATE
M	REPORTING PERIOD END DATE
M	HARS MESSAGE VERSION IDENTIFIER
M	ORGANISATION CODE (CODE OF SUBMITTING ORGANISATION)
M	DATE AND TIME DATA SET CREATED
M	HARS TEST INDICATOR

HARS Record Identity

Each record within a HIV and AIDS Reporting Data Set submission must contain a unique identifier, to support data management and error reporting within the Health Protection Agency systems.

The Mandatory, Required or Optional (M/R/O) column indicates the requirements for inclusion of data:

M = this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present.

HARS RECORD IDENTIFIER

M/R/O	Data Set Data Elements
M	HARS UNIQUE IDENTIFIER

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INDEPENDENT HEALTH CARE SERVICE PLAN

Change to Supporting Information: Changed Description

An Independent Health Care Service Plan is a plan for the provision of a SERVICE.

~~The type of~~ ~~SERVICE~~ ~~and numbers of~~ ~~PATIENTS~~ ~~intended to be provided as part of an independent health care registration.~~An Independent Health Care Service Plan is the type of SERVICE and numbers of PATIENTS intended to be provided as part of an independent health care registration.

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MAINTENANCE

Change to Supporting Information: Changed Description

~~The NHS Data Model and Dictionary maintenance process follows the steps listed below:~~

~~Need Identified~~
~~Identify Sponsor and Developer~~
~~Analysis and Data Modelling~~
~~Draft Change Request~~
~~Consultation Process~~
~~Information Standards Board for Health and Social Care (ISB)~~

~~This process is described below.~~

~~Demonstrations~~

~~A PowerPoint presentation is also available which will take you through this process. To view this presentation, see the~~ ~~NHS Data Model and Dictionary Maintenance Process~~.

~~Need Identified~~

The NHS Data Model and Dictionary Service are approached when changes to information standards are required. This could be the introduction of a new information standard or an amendment, deletion or retirement of an existing one.

~~Identify Sponsor and Developer~~

The Sponsor and Developer are responsible for producing the documentation to support the Information Standards Notice (ISN), this includes: Standard Specification Implementation Plan Supporting Documents, for example, technical guidance etc.

~~Analysis and Data Modelling~~

The proposed information standard is analysed against existing standards within the NHS Data Model and Dictionary. Stakeholders are involved during this development stage to clarify and resolve any potential issues.

~~Draft Change Request~~

The Change Request: is a document that illustrates how the NHS Data Model and Dictionary is impacted by the proposed new standard is reviewed during the Information Standards Board for Health and Social Care appraisal process

~~Consultation Process~~

A draft Change Request may be made available on the NHS Data Model and Dictionary Service Consultation Website, where stakeholders are invited to comment on the suggested changes. For further information on the Consultation Website, see ~~NHS Data Model and Dictionary Service Consultation Website. Comments are shared with the Information Standards Board for Health and Social Care.~~

~~Information Standards Board for Health and Social Care (ISB)~~

~~The~~ ~~Information Standards Board for Health and Social Care~~ provide an independent mechanism for the assurance and approval of Information Standards for use in the NHS (England). They ensure that new information standards are implementable, interoperable, fit for purpose and safe when implemented in the NHS and Social Care.
~~For each change, the Information Standards Board for Health and Social Care (ISB) may:~~
~~Reject the Change~~
~~Conditionally Approve the Change or~~
~~Approve the Change~~

~~1. Reject the Change (Change Rejected)~~
~~The Information Standards Board for Health and Social Care may reject the change, i.e. the change is not fit for purpose.~~

~~2. Conditionally Approve the Change (Further Analysis)~~
~~The change could be returned to the Sponsor, Developer and NHS Data Model and Dictionary Service for further analysis and to make changes to the submission documents and Change Request.~~

~~3. Approve the Change (Publishing of Information Standards Notices and Updating the NHS Data Model and Dictionary~~

~~Publishing of~~ ~~Information Standards Notices~~
~~Assured and approved data standards are published as~~ ~~Information Standards Notices~~ (~~ISNs) by the~~ ~~Information Standards Board for Health and Social Care~~
~~Not all~~ ~~Information Standards Notices~~ ~~include a change to the NHS Data Model and Dictionary. Where the change affects the NHS Data Model and Dictionary, the~~ ~~Information Standards Notice~~ ~~will include a link to the Change Request.~~
~~Information Standards Notices~~ ~~can be found on the~~ ~~Information Standards Board for Health and Social Care website~~ ~~and~~ ~~Data Set Change Notices can be found on the~~ ~~NHS Connecting for Health website~~.
~~You can sign up to receive notification of new~~ ~~Information Standards Notices~~ ~~by subscribing to the~~ ~~ISB Mailing List~~.
~~For some~~ ~~Information Standards Notices~~ ~~there may be an Advanced Notification (AN) which provides details of the proposed change, their potential effects and proposed timeframes. An Advanced Notification is very similar to an~~ ~~Information Standards Notice. The main differences are they have:~~
~~a proposed implementation date, which may differ from the final related~~ ~~Information Standards Notice~~ ~~and~~
~~a watermark of ‘Advanced Notification’ to highlight that this is a proposed change~~

~~Updating the NHS Data Model and Dictionary~~
~~Once the change has been approved, the information is usually incorporated into the NHS Data Model and Dictionary around the change implementation date and a new release is published~~
~~The What's New page shows the information standards that have been incorporated into each release of the NHS Data Model and Dictionary~~
~~You can sign up to receive notification of new releases of the NHS Data Model and Dictionary by subscribing to the~~ ~~NHS Data Model and Dictionary Service Mailing List~~.

~~What would you like to do next?~~

~~NHS Data Model and Dictionary Content~~

~~Access the NHS Data Model and Dictionary~~ ~~Main Menu~~.

~~Help Pages~~

~~If you need help using the NHS Data Model and Dictionary, access the~~ ~~Help~~ ~~pages.~~

The NHS Data Model and Dictionary maintenance process follows the steps listed below:

Need Identified
Identify Sponsor and Developer
Analysis and Data Modelling
Draft Change Request
Consultation Process
Information Standards Board for Health and Social Care (ISB)

This process is described below.

Demonstrations

A PowerPoint presentation is also available which will take you through this process. To view this presentation, see the NHS Data Model and Dictionary Maintenance Process.

Need Identified

The NHS Data Model and Dictionary Service are approached when changes to information standards are required. This could be the introduction of a new information standard or an amendment, deletion or retirement of an existing one.

Identify Sponsor and Developer

The Sponsor and Developer are responsible for producing the documentation to support the Information Standards Notice (ISN), this includes: Standard Specification Implementation Plan Supporting Documents, for example, technical guidance etc.

Analysis and Data Modelling

The proposed information standard is analysed against existing standards within the NHS Data Model and Dictionary. Stakeholders are involved during this development stage to clarify and resolve any potential issues.

Draft Change Request

The Change Request: is a document that illustrates how the NHS Data Model and Dictionary is impacted by the proposed new standard is reviewed during the Information Standards Board for Health and Social Care appraisal process

Consultation Process

A draft Change Request may be made available on the NHS Data Model and Dictionary Service Consultation Website, where stakeholders are invited to comment on the suggested changes. For further information on the Consultation Website, see NHS Data Model and Dictionary Service Consultation Website. Comments are shared with the Information Standards Board for Health and Social Care.

Information Standards Board for Health and Social Care (ISB)

The Information Standards Board for Health and Social Care provide an independent mechanism for the assurance and approval of Information Standards for use in the NHS (England). They ensure that new information standards are implementable, interoperable, fit for purpose and safe when implemented in the NHS and Social Care.
For each change, the Information Standards Board for Health and Social Care (ISB) may:
Reject the Change
Conditionally Approve the Change or
Approve the Change

1. Reject the Change (Change Rejected)
The Information Standards Board for Health and Social Care may reject the change, i.e. the change is not fit for purpose.

2. Conditionally Approve the Change (Further Analysis)
The change could be returned to the Sponsor, Developer and NHS Data Model and Dictionary Service for further analysis and to make changes to the submission documents and Change Request.

3. Approve the Change (Publishing of Information Standards Notices and Updating the NHS Data Model and Dictionary

Publishing of Information Standards Notices
Assured and approved data standards are published as Information Standards Notices (ISNs) by the Information Standards Board for Health and Social Care
Not all Information Standards Notices include a change to the NHS Data Model and Dictionary. Where the change affects the NHS Data Model and Dictionary, the Information Standards Notice will include a link to the Change Request.
Information Standards Notices can be found on the Information Standards Board for Health and Social Care website.
Data Set Change Notices can be found on the Information Standards Board for Health and Social Care website.
You can sign up to receive notification of new Information Standards Notices by subscribing to the ISB Mailing List.
For some Information Standards Notices there may be an Advanced Notification (AN) which provides details of the proposed change, their potential effects and proposed timeframes. An Advanced Notification is very similar to an Information Standards Notice. The main differences are they have:
a proposed implementation date, which may differ from the final related Information Standards Notice and
a watermark of ‘Advanced Notification’ to highlight that this is a proposed change

Updating the NHS Data Model and Dictionary
Once the change has been approved, the information is usually incorporated into the NHS Data Model and Dictionary around the change implementation date and a new release is published
The What's New page shows the information standards that have been incorporated into each release of the NHS Data Model and Dictionary
You can sign up to receive notification of new releases of the NHS Data Model and Dictionary by subscribing to the NHS Data Model and Dictionary Service Mailing List.

What would you like to do next?

NHS Data Model and Dictionary Content

Access the NHS Data Model and Dictionary Main Menu.

Help Pages

If you need help using the NHS Data Model and Dictionary, access the Help pages.

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MENTAL HEALTH MINIMUM DATA SET OVERVIEW

Change to Supporting Information: Changed Description

The Mental Health Minimum Data Set was introduced by Data Set Change Notice 20/19/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 (Data Set Change Notice 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. Prior to April 2013 the frequency of the submission will change to a monthly basis.

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 Scale (Working Age Adults), or HoNOS (Working Age Adults)). It records the key role played by partner agencies, particularly social services.

The Mental Health Minimum Data Set describes Adult Mental Health Care Spells. These comprise all interventions made for a PATIENT by a specialist Adult Mental Health Care Team from initial REFERRAL REQUEST to final discharge. For some individuals the Adult 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 Nation Outcome Scale (Working Age Adults) contacts with mental health professionals such as care co-ordinators, psychiatric NURSES and CONSULTANTS; and also any diagnosis and treatment.

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

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

~~The~~ ~~Mental Health Minimum Data Set~~ data is collected from NHS funded providers of specialist mental health services and submitted via the Bureau Services Portal provided by the Systems and Services Delivery (SSD) team at NHS Connecting For Health.The Mental Health Minimum Data Set data is collected from NHS funded providers of specialist mental health services and submitted via the Bureau Services Portal provided by the Systems and Services Delivery (SSD) team. The Bureau Service processes submissions and produces local extracts for provider and commissioner ORGANISATIONS, and a national pseudonymised extract for the Health and Social Care Information Centre, for storage, analysis and reporting.

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

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

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

Mental Health Minimum Data Set Version History

Version	Date Issued	Summary of Changes	DSCN / ISN	Implementation Date
1.0	November 1999	Introduction of Mental Health Minimum Data Set	DSCN 20/99/P13	April 2000
1.1	June 2002	Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)	DSCN 27/2002	April 2003
1.2	September 2002	Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)	DSCN 29/2002	April 2003
1.3	October 2002	Data Standards - Changes to Mental Health Minimum Data Set (MHMDS)	DSCN 48/2002	April 2003
2.0	October 2002	Mental Health Minimum Data Set - Mandatory Central returns. This version of the data set incorporates changes defined in Data Set Change Notice 27/2002, 29/2002 and 48/2002.	DSCN 49/2002	April 2003
2.1	November 2007	Introduction of Mental Health Minimum Data Set Version 2.1	DSCN 37/2007	November 2007
3.0	February 2008	Introduction of Mental Health Minimum Data Set Version 3.0 - incorporating changes required for Mental Health Act 2007 and Public Service Agreement Delivery Agreement 16 (Social Exclusion)	DSCN 06/2008	April 2008
~~3.5~~	~~November 2010~~	~~Advance notification of changes to the~~ ~~Mental Health Minimum Data Set~~ ~~to meet~~ ~~Payment by Results~~ ~~requirements.~~	~~ISB 0011~~ ~~Amd 41/2010~~	~~01 April 2011~~
3.5	November 2010	Advance notification of changes to the Mental Health Minimum Data Set to meet Payment by Results requirements	ISB 0011 Amd 41/2010	01 April 2011
4.0	April 2011	Introduction of Mental Health Minimum Data Set (Version 4-0) - incorporating changes required for Payment by Results and reduction of burden	Amd 87/2010	01 April 2012
4.1	November 2012	Introduction of Mental Health Minimum Data Set (Version 4-1) - incorporating changes required for the collection of commissioner history	Amd 25/2012	01 April 2013

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METADATA FILES

Change to Supporting Information: Changed Description

Files Available

Metadata files are used by the NHS to validate data. The files facilitate data consistency and quality. The files are:
- Diagnosis (International Classification of Diseases (ICD))
- OPCS Classification of Interventions and Procedures (OPCS-4)
- NHS Postcode Directory
- Frozen Postcode Directory
- Country Pseudo Postcodes
~~The~~ ~~International Classification of Diseases (ICD)) file is issued by NHS Connecting for Health, from whom a specification is available. It is intended to reissue this file in line with the~~ ~~International Classification of Diseases (ICD)) updates.~~
~~The~~ ~~OPCS-4~~ ~~metadata file and specification is issued by the NHS Classifications Service to support implementation of new releases; see~~ ~~Contact Details~~.
~~The full and reduced versions of the~~ ~~NHS Postcode Directory~~ ~~are issued every quarter by the~~ ~~Organisation Data Service~~. ~~Named recipients both inside the NHS and other recipients licensed to use this data in support of the NHS are able to access it through the online distribution service,~~ ~~Technology Reference Data Update Distribution Service (TRUD)~~ ~~and through the~~ ~~Organisation Data Service~~ ~~pages on NHSnet; see~~ ~~Contact Details~~.
~~A full description of the~~ ~~NHS Postcode Directory~~ ~~and the~~ ~~Organisation Data Service~~ ~~reduced postcode data files, can be found by browsing the~~ ~~Office for National Statistics~~ ~~Data section of the~~ ~~Organisation Data Service~~ ~~pages on NHSnet at:~~
- ~~http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/~~ (~~NHS Postcode Directory) and~~
- ~~http://nww.connectingforhealth.nhs.uk/ods/downloads/postcode/~~ ~~(reduced files).~~

~~The same descriptions can also be accessed via the~~ ~~Technology Reference Data Update Distribution Service (TRUD)~~.

~~Any area within the NHS taking advantage of the supply of metadata by the~~ ~~Office for National Statistics~~ ~~will be expected to abide by any rules and conditions imposed by the~~ ~~Office for National Statistics~~ ~~Section supplying the metadata.~~
~~Format of Metadata Files~~
~~The following pages give the record layouts and data content for the Operation and Country Pseudo Postcode metadata files.~~
~~Country Pseudo Postcode File DataContent~~
Format of Metadata Files
The following pages give the record layouts and data content for the Operation and Country Pseudo Postcode metadata files.
Country Pseudo Postcode File Data Content

This file contains about 130 records. The usual country of residence for short term Overseas Visitors is derived from the country pseudo postcode. The codes are available in electronic format on the NHS Postcode Directory ("Gridlink version").
The expanded area code field contains the country of birth code in characters 1-4 (a repeat of the characters 3-6 in the pseudo postcode). The remainder of the expanded area code is blank except for codes 993C (UK nos) and 993V (no fixed abode) where characters 5-7 are 9space9.
COUNTRY PSEUDO FILE RECORD LAYOUT
Start Pos Size Data Type Field Description
1 11 X selection indicators
12 6 X 6 digit postcode (POSTSIX)
18 1 A 7th digit
19 6 X filler
25 50 X name of country
75 5 X filler
80 19 X area details
99 154 X filler

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NATIONAL CANCER WAITING TIMES MONITORING DATA SET OVERVIEW

Change to Supporting Information: Changed Description

Introduction

The Cancer Reform Strategy (2007) introduced new and changed commitments in terms of service standards for cancer PATIENTS that must be met. A Review of Cancer Waiting Times Standards was carried out by the Department of Health and published alongside Improving Outcomes: A Strategy for Cancer (2011). Following this review it was confirmed in Improving Outcomes: A Strategy for Cancer that:

“overall, cancer waiting time standards should be retained. Shorter waiting times can help to ease patient anxiety and, at best, can lead to earlier diagnosis, quicker treatment, a lower risk of complications, an enhanced patient experience and improved cancer outcomes. The current cancer waiting times standards will therefore be retained.”

This updated version of the National Cancer Waiting Times Monitoring Data Set therefore supports the continued management and monitoring of the following waiting times:

A maximum two week wait from an urgent GP referral for suspected cancer to DATE FIRST SEEN by a specialist for all suspected cancers
A maximum one month (31-day) wait from diagnosis (CANCER TREATMENT PERIOD START DATE) to First Definitive Treatment for all cancers
A maximum two month (62-day) wait from urgent GP referral for suspected cancer to First Definitive Treatment for all cancers
A maximum one month (31-day) wait from urgent GP referral for suspected cancer to First Definitive Treatment for children’s cancers, testicular cancers and acute leukaemia
A maximum 62-day wait from referral from a cancer Screening Programme to first treatment for all cancers
A maximum 62-day wait from a CONSULTANTS decision to upgrade the urgency of a PATIENT they suspect to have cancer to first treatment for all cancers
A maximum 31-day wait for all subsequent treatments for new cases of primary and recurrent cancer where an Anti-Cancer Drug Regimen, surgery or Radiotherapy is the chosen CANCER TREATMENT MODALITY;
A maximum two week wait from referral for breast symptoms (where cancer is not initially suspected) to DATE FIRST SEEN.

Information Standards Notice ISB 0147 Amd 23/2011 revised the National Cancer Waiting Times Monitoring Data Set published in Data Set Change Notice 20/2008, which previously expanded upon and superseded Data Set Change Notice 22/2002, the original data set used by the Cancer Waiting Times Database for central data capture to support performance management and commissioning of cancer services.

Treatment Scenarios

The treatment scenarios listed on the National Cancer Waiting Times Monitoring Data Set (scenarios two to seven) are to be used to manage the collection of data for all PATIENTS with cancer. Cancer for the purpose of this data collection exercise is defined using the International Classification of Diseases (ICD) codes. Data must be collected and transmitted as specified for all PATIENTS with a PRIMARY DIAGNOSIS within the range C00 to C97 or D05, or a secondary or metastatic disease linked to the original PRIMARY DIAGNOSIS (ICD) within this range (excluding categories relating to non-melanoma skin cancer). A full list of the International Classification of Diseases (ICD) diagnosis codes the Cancer Waiting Times Database will accept is available at: Cancer Waiting Times - Useful Documentation and Links.

Data Set Notation:

M = Mandatory: the Standard Contract Schedule 5 requires NHS provider ORGANISATIONS to submit this information on a monthly basis. The Department of Health require the data to be submitted 25 working days after the end of each month or quarter.
M* = Mandatory if applicable: the Standard Contract Schedule 5 requires NHS provider ORGANISATIONS to submit this information on a monthly basis, where collection of the item was applicable to them. The Department of Health require the data to be submitted 25 working days after the end of each month or quarter.
O = Optional
O* = Optional if applicable: These optional fields should only be populated if they relate to the PATIENT PATHWAY identified in scenarios 1 to 7 and the conditions required for their use are met.
N/A = Not Applicable

Reporting

Cancer Waiting Times Database

~~The existing Cancer Waiting Times Database (developed and maintained by NHS Connecting for Health) has been upgraded to support the collection of data outlined in~~ ~~Information Standards Notice ISB 0147 Amd 23/2011~~.The existing Cancer Waiting Times Database has been upgraded to support the collection of data outlined in Information Standards Notice ISB 0147 Amd 23/2011. The revision to the National Cancer Waiting Times Monitoring Data Set outlined in Information Standards Notice ISB 0147 Amd 23/2011 increases the level of granularity and transparency around patient choice delays and improve the reporting of cancer treatment.

Patient level information

The Trust first seeing a PATIENT in a particular month or quarter is responsible for ensuring that the mandated data fields, up to DATE FIRST SEEN, are complete on the database by the national deadline.
The Trust first treating or giving subsequent treatment to a PATIENT in a particular month or quarter is responsible for ensuring that the mandated data fields on that PATIENT are complete on the database by the national deadline.
Data to be complete and validated 25 working days after the REPORTING PERIOD END DATE, either month or quarter
Specified dates are available at: Cancer Waiting Times - Useful Documentation and Links.

How the data set is transmitted

Information can be entered either manually through the Cancer Waiting Times Record screen or via the upload function. The specification for the upload file is detailed in the 'National Cancer Waiting Times User Manual' available at: Cancer Waiting Times - Useful Documentation and Links.

The upload function will retain the current CSV functionality, however the current NHS standard for the transmission of data sets is XML. The ability to transmit the data to the Cancer Waiting Times Database in XML format will be introduced from Autumn 2012 with the current CSV upload function being discontinued from Autumn 2013 by Information Standards Notice ISB 0147 Amd 6/2012.

Security and Confidentiality

Security and confidentiality information to accompany the collection of this information is available at: Cancer Waiting Times - Useful Documentation and Links.

Further guidance

Further guidance has been produced by the Department of Health and is available at: Cancer Waiting Times - Useful Documentation and Links.

Any additional queries regarding the National Cancer Waiting Times Monitoring Data Set should be addressed to CANCER-WAITS@dh.gsi.gov.uk.

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NHS HEALTH CHECKS DATA SET MESSAGE VERSIONS renamed from NHS HEALTH CHECKS DATA SET MESSAGE VERSIONS

Change to Supporting Information: Changed Name

Changed Name from Data_Dictionary.Messages.Clinical_Data_Sets.Message_Documentation.NHS_Health_Checks_Data_Set_Message_Versions to Data_Dictionary.Messages.Clinical_Data_Sets.Message_Documentation.NHS_Health_Checks_Data_Set_Message_Versions

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WHAT'S NEW: MARCH 2013 renamed from WHAT'S NEW: FEBRUARY 2013

Change to Supporting Information: Changed Description, Name

Release: March 2013

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1364 (Immediate) - DDCN 1364/2013 Operating Theatre
CR1335 (1 April 2013) - ISB 1593 Amd 27/2012 Venous Thromboembolism Risk Assessment Data Set
CR1340 (1 April 2013) - ISB 0090 Amd 37/2012 Organisation Data Service - Non-Legislative Organisations
CR1321 (1 April 2013) - ISB 0011 Amd 25/2012 Mental Health Minimum Data Set version 4.1

Release: February 2013

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1336 (Immediate) - DDCN 1336/2013 XML Schema Constraint Pages
CR1362 (Immediate) - DDCN 1362/2013 Update to Organisations in the NHS Data Model and Dictionary
CR1246 (Immediate) - DDCN 1246/2013 Guidance for Merging Organisations
CR1345 (Immediate) - DDCN 1345/2013 e-Government Interoperability Framework (e-GIF) and Government Data Standards Catalogue
CR1354 (Immediate) - DDCN 1354/2013 Treatment Function Code - Well Babies

Release: December 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1155 (Immediate) - ISB 1567 Amd 12/2011 National Joint Registry Data Set Version 5
CR1324 (1 December 2012) - ISB 1067 Amd 23/2012 Workforce Data Set Version 2.5
CR1196, CR1287 and CR1195 (1 January 2013) - ISB 1521 Amd 64/2010 Cancer Outcomes and Services Data Set, Cancer Outcomes and Services Data Set Message and Retirement of Cancer Registration Data Set and National Cancer Data Set

The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2013:

CR1337 (1 April 2013) - ISB 1072 Amd 30/2012 Update to Child and Adolescent Mental Health Services Secondary Uses Data Set

Release: November 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1166, CR1167 and CR1306 (1 November 2012) - ISB 0092 Amd-16-2010 Commissioning Data Set Version 6-2, Commissioning Data Set XML Message Version 6-2 and Retirement of CDS 6-0
CR1305 (1 April 2013) - ISB 0092 Amd 06/2011 Allied Health Professions Referral to Treatment (AHP RTT) Update - CDS 6-2
CR1286 (1 November 2012) - ISB 0028 Amd 17/2012 Treatment Function Codes Update
CR1343 (Immediate) - DDCN 1343/2012 Change of name for NHS Commissioning Board Authority
CR1342 (Immediate) - DDCN 1342/2012 Overseas Visitors Update
CR1341 (Immediate) - DDCN 1341/2012 Discharge Default Code Descriptions
CR1323 (Immediate) - National Cancer Waiting Times Monitoring Data Set Update for "Delay Reason To Treatment For Cancer"

CR1323 is a corrigendum to CR1258 (1 July 2012) - ISB 0147 Amd 23/2011 Changes to the National Cancer Waiting Times Monitoring Data Set published in the June 2012 release

The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2013:

CR1231 and CR1288 (1 April 2013) - ISB 1570 Amd 164/2010 HIV and AIDS Reporting Data Set and HIV and AIDS Related Data Set Message

Release: September 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1103 (Immediate) - ISB 0066 Amd 43/2010 Renal Data Set - Data Item Addition, Changes and Deletions
CR1334 (Immediate) - DDCN 1334/2012 Psychology Definitions
CR1331 (Immediate) - DDCN 1331/2012 Activity Date Time Type
CR1329 (Immediate) - DDCN 1329/2012 Change of name for "Health and Social Care Information Centre"

Release: August 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1326 (Immediate) - DDCN 1326/2012 Health and Care Professions Council
CR1241 (Immediate) - DDCN 1241/2012 NHS dictionary of medicines and devices
CR1292 (Immediate) - ISB 1549 Amd 4/2011 and DDCN 1292/2012 Deprecation and withdrawal of version 3.2 of the Acute Myocardial Infarction Data Set and subsequent retiring of the Data Set from the NHS Data Model and Dictionary

Release: June 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1314 (Immediate) - DDCN 1314/2012 Reasonable Offer Update
CR1282 (29 June 2012) - ISB 0090 Amd 36/2011 Independent Sector Healthcare Provider (ISHP) Codes extended for ISHPs and Sites
CR1258 (1 July 2012) - ISB 0147 Amd 23/2011 Changes to the National Cancer Waiting Times Monitoring Data Set

Release: May 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1215 (1 June 2012) - ISB 1067 Amd 30/2011 National Workforce Data Set
The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2013:
CR1028 (1 April 2013) - ISB 1069 Amd 14/2012 Children and Young People's Health Services Data Set
CR1029 (1 April 2013) - ISB 1072 Amd 12/2012 Child and Adolescent Mental Health Services (CAMHS) Data Set
CR1104 (1 April 2013) - ISB 1513 Amd 13/2012 Maternity Secondary Uses Data Set

Release: March 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1242 (Immediate) - DDCN 1242/2012 Retirement of Mental Health Minimum Data Set Version 3
CR1238 and CR1276 (1 April 2012) - ISB 1577 Amd 10/2011 Diagnostic Imaging Data Set and Diagnostic Imaging Data Set Message v 1-0
CR1290 (Immediate) - DDCN 1290/2012 Data Set Notation
CR1263 (Immediate) - ISB 0090 Amd 5/2012 Health and Social Care Bill Changes
CR1255 (31 March 2012) - ISB 1576 Amd 08/2011 Quarterly Bed Availability and Occupancy Data Set
CR1295 (Immediate) - Retirement of old Commissioning Data Set messages
The Information Standards Board for Health and Social Care have been involved in the redesign and retirement of the old Commissioning Data Set Pages, however a formal Information Standards Notice (ISN) will not be published as there are no changes to data standards.

Release: January 2012

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1285 (Immediate) - DDCN 1285/2012 Elective Admission Type
CR1252 (Immediate) - DDCN 1252/2011 Geographic Area Changes

Release: November 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1264 (Immediate) - ISB 1077 Amd 3/2012 Automatic Identification and Data Capture (AIDC) for Patient Identification Data Set
CR1274 (Immediate) - DDCN 1274/2011 CDS Prime Recipient Identity Update
The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2012:
CR1265 (1 April 2012) - ISB 1520 Amd 29/2011 Changes to the Improving Access to Psychological Therapies Data Set

Release: October 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1271 (Immediate) - DDCN 1271/2011 Commissioning Data Set Addressing Grid Update
CR1268 (Immediate) - DDCN 1268/2011 Sexual Orientation Code
The following has been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2012:
CR1158 and CR1260 (1 April 2012) - ISB 1533 Amd 63/2010 Systemic Anti-Cancer Therapy Data Set and Systemic Anti-Cancer Therapy Data Set Message Schema
The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 July 2012:
CR1270 (1 July 2012) - ISB 1080 Amd 25/2011 Amendments to NHS Health Check Data Set
CR1250 (1 July 2012) - ISB 1080 Amd 25/2011 NHS Health Checks Data Set Message Schema Version 2.0.0

Release: August 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1232 (Immediate) - ISB 0034 Amd 26/2006 Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) - NHS Data Model and Dictionary Overview
CR1222 (1 April 2012) - ISB 0021 Amd 86/2010 Introduction of the International Classification of Diseases Tenth Revision 4th Edition
CR1190 (1 September 2011) - ISB 1538 Amd 131/2010 Chlamydia Testing Activity Data Set
CR1188 (Immediate) - Amd 85/2010 Genitourinary Medicine Clinic Activity Data Set (GUMCAD) Extension to include Enhanced Sexual Health Services (ESHS)

The following data set is initially being introduced for local use only. A future Information Standards Notice will be published to notify providers and system suppliers of the requirement to flow the data set nationally:

CR1105 (1 April 2012) - ISB 1510 Amd 25/2010 Community Information Data Set

Release: July 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1249 (Immediate) - DDCN 1249/2011 General Pharmaceutical Council Registration Changes

The following has been incorporated early to allow users to see the changes, but please note that the implementation date is 1 July 2012:

CR1148 (1 July 2012) - ISB 1080 Amd 129/2010 NHS Health Checks Data Set

Release: June 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1256 (Immediate) - DDCN 1256/2011 School Definitions
CR1117 (26 August 2011) - ISB 0090 Amd 94/2010 Organisation Data Service Identification Codes for Local Authorities in England and Wales
CR1251 (Immediate) - DDCN 1251/2011 Change to the Format/Length of Weekly Hours Worked
CR1243 (Immediate) - DDCN 1243/2011 National Interim Clinical Imaging Procedure (NICIP) Code Set

Release: April 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1154 (1 April 2011) - ISB 0011 Amd 87/2010 Mental Health Minimum Data Set Version 4.0
CR1234 (Immediate) - DDCN 1234/2011 Technology Reference Data Update Distribution Service (TRUD)
CR1168 (Immediate) - ISB 0097 Amd 140/2010 Genitourinary Medicine Access Monthly Monitoring Data Set Amendments - Removal of Human Immunodeficiency Virus data

The following has been incorporated early to allow users to see the changes, but please note that the implementation date is 1 April 2012:

CR1050 (1 April 2012) - ISB 1520 Amd 51/2010 Improving Access to Psychological Therapies Data Set

Release: March 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1224 (1 April 2011) - ISB 0092 Amd 02/20110 Commissioning Data Set Schema Version 6-1-1
CR1223 (Immediate) - DDCN 1223/2011 Updates to Family Planning References
CR1225 (Immediate) - DDCN 1225/2011 Practitioners with Special Interests
CR1216 (1 April 2011) - ISB 0028 Amd 170/2010 Changes to Treatment Function Codes
CR1203 (1 April 2011) - ISB 0084 Amd 150/2010 Introduction of OPCS Classification of Interventions and Procedures Version 4.6

Release: January 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1116 (1 April 2010) - ISB 0003 Amd 79/2010 Immunisation Programmes Activity Data Set (KC50)
CR1112 (1 April 2010) - ISB 1511 Amd 26/2010 NHS Continuing Healthcare and NHS Funded Nursing Care
CR1068 (Immediate) - ISB 0133 Amd 161/2010 Change To Central Return: Human Papillomavirus (HPV) Immunisation Programme - Vaccine Monitoring Minimum Data Set
CR1211 (Immediate) - DDCN 1211/2010 Commissioning Data Set Addressing Grid / Organisation Code (Code of Commissioner) Update

Release: December 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1175 (1 April 2011) - ISB 1518 Amd 166/2010 Changes to Sexual and Reproductive Health Activity Data Set
CR1198 (Immediate) - ISB 1067 Amd 165/2010 National Workforce Data Set
CR1207 (01 December 2010) - ISB 1573 Amd 168/2010 Mixed-Sex Accommodation
CR1149 (01 January 2011) - ISB 0139 Amd 99/2010 GUMCAD: Change to Genitourinary (GU) Episode Types

Release: November 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1119 (Immediate) - DDCN 1119/2010 Organisation Codes Update
CR1192 (Immediate) - DDCN 1192/2010 Change of name for "Health Solution Wales"
CR1199 (Immediate) - DDCN 1199/2010 General Pharmaceutical Council and Royal Pharmaceutical Society of Great Britain Update
CR1189 (Immediate) - DDCN 1189/2010 National Institute for Health and Clinical Excellence
CR1187 (Immediate) - DDCN 1187/2010 Introduction of the Department for Education

Release: September 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

CR1128 (Immediate) - DDCN 1128/2010 Changes to reporting procedures for Overseas Visitors from the European Economic Area and Switzerland
CR1173 (Immediate) - DDCN 1173/2010 Care Quality Commission Update
CR1143 (Immediate) - DDCN 1143/2010 General Pharmaceutical Council
CR1061 (1 October 2010) - ISB 0092/2010 CDS Type 20: Out-patient: Retirement of Default Codes for Out-patient Procedures
CR1133 (Immediate) - ISB 00289/2010 National Specialty List

Release: August 2010

The August 2010 Release introduces the NHS Data Model and Dictionary Help Pages.

Release: July 2010

Information Standards Notices and Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

CR1134 (Immediate - ISB 1067/2010 Amd 109/2010 National Workforce Data Set
CR1082 (Immediate) - ISB 0153/2010 Critical Care Minimum Data Set
CR1121 (Immediate) - DSCN 17/2010 Retirement of Data Standard KC60 Central Return