This return is out of date therefore the information should not be used.
For the latest version of the guidance, please see the Health and Social Care Information Centre website at: Ambulance Services Collection (KA34).

Ambulance Services Data Set (KA34) Overview

The Ambulance Services Data Set (KA34) carries the data for monitoring key targets and standards on services provided by NHS Trusts. It should be used to record information on Ambulance Services.

National Neonatal Data Set Overview

The National Neonatal Data Set has been incorporated early to allow users to see the changes, but please note that the implementation date is 1 June 2014.

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.

Note: items in the M/R/O column which are shown with notation P have not been approved by the Information Standards Board for Health and Social Care, and are included to facilitate piloting and testing of future Neonatal Data Analysis Unit data requirements, prior to formal inclusion in later versions of the data set.  These items have been included in the data set layout in order to provide advance notice to data providers and system suppliers of the intention to require these items at a later date. Unless ORGANISATIONS are engaged in piloting activities relating to these items, they should NOT submit any data item marked P.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

This section contains data items to capture PATIENT identifiers, demographic information and organisational data.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

The data items in this section apply only to PATIENTS receiving kidney Renal Dialysis. The section contains items such as PATIENT observations relevant to their Renal Dialysis treatment and adequacy, complications and procedures to construct access.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

This section specifies items applicable only to paediatric renal PATIENTS.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

This section captures indicators on the prescription of various medications and items specific to renal care and their dosages.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

This is a general nephrology section capturing a wide range of data. It includes a PATIENT’s treatment, procedures, co-morbidities, test results and observations.

National Renal Data Set Overview

Items that are marked * are not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.Items that are marked * were not approved by the Information Standards Board for Health and Social Care as they are under review and will be defined at a later version.

There are two distinct areas of this section, data items to be captured for the recipient of a kidney transplant and the data items to be captured for the donor of that transplant.

Quarterly Monitoring Cancelled Operations Data Set (QMCO) Overview

The Quarterly Monitoring Cancelled Operations Data Set (QMCO) carries the data for monitoring key targets and standards on services provided by NHS Trusts and Primary Care Trusts. It should be used to record information on operation cancellations.

Adult Mental Health Care Spell is a Care Spell, which is an ACTIVITY GROUP.An Adult Mental Health Care Spell is a Care Spell, which is an ACTIVITY GROUP.

A continuous period of care or assessment for an adult (including elderly) PATIENT provided by a Health Care Provider's specialist mental health services.An Adult Mental Health Care Spell is a continuous period of care or assessment for an adult (including elderly) PATIENT provided by a Health Care Provider's specialist mental health services. This includes the care or assessment of adult and elderly PATIENTS with drug or alcohol dependence but excludes child and adolescent psychiatry PATIENTS and PATIENTS whose only mental disorder is a learning disability. The specialist mental health services are delivered by mental health professionals, some of whom may receive referrals directly.

An Adult Mental Health Care Spell is initiated by a referral, or the temporary or permanent transfer of main responsibility for provision of mental health care for the PATIENT from another Health Care Provider, and ends with a DISCHARGE DATE (MENTAL HEALTH SERVICE).

For referrals, the Adult Mental Health Care Spell commences with an initial assessment which will determine whether treatment or care by the Health Care Provider's specialist mental health services is appropriate. If not appropriate, then the Adult Mental Health Care Spell will end.

Adult Mental Health Care Team is a CARE PROFESSIONAL TEAM.An Adult Mental Health Care Team is a CARE PROFESSIONAL TEAM.

An Adult Mental Health Care Team is a team of professionals delivering specialist mental health services, including secondary and self-referral services, for adult and elderly PATIENTS. This includes the care or assessment of adult and elderly PATIENTS with drug or alcohol dependence but excludes child and adolescent psychiatry PATIENTS and PATIENTS with Learning Disabilities.

The Adult Mental Health Care Team can be multidisciplinary and may contain members who are employees of the Health Care Provider or be employees of other NHS or non-NHS ORGANISATIONS.

An Adult Mental Health Care Team Episode is an ACTIVITY GROUP.

A continuous period of care for a PATIENT by one or more Adult Mental Health Care Teams.An Adult Mental Health Care Team Episode is a continuous period of care for a PATIENT by one or more Adult Mental Health Care Teams.

This return is out of date therefore the information should not be used.
For the latest version of the guidance, please see the Health and Social Care Information Centre website at: Ambulance Services Collection (KA34).

Contextual Overview

• The Department of Health requires summary details from NHS Health Care Providers on ambulance activity. The Ambulance Services Data Set (KA34) provides performance management measures of response times; these are also required by NHS Trusts for Ambulance Service internal monitoring and for defining service agreements.
• The information originally monitored 'Your guide to the NHS' targets and the standards introduced following a review of ambulance performance standards in 1996-97. The standards required that all Ambulance Services would be expected to reach 75% of immediately life-threatening calls within 8 minutes irrespective of location and that all incidents that require a fully equipped Ambulance vehicle (car or Ambulances) must have a vehicle, able to transport the PATIENT in a clinically safe manner (Emergency Ambulance), arrive within 19 minutes of the TRANSPORT REQUEST being made in 95% of cases.
• The information is required to inform strategic policy development, to provide data to the Care Quality Commission for performance and activity assessment, to ensure that Spending Review bids reflect changes to overall demand and to inform the development of Ambulance Service reference costs.
• Information based on the data set is published annually in the Health and Social Care Information Centre's Statistical Bulletin 'Ambulance services; England'.

Collection and Submission of the Ambulance Services Data Set (KA34)

• The Ambulance Services Data Set (KA34) is completed by NHS Trusts providing Ambulance Services.
• The Ambulance Services Data Set (KA34) relates to ACTIVITY taking place over a 12 month period, between 1 April of one year and 31 March of the following year. The return is made annually and submitted within one month of the end of the year to which it relates, online to the Health and Social Care Information Centre via the Omnibus Survey system.
• The Ambulance Services Data Set (KA34) requires the ORGANISATION CODE and ORGANISATION NAME of the NHS Ambulance Trust - the NHS Health Care Provider of the Ambulance Service.

Synopsis of the Ambulance Services Data Set (KA34)

Part 1 Additional Guidance

• EMERGENCY CALLS RESOLVED BY TELEPHONE TOTAL is not required for RESPONSE CATEGORY National Code 'Category A: immediately life threatening - presenting conditions which require a fully equipped Emergency Ambulance to attend the incident'.

• EMERGENCY RESPONSE WITHIN 8 MINUTES TOTAL and EMERGENCY CALLS RESOLVED BY TELEPHONE TOTAL are not required for RESPONSE CATEGORY National Code 'Category B: serious but not immediately life threatening'.

• EMERGENCY RESPONSE WITHIN 8 MINUTES TOTAL, EMERGENCY RESPONSE NO AMBULANCE REQUIRED TOTAL, EMERGENCY RESPONSE AMBULANCE ARRIVED TOTAL and EMERGENCY RESPONSE WITHIN 19 MINUTES TOTAL are not required for RESPONSE CATEGORY National Code 'Category C: other emergency calls which are not immediately life threatening or serious'.

Only the first Emergency Ambulance to arrive at the scene of the TRANSPORT REQUEST INCIDENT should be included in lines 05 and 06 where more than one Emergency Ambulance has been despatched.

Timing of Emergency Response Times

In order to calculate the response time, the 'clock starts' at the TRANSPORT REQUEST CALL CONNECT TIME and the 'clock stops' on the TRANSPORT REQUEST FIRST RESPONSE ARRIVAL TIME or the AMBULANCE ARRIVAL TIME at the scene of the TRANSPORT REQUEST INCIDENT.

An Emergency Response within 8 minutes means 8 minutes 0 seconds (i.e. 480 seconds) or less. Similarly, 19 minutes means 19 minutes 0 seconds or less.

Cross-border Transport Requests

A TRANSPORT REQUEST/TRANSPORT REQUEST INCIDENT that crosses more than one Ambulance Service's boundary should be reported by only one Ambulance Service.

Each NHS Ambulance Service is responsible for reporting on the performance of all Emergency Transport Requests for which it receives the initial TRANSPORT REQUEST. This includes TRANSPORT REQUESTS received by an Ambulance Service that relate to TRANSPORT REQUEST INCIDENTS occurring outside its recognised boundary and TRANSPORT REQUESTS relating to TRANSPORT REQUEST INCIDENTS within or outside its boundary that are subsequently transferred to another Ambulance Service for response.

An Ambulance Service should not report, or report on the performance relating to, any TRANSPORT REQUEST INCIDENT where another Ambulance Service received the initial TRANSPORT REQUEST, even if the TRANSPORT REQUEST was transferred to and dealt with by that Ambulance Service. NHS Trusts responsible for dealing with any cross-border TRANSPORT REQUESTS should advise the NHS Trusts who received the initial TRANSPORT REQUEST of all appropriate clock times for performance reporting purposes.

Where an NHS Ambulance Service asks another NHS Ambulance Service to undertake a TRANSPORT REQUEST on its behalf, the responsibility for dealing with the TRANSPORT REQUEST in the most appropriate way passes to the receiving Ambulance Service once it has accepted it.

Air Ambulances

Air Ambulances are managed locally by Ambulance Services and financed through charitable funding. Any PATIENT TRANSPORT JOURNEY provided by air Ambulance should, therefore, not be included in the Ambulance Services Data Set (KA34).

An Appointment Request is a type of SERVICE REQUEST for an APPOINTMENT.

Each originating request may result in one or more APPOINTMENT OFFERS, the originating request may be from:

• a PATIENT self-referral REFERRAL REQUEST
• a REFERRAL REQUEST from one ORGANISATION or CARE PROFESSIONAL to another ORGANISATION or CARE PROFESSIONAL
• follow up to a previous APPOINTMENT at which attendance or contact has taken place related to the same REFERRAL REQUEST
• an APPOINTMENT at which attendance did not take place for whatever reason, requiring a new APPOINTMENT to be made
• an invitation for an APPOINTMENT as part of a HEALTH PROGRAMME
• an ACTIVITY which requires an APPOINTMENT to be made for further care or treatment.

Each Appointment Request should be reviewed by the receiving CARE PROFESSIONAL, ORGANISATION or SERVICE to decide whether an offer of an APPOINTMENT should be made. DECISION TO OFFER AN APPOINTMENT DATE records the date the decision was made to offer an APPOINTMENT.

It is on this date it is considered that the PATIENT has been added to the Out-Patient Waiting List for the APPOINTMENT with the expectation that it will take place.

When it is decided that an offer of an APPOINTMENT should be made then one or more APPOINTMENT OFFER should be offered each of which will record a separate and different APPOINTMENT DATE OFFERED and APPOINTMENT TIME OFFERED to the PATIENT.

The APPOINTMENT DATE OFFERED and APPOINTMENT TIME OFFERED of the APPOINTMENT OFFER equate to the allocated APPOINTMENT SLOT.

When more than one date is offered for the same Appointment Request, the PATIENT can choose which date and time to accept. APPOINTMENT ACCEPTED DATE records whether the offer has been accepted. When multiple dates are offered, the PATIENT should only be allowed to select one of them.

The SERVICE REQUEST DATE and SERVICE REQUEST TIME will also be the default created and recorded date and time for each APPOINTMENT OFFER made for the Appointment Request.

The minimum Commissioning Data Sets information flow requirement to enable Hospital Episode Statistics, 18 Weeks ACTIVITY reporting, and Payment by Results to be supported by the Secondary Uses Service is shown in the table below.

The Secondary Uses Service supports every CDS TYPE but only a subset is mandated to flow.

Commissioning Data Sets may flow to the Secondary Uses Service using either Net Change or Bulk Replacement Commissioning Data Set Submission Protocols.  Many Standard NHS Contracts between Health Care Providers and the commissioners of their SERVICES, now specify weekly submission of initially-coded data sets to the Secondary Uses Service.  The use of Net Change Commissioning Data Set Submission Protocols is recommended for submissions of this frequency.

The use of XML was mandated by the e-Government Interoperability Framework (e-GIF) programme as the standard to be used for messaging by government organisations and has accordingly been adopted by the NHS.

For the submission of Commissioning Data Set data to the Secondary Uses Service, XML based messaging has been developed replacing all previously published Commissioning Data Set Message formats.

The CDS-XML Message Schema is supported and applied in the Secondary Uses Service front-end software service (the XML Transfer Service - XTS) to enforce a nationally agreed data specification and thus help protect the data quality and integrity of the data submitted to and stored within the Secondary Uses Service.

It should be noted that after accepting the schema instance data, the Secondary Uses Service then applies further logical data validations and may identify and report further data conditions.

For the most part, the schema applies the data specifications as authorised by the NHS and documented in the NHS Data Model and Dictionary. However, as the NHS Data Model and Dictionary is updated on a continuous time basis and schemas are usually less dynamic and by nature updated on a longer time cycle, there may be subtle differences in the data specifications applied in the schema. However, as the NHS Data Model and Dictionary is updated on a continuous time basis and schemas may be less dynamic and updated on a longer time cycle, there may be subtle differences in the data specifications applied in the schema. For example, additional National Codes may be supported in one version of the Commissioning Data Set XML schema but not in earlier versions. Where this is the case, information relating to the supported National Codes can be found on the CDS Version 6-2 XML Schema Constraints page and associated Attribute and Data Elements.

This variation often applies where a schema may contain historic data element values and the NHS Data Model and Dictionary may have been updated with a revised set of values since the schema was last released.Additionally a schema may deliberately retain historic National Codes as well as supporting the new National Codes in order to enable NHS users to be able to process historic data.

Another variation is where a schema deliberately retains historic values as well as supporting the new values in order to enable NHS users to be able to process historic data.

Schema Standards
The overall standards applied and supported by the schema are:

• W3C schema standards
• e-Government Interoperability Framework (e-GIF)
• e-GOV Best Practice guidelines for XML Schema
• The NHS Data Model and Dictionary

Note:
e-GIF and the Government Data Standards Catalogue have been archived and are available for reference only.

Schema Documentation
Schema documentation usually consists of several related publications:

• Information Standards Notices (ISN)  issued for NHS business, process and definition changes; these will usually include the Data Sets, Data Element definitions etc.
• Information Standards Notices issued to authorise the CDS-XML Schema itself
• The CDS-XML Schema Release Notice which provides a technical overview of the release (in MS WORD)
• The XMLSPY©) generated Schema Documentation which is a large collection of HTML files.

• The Standard Data Elements
• The Standard Data Structures
• All sub-component schemas for CDS TYPES including the Commissioning Data Set Headers and Trailers

Day Care Session is a SESSION.A Day Care Session is a SESSION.

A Day Care Session under the control of a CARE PROFESSIONAL, run at a Day Care Facility. Sessions will generally last for half a day, an evening or a whole day.A Day Care Session is under the control of a CARE PROFESSIONAL, run at a Day Care Facility.

PATIENTS participating in a Day Care Session will be recorded as Day Care Attendances.Sessions will generally last for half a day, an evening or a whole day.

Information recorded for a Day Care Session includes:PATIENTS participating in a Day Care Session will be recorded as Day Care Attendances.

An indication of whether the face to face contact is the first occasion on which a PATIENT is seen by the particular Professional Staff Group Service, staff group (community) or Sexual and Reproductive Health Service between 1st April and the following 31st March. This contact may also be the Initial Contact.

An Initial Contact is not necessarily the First Contact In Financial Year as the PATIENT may have had another episode which ended earlier in the financial year.

Classification:

A Fraction is a CLINICAL INTERVENTION.

A Fraction is a set of exposures delivered or intended to be delivered to a PATIENT in the course of one visit to a Radiotherapy room.

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

Genitourinary Consultant Clinic Attendance is a CARE CONTACT.A Genitourinary Consultant Clinic Attendance is a CARE CONTACT.

An attendance of a PATIENT at or contact with a Consultant Clinic as part of a Sexual Health And HIV Episode.A Genitourinary Consultant Clinic Attendance is an attendance of a PATIENT at or contact with a Consultant Clinic as part of a Sexual Health And HIV Episode.

Information recorded for a Genitourinary Consultant Clinic Attendance includes:

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.The Mental Health Minimum Data Set was introduced by DSCN 20/99/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.Since April 2003 (DSCN 49/2002) it has been a mandatory requirement that all Providers of specialist adult, including elderly, mental health services submit central Mental Health Minimum Data Set returns on a quarterly basis, with an additional annual submission. 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.  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. 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.hscic.gov.uk/mhmdsFor further information on the Mental Health Minimum Data Set, please view the Health and Social Care Information Centre website at: Mental Health Minimum Data Set.

Mental Health Minimum Data Set Version History

The full list of documentation related to this standard can be found on the Information Standards Board for Health and Social Care webiste at: Standard ISB 0011

A Mental Health Responsible Clinician is a CARE PROFESSIONAL.

A Mental Health Responsible Clinician is a CARE PROFESSIONAL, with a MENTAL HEALTH RESPONSIBLE CLINICIAN PROFESSION within a particular TREATMENT FUNCTION, to act as the clinical supervisor for a Mental Health Care Spell.

There will be only one CARE PROFESSIONAL assigned to a PATIENT as the Mental Health Responsible Clinician at any one time. These assignments may change during the course of a Mental Health Care Spell, though not necessarily at the time of a Care Programme Approach Review.

The role of Mental Health Responsible Clinician was introduced in the Mental Health Act 2007 and replaces the role of the Responsible Medical Officer.

Information recorded for a Mental Health Responsible Clinician includes:

Mental Health Responsible Clinician Assignment is an ACTIVITY GROUP.A Mental Health Responsible Clinician Assignment is an ACTIVITY GROUP.

The period of time a Mental Health Responsible Clinician is assigned to the PATIENT.A Mental Health Responsible Clinician Assignment is the period of time a Mental Health Responsible Clinician is assigned to the PATIENT.

The National Interim Clinical Imaging Procedure Code Set (NICIP Code Set) is a comprehensive national standard set of codes and descriptions for imaging procedures and is maintained by the UK Terminology Centre.  It is intended for use in all Imaging Department information systems.

The NICIP Code Set has been approved by the Information Standards Board for Health and Social Care (ISB) and is mandated for all in-scope use cases.The NICIP Code Set was approved by the Information Standards Board for Health and Social Care (ISB) and is mandated for all in-scope use cases. Further detail about the initial information standard and subsequent amendments can be found on the Information Standards Board for Health and Social Care website at: ISB 0148 "Interim Clinical Imaging Procedure Codes".

The NICIP Code Set is released biannually. The release dates are the 1st of April and the 1st of October each year.

All versions of the NICIP Code Set, both with and without SNOMED CT maps, are only available from the Technology Reference Data Update Distribution Service (TRUD).

Clinicians and system managers working with the Picture Archiving and Communication Systems (PACS) and Radiology Information Systems (RIS) can make requests for additions to the NICIP Code Set. All requests must first be checked for conformance to the Editorial Principles.

Requests for changes to the NICIP Code Set should be made via the Information Standards Service Desk and clearly marked “Diagnostic Imaging."

For further information on the National Interim Clinical Imaging Procedure Code Set, see the UK Terminology website.

Operating Theatre Session is a SESSION.An Operating Theatre Session is a SESSION.

A period of OPERATING THEATRE time allocated to one or more consultant firms (CONSULTANT).An Operating Theatre Session is a period of OPERATING THEATRE time allocated to one or more consultant firms (CONSULTANT).

A SESSION is either scheduled or unscheduled.

• A scheduled session is when the allocation of time is made to one CONSULTANT whose firm is responsible for the utilisation of this session. It does not include time made available for an operation on a particular PATIENT unless the operation is included in a scheduled session as above and performed by a member of a consultant firm of the same TREATMENT FUNCTION CODE as that allocated to the session.
• An unscheduled session is when an allocation of time is made available for one or more Theatre Cases in any circumstances outside a scheduled session as above. Theatre Cases in unscheduled sessions may be the responsibility of different CONSULTANTS.

A scheduled session is when the allocation of time is made to one CONSULTANT whose firm is responsible for the utilisation of this session. It does not include time made available for an operation on a particular PATIENT unless the operation is included in a scheduled session as above and performed by a member of a consultant firm of the same TREATMENT FUNCTION CODE as that allocated to the session.

An unscheduled session is when an allocation of time is made available for one or more Theatre Cases in any circumstances outside a scheduled session as above. Theatre Cases in unscheduled sessions may be the responsibility of different CONSULTANTS.

An Operating Theatre Session may under/over-run the allocated time. The allocation, i.e. consultant firm, time and/or theatre may change by agreement any time before the session starts.

An Operating Theatre Session should be considered cancelled if the time slot allocation is not used to perform at least one operation.

Primary Procedure Date is an ACTIVITY DATE TIME.A Primary Procedure Date is an ACTIVITY DATE TIME.

Primary Procedure Date is the ACTIVITY DATE of the PRIMARY OPERATION (OPCS-4).A Primary Procedure Date is the ACTIVITY DATE of the primary Patient Procedure.

Data Set Change Notice 18/2006 published in December 2006, defined essential new data items required to support the measurement of 18 week REFERRAL TO TREATMENT PERIODS (monitoring of DH PSA target 13 - "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment"). In particular, the Data Set Change Notice 18/2006 introduced the following new data items.DSCN 18/2006 published in December 2006, defined essential new data items required to support the measurement of 18 week REFERRAL TO TREATMENT PERIODS (monitoring of DH PSA target 13 - "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment").

In particular, DSCN 18/2006 introduced the following new data items.

• PATIENT PATHWAY IDENTIFIER
• REFERRAL TO TREATMENT PERIOD START DATE
• REFERRAL TO TREATMENT PERIOD END DATE
• REFERRAL TO TREATMENT STATUS (replaced with REFERRAL TO TREATMENT PERIOD STATUS at CDS V6-2)

Strategic reporting of 18 weeks will be undertaken by the Secondary Uses Service using data obtained via the Commissioning Data Sets. The new data items defined in Data Set Change Notice 18/2006 are enabled to flow in Commissioning Data Set versions 6-1 and 6-2, and will continue to flow in subsequent versions. The data items defined in DSCN 18/2006 are enabled to flow in Commissioning Data Set versions 6-1 and 6-2, and will continue to flow in subsequent versions.

However, an event which results in an update to the REFERRAL TO TREATMENT PERIOD STATUS may occur outside the events that are defined in the Commissioning Data Sets (typically Outpatient or Inpatient encounters) and will therefore not flow to the Secondary Uses Service. These types of events have been termed as "administrative events". They can be defined as any communication event between the Health Care Provider and the PATIENT that occurs outside of an outpatient attendance or inpatient admission and that results in the PATIENT's REFERRAL TO TREATMENT PERIOD STATUS being changed to stop the 18 week clock. These events are not face to face consultations and do not necessarily involve clinical staff.

These Referral To Treatment Clock Stop Administrative Events may be carried using the Commissioning Data Set Type 020 Outpatient record type. They are differentiated from PATIENT contact ACTIVITY by the FIRST ATTENDANCE value carried within them. FIRST ATTENDANCE national code 5 "Referral to treatment clock stop administrative event" signifies that an ACTIVITY has taken place which has ended the REFERRAL TO TREATMENT PERIOD and changed the REFERRAL TO TREATMENT PERIOD STATUS to one of the following:

• 30 Start of First Definitive Treatment
• 31 Start of Active Monitoring initiated by the PATIENT
• 32 Start of Active Monitoring initiated by the CARE PROFESSIONAL
• 34 Decision not to treat - decision not to treat made or no further contact required
• 35 PATIENT declined offered treatment
• 36 PATIENT died before treatment

When to Use Referral To Treatment Clock Stop Administrative Events

These events may happen because:

• The ACTIVITY ending the event does not qualify as a "patient contact" between a clinician and PATIENT, or
• The ACTIVITY occurred in a setting where IT systems cannot produce REFERRAL TO TREATMENT PERIOD data items, or
• The ACTIVITY would be carried in a Commissioning Data Set record type not currently processed by the Secondary Uses Service

Secondary Uses Service Processing

The Secondary Uses Service currently processes the following Commissioning Data Set record types in order to build Referral To Treatment pathways.

• CDS V6-1 Type 020 - Outpatient CDS / CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode CDS / CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode CDS / CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set

All other types are not currently processed and so if they carry the  REFERRAL TO TREATMENT PERIOD END DATE for a REFERRAL TO TREATMENT PERIOD, a Referral To Treatment Clock Stop Administrative Event must also be sent in order to inform the Secondary Uses Service of the clock stop.

Note that future versions of the Secondary Uses Service will also process:

• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) CDS / CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) CDS / CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) CDS / CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) CDS / CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

The dates when ORGANISATIONS submitting REFERRAL TO TREATMENT PERIOD data to the Secondary Uses Service can cease having to also send a Referral To Treatment Clock Stop Administrative Event when a clock stop is carried in one of the Elective Admission List Commissioning Data Set Types, will be notified as part of the Secondary Uses Service release documentation. It is also anticipated that CDS V6-2 Type 021 - Future Outpatient CDS will be processed once piloting is complete and its use is approved by the Information Standards Board for Health and Social Care. A cancelled future APPOINTMENT record could carry a REFERRAL TO TREATMENT PERIOD Clock Stop. Again the timescales will be notified as part of the Secondary Uses Service release documentation.

There are no current plans for the Secondary Uses Service to process the remaining Commissioning Data Set Types:

• CDS V6-1 Type 010 - Accident and Emergency CDS / CDS V6-2 Type 010 - Accident and Emergency Commissioning Data Set
• CDS V6-1 Type 040 - Elective Admission List - End Of Period Census (Old) CDS / CDS V6-2 Type 040 - Elective Admission List - End Of Period Census (Old) Commissioning Data Set
• CDS V6-1 Type 050 - Elective Admission List - End Of Period Census (New) CDS / CDS V6-2 Type 050 - Elective Admission List - End Of Period Census (New) Commissioning Data Set
• CDS V6-1 Type 090 - Elective Admission List - Event During Period (Available / Unavailable) CDS / CDS V6-2 Type 090 - Elective Admission List - Event During Period (Available or Unavailable) Commissioning Data Set
• CDS V6-1 Type 100 - Elective Admission List - Event During Period (Old Service Agreement) CDS / CDS V6-2 Type 100 - Elective Admission List - Event During Period (Old Service Agreement) Commissioning Data Set
• CDS V6-1 Type 110 - Elective Admission List - Event During Period (New Service Agreement) CDS / CDS V6-2 Type 110 - Elective Admission List - Event During Period (New Service Agreement) Commissioning Data Set
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode CDS / CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 140 - Admitted Patient Care - Finished Delivery Episode CDS / CDS V6-2 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set
• CDS V6-1 Type 150 - Admitted Patient Care - Other Birth Event CDS / CDS V6-2 Type 150 - Admitted Patient Care - Other Birth Event Commissioning Data Set
• CDS V6-1 Type 160 - Admitted Patient Care - Other Delivery Event CDS / CDS V6-2 Type 160 - Admitted Patient Care - Other Delivery Event Commissioning Data Set
• CDS V6-1 Type 170 - Admitted Patient Care - Detained and/or Long Term Psychiatric Census CDS / CDS V6-2 Type 170 - Admitted Patient Care - Detained and or Long Term Psychiatric Census Commissioning Data Set
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode CDS / CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set
• CDS V6-1 Type 200 - Admitted Patient Care - Unfinished Delivery Episode CDS / CDS V6-2 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set

This is because a Referral To Treatment Clock Stop Administrative Event occurring in the scenarios where these record types are generated, would be rare. However this will be reviewed as part of the ongoing maintenance of the Referral To Treatment Clock Stop Administrative Event, and the requirements for the Secondary Uses Service.

When NOT to Use a Referral To Treatment Clock Stop Administrative Event

The Referral To Treatment Clock Stop Administrative Event should NOT be used to correct previously submitted records where a REFERRAL TO TREATMENT PERIOD END DATE was submitted incorrectly to the Secondary Uses Service.

For example, if an Out-Patient Appointment took place where First Definitive Treatment was started, but the REFERRAL TO TREATMENT PERIOD END DATE was not sent in the corresponding CDS V6-1 Type 020 - Outpatient Commissioning Data Set/ CDS V6-2 Type 020 - Outpatient Commissioning Data Set record as it was not entered on the Patient Administration System until later; then the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set record should be resubmitted with the correct data. A Referral To Treatment Clock Stop Administrative Event should NOT be used.

Where an ORGANISATION's Patient Administration System supports the submission of cancelled and Did Not Attend appointments in the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set, the Referral To Treatment Clock Stop Administrative Event should NOT be used when a PATIENT has a booked Out-Patient Appointment, which is then cancelled because, for example, the PATIENT dies. In these cases the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set can carry the details of a cancelled CARE ACTIVITY, including the REFERRAL TO TREATMENT PERIOD END DATE and update to the REFERRAL TO TREATMENT PERIOD STATUS. (Note - not all Patient Administration Systems provide functionality to create and submit Commissioning Data Set records for cancellations/Did Not Attend's as this is not yet mandated - you should contact your Patient Administration System support team to ascertain whether your Patient Administration System supports this. If not, then it is permissible to send a Referral To Treatment Clock Stop Administrative Event in order to stop the clock in the Secondary Uses Service instead).

Referral To Treatment Clock Stop Administrative Events only require a sub-set of the data elements contained in the CDS V6-1 Type 020 - Outpatient Commissioning Data Set / CDS V6-2 Type 020 - Outpatient Commissioning Data Set record, to be submitted to the Secondary Uses Service. All other data elements not listed should be omitted from the XML submission of the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set record to the Secondary Uses Service. The submission of a Referral To Treatment Clock Stop Administrative Event is not reliant on the use of the Net Change Commissioning Data Set Submission Protocol to the Secondary Uses Service

The required data elements making up a Referral To Treatment Clock Stop Administrative Event are:

Regular Attender Episode is an ACTIVITY GROUP.A Regular Attender Episode is an ACTIVITY GROUP.

This is a period of care for a regular day attender attending one or more Day Care Facilities of a Health Care Provider within a particular day care function. Regular day attenders are PATIENTS attending a Day Care Facility who are not currently using a Hospital Bed or on Home Leave or on Mental Health Leave of Absence for a period of 28 days or less.A Regular Attender Episode is a period of care for a regular day attender attending one or more Day Care Facilities of a Health Care Provider within a particular day care function.

Regular Attender Episodes must be made up of one or more Day Care Attendances.Regular day attenders are PATIENTS attending a Day Care Facility who are not currently using a Hospital Bed or on Home Leave or on Mental Health Leave of Absence for a period of 28 days or less.

Information recorded for a Regular Attender Episode includes:Regular Attender Episodes must be made up of one or more Day Care Attendances.

A Specialist Community Public Health Nurse is a type of CARE PROFESSIONAL.A Specialist Community Public Health Nurse is a CARE PROFESSIONAL.

A PERSON whose name is registered in the Specialist Community Public Health Nurse's part of the Nursing and Midwifery Council Register maintained by the Nursing and Midwifery Council.A Specialist Community Public Health Nurse is a PERSON whose name is registered in the Specialist Community Public Health Nurse's part of the Nursing and Midwifery Council Register maintained by the Nursing and Midwifery Council.

The Specialist Community Public Health Nursing Committee's definition of Specialist Community Public Health Nursing is:

"Specialist Community Public Health Nursing aims to reduce health inequalities by working with individuals, families, and communities promoting health, preventing ill health and in the protection of health. The emphasis is on partnership working that cuts across disciplinary, professional and organisational boundaries that impact on organised social and political policy to influence the determinants of health and promote the health of whole populations". 

For further information on the Specialist Community Public Health Nursing Committee, see the Nursing and Midwifery Council website.

There are currently four types of Specialist Community Public Health Nurses listed on the Nursing and Midwifery Council Register:

• Specialist Community Public Health Nurse - Family Health Nurse
• Specialist Community Public Health Nurse - Health Visitor
• Specialist Community Public Health Nurse - Occupational Health Nurse
• Specialist Community Public Health Nurse - School Nurse

A Specialist Community Public Health Nurse: Family Health Nurse is a CARE PROFESSIONAL.

Since 2001 the World Health Organisation Health Organisation Europe’s Family Specialist Community Public Health Nurse - Family Health Nurse role has been developing in remote and rural areas of Scotland.

In 2003, an independent evaluation identified a need for facilitation of the Specialist Community Public Health Nurse - Family Health Nurse role and family-health orientated approaches with local primary health care teams. The Scottish Executive Health Department appointed three part-time, regionally-based Family Health Practice Development Facilitators (FHPDFs)  in December 2003 to work over an 18-month period. The Scottish government are currently exploring the possibility of rolling out the model across Scotland.

A Specialist Community Public Health Nurse: Health Visitor is a CARE PROFESSIONAL. 

A Specialist Community Public Health Nurse - Health Visitor is a qualified and registered NURSE or MIDWIFE who is specially trained to assess the health needs of individuals, families and the wider community by offering practical help and advice.

The role involves visiting people in their homes, in particular new parents and children under five, as well as working with other sections of the community. Working as a Specialist Community Public Health Nurse - Health Visitor may also include tackling the impact of social inequality on health, and working closely with at-risk or deprived groups.

A Specialist Community Public Health Nurse: Occupational Health Nurse is a CARE PROFESSIONAL.

Specialist Community Public Health Nurse - Occupational Health Nurses work in a variety of settings mainly industry, health services, commerce, and education. They can be employed as independent practitioners or as part of a larger occupational health service team, often attached to a personnel department. Specialist Community Public Health Nurse - Occupational Health Nurses are considered to be leaders in public health in the workplace setting.  

A Specialist Community Public Health Nurse: School Nurse is a CARE PROFESSIONAL.

Specialist Community Public Health Nurse - School Nurses provide a variety of services such as:

• providing health and sex education within Schools
• carrying out developmental screening
• undertaking health interviews, administering immunisation programmes etc.

Release: March 2014

• CR1388 (1 April 2014) - ISB 0090 Amd 17/2013 Updates to the Cancer Outcomes and Services Data Set and XML Schema
• CR1370 (1 April 2014) - ISB 0090 Amd 17/2013 Updates to the Systemic Anti-Cancer Therapy Data Set and XML Schema
• CR1322 (1 April 2014) - ISB 0090 Amd 17/2013 Changes to the Radiotherapy Data Set
• CR1387 (1 April 2014) - ISB 0084 Amd 10/2013 Introduction of OPCS-4.7
• CR1376 (1 April 2014) - ISB 1607 Amd 26/2013 Emergency Care Weekly Situation Report Data Set
• CR1433 (Immediate) - DDCN 1433/2014 Data Services for Commissioners
• CR1467 (1 April 2014) - DDCN 1467/2014 Retirement of Standards
• CR1464 (1 April 2014) - DDCN 1464/2014 Retirement of Standards - Domains and Diagrams
• CR1458 (1 April 2014) - DDCN 1458/2014 Retirement of Standards - DSCNs - 11/97/P05, 12/97/P06, 15/97/P09, 18/97/P12, 22/96/P19, 32/96/P27, 49/97/P35, 62/95/P51, 07/2007, 08/2009, 17/92, 20/2001, 22/2006 and 38/2002
• CR1444 (1 April 2014) - DDCN 1444/2014 Retirement of Standards
• CR1436 (1 April 2014) - DDCN 1436/2014 Retirement of Standards
• CR1435 (1 April 2014) - DDCN 1435/2014 Retirement of Standards - DSCNs 22/95/P21, 20/91, 21/93, 40/95/P34, 09/94/P04, 93/95/P76, 23/94/A04, 8/92 and 17/93
• CR1432 (1 April 2014) - DDCN 1432/2014 Retirement of Standards - DSCN 3/92, DSCN 12/96/P11, DSCN 50/94/P36, DSCN 66/96/W09 and DSCN 16/93
• CR1429 (1 April 2014) - DDCN 1429/2014 Retirement of Standards - DSCN 07/96/P06
• CR1425 (1 April 2014) - DDCN 1425/2014 Retirement of Standards
• CR1423 (1 April 2014) - DDCN 1423/2014 Retirement of Standards - DSCNs 37/98/A09, 14/97/P08, 12/2002, 37/2003, 14/2004 and 27/2001
• CR1419 (1 April 2014) - DDCN 1419/2014 Retirement of Standards - DSCNs 39/98/A11, 09/99/P06, 11/99/P07, 13/2003, 38/2001, 22/2001, 19/98/A02, 40/96/P34, 29/94/P19, 49/94/P35, 34/95/P29, 53/96/P44 and 96/95/P79
• CR1418 (1 April 2014) - DDCN 1418/2014 Retirement of Standards
• CR1417 (1 April 2014) - DDCN 1417/2014 Retirement of Standards - DSCNs 13/95/P12, 44/2001, 29/2004, 18/98/W02 and 24/98/F01
• CR1416 (1 April 2014) - DDCN 1416/2014 Retirement of Standards - KC64 - DSCNs 05/98/P05 and 26/95/W02
• CR1414 (1 April 2014) - DDCN 1414/2014 Retirement of Standards - DSCNs 03/99/P03, 10/2002, 12/99/A04, 20/98/A03, 30/98/P21, 35/99/P25, 37/97/P24 and 43/97/P29
• CR1413 (1 April 2014) - DDCN 1413/2014 Retirement of Standards - DSCNs 13/97/P07, 15/96/P14, 17/2001, 20/2004, 21/2001, 21/2003, 28/98/P20, 33/2003 and 43/2002
• CR1409 (1 April 2014) - DDCN 1409/2014 Retirement of Standards - DSCN's 46/97/P32, 01/2004, 04/2004, 11/2005, 27/2002, 31/2002, 53/2002 and 54/2002

Release: February 2014

• CR1460 (Immediate) - DDCN 1460/2014 NHS Dental Services Update
• CR1459 (Immediate) - DDCN 1459/2014 General Medical Practitioner (Specified), Doctor Index Number and General Medical Practitioner PPD Code Update
• CR 1446 (Immediate) - DDCN 1446/2014 Health and Social Care Information Centre Update
• CR1404 (Immediate) - DDCN 1404/2014 Retirement of e-Gif definitions
• CR1395 (28 February 2014) - ISB 0090 Amd 17/2013 Organisation Data Service – NHS Postcode Directory

Release: January 2014

• CR1386 (31 January 2014) - ISB 0090 Amd 9/2013 Special Health Authority (SpHA) Code Structure Change
• CR1443 (Immediate) - DDCN 1443/2014 Change of name of the National Institute for Health and Clinical Excellence
• CR1441 (Immediate) - DDCN 1441/2014 Retirement of Review of Central Returns (ROCR) - Central Return Form KH03A
• CR1440 (Immediate) - DDCN 1440/2014 Retirement of Review of Central Returns (ROCR) - Genitourinary Medicine Access Monthly Monitoring Data Set
• CR1439 (Immediate) - DDCN 1439/2013 Retirement of Review of Central Returns (ROCR) Returns
• CR1405 (Immediate) - DDCN 1405/2013 Overseas Visitors
• CR1393 (Immediate) - DDCN 1393/2013 Amendment to Inter-Provider Transfer Administrative Minimum Data Set Overview
• CR1392 (Immediate) - DDCN 1392/2013 Review of Central Returns (ROCR) Discontinuations - Referral to Treatment Performance Sharing Data Set
• CR1391 (Immediate) - DDCN 1391/2013 Review of Central Returns (ROCR) Discontinuations - Referral to Treatment (RTT) Summary Patient Tracking List Data Set

The following have been incorporated early to allow users to see the changes, but please note that the implementation date is 1 June 2014:

• CR1346 (1 June 2014) - ISB 1595 Amd 32/2012 National Neonatal Data Set

Release: November 2013

• CR1424 (Immediate) - DDCN 1424/2013 Application Identifier (GS1)
• CR1367 (29 November 2013) - ISB 0090 Amd 5/2013 Organisation Data Service - Introduction of New Sub Type Identifier for Private Dental Practices
• CR1359 (29 November 2013) - ISB 0090 Amd 47/2012 Organisation Data Service - Identification Codes for Local Authorities
• CR1407 (Immediate) - DDCN 1407/2013 Clinical Investigations
• CR1415 (Immediate) - DDCN 1415/2013 Area Teams
• CR1411 (Immediate) - DDCN 1411/2013 Update to Supporting Information: SNOMED CT®

Release: September 2013

• CR1348 (1 October 2013) - ISB 1597 Amd 35/2012 Breast Screening Programmes Data Set (KC63 and KC62)
• CR1403 (Immediate) - DDCN 1403/2013 Religious or Other Belief System Affiliation
• CR1384 (Immediate) - DDCN 1384/2013 Health and Social Care Information Centre Rebranding of XML Schemas
• CR1397 (Immediate) - DDCN 1397/2013 Retired Main Specialty Codes

Release: July 2013

• CR1377 (Immediate) - ISB 0105 Retirement of Accident and Emergency Quarterly Monitoring Data Set (QMAE)

Release: May 2013

• CR1363 (Immediate) - ISB 1067 Amd 43/2012 National Workforce Data Set Version 2.6
• CR1382 (Immediate) - DDCN 1382/2013 National Renal Data Set amendment
• CR1381 (Immediate) - DDCN 1381/2013 Healthcare Resource Groups
• CR1235 (1 June 2013) - ISB 1588 Amd 11/2012 Accident and Emergency Clinical Quality Indicators

Release: April 2013

• CR1372 (Immediate) - DDCN 1372/2013 Organisation Update: April 2013
• CR1369 (Immediate) - DDCN 1369/2013 Organisation Codes and Organisation Types
• CR1347 (1 April 2013) - ISB 1521 Amd 40/2012 Updates to the Cancer Outcomes and Services Data Set and XML Schema

Release: March 2013

• 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