• A broad classification of types of diagnoses which may be made as a result of Accident and Emergency Attendance. The full description is made up of codes from three tables - ACCIDENT AND EMERGENCY DIAGNOSIS, Accident and Emergency Attendance: ANATOMICAL AREAS and Accident and Emergency Attendance: ANATOMICAL SIDE. ANATOMICAL AREA (a classification of parts of the human body) and ANATOMICAL SIDE (an indication of the side of the human body) together give the Anatomical Site of clinical problems presented at an Accident and Emergency Attendance.
• 
  
• The Accident and Emergency Diagnosis Tables have been mapped to diagnoses in SNOMED CT®, and are available on request from the Technology Reference Data Update Distribution Service (TRUD).

• The SNOMED CT® subset original ID is 28511000000135 , and
• The SNOMED CT® subset name is Concepts mapped to Data Dictionary A&E Diagnosis Codes.

• Certain items are sub-analysed to specify the diagnosis, investigation or treatment more precisely. These are marked with an asterisk. The diagnosis sub-analysis list follows the main diagnosis list, and the treatment sub-analysis list follows the main treatment list.

• It is recommended that computerised systems provide a minimum of six character fields for each category in order to accommodate more detailed information if necessary. Where fewer than six characters are required for coding, such as for investigations and treatments, it is recommended that the codes are left-justified and the unused fields left blank.
• 
  
• ACCIDENT AND EMERGENCY DIAGNOSIS is a six character code, comprising:
  
  

  Diagnosis Condition	n2
  Sub-Analysis	n1
  Accident and Emergency Attendance - ANATOMICAL AREA	n2
  Accident and Emergency Attendance - ANATOMICAL SIDE	an1

  Accident and Emergency Diagnosis - Diagnosis Condition

  Diagnosis Condition	Code
  Laceration	01
  Contusion/abrasion*	02
  Soft tissue inflammation	03
  Head injury*	04
  Dislocation/fracture/joint injury/amputation*	05
  Sprain/ligament injury	06
  Muscle/tendon injury	07
  Nerve injury	08
  Vascular injury	09
  Burns and scalds*	10
  Electric shock	11
  Foreign body	12
  Bites/stings	13
  Poisoning* (including overdose)	14
  Near drowning	15
  Visceral injury	16
  Infectious disease*	17
  Local infection	18
  Septicaemia	19
  Cardiac conditions*	20
  Cerebro-vascular conditions	21
  Other vascular conditions	22
  Haematological conditions	23
  Central Nervous System conditions* (excluding strokes)	24
  Respiratory conditions*	25
  Gastrointestinal conditions*	26
  Urological conditions (including cystitis)	27
  Obstetric conditions	28
  Gynaecological conditions	29
  Diabetes and other endocrinological conditions*	30
  Dermatological conditions	31
  Allergy (including anaphylaxis)	32
  Facio-maxillary conditions	33
  ENT conditions	34
  Psychiatric conditions	35
  Ophthalmological conditions	36
  Social problem (includes chronic alcoholism and homelessness)	37
  Diagnosis not classifiable	38
  Nothing abnormal detected	39

  *Item sub-analysed

  Accident and Emergency Diagnosis - Sub-analysis

  Sub-analysis		Code
  Contusion/abrasion	- contusion - abrasion	1 2
  Head Injury	- concussion - other head injury	1 2
  Dislocation/fracture/joint injury/amputation	- dislocation - open fracture - closed fracture - joint injury - amputation	1 2 3 4 5
  Burns and scalds	- electric - thermal - chemical - radiation	1 2 3 4
  Poisoning	- prescriptive drugs - proprietary drugs - controlled drugs - other, including alcohol	1 2 3 4
  Infectious disease	- notifiable disease - non-notifiable disease	1 2
  Cardiac conditions	- myocardial ischaemia & infarction - other non-ischaemia	1 2
  Respiratory conditions	- bronchial asthma - other non-asthma	1 2
  Central Nervous System conditions	- epilepsy - other non-epilepsy	1 2
  Gastrointestinal conditions	- haemorrhage - acute abdominal pain - other	1 2 3
  Diabetes and other endocrinological conditions	- diabetic - other non-diabetic	1 2

  Anatomical Site

  Accident And Emergency Anatomical Area - Area

  Anatomical Area	Code
  Head and Neck
  Brain	01
  Head	02
  Face	03
  Eye	04
  Ear	05
  Nose	06
  Mouth, Jaw, Teeth	07
  Throat	08
  Neck	09
  Upper Limb
  Shoulder	10
  Axilla	11
  Upper Arm	12
  Elbow	13
  Forearm	14
  Wrist	15
  Hand	16
  Digit	17
  Trunk
  Cervical spine	18
  Thoracic	19
  Lumbosacral spine	20
  Pelvis	21
  Chest	22
  Breast	23
  Abdomen	24
  Back/buttocks	25
  Ano/rectal	26
  Genitalia	27
  Lower Limb
  Hip	28
  Groin	29
  Thigh	30
  Knee	31
  Lower leg	32
  Ankle	33
  Foot	34
  Toe	35
  Multiple Site	36
  Accident and Emergency Anatomical Side
  Left	L
  Right	R
  Bilateral	B
  Not applicable	8

• A broad classification of types of investigation which may be requested to assist with diagnosis as a result of Accident and Emergency Attendance.
• 
  
• Certain items are sub-analysed to specify the diagnosis, investigation or treatment more precisely. These are marked with an asterisk. The diagnosis sub-analysis list follows the main diagnosis list, and the treatment sub-analysis list follows the main treatment list.
• 
  
• It is recommended that computerised systems provide a minimum of six character fields for each category in order to accommodate more detailed information if necessary. Where fewer than six characters are required for coding, such as for investigations and treatments, it is recommended that the codes are left-justified and the unused fields left blank.
• 
  
• ACCIDENT AND EMERGENCY INVESTIGATION is a six character code, comprising:

Investigation	n2 (see Table below)
Local sub-Analysis	up to an4

Accident And Emergency Investigation Table

Investigation	Code
X-ray plain film	01
Electrocardiogram	02
Haematology	03
Cross match blood/group and save serum for later cross match	04
Biochemistry	05
Urinalysis	06
Bacteriology	07
Histology	08
Computerised Tomography - Retired 2006-04-01	09
Ultrasound	10
Magnetic Resonance Imaging	11
Computerised Tomography (excludes genitourinary contrast examination/tomography)	12
Genitourinary contrast examination/tomography	13
Clotting studies	14
Immunology	15
Cardiac enzymes	16
Arterial/capillary blood gas	17
Toxicology	18
Blood culture	19
Serology	20
Pregnancy test	21
Dental investigation	22
Refraction, orthoptic tests and computerised visual fields	23
None	24
Other	99

Items expected to be sub-analysed at discretion of individual Accident and Emergency Departments.

• A broad classification of types of treatment or guidance which may be provided to a PATIENT as a result of Accident and Emergency Attendance.
• 
  
• Certain items are sub-analysed to specify the diagnosis, investigation or treatment more precisely. These are marked with an asterisk. The diagnosis sub-analysis list follows the main diagnosis list, and the treatment sub-analysis list follows the main treatment list.
• 
  
• It is recommended that computerised systems provide a minimum of six character fields for each category in order to accommodate more detailed information if necessary. Where fewer than six characters are required for coding, such as for investigations and treatments, it is recommended that the codes are left-justified and the unused fields left blank.
• 
  
• ACCIDENT AND EMERGENCY TREATMENT is a six character code, comprising:

Condition	n2 (see Treatment Table below)
Sub-Analysis	n1 (see Sub-analysis Table below)
Local use	up to an3

Accident and Emergency Treatment - Treatment

Treatment	Code
Dressing*	01
Bandage/support	02
Sutures*	03
Wound closure (excluding sutures)*	04
Plaster of Paris*	05
Splint	06
Prescription - Retired 2006-04-01	07
Removal foreign body	08
Physiotherapy*	09
Manipulation*	10
Incision & drainage	11
Intravenous cannula	12
Central line	13
Lavage/emesis/charcoal/eye irrigation	14
Intubation & Endotracheal tubes/laryngeal mask airways/rapid sequence induction	15
Chest drain	16
Urinary catheter/suprapubic	17
Defibrillation/pacing*	18
Resuscitation/cardiopulmonary resuscitation	19
Minor surgery	20
Observation/electrocardiogram, pulse oximetry/head injury/trends	21
Guidance/advice only*	22
Anaesthesia*	23
Tetanus*	24
Nebuliser/spacer	25
Parenteral thrombolysis*	28
Other Parenteral drugs*	29
Recording vital signs	30
Burns review	31
Recall/x-ray review	32
Fracture review	33
Wound cleaning	34
Dressing/wound review	35
Sling/collar cuff/broad arm sling	36
Epistaxis control	37
Nasal airway	38
Oral airway	39
Supplemental oxygen	40
Continuous positive airways pressure/nasal intermittent positive pressure ventilation/bag valve mask	41
Arterial line	42
Infusion fluids	43
Blood product transfusion	44
Pericardiocentesis	45
Lumbar puncture	46
Joint aspiration	47
Minor plastic procedure/split skin graft	48
Active rewarming of the hypothermic patient	49
Cooling - control body temperature	50
Medication administered*	51
Occupational Therapy*	52
Loan of walking aid (crutches)	53
Social work intervention	54
Eye*	55
Dental treatment	56
Prescription/medicines prepared to take away	57
Other (consider alternatives)	27
None (consider guidance/advice option)	99

Items sub-analysed in Table below

Accident and Emergency Treatment - Sub-analysis

Sub-analysis Treatment		Code
Dressing	- dressing minor wound/burn/eye - dressing major wound/burn	1 2
Sutures	- primary sutures - secondary/complex suture - removal of sutures/clips	1 2 3
Wound closure (excluding sutures)	- steristrips - wound glue - other (e.g. clips)	1 2 3
Plaster of Paris	- application Plaster of Paris - removal Plaster of Paris	1 2
Physiotherapy	- strapping, ultra sound treatment, short wave diathermy, manipulation - gait re-education, falls prevention	1 2
Manipulation	- manipulation of upper limb fracture - manipulation of lower limb fracture - manipulation of dislocation	1 2 3
Defibrillation/pacing	- defibrillation - external pacing	1 2
Guidance/advice only	- written - verbal	1 2
Anaesthesia	- general anaesthetic - local anaesthetic - regional block - entonox - sedation - other	1 2 3 4 5 6
Tetanus	- immune - tetanus toxoid course - tetanus toxoid booster - human immunoglobulin - combined tetanus/diphtheria course - combined tetanus/diphtheria booster	1 2 3 4 5 6
Parenteral thrombolysis	- streptokinase parenteral thrombolysis - recombinant - plasminogen activator	1 2
Other Parenteral drugs	- intravenous drug, e.g. stat/bolus - intravenous infusion	1 2
Medication administered	- oral - intra-muscular - subcutaneous - per rectum - sublingual - intra-nasal - eye drops - ear drops - topical skin cream	1 2 3 4 5 6 7 8 9
Occupational Therapy	- OT functional assessment - OT activities of daily living equipment provision	1 2
Eye	- orthoptic exercises - laser of retina/iris or posterior capsule - retrobulbar injection - epilation of lashes - subconjunctival injection	1 2 3 4 5

An Application Identifier (GS1) (AI) is a 2,3 or 4 digit number, that indicates the meaning (or status) of the data, which immediately follows the Application Identifier (GS1). It is only used with GS1 data carriers, such as GS1-128 and CS1 DataMatrix bar codes.

An Application Identifier (GS1) identifies the type of data used for the purposes of Automatic Identification and Data Capture using GS1 standards.

A set of national (2 digit) numbers are issued for use in the NHS. These are:

For guidance on the Commissioning Data Set Layout, see the Commissioning Data Set Redesign Guidance Notes on the NHS Data Model and Dictionary website.

For guidance on the Commissioning Data Set Layout, see the Commissioning Data Set Redesign Guidance Notes on the NHS Data Model and Dictionary website.

NHS DATA MODEL AND DICTIONARY

Version 3

What's New: August 2014

Welcome to the NHS Data Model and Dictionary for England If you would like to know more about us or need help using the NHS Data Model and Dictionary, see the Help pages The NHS Data Model and Dictionary provides a reference point for approved Information Standards and Collections (including Extractions) (ISCEs) to support health care activities within the NHS in England. It has been developed for everyone who is actively involved in the collection of data and the management of information in the NHS. The NHS Data Model and Dictionary is maintained and published by the NHS Data Model and Dictionary Service and all changes are governed by the Standardisation Committee for Care Information. Changes are published as Information Standards and Collections (including Extractions) Notices (ISCE) and Data Dictionary Change Notices (DDCN).

Related Links Frequently Asked Questions Department of Health website Health and Social Care Information Centre website Standardisation Committee for Care Information website

Background

• The NHS Postcode Directory is maintained, on behalf of the Organisation Data Service, by the Office for National Statistics.

• The NHS Postcode Directory:

  • contains a record for every POSTCODE in the UK, Channel Islands and the Isle of Man

  • associates each POSTCODE with a variety of geographical information, such as grid references and census area codes, and codes for National Health Care Groupings, Higher Level Health Geographies and health commissioning ORGANISATIONS

  • file also includes pseudo POSTCODES covering default codes and overseas countries.

• Two versions are issued every quarter by the Organisation Data Service:

  • The full NHS Postcode Directory is restricted to NHS users and users working in direct support of the NHS

  • The less comprehensive Organisation Data Service reduced POSTCODE data files are made available to all.

• Users are able to download files through the:

  • Technology Reference Data Update Distribution Service (TRUD) and

  • Organisation Data Service pages on the Health and Social Care Information Centre website.

• Full descriptions of the:

  • NHS Postcode Directory can be found at Data Supplied by the Office of National Statistics

  • Reduced POSTCODE data files can be found at ODS Postcode Files.

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

• The Office for National Statistics supplies products either as a download free of charge or on CD or DVD in line with the Office for National Statistics charging policy. For further information see National Statistics Postcode Products.

Postcodes

• All POSTCODES made available via the Organisation Data Service postcode files have been standardised to the eight character postcode format as used by the Royal Mail's Postal Address File (PAF). All NHS ORGANISATIONS should ensure that they conform to the POSTCODE format.

  POSTCODES are of the general format:

Character Position	1	2	3	4	5	6	7	8
Format	a	a/n	a/n	a/n	space	n	a	a
Coding Frame	Outward Code				space	Inward Code

• The coding frame allows the use of digits 0 (zero) to 9 and the use of upper-case alpha characters; no special characters are allowed.

• The fifth character of all standard format POSTCODES is always a space, and separates the outward and inward parts of the POSTCODE. The outward part of the POSTCODE is left-justified and can contain 2, 3 or 4 characters, and is space-filled in character positions 3 and 4 where required. The inward part of the POSTCODE is always 3 characters.

  The following table gives examples of typical POSTCODES:

  Character Position								Allocated by	Notes
  1	2	3	4	5	6	7	8
  W	9				3	X	X	Royal Mail
  D	A	1			5	P	L	Royal Mail
  M	K	4	5		1	T	E	Royal Mail
  Z	Z	9	9		4	L	Z	ODS	POSTCODES for PATIENTS who are Overseas Visitors
  Z	Z	9	9		3	W	Z	ODS	Pseudo POSTCODES

Related Products

• The Office for National Statistics produces a version of the NHS Postcode Directory that is based on a stable area base to facilitate time series analysis - the 1991-based Frozen Postcode Directory. This is available from the Office for National Statistics.

• The Organisation Data Service issues the two supporting publications which are updated for and included with each quarterly publication of the postcode directories. This ensures that any new customers receive the necessary information.

  • The "NHSPD User Guide" contains a description of the NHS Postcode Directory and its content along with information about the methodologies used, data quality and limitations.

  • The "NHS PD Version Notes" contains a range of summary statistics and highlights important issues that may affect customers.

• Electronic copies are provided through the:

  • Online distribution service Technology Reference Data Update Distribution Service (TRUD) and

  • Organisation Data Service pages on the Health and Social Care Information Centre website.

Changes

• Requests and suggestions for improvements to the NHS Postcode Directory or queries relating to its use should be directed to the Organisation Data Service, who are taking the lead on this product on behalf of the NHS.

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 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 accepted as a standard by the Standardisation Committee for Care Information. 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:

A Regulatory Body is an ORGANISATION appointed by the Government to establish national standards for qualifications and to ensure consistent compliance with them.

The table below shows CARE PROFESSIONALS and the Regulatory Body they are regulated by.

An ACTIVITY may have many dates associated with it but may only have one date of a particular type.

National Codes:

Note: This list is not in alphabetical order.

The type of ACTIVITY GROUP.

National Codes:

Note:
The list is not in alphabetical order.

The type of ASSESSMENT TOOL.

National Codes:

The CONTRACEPTION METHOD refers to the method of CONTRACEPTION used by a PATIENT.

National Codes:

The destination of a PATIENT on completion of a Hospital Provider Spell, or a note that the PATIENT died or was a still birth.

National Codes:

The type of Group Session provided by a Community Health Service.

National Codes:

An indication of whether a Clinical Investigation result is sensitised or non-sensitised. 

National Codes:

The Mental Health Care Cluster assigned to a PATIENT.

National Codes:

National Codes:

Note:
This data item is included in Commissioning Data Set version 6-2, but should not be submitted until further development by the Department of Health has been undertaken.

An ORGANISATION CODE is a code which identifies an ORGANISATION uniquely.

ORGANISATION CODES are managed by:

• Organisation Data Service (ODS)
• NHS Prescription Services
• NHS Dental Services.

Notes:

• Organisation Data Service codes can be downloaded:
  • from the Organisation Data Service website and
  • via files issued by the Technology Reference Data Update Distribution Service (TRUD)
• Organisation Data Service contact details can be found at Contact Details.

ORGANISATION CODING FRAMES

• All NHS ORGANISATIONS are coded using coding frames, as shown in the tables below:

A Frame:

Example
Non NHS Organisation (Independent Provider) e.g. 8HA03

• 8 = Organisation Type Identifier
• Remainder = Organisation Identifier

B Frame:

Example
Local Service Provider e.g. LSP01

• LSP = Organisation Type Identifier
• 01 = Organisation Identifier

Also:

C Frame:

Example
School e.g. EE134290

• EE = Organisation Type Identifier
• Remainder = Organisation Identifier

D Frame:

Example
Care Trust e.g. TAK

• T = Organisation Type Identifier
• AK = Organisation Identifier

Also:

E Frame:

Example
Government Office Region (GOR) e.g. K

• K = Organisation Identifier

F Frame:

Example
Pharmacy Headquarters e.g. P001

• P = Organisation Type Identifier
• 001 = Organisation Identifier

Also:

G Frame:

Example
GP Practices in England and Wales e.g. Y00001

• Y = Organisation Type Identifier
• 00001 = Practice Identifier

Also:

H Frame:

Example
Cancer Network e.g. N01

• N0 (where the 2nd character is numeric and not alpha) = Organisation Type Identifier
• 1 = Organisation Identifier

Also:

I Frame:

Example
Special Health Authority (SpHA) e.g. T1150

• T1 = Organisation Type Identifier
• 150 = Organisation Identifier

K Frame:

Example
NHS Wales Informatics Service e.g. W00

• W00 = Organisation Identifier

L Frame:

Example
Northern Ireland Local Commissioning Group e.g. ZC010

• Characters 1-3 (ZC0) AND character 5 (0) = Organisation Type Identifier
• Character 4 = Organisation Identifier

Note: this is a 5 character method of displaying Northern Ireland Local Commissioning Group identifiers.
Characters 3 and 5 are ‘fillers’. If a 3 character code is required (as used by the Office for National Statistics in the NHS Postcode Directory) zeros can be omitted, e.g. ZC1.
The 3 character method of displaying the Northern Ireland Local Commissioning Group identifiers fit under the H Frame.
Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009.

M Frame:

Example
Clinical Commissioning Group (CCG) e.g. 12A

• 12A = Organisation and Organisation Type Identifier

Also:

N Frame:

Example
GP Abeyance and Dispersal GP Practice e.g. G7817414

• G78 = Organisation Type Identifier
• 17414 = Organisation Identifier

The structure and format of ORGANISATION CODES maintained by the Organisation Data Service, NHS Prescription Services, NHS Dental Services and other agencies are detailed in the tables below.

ORGANISATION CODES TABLES

Table 1: CODING FORMATS FOR ORGANISATIONS IN ENGLAND AND WALES

Notes:

• Codes for Executive Agency, Executive Agency Programme, Executive Agency Site and Executive Agency Programme Department do not easily fit into the coding frames as shown above and are therefore not included. This is due to their unusual structure in that there are more hierarchical 'tiers' than with other organisations.

Executive Agency and Executive Agency Programme are both considered Organisation level entities, although each Programme does have a relationship to an Executive Agency. Executive Agency codes are three characters long. Executive Agency Programme codes are six, and their first three characters are the same as the Executive Agency they are associated to.

Department codes of eight characters long can then be allocated underneath a Programme code (sharing the first six characters). Executive Agency Site codes of five characters long can be allocated under an Executive Agency code (and share the first three characters).

• A-9 indicates that characters A-Z and 0-9 are valid: except B, I, O, S, U and Z (to avoid ambiguity). This applies to all ORGANISATION CODES in the Coding Format Table above except Independent Sector Healthcare Providers (ISHP).

Table 2: CODING FORMATS FOR ORGANISATIONS IN SCOTLAND

Scottish ORGANISATION CODES are supplied by the Information Standards Directorate (ISD) from NHS Scotland and published by the Organisation Data Service.

Table 3: CODING FORMATS for ORGANISATIONS in OTHER HOME COUNTRIES

Note: A-9 indicates that characters A-Z and 0-9 are valid: except B, I, O, S, U and Z (to avoid ambiguity).

An indication of whether the CARE PROFESSIONAL TEAM undertaking a Rehabilitation Assessment, is specialised or non-specialised.

This information is recorded for the purposes of the National Tariff Payment System. 

National Codes:

Note:
This data item is included in Commissioning Data Set version 6-2, but should not be submitted until further development by the Department of Health has been undertaken.

The source of referral of a Mental Health Care Spell.

National Codes:

Notes:

• * National Codes N1 and N2 are for use in the Improving Access to Psychological Therapies Data Set only.
• ** National Code M5 can only be used for the Mental Health and Learning Disabilities Data Set and Child and Adolescent Mental Health Services Secondary Uses Data Set, if referrals from Jobcentre Plus are accepted.

Permitted National Codes:

CARE PROFESSIONAL TYPE CODE (PREGNANCY FIRST CONTACT) is the CARE PROFESSIONAL TYPE CODE of the first CARE PROFESSIONAL seen by the mother within a Maternity Episode for Antenatal care.

Permitted National Codes:

Notes:
CDS SENDER IDENTITY is the mandatory NHS ORGANISATION CODE of the ORGANISATION acting as the physical Sender of Commissioning Data Set submissions.

Usage:
The Commissioning Data Set sender must make sure that the Commissioning Data Set extraction and submission facilities and processes differentiate correctly between:

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

• National Code 'First Accident and Emergency Attendance - the first in a series, or the only attendance, in a particular Accident and Emergency Episode' or
• National Code 'Follow-up Accident and Emergency Attendance - unplanned: a subsequent unplanned attendance at the same department, and for the same incident as the first attendance'.

EMERGENCY CARE ATTENDANCES TOTAL excludes attendances at a Consultant Clinic.

LOCATION TYPE will be replaced with ACTIVITY LOCATION TYPE CODE, which should be used for all new and developing data sets and for XML messages.

The codes used for this Data Element are under review.

Permitted National Codes for use in the Commissioning Data Sets:

Use in the Future Outpatient CDS:
If the type of LOCATION where treatment is intended to take place is not yet known, this Data Element should be omitted.

If the Mental Health Responsible Clinician is the PATIENT's GENERAL MEDICAL PRACTITIONER, the code will be 600. If the Mental Health Responsible Clinician is a CONSULTANT, it will typically be one of the adult or elderly mental health MAIN SPECIALTIES, although it may be either a learning disability or child and adolescent psychiatry in certain circumstances. When the Mental Health Responsible Clinician is not a CONSULTANT, this should be the appropriate pseudo-specialty code or left blank.

Permitted National Codes:

ORGANISATION CODE (PCT OF RESIDENCE) is the ORGANISATION CODE derived from the PATIENT's POSTCODE OF USUAL ADDRESS, where they reside within the boundary of a:

• Primary Care Trust (until 31 March 2013)
• Care Trust
• Local Health Board (Wales)
• Scottish Health Board
• Northern Ireland Local Commissioning Group Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009
• Primary Healthcare Directorate (Isle of Man).

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

For PATIENTS who are Overseas Visitors: Organisation Data Service Default Code X98 'Primary Care Organisation Not Applicable (Overseas Visitors) should be reported.
Note: A review of Organisation Data Service Default Codes is planned to be carried out and this default code will be updated as part of that.

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

At April 2013, Primary Care Trusts will no longer exist.  Health Care Providers still using Commissioning Data Set version 6-1 (CDS-XML schema 6-1-1) at this point must complete the ORGANISATION CODE (PCT OF RESIDENCE) field in the PATIENT IDENTITY group structures, with the data which is carried in ORGANISATION CODE (RESIDENCE RESPONSIBILITY) in Commissioning Data Set version 6-2 (generally, this will be the Clinical Commissioning Group (CCG) of Residence, where the CCG has taken over the responsibilities of the Primary Care Trust).

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

SITE CODE (OF INTENDED PLACE OF DELIVERY) is the ORGANISATION SITE CODE of the ORGANISATION that is the intended place of delivery of the baby as part of a Maternity Episode.

* Note: default codes ZZ201, ZZ888 and ZZ203 are only valid for the National Neonatal Data Set - Episodic and Daily Care.

This is a composite data item required to be recorded within a Hospital Episode Statistics Psychiatric Census Record: Additional Data Field and is a description of the characteristics of a ward which covers resources available to intended users. It is derived from several constituent components each of which although based upon NHS Data Model and Dictionary attribute classifications, are not the same; for example, Home Leave has been added to each classification list.

The derived value has six constituent component parts, AABCDEF. The value is derived as follows:

Thus Home Leave on Psychiatric Census Date would be:

This is a composite data item required to be recorded within a Hospital Episode Statistics General Episode Record and is a description of the characteristics of a ward which covers resources available to intended users. It is derived from several constituent components each of which although based upon NHS Data Model and Dictionary attribute classifications, are not the same; for example, Home Leave has been added to each classification list.

The derived value has six constituent component parts, AABCDEF. The value is derived as follows: