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NHS Data Model and Dictionary Service Open Day 20 May 2008 ...

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NHS Data Model and Dictionary Service Open Day 20 May 2008 ...

  1. 1. datastandards@nhs.net NHS Welcome NHS Data Model and Dictionary Service Open Day
  2. 2. datastandards@nhs.net NHS The NHS Data Model and Dictionary for England • A collection of definitions about data • Datum: a single piece of information, as a fact, statistic or code • Dictionary: a selection of the words of a language, usually arranged alphabetically, giving information about their meanings
  3. 3. datastandards@nhs.net NHS The NHS Data Model and Dictionary for England • Model: A simplified view of reality • allows some ideas to be shared
  4. 4. datastandards@nhs.net NHS Aim of the Day: To enable users to discuss the NHS Data Model and Dictionary with the National team
  5. 5. datastandards@nhs.net NHS • Timings • Toilets • Fire Drill (not planned for today) • Mobile Phones • Smoking - Cavendish Square • Breaks served in the lounge • Lunch served in the lounge Domestics
  6. 6. datastandards@nhs.net NHS Agenda • Introductions • Genitourinary Medicine • What We Do • CDS Version 6 • Topical Work • 18 weeks • Break • Break • Break Out Sessions • Open Discussion • Lunch around 12:30 • Review of the Open Day • Close no later than 4pm
  7. 7. datastandards@nhs.net NHS Some Ground Rules • This will be short, and very boring if we talk and you listen - challenge us! • We will discuss current work - this is our direction of travel, not definitive standards • Your comments will not be attributed to you
  8. 8. datastandards@nhs.net NHS Introductions by table • Your: - Name - Role - Organisation
  9. 9. datastandards@nhs.net NHS Questions • Feel free to ask questions at any time • If there is an area you want to explore in the open discussion, make a note for later
  10. 10. datastandards@nhs.net NHS Slides/ Evaluation • The Open Day Slides will be available on the NHS Data Model and Dictionary Service website at: http://www.connectingforhealth.nhs.uk/sys temsandservices/data/datamodeldictionary /index_html • An Evaluation Questionnaire will be sent to you by Events Online - please complete it
  11. 11. datastandards@nhs.net NHS NHS Data Model & Dictionary Service The TeamThe Team Summary of Role and Responsibilities: • Analyse, model and develop change proposals for NHS Data Standards • Provide support and guidance on NHS Data Standards and the NHS Data Model and Dictionary
  12. 12. datastandards@nhs.net NHS NHS Data Model & Dictionary Service The TeamThe Team Content Manager: Nicholas Oughtibridge Business Analysts: • Angela Faulding • Bushra Khatoon • Cath Chilcott • David Barnet • Gill Foley
  13. 13. datastandards@nhs.net NHS Any Questions
  14. 14. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  15. 15. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  16. 16. datastandards@nhs.net NHS NHS Data Model and Dictionary: The NHS Data Model and Dictionary: • provides a reference point for assured information standards to support health care activities within the NHS in England; • together with Data Set Change Notices represent the agreed data standards which should be collected across the NHS.
  17. 17. datastandards@nhs.net NHS NHS Data Dictionary Release Cycle • The NHS Data Model and Dictionary is updated once changes pass their implementation date • Often this includes April and October • May include other months, for example February 2008 • Each item is independently version controlled • The history of every change is included with every item
  18. 18. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  19. 19. datastandards@nhs.net NHS It holds: • News • NHS Data Model and Dictionary • Help (Frequently Asked Questions) • Events • Mailing List • Consultation Website • Publications • XML Schemas • Commissioning Data Set Supporting Information • Link to Data Set Change Notice Website • Useful Links NHS Data Model and Dictionary Service Website
  20. 20. datastandards@nhs.net NHS
  21. 21. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  22. 22. datastandards@nhs.net NHS Frequently Asked Questions Categories A-Z Listing Popularity Sub Categories FAQ Pages FAQ Pages FAQ Pages FAQ Pages
  23. 23. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  24. 24. datastandards@nhs.net NHS • Check the NHS Data Model and Dictionary • Look at Frequently Asked Questions • Search other websites: • e.g. Department of Health, Information Standards Board for Health and Social Care etc • Contact other Help Desks • e.g. Secondary Uses Service, National Administrative Codes Service etc. Options for Resolving Data Definition Queries
  25. 25. datastandards@nhs.net NHS Data Definition Queries Data Standards and Products Helpdesk: datastandards@nhs.net • full name • job title • telephone number • full postal address • organisation code (if you are an NHS user) • suggested resolution
  26. 26. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  27. 27. datastandards@nhs.net NHS Consultation Website: What is it? • View NHS data standards during development stages • Review and comment on work in progress • Discuss work with the NHS Data Model and Dictionary Service
  28. 28. datastandards@nhs.net NHS Consultation Website: Example Sites • 18 weeks • Commissioning Data Set V6 • Mental Health Minimum Data Set • Removal of EDIFACT • Genitourinary Medicine Access Monthly Monitoring Data • Identifying the Responsible Commissioner • 18 Weeks Clock Rules Suite
  29. 29. datastandards@nhs.net NHS Consultation Website: Access Email: datastandards@nhs.net Note: Users granted access to the Consultation Website are automatically added to the NHS Data Model and Dictionary Service Mailing List
  30. 30. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  31. 31. datastandards@nhs.net NHS NHS Data Model and Dictionary Mailing List: What is it? • It is designed to make users aware of NHS Data Model and Dictionary Service products, such as: - New NHS Data Model and Dictionary releases - Forthcoming events such as NHS Data Model and Dictionary Open Days, Training Courses - Consultation of a draft Change Request
  32. 32. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  33. 33. datastandards@nhs.net NHS Introduction to the NHS Data Model and Dictionary Training Course • Objective: Develop a greater understanding of the NHS Data Model and Dictionary • Target Audience: NHS Information professionals in Trusts, Primary Care Trusts and Health Authorities • Delivery: 2 day course based in Leeds, 6 times a year Next course June 2008 in Leeds
  34. 34. datastandards@nhs.net NHS Course Content The training course includes presentations on the following topics: • Background • Data Standards • Change Process • NHS Data Model and Dictionary • Data Validation • Data Modelling • Data Definition Queries
  35. 35. datastandards@nhs.net NHS Course Content On successful completion of the course, participants will be able to: • Understand the need for Data Standards • Understand how to navigate the NHS Data Model and Dictionary • Read a Data Model • Use the NHS Data Model and Dictionary to resolve data definition queries
  36. 36. datastandards@nhs.net NHS NHS Data Model and Dictionary Service Products NHS Data Model and Dictionary NHS Data Model and Dictionary NHS Data Model and Dictionary Website NHS Data Model and Dictionary Website NHS Data Model and Dictionary Consultation Website NHS Data Model and Dictionary Consultation Website Frequently Asked Questions Frequently Asked Questions Training Courses Training Courses Open Days Open Days Query Resolution Query Resolution Mailin g List Mailin g List Supporting Development Supporting Development
  37. 37. datastandards@nhs.net NHS Supporting Development • Each Change Request: • Requires a: • Sponsor and • Developer • Is assured by the Information Standards Board for Health and Social Care
  38. 38. datastandards@nhs.net NHS Supporting Development • The Information Standards Board for Health and Social Care: • provide an independent mechanism for the assurance and sign off of Information Standards for use in the NHS (England) • publish the assured change as a Data Set Change Notices (DSCN) DSCN Mailing List: http://www.connectingforhealth.nhs.uk /dscn/mailist
  39. 39. datastandards@nhs.net NHS Any Questions
  40. 40. datastandards@nhs.net NHS Association for Informatics Professionals in Health & Social Care ASSIST Association for Information Management & Technology Staff in Health ASSIST National Conference & Awards Thursday, 22 May 2008 London – Oval Cricket Ground Key note speaker: Matthew Swindells Book online @ http://www.connectingforhealth.nhs.uk/events/
  41. 41. datastandards@nhs.net NHS www.dh.gov.uk
  42. 42. datastandards@nhs.net NHS National Workforce Data The Operating Framework for 2008/09 • Electronic Staff Record (ESR) Data Warehouse • Strategic workforce planning and monitoring purposes Human Resource and Payroll System for England and Wales
  43. 43. datastandards@nhs.net NHS The Operating Framework for 2008/09 Roles & Responsibilities • Strategic Health Authorities • NHS Trusts • Primary Care Trusts Expected to profile and monitor their workforce numbers and payroll monthly National Workforce Data
  44. 44. datastandards@nhs.net NHS National Workforce Data Introduces data definitions for Workforce
  45. 45. datastandards@nhs.net NHS National Workforce Data Categories: 1. Organisational 2. Personal/Operational 3. Deployment 4. Education 5. Absence 6. Staff Movements and Numbers
  46. 46. datastandards@nhs.net NHS National Workforce Data Key Points:- • Not linked to Main Specialty Code • Evolution of Workforce data needs means further releases expected
  47. 47. datastandards@nhs.net NHS Cancer Waiting Times Cancer Reform Strategy (2007) 1. Align with 18 weeks data set, cancer registry and radiotherapy collections 2. Incorporate more cancer patients under the 62 day referral to treatment pathway Continued…
  48. 48. datastandards@nhs.net NHS Cancer Waiting Times Cancer Reform Strategy (2007) 3. Include all cancer patients requiring more than one treatment for a primary or recurrent cancer receive all their treatment within 31 days of being ready to start treatment 4. Patients with breast symptoms where cancer is not suspected
  49. 49. datastandards@nhs.net NHS Cancer Waiting Times Support: • Patient Outcomes Treatment Packages • Service reconfiguration and local planning • Policy development and decision- making. • Cancer registries and their datasets
  50. 50. datastandards@nhs.net NHS Cancer Waiting Times Key points: • Extended data set imminent • Reporting through Secondary Uses service from 2012
  51. 51. datastandards@nhs.net NHS New definitions • Consultant led activity / service • Non-consultant led activity / service • Interface Service
  52. 52. datastandards@nhs.net NHS Sex and Gender • Sex A statement, as far as is known, about the phenotypical sex of the person based on observation of his/her biological and physiological characteristics • Not known • Male • Female • Indeterminate • Gender A statement by the individual about the gender they identify themselves to be (i.e. self- defined) • Not known • Male • Female • Other- The person has a clear idea of what their gender is, but it is neither discretely male nor female, e.g. agendered, bi- gendered, pan-gendered, transgender, third gender
  53. 53. datastandards@nhs.net NHS Sex and Gender • Sex How the body looks • Gender How you choose to behave
  54. 54. datastandards@nhs.net NHS Person Sex at Registration and Gender Recognition Act 2004 • The ONS data element ‘Person Sex at Registration’ is the person’s legal sex • as originally defined at birth registration • and possibly modified by issue of a Full Gender Recognition Certificate under the Gender Recognition Act 2004. • The ONS may be the source of information for NHS data about Person Sex. • People who are planning to have their ‘Sex at Registration’ entry modified must be made aware of the implications of not disclosing their phenotypical sex to a health care professional when seeking health care.
  55. 55. datastandards@nhs.net NHS Ethnic Category • Mandating collection in non-admitted settings including clinics and Accident & Emergency • Updating Commissioning Data Set 10, 20 and 21 • Updating Schema for 6-1
  56. 56. datastandards@nhs.net NHS Commissioning Data Set 5 closedown • Commissioning Data Set 5 is no longer the approved standard • SUS supports the current standard and the immediate past standard • Release 4 (October 2008) requires a new schema 6-1 • Release 4 cannot support Commissioning Data Set 5
  57. 57. datastandards@nhs.net NHS SUS Output • Defining SUS derived output for • 18 weeks • Mental Health • Will be used for Performance Sharing for 18 weeks Breakout
  58. 58. datastandards@nhs.net NHS Any Questions
  59. 59. datastandards@nhs.net NHS Break Out Sessions • Developing Standards • Navigation and the Consultation Website • Healthcare Resource Group (HRG) 4 • Secondary Uses Service and 18 Week Reports
  60. 60. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) • 33 Expert Working Groups • Managed by the Information Centre for Health & Social Care • Developed the HRG4 currency • Support Payment by Results tariff policy
  61. 61. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) • A major revision of groupings increased from 550 to 1,400 • Focus on cost rather than length of stay • 25% Increase in OPCS codes
  62. 62. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) History: • 2006/7 – Reference Costs used HRG4 for the first time • Used to inform the 2009/10 national tariff under Payment by Results
  63. 63. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) Expected: • 2007/8 – Reference Costs use HRG4 • Use to inform the 2010/11 national tariff
  64. 64. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) 1. Increased clinical coverage: • Specialist Palliative Care • Diagnostic Imaging • Chemotherapy • Radiotherapy • Critical Care • Rehabilitation
  65. 65. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) 2. Improved use of Complications & Co-morbidities: to reflect variations in severity and complexity
  66. 66. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) 3. Unbundling activity: to handle high cost drugs and other high cost elements of care
  67. 67. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) 4. Setting independence: unbundling will help to make HRG’s ‘setting independence’
  68. 68. datastandards@nhs.net NHS HRG4 – Raise Awareness Involve clinicians:- • To ensure accurate coding and optimise HRG classification • To assist in identifying new data items • To help develop meaningful reference costs • To own and use the data • To help you to interpret variations from the norm
  69. 69. datastandards@nhs.net NHS Healthcare Resource Group 4 (HRG4) Key Issues for Reference Costs: • Data Quality • Accuracy • Timeliness • Director of Finance sign-off
  70. 70. datastandards@nhs.net NHS The Operating Framework for 2008/09 Standard Contract Clause 29 • From April 2008 -Initially coded datasets weekly -Comprehensively coded datasets monthly • From April 2009 -Secondary Uses Service (SUS) standard repository for reconciliation and payments
  71. 71. datastandards@nhs.net NHS The Operating Framework for 2008/09 Standard Contract Clause 29 Failure to comply with the information requirements in terms of: • Accuracy • Completeness • Timeliness Can result in Main Body, Clause 29 being enacted which can result in funds being withheld
  72. 72. datastandards@nhs.net NHS So what – they always say that! Host commissioners can instruct all commissioners to: • Withhold 10% of income until hosts receive / accept data • No interest payments on withheld income
  73. 73. datastandards@nhs.net NHS HRG4 - Your involvement is vital! Remember:- 1. Raise awareness of HRG4 within your organisation 2. Use OPCS-4.4 or lose money 3. Involve clinicians 4. SUS will be repository for payment, reconciliation and performance from April 2009
  74. 74. datastandards@nhs.net NHS
  75. 75. datastandards@nhs.net NHS Data Model Components NHS Number NHS Number (Baby) NHS Number (Mother) Carer Support Indicator Data Elements Local Patient Identifier Organisation Code (Local Patient Identifier) Organisation Code Type NHS Number Birth Date Accident and Emergency Attendance Organisation Code (Code of Provider) Organisation Code (Code of Commissioner) Reporting Period (Mental Health) NHS Number Electoral Ward of Usual Address Mental Health Minimum Data Set Data Sets PATIENT ACTIVITY Classes for Subject of 1 0..* Relationship K NHS Number Carer Support Indicator Carer Permission Date Chronically Sick or Disabled Drug Misuse Database Number ….. K Activity Identifier Attributes
  76. 76. datastandards@nhs.net NHS Any Questions
  77. 77. datastandards@nhs.net NHS Genitourinary Medicine (GUM) Data Facts… • GUM is in the 18 weeks Target • ConsultantNurseMidwife-led data must be submitted in the Out-patient Commissioning Data Set
  78. 78. datastandards@nhs.net NHS Security Issues and Patient Confidentiality Sensitive data, such as HIV and venereal diseases must omit the following:- • NHS Number • Birth Date • Patient Name • Postcode of Usual Address Genitourinary Medicine (GUM) Data To be removed from CDS
  79. 79. datastandards@nhs.net NHS Genitourinary Medicine (GUM) Data British Association for Sexual Health and HIV • Developing a list of venereal disease classification codes • Exceptions to the sensitive data rule…
  80. 80. datastandards@nhs.net NHS GUM Clinic Activity Data Set Replaces the KC60 Sexually Transmitted Infections Central Return with a patient level data set
  81. 81. datastandards@nhs.net NHS GUM Clinic Activity Data Set DSCN 04/2008 - Sensitive Data • Local Patient Identifier • Lower Layer Super Output Area of Residence • Age • Gender
  82. 82. datastandards@nhs.net NHS GUM Clinic Activity Data Set DSCN 04/2008
  83. 83. datastandards@nhs.net NHS Genitourinary Waiting Times Introduces a new aggregate level data set
  84. 84. datastandards@nhs.net NHS Genitourinary Medicine Remember:- 1. ConsultantNurse-led activity must be transmitted in OP CDS 2. Exceptions to the sensitive data rules 3. Patient Name & Address to be removed from CDS 4. Included in 18 weeks
  85. 85. datastandards@nhs.net NHS
  86. 86. datastandards@nhs.net NHS Commissioning Data Set Version 6
  87. 87. datastandards@nhs.net NHS Commissioning Data Set Purpose • Allows organisations to receive activity level data • Supports Commissioning • Feeds Hospital Episode Statistics • Covers • Past, current and future admitted patients including day case, long stay and psychiatric • Past and future out-patients including ward- attenders, nurse/midwife/therapist and diagnostics • Past Accident and Emergency attendances
  88. 88. datastandards@nhs.net NHS Commissioning Data Set Version 6 • Evolution over 15 years, not revolution • Move to re-use common components • Summary of time-table • Notice of change published in May '06 • Schema and Tables published May ’07 • Mandatory by 31 March 2008
  89. 89. datastandards@nhs.net NHS Commissioning Data Set 6 • XML – protects the integrity of the data • Commissioning Data Set 5 has proved challenging to some providers • Prevents invalid data for almost all fields • Exceptions include NACS, ICD, OPCS, READ
  90. 90. datastandards@nhs.net NHS Categorisation of Data Quality Missing Default Other Invalid Valid Data
  91. 91. datastandards@nhs.net NHS Categorisation of Data Quality Missing Default Other Valid Data
  92. 92. datastandards@nhs.net NHS If the admission is in a series of regular day or night admissions Then use either National Code 0 or 1 Otherwise, don’t send the field
  93. 93. datastandards@nhs.net NHS A numberA number Values 0 or 1Values 0 or 1 One digit longOne digit long
  94. 94. datastandards@nhs.net NHS
  95. 95. datastandards@nhs.net NHS Main New Content • Payment by Results • Paediatric and neonatal critical care • Discharge ready date • Age • 18 Weeks • Pathway identifier • RTTP data items • Future out- patients • Earliest reasonable offer date
  96. 96. datastandards@nhs.net NHS Big impact - Content • Future out-patients • Elective Admission List • Critical Care • Patient Pathways • Referral to treatment periods • Diagnostic systems
  97. 97. datastandards@nhs.net NHS Big impact - Submission • Move to WEEKLY within 5 days of a week end (7 day period) • Net change protocol for weekly submissions • Source: Operating Framework
  98. 98. datastandards@nhs.net NHS Timetable – content Topic DSCN Publish Collect from Submit from Paediatric Critical Care 01/2007 Feb '07 Apr '07 Dec '07 Neonatal Critical Care 15/2006 Aug '06 Apr '07 Dec '07 Age 08/2007 Apr '07 Oct '07 Dec '07 Discharge Ready Date 13/2007 May '07 Oct '07 Dec '07 Patient Pathway 18/2006 Dec '06 Jan '07 Dec '07 Referral to treatment periods 18/2006 Dec '06 Jan '07 Dec '07 Earliest Reasonable Offer Date 09/2007 Apr '07 Oct '07 Dec '07 Diagnostic data flow 02/2007 Feb '07 Oct '07 Oct '07 CDS 5 refresh 27/2007 Aug ‘07 Ongoing Oct '07 CDS 6 XML schema 14/2007 Jun '07 (message) Dec '07 CDS 6 tables 18/2007 May ’07 (message) Dec ‘07
  99. 99. datastandards@nhs.net NHS Timetable – submission Topic Implement Mandated Diagnostic data through out-patients Dec '07 Apr '08 Elective Admission List Apr '08 Future Out-patient appointments Dec '07 Apr '08 Use of net change protocol Use of CDS 6 Retire Commissioning Data Set 4 Jul '07 Retire Commissioning Data Set 5 Apr '08 Timely submission (weekly within 5 days of a week end) Apr '08 Secondary Uses Service extracts Dec '07
  100. 100. datastandards@nhs.net NHS When does CDS 5 retire • Formerly: 31 March 2008 • Technically: SUS only supports 2 versions, current and previous. CDS 5 retires as soon as we need any update to CDS 6. • Expected withdrawal – no later than Oct 2008
  101. 101. datastandards@nhs.net NHS CDS Version 6.1 • Release: October 2008 • Content Changes: Ethnic Category in:- • Outpatient CDS • Future Outpatient CDS • Coincide with withdrawal CDS Version 5
  102. 102. datastandards@nhs.net NHS Any Questions
  103. 103. datastandards@nhs.net NHS Measuring 18 weeks 'By 2008 no one will wait longer than 18 weeks from GP referral to hospital treatment.' The NHS Improvement Plan June 2004
  104. 104. datastandards@nhs.net NHS Aim To define and measure the length of wait from GP referral to first definitive treatment
  105. 105. datastandards@nhs.net NHS Patient What are we trying to measure? Lets look at some pathways
  106. 106. datastandards@nhs.net NHS Clinical Assessment Attendance Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  107. 107. datastandards@nhs.net NHS Interface Service Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  108. 108. datastandards@nhs.net NHS Interface Service Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  109. 109. datastandards@nhs.net NHS Interface Service Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  110. 110. datastandards@nhs.net NHS Clinical Assessment Attendance Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  111. 111. datastandards@nhs.net NHS Clinical Assessment Attendance Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  112. 112. datastandards@nhs.net NHS Clinical Assessment Attendance Walk in centre attendances Outpatient attendances Radiology investigations Physiological Measurements Elective Admissions Emergency Admissions Accident and Emergency attendances GP Attendances Patient
  113. 113. datastandards@nhs.net NHS What’s new • Multiple stages • CAS / CATS / ICATS / RMC / Interface Services • Outpatients, GU Medicine • Admitted Patients • Multiple providers – “Performance” sharing • Commissioner target
  114. 114. datastandards@nhs.net NHS
  115. 115. datastandards@nhs.net NHS The strategic approach • Measurement using the Commissioning Data Set • Patient Pathway Identifier to link records • Referral to Treatment Period Status to identify the anticipated or final status of each activity • Referral to Treatment Period Start Date and Referral to Treatment Period End Date
  116. 116. datastandards@nhs.net NHS Commissioning Data Set Version 6 Type IDs • Accident and Emergency: 010 – Accident & Emergency • Care Activity: 020 – Outpatient 021 – Future Outpatient • Admitted Patient Care: 120 – Finished Birth Episode 130 – Finished General Episode • etc…
  117. 117. datastandards@nhs.net NHS Referral to Treatment (RTT) Status • First activity • Subsequent Activity • Last Activity (First Definitive Treatment) • Activity that is not part of a Referral to Treatment period • Not yet known
  118. 118. datastandards@nhs.net NHS First Definitive Treatment the start of the first treatment that is intended to manage a patient's disease, condition or injury in a REFERRAL TO TREATMENT PERIOD
  119. 119. datastandards@nhs.net NHS A worked example - Referral CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 Future Outpatient CDS First ACTIVITY in RTT Period Referral Request Received Date
  120. 120. datastandards@nhs.net NHS A worked example - Appointment CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 Future Appointment Date Future Outpatient CDS First ACTIVITY in RTT Period
  121. 121. datastandards@nhs.net NHS A worked example - Attended CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 Outpatient CDS Attendance Date First ACTIVITY in RTT Period
  122. 122. datastandards@nhs.net NHS A worked example - X-Ray booked CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 021 1 31/1/07 9/1/07 20 subsequent activity in RTT Period- further ACTIVITIES anticipated Future X-Ray Date Future Outpatient CDS
  123. 123. datastandards@nhs.net NHS A worked example - X-Ray attended CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 021 1 31/1/07 9/1/07 20 020 1 31/1/07 9/1/07 20 Outpatient CDS X-Ray Attendance Date subsequent activity in RTT Period - further ACTIVITIES anticipated
  124. 124. datastandards@nhs.net NHS A worked example - Decide to admit CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 021 1 31/1/07 9/1/07 20 020 1 31/1/07 9/1/07 20 030 1 9/1/07 30 Elective Admission List CDS Anticipated start of the FIRST DEFINITIVE TREATMENT in the RTT Period
  125. 125. datastandards@nhs.net NHS A worked example - TCI given CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 021 1 31/1/07 9/1/07 20 020 1 31/1/07 9/1/07 20 030 1 9/1/07 30 030 1 19/3/07 9/1/07 30 To Come In (TCI) Date the start of the FIRST DEFINITIVE TREATMENT in the RTT Period Elective Admission List CDS
  126. 126. datastandards@nhs.net NHS A worked example - Admitted CDS Type Patient Pathway ID Activity Date Start Date End Date RTT Status 021 1 9/1/07 10 021 1 24/1/07 9/1/07 10 020 1 24/1/07 9/1/07 10 021 1 31/1/07 9/1/07 20 020 1 31/1/07 9/1/07 20 030 1 9/1/07 30 030 1 19/3/07 9/1/07 30 130 1 19/3/07 9/1/07 19/3/07 30 Admission DateAPC Finished General Episode CDS Start of the FIRST DEFINITIVE TREATMENT in the RTT Period
  127. 127. datastandards@nhs.net NHS Length of wait measurement • For waits for non-admitted treatment (RTTP End Date – RTTP Start Date) • For waits ending in treatment through elective admission (RTTP End Date – RTTP Start Date) less (RTTP End Date – EROD for admission) This is the only adjustment to take into account patient choice
  128. 128. datastandards@nhs.net NHS “Performance” Sharing • Shares “success” between the organisations involved in each patient’s care • Used by Healthcare Commission from Jan 09 • Taken from Secondary Uses Service • Requires CDS 6 or above with 18 weeks data
  129. 129. datastandards@nhs.net NHS Inter-provider transfer • In an estimated 10% to 20% of referral to treatment periods involve multiple providers • Receiving provider needs Patient Pathway information at the time of transfer • Will also reduce administrative errors • Many providers are using it internally too
  130. 130. datastandards@nhs.net NHS Any Questions
  131. 131. datastandards@nhs.net NHS Open Discussion
  132. 132. datastandards@nhs.net NHS Review of the day Please complete the Evaluation Questions which will be sent to you by Events Online Thank you for attending

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