WHC_2005_102 LTA Information Specification - Health in Wales

WHC (2005) 102

WELSH HEALTH CIRCULAR

Parc Cathays

Caerdydd CF10 3NQ

Cathays Park

Cardiff CF10 3NQ

Issue Date: 30th December 2005

Status: Action

Title: Core Information Requirements Specification and Standards to support the LHB commissioning process

For Action by:

Chief Executives: NHS Trusts

Chief Executives: Local Health Boards

Business Services Centre

Action required See paragraph 11

For Information to: Health Solutions Wales, National Public Health Service, Health CommissionWales

Sender: Mr Gordon McKenzie, Head of Information Services Division, Resources Directorate, Healthand Social Care Department, National Assembly for Wales

National Assembly contact(s) : Pam Hall, Programme Director- Corporate Health InformationProgramme, Programme Management Unit, 6 th Floor, Churchill House, Churchill Way, Cardiff,CF10 2HH Tel 02920 207609 email pam.hall@pmuw.wales.nhs.uk

Enclosure(s): Core Information Requirements Specification and Standards to support the LHB commissioning process

Tel: 029 20825111 GTN: 1208Llinell union/Direct line: 029 2020 7609

Ffacs/Fax: 029 2020 9520

http://howis.wales.nhs.uk/whcirculars.cfm

Distribution List

Chief Executives NHS Trusts

Chief Executives Local Health Boards

Director Welsh NHS Confederation

Chief Officer Association of Welsh Community Health Councils

Director Welsh Local Government Association

Dean University of Wales, Bangor

Chief Executive Commission for Racial Equality

Secretary British Dental Association in Wales

Postgraduate Dean University of Wales College of Medicine

Director information services University of Wales College of Medicine

Secretary British Medical Association (Wales)

Regional Head of Health UNISON

Board Secretary Royal College of Nursing (Wales)

Welsh Council Representative British Dietetic Association

Wales Secretary British Orthoptic Society

Wales Secretary AMICUS MSF

Regional Secretary The GMB

Regional Secretary Transport & General Workers Union

Chair Community Pharmacy Wales

Chair Royal College of General Practitioners

General Secretary Wales TUC

Assistant Director Chartered Society of Physiotherapists

Officer for Wales Society of Radiographers

IR Officer Society of Chiropodists and Podiatrists

Regional Secretary Union of Construction Allied Trades and Technicians

Board Secretary for Wales Royal College of Midwives

Officer for Wales AMICUS Electrical & Engineering Staff Association

Regional Secretary AMICUS Amalgamated Electrical and EngineeringUnion

Welsh Executive Royal Pharmaceutical Society of Great Britain

Information Officer Wales Council for Voluntary Action

National Member for Wales AMICUS - Guild of Health Care Pharmacists

Business manager Institute of Health Care Management Welsh Division

Chief Executive Association of Optometrists

Librarian British College of Optometrists

Auditor General Wales Audit Office

Director Business Service Centre

Secretariat Statutory Committees

Regional Directors NHS Wales Regional Offices

Chief Executive Health Commission Wales (Specialist Services)

Chief Executive Health Professions Wales

National Director National Public Health Service

Librarian National Public Health Service

Chief Executive Welsh Language Board / Bwrdd yr Iaith Gymraeg

Librarian Health Promotion Library

Chief Executive National Leadership and Innovation Agency forHealthcare

Delivery and Support Unit

Dear Colleague,

Core Information Requirements Specification and Standards to support the LHBcommissioning process

Summary

1. This circular provides a core, minimum Information Specification to support LongTerm Agreements (LTAs) following a consultation process undertaken in thesummer 2005.

2. It completes the Information Specification development process following lettersto the service in May 2005 and July 2005.

3. The Information Specification aims to introduce consistent data standards, dataquality targets and delivery timescales for data provided by Trusts and isintended to provide a minimum standard to be applied to LTAs, from April 2006.

4. The Corporate Health Information Programme (CHIP) has recently been initiated,following its notification in WHC (2005) 050. This Information Specification isbeing issued under the CHIP Programme recognising the corporate benefits ofconsistent data standards for the whole NHS community.

Background

5. Local Health Boards (LHBs) are provided with their information processing andanalysis service by the Business Services Centre (BSC). Each BSC office haslocal data processing arrangements with the Trusts in their local area often withdifferent data standards and timeliness of provision, where often nationalstandards are not defined. These variable standards have resulted ininconsistent and inefficient processes to maintain accurate and timely LTAmonitoring reports.

6. As the same data, or information generated from it, is used by other NHSorganisations and the Welsh Assembly Government, it is important that the datais of consistent quality and timeliness and is fit for purpose.

7. Work is underway to finalise the minimum datasets for Outpatient Referrals byMarch 2006 and Outpatient waiting lists by June 2006. The A&E minimumdataset is also under review and further developments will be advised during2006.

8. This circular builds upon developments with regard to the NHS Wales DataSwitching Service (WHC (2003) 080), which outlined a move towards consistentdata provision through a single framework. This is already working successfully

for Admitted Patient Care and Outpatient Activity data and will be extended toother datasets in future.

9. The Information Specification provides clarity on the roles and responsibilities ofthe organisations involved in the provision and processing of data andinformation reporting responsibilities.

10. The Information Specification incorporates the changes notified in WHC (2005)090, regarding the implementation of the Guide to Good Practice, DatasetChange Notices (DSCN) 13/05W & 14/05W and WHC (2005) 092 Reporting ofmonthly waiting times

Actions required

11. The Information Specification includes a timetable outlining standardised datesfor data provision (Section 7) for 2006/07 onwards.

A range of data quality standards are included, to monitor compliance against theData Accreditation standards.

Specific issues regarding minimum datasets are:

� Admitted Patient Care - dataset previously mandated and data flowingaccording to requirements via Health Solutions Wales. The dataset has beenupdated in line with DSCN 13/05W and 14/05W.

� Elective Admission List - dataset previously mandated, Trusts are required toprovide these datasets to the required timescales. All Trusts to note theupdates to the datasets in line with DSCN 13/05W and 14/05W.

� Outpatient Activity - dataset previously mandated, data flowing according torequirements via Health Solutions Wales. All Trusts to note the updates to thedataset in line with DSCN 13/05W and 14/05W.

� Outpatient Referrals dataset - dataset will be finalised by March 2006 and willbe introduced by Trusts during 2006. Trusts who already provide Referraldatasets should continue to do so and should adopt the finalised data formatas soon as possible in 2006-07.

Trusts who are not currently providing a Referral dataset mustdemonstrate their ability to introduce this through a resourcedimplementation plan, to be agreed with their local LHBs.

� Outpatient Waiting Lists dataset - dataset will be finalised by June 2006, andwill be introduced by Trusts in 2006. Trusts who are already providingOutpatient waiting list datasets should to continue to do so and should adoptthe finalised data format as soon as possible in 2006-07.

Trusts who are not currently providing an Outpatient Waiting Listdataset must demonstrate their ability to introduce this through aresourced implementation plan, to be agreed with their local LHBs.

� A&E dataset - dataset will be finalised by March 2006, and will be introducedby Trusts in 2006. Trusts who already provide data to the AWISS databaseshould continue to do so and should adopt the finalised data format.

Trusts who are not currently providing an A&E dataset mustdemonstrate their ability to introduce this through a resourcedimplementation plan, to be agreed with their local LHBs.

Yours sincerely

Gordon McKenzieHead of Information Services DivisionResources DirectorateHealth and Social Care Department

LHB Information Requirements Specification Page 1 December 05

Local Health Board (LHB) CoreInformation Requirements

Specification and Standards tosupport the LHB commissioning

process

Local Health Board (LHB) Core Information Requirements Specification andStandards to support the LHB commissioning process

1. Introduction

1.1. Aims

1.1.1. This document has been produced as part of the NHS Wales Business ServicesCentre led Information Systems Review. The project included representatives fromthe Welsh Assembly Government, LHBs and other stakeholder organisations. It hasalso been subject to a formal consultation process undertaken by the WelshAssembly Government in summer 2005.

1.1.2. The document is intended to provide a framework to Trusts and other keyprocessors of data, specifying the core, common, information requirements andassociated standards that are required by all Welsh Local Health Boards tounderpin and support the commissioning and performance management process.It is recognised that there may be requirements for local additional data – this to bedetermined on a regional basis.

1.1.3. The purpose of mandating a single core specification is as follows:

• Consistency of reporting across the NHS in Wales• Improved coverage and timely availability of information to LHBs and other

key users• Reduced ad hoc demand for information requests• Single, clear and agreed, definitive sources and flows of data• Clearly defined data definitions and standards in accordance with the NHS

Wales Data Dictionary• The availability of more meaningful comparative and benchmarking

information• Economies of scale, especially with regard to service delivery models

1.2. Process

1.2.1. Processes to identify specific LHB requirements and associated data standardshave included

• BSC Information staff working in partnership with LHB colleagues• Regional LHB Information Groups and other fora• LHB Information Requirements Workshops• LHB Information Requirements Questionnaire• Discussion with LHB Directors of Finance• All Wales Information colleagues

1.2.2. The document brings together and builds upon a number of examples ofexisting good practice at local and regional level, and is based upon previouslyagreed data definitions and published timescales for provision of data.

2. Roles and responsibilities

2.1. Local Health Boards

2.1.1. Work with Trusts to develop these core requirements, ensuring they reflect bothlocal and national business objectives and decision support needs, and avoidingwhere possible duplicate information flows. .

2.1.2. Work with Trusts and the BSC to ensure timely availability of targets and profiles tosupport the performance agenda. These to conform to core measures as defined bythe NHS Wales Data Dictionary.

2.1.3. Work with the BSC and Trusts to enforce these requirements as part of the LongTerm Agreement (LTA) management process with Trusts.

2.1.4. Channel all information requests through the BSC to avoid possible duplication ofeffort, and to maximise consistency of reporting.

2.1.5. Minimise requests for ad-hoc reporting, in recognition that supporting additionalinformation requests is often complex to resource, aim to plan ahead and agreeadditional information requirements as part of the annual agreement process.

2.1.6. Work with others to develop the skills and culture needed to exploit informationservices and products within the LHB.

2.2. Trusts

2.2.1. Work with LHBs to develop these core requirements, ensuring they reflect bothlocal and national business objectives and decision support needs, and avoidingwhere possible duplicate information flows.

2.2.2. Provide the data to support these core requirements. This is seen as an essentialprerequisite to the successful management and delivery of the performanceprocess

2.2.3. Where possible, a single flow of information, from Trusts to LHBs via the SwitchingService and the BSC, is also required to ensure consistency of reporting.

2.2.4. Where Trusts are unable to fully comply, discussions to take place with LHBs, withsupporting evidence that Trusts have plans in place to address shortfalls. However,implementation will be also subject to guidance and timescales as set out by WelshAssembly Government.

2.2.5. Whilst the main aim of this specification is to rationalise information flows and adhoc requests for information, Trusts will try to respond to reasonable additional localand emerging LHB information needs which are not defined in the corerequirements. This may require an agreed resource plan between LHBs and theTrust.

2.3. Business Services Centre

2.3.1. The capture of data from the Switching Service or Trusts, subsequent processing,and reporting to LHBs on the core information requirements as defined. Reportingtimetables and standards are also described below.

2.3.2. To provide as a minimum the data outputs specified in Annex 11. These outputswill comply with National definitions and Standards and will be provided through thenew suite of applications being implemented in 2005/06.

2.3.3. The BSC has a responsibility to communicate with Trusts and develop anunderstanding of Local Trust issues, processes and application of business rulesrelevant to the information provided by Trusts. This is vital to the BSC role ofsupporting LHBs in the use and understanding of information provided.

2.3.4. To develop, maintain and promote the use of those core information systemsrequired to enable these processes, addressing enabling issues and adding valueto the interpretation of this information where appropriate.

2.3.5. These systems to be developed and supported in a cost-efficient and corporatemanner, learning from best practice and avoiding diseconomies of scale andduplication of effort across BSC offices. The aim is to introduce a single servicedelivery model and one suite of applications and systems in 2005/2006 so thatresources can be freed-up to focus on

• new or un-addressed LHB information requirements

• information analysis and reporting (rather than processing and back- officework)

• working with LHBs to facilitate skills development and promoting the use ofinformation

2.3.6. These services to be managed and delivered as part of the Service LevelAgreement arrangements between the BSC and LHBs and to be underpinned byPerformance Indicators sensitive to key areas of service delivery.

2.3.7. In addition to manage and monitor any ad-hoc requirements generated by LHBs

2.4. Health Solutions Wales

2.4.1. Hosts the NHS Wales Data Switching Service which is responsible for receivingand processing data from NHS Trusts within specified time-scales

2.4.2. Ensuring adherence to national data standards and definitions using the TrustValidation at Source module and associated methodologies

2.4.3. Provision of information services as specified in service level agreement with WelshAssembly Government to a wide range of customers using data received from NHS

Trusts. These services include provision of information analyses, statisticalanalyses and maintenance of the NHS Wales Data Dictionary.

3. The Core Requirements

3.1. These requirements and standards relate to the content, format, coverage,timeliness, quality and robustness of data supplied.

3.2. Information is required to enable monitoring of performance against LTA activity,financial and other agreed targets. Where appropriate, additional mandatednational policy requirements are also referenced - especially those relating to:

3.2.1. NHS Wales Data Standards. These are defined in the NHS Wales DataDictionary and supplementary guidance. Should guidance be required, the NHSData Standards lead will be consulted.

3.2.2. Mandated data sources and data flows, notably the requirement to rationalise andimprove the effectiveness of these, for example, via the use of electronic minimumdata sets derived as a by-product of operational systems.

3.2.3. The need to rationalise and harmonise flows, reporting, data standards and ways ofworking within IM&T across the 22 LHBs, 14 Trusts and various IM&T supportagencies in Wales.

3.2.4. Addressing mandated Welsh Assembly Government reporting requirements andperformance management initiatives. issues relevant in 2005/2006 include

• Information to support the SaFF• Balanced Scorecard• Healthcare Activity Measurement• Demand Management

4. Escalation procedures

4.1.1. It is anticipated that Local Health Boards, Trusts and each Regional BSCInformation function will work together to identify local and effective procedures to;

4.1.2. monitor Trust and other agency compliance with these requirements

4.1.3. include escalation arrangements where the requirements are not met

§ in the first instance, Regional BSC & Trust Information Managers to worktogether to resolve in partnership

§ failing that, escalation to the agreed local / regional forum for LHB informationmanagement

§ failing that, escalation to Assembly Regional Office so that issues can beraised with Trust Chief Executive as part of the Performance ManagementProcess

5. Key principles

5.1. No duplicate data flows

Where data is already held corporately then the BSC will use this source data

5.2. Openness and collaboration between agencies

5.3. Improved information sharing and the breaking down of ‘islands of information’

5.4. Quality data based on clear common standards and timescales

5.5. No changes in applied definitions without prior agreement

5.6. The need for residential and GP population based data (all Trusts) together with atotal view of activity performed

5.7. An emphasis on electronic minimum data sets (MDSs) and person based data sets(rather than person identifiable) derived from existing operational systems

5.8. Provision of data in electronic form so as to speed transmission, minimiseprocessing and reduce paper

5.9. Secure transmission and storage of data so as to safeguard patient confidentiality

5.10. Adherence to Caldicott, Data Protection Act 1998, Freedom of Information Act andassociated requirements

5.11. Conformance with the Welsh IM&T strategic direction and Welsh AssemblyGovernment information requirements

6. Priority areas for development in 2006/2007 onwards

6.1. Whilst this framework document addresses the core secondary care informationrequirements, it is recognised that there will be a requirement to capture morecomplete measures of healthcare activity on an ongoing basis – especially inareas such as primary and community care, but also where these reflectchanges in clinical practice, more integrated models of healthcare delivery,

alternatives to consultant-led activity, address the strategic needs of Wanlessetc.

6.2. Current identified priority areas include:

• Nurse-led hospital activity – collection of data for Nurse-led clinics is underdevelopment and anticipated to be introduced by 2006-07, subject toAssembly notification.

The remaining data requirements to be considered as part of the Corporate HealthInformation Programme, in the meantime LHBs and Trusts may develop localagreements to report these where opportunities and systems exist:

• Second Offer scheme data requirements• Community based healthcare services• Allied Health Professionals• Diagnostic and therapy services• Mental health• Intermediate care• Primary Care Information• Unified Assessment and Care Management programmes

6.3. Amendments and additions to this specification will be required as and whenoutputs of these areas are agreed and implemented by the NHS in Wales.

7. Submission of Data

7.1. Timescales and Return methods Data should be submitted in accordance with the following time-scales:

Comment Detail Trust to BSCOffices

BSC to LHB Frequency

Aggregate WaitingLists (PP01w)

as specified inWHC2005(092)– See Annex 1

7 Wk Days 10 Wk Days Monthly

Waiting Times forAngiogram and

Angioplasty

as specified inWHC2005(026)– See Annex 2

7 Wk Days 10 Wk Days Monthly

Aggregate LTA

(PP01a)See Annex 3 15 Wk Days 20 Wk Days Monthly

Aggregate ReferralData

as specified in2005(11) – See

Annex 815 Wk Days 20 Wk Days Monthly

MDS Activity(APC)

To include finished episodes.

Collection of Unfinished episodes may be introduced in the future, subjectto appropriate Standards approval procedures (for long stay specialtiesmonitored in bed-days). In the meantime, Trusts may be requested toprovide data locally.

See Annex 417 Wk Days

via Switching Service22 Wk Days Monthly

MDS Activity(OP)

See Annex 520 Wk Days

via switching service25 Wk Days Monthly

MDS Waiting List

(Elective AdmissionList)

See Annex 6 7 Wk Days 10 Wk Days Monthly

MDS Waiting List

(Out Patients)

National dataset being developed in the 1st qtr 2007.

In the meantime, Trusts who are already submitting data tocontinue to do so.

MDS ReferralNational dataset being developed in final qtr 2005-06.

In the meantime, Trusts who are already submitting data tocontinue to do so.

Comment Detail Trust to BSCOffices

BSC to LHB Frequency

Accident &Emergency

National dataset under development in line with policycommitment to collect data nationally.

In the meantime, Trusts who are already submitting data toAWISS to continue to do so.

Day care Only Aggregate provider based data available. To be agreedlocally To be agreed locally To be agreed

locallyTo be agreed

locally

Regular day/nightadmissions

To be sourced from PEDW data. To be agreedlocally

as per MDS Activity(APC) above

To be agreedlocally

Community nursingservices

Reporting requirements and frequency to be agreed locally.Where possible on a regional basis

To be agreedlocally

To be agreed locally To be agreedlocally

To be agreedlocally

Child health Data will be sourced via Health Solutions Wales. To be agreed N/A N/A Monthly

- WK Day’s = Working Days

- MDSs to be submitted via switching service where agreed in accordance with published time-scales

7.2. Ad hoc returns to LHBs

7.2.1. The provision of individual patient data sets should minimise the needfor ad-hoc returns from those providers able to supply data sets. LHBsshould plan their information requirements on an annual basis in orderto minimise the burden created by ad-hoc reporting, and Providersshould respond to reasonable commissioner needs for ad-hocinformation.

7.2.2. Access to other individual patient data sets may also be required forspecific purposes.

7.3. Long Term Agreement (LTA) currencies

Key principles are as follows:

7.3.1. It is envisaged that speciality based LTAs will remain the main basisfor agreeing LTAs; specialty name and code should be consistentacross providers and compliant with national standards. (Somecondition based LTAs may also be developed)

7.3.2. Primary currencies are the basis for costing and agreeing LTAs. It isrecognised that some Trusts and Commissioners contract on differentcurrencies, it is anticipated that the development of commissioning,under the Designed for Life strategy, will inform future developmentsand consistency.

7.3.3. Supplementary analyses may be routinely used to assist in LTAmonitoring: these will generally be derivable from individual patientdata sets sent to the BSC.

7.3.4. In accordance with National Data Standards, Outpatient proceduresare not to be included in the day-case activity or waiting list figures.

7.3.5. Implementation of HRG based case mix measures to support nationalstrategic Financial initiatives eg possible introduction of tariffs

7.4. Data standards and reporting

7.4.1. The Data Accreditation standards will be used as the basis formeasuring data completeness and validity. These will be reported by

HSW (for Admitted Patient Care and Out Patient activity data) and theBSC for other datasets. The standards are:

A: Minimum Data standards for Admitted Patient CareActivity (APC) (%complete and valid)

NHS Number 90%Postcode of usual address (for long stay patients this must refer tothe previous address of the patient: it should not be the hospital) 98%

Ethnic Group (Subject to training and implementation for data collection) 95%

Commissioner Code 98%LHB of Residence 99%Code of Registered GP 98%Administrative Category (on admission) 98%Legal Status Classification (on admission) 98%Decision to Admit Date 98%Specialty Function Code 98%Healthcare Resource Group (HRG) 95%Consultant Code 95%

Primary Diagnosis Code (within 3 months of episode end date) 95%

Patient Classification 95%Admission Method 98%Source of Admission 98%Discharge Destination 95%Discharge Method 95%

B: Minimum Standards for Outpatients Activity Data

NHS Number 90%Patients usual address 98%Commissioner Code 98%LHB of Residence 99%Code Registered GP 98%Administrative Category Code 98%Specialty Function Code 98%Source of Referral 95%Clinical Referral Date 98%Attended or Did Not Attend 98%Outcome of Attendance 95%First Attendance 95%

C: Minimum Standards for Elective Admission List Data

NHS Number 90%Patients usual address 98%Commissioner Code 98%LHB of Residence 98%Code of Registered GP 98%Speciality Function Code 98%Intended Management 98%Decision to Admit Date (for this provider) 98%

8. Additional Local LHB Requirements

This section to include details of any additional local information requirementsand associated specifications and standards - specific either to the needs ofindividual or groups of LHBs. Procedures for the capture and dissemination ofthis information to be agreed with the local Regional BSC Information Office.

Annex 1 - Aggregate Waiting Lists (PP01w)

Field description Short name Data type Link tocmds

Comment

Data reference

(list type)

Ref Alpha-numeric n/a IP for in-patients, DC for day cases and OP forout-patients.

Return date

(date on which the list ismeasured - last day of themonth to which the returnrelates)

Date Numeric with 8digits in theformatccyymmdd

Sameformat ascmds field

ccyy = year with century, eg 2004 not 04;

mm = 2 digit month, using a leading zero ifnecessary;

dd = 2 digit date, using a leading zero ifnecessary

Local Health Board (LHB)code

LHBCode Alpha-numericwith 3 digits, e.g.6B1 forAnglesey

Sameformat asEAL CMDS

This is the LHB of residence of the patient.Patients should be allocated to LHBs using theONS postcode to LHB look up file (see WHC2003(19)).

See guidance in WHC(2003)82 and DSCN39/2003 (W) for location of LHB residencecode in EAL CMDS

Trust code TrustCode Alpha-numericwith 3 digits

First threecharactersof cmdsfield

As given in Annex F (WHC 2005(92))

Consultant specialtyfunction code

MainSpec Numeric with 3digits

As given in Annex H (WHC 2005(92))

Agreed local sub-specialtycode

LocalSpec Numeric with 3digits

As given in Annex H (WHC 2005(92))

The number of relevant residents waiting:

Months Wait MonWait Integer numeric n/a Months wait on waiting lists

Count Count Integer numeric n/a Number of patients on the waiting lists

Annex 2a –Monthly Collection of Counts of Patients Waiting forAngioplasty

Comment

Data Reference

(list type)

Ref Alpha-numeric n/a IP for patients, DC for day cases

Return Date

(date on which the list ismeasured – last day of themonth to which the returnrelates)

CMDSDate Numeric with 8digits in theformatccyymmdd

mm= 2 digit month, using a leading zero ifnecessary;

dd= 2 digit date, using a leading zero ifnecessary

Commissioner code

(specialist services)

CommCode Alpha-numericwith 5 digits

Sameformat ascmds fields

This field will be used only to indicate patientswaiting for services commissioned by HealthCommission Wales (code W01HC) or otherspecial commissioners

As given in Annex F. WHC(2005)026

This is the LHB residence of the patient.Patients should be allocated to LHBs using theONS postcode to LHB look up file (see WHC2003(19))

See guidance in WHC(2005)82 and DSCN39/2003 (W) for location of LHB residence codein EAL CMDS

Trust code Trustcode Alpha-numericwith 3 digits

As given in Annex E. WHC(2005)026

Procedure Code ProcCode Alpha-numericwith 3 digits

up to 1 month WL0To1 Integer numeric n/a

over 1 month and up to 2months

WL1To2 Integer numeric n/a

over 2 months and up to 3months

If the number is zero, zero must be submitted –the field must not be left blank.

Time waiting is the difference in calendarmonths between the return date and the date ofdecision to admit, not counting periods ofsuspension.

over 10 months and up to11 months

over 12 months WLover12 Integer numeric n/a

The number of residentson the elective admissionwaiting list or out-patientlist in a period ofsuspension

WLSusp Integer numeric n/a

Annex 2b –Monthly Collection of Counts of Patients Waiting forAngiogram

Comment

Data Reference

(list type)

Ref Alpha-numeric n/a IP for patients, DC for day cases

Return Date

(date on which the list ismeasured – last day of themonth to which the returnrelates)

CMDSDate Numeric with 8digits in theformatccyymmdd

mm= 2 digit month, using a leading zero ifnecessary;

dd= 2 digit date, using a leading zero ifnecessary

Commissioner code

(specialist services)

CommCode Alpha-numericwith 5 digits

Sameformat ascmds fields

This field will be used only to indicate patientswaiting for services commissioned by HealthCommission Wales (code W01HC) or otherspecial commissioners

As given in Annex F. WHC(2005)026

This is the LHB residence of the patient.Patients should be allocated to LHBs using theONS postcode to LHB look up file (see WHC2003(19))

See guidance in WHC(2003)82 and DSCN39/2003 (W) for location of LHB residence codein EAL CMDS

Trust code Trustcode Alpha-numericwith 3 digits

As given in Annex E. WHC(2005)026

Procedure Code ProcCode Alpha-numericwith 3 digits

up to 1 month WL0To1 Integer numeric n/a

over 1 month and up to 2months

WL5To6 Integer numeric n/a If the number is zero, zero must be submitted –the field must not be left blank.

Time waiting is the difference in calendarmonths between the return date and the date ofdecision to admit, not counting periods ofsuspension.

over 12 months WLover12 Integer numeric n/a

The number of residentson the elective admissionwaiting list or out-patientlist in a period ofsuspension

WLSusp Integer numeric n/a

Annex 3 – Aggregate LTA (PPO1a)

Rating

1=mandatory

2=optional

CONTENT DETAILS Format/length

1 Provider an3

2 Provider site an5

2 Commissioner an5

1 LHB an3

1 Period ccyymmdd

1 Specialty an3

2 Sub Specialty codes an3

2 LTA description an50

1 Patient Class an50

1 Activity Type an50

1 Number n8

1 Currency an50

Annex 4 – MDS Activity (APC)

Rating

1=mandatory

2=optional

CONTENT DETAILS PEDWdata item

Format/length

1 Record Id an1

CONTRACT DETAILS

1 Provider Code Yes an5

1 Commissioner Code Yes an5

1 Commissioning Serial Number Yes an6

1 Commissioners Reference Number an17

PATIENT DETAILS

1 NHS Number Yes n10

1 NHS Number Status Indicator Yes n2

1 Patient's name Yes an70 or structuredname with 2 an35elements

1 Name Format Code Yes n1

1 Patient's usual address Yes an175 (5 lines eachan35)

1 Postcode of Usual Address Yes an8

1 Local Health Board of Residence Yes an3

1 Sex Yes n1

1 Marital Status (Mandatory for PsychiatricPatients)

Yes n1

1 Birth Date Yes ccyymmdd

1 Birth Date Status Yes n1

1 General Medical Practitioner (code of registeredGMP)

Yes an8

1 Local Patient Identifier (Case Record Number) Yes an10

1 Ethnic Group Yes an2

1 Legal Status Classification Yes n2 - Legal StatusClassification andAdministrativeCategory replacedCategory of Patientin April 1999

Rating

1=mandatory

2=optional

Format/length

REFERRAL DETAILS

1 Referrer Code Yes an8

1 Referring Organisation Code Yes an6

PROVIDER SPELL DETAILS

1 Hospital Provider Spell Number Yes an12

1 Administrative Category Yes

1 Decision to Admit Date Yes ccyymmdd

1 Decision to Admit Date Status Yes n1

1 Start Date (Hospital Provider Spell) Yes ccyymmdd

1 Admission Method (Hospital Provider Spell) Yes n2

1 Duration of Elective Wait Yes n4

1 Intended Management Yes n1

1 Source of Admission (Hospital Provider Spell) Yes n2

1 Discharge Date (Hospital Provider Spell) Yes ccyymmdd

1 Discharge Date Status Yes n1

1 Discharge Method (Hospital Provider Spell) Yes n1

1 Discharge Destination (Hospital Provider Spell) Yes n2

1 Patient Classification Yes n1

1 Healthcare Resource Group (HRG) Yes an3 –HealthResource Group(HRG) replaced(DRG) in April 2000

CONSULTANT EPISODE DETAILS

1 Episode Number Yes n2

1 Last Episode in Spell Indicator n1

1 Site Code (of treatment) Yes an5

1 Ward Type at Start of Episode Yes n7

1 Start Date (Consultant Episode) Yes ccyymmdd

1 End date (Consultant Episode) Yes ccyymmdd

1 End Date Status Yes n1

1 Specialty Function Code n3

1 Consultant Specialty Function Code Yes n3

1 Local Sub Specialty (Wales) Yes an3

Rating

1=mandatory

2=optional

Format/length

1 Consultant Code Yes an8

1 First Regular Day or Night Admission Yes n1

1 Neonatal Level of Care Yes n1

1 Psychiatric Patient Status Yes n1

Diagnostic Codes

Mandatory ICD-10 diagnostic coding

1 Primary (ICD) Yes an6

1 Subsidiary (if necessary) (ICD) Yes an6

1 1st Secondary (ICD) Yes an6

1 2nd Secondary (ICD) Yes an6

1 3rd Secondary (ICD) Yes an6

1 4th Secondary (ICD) Yes an6

1 5th Secondary (ICD) an6

1 Histological Diagnosis Yes an6

1 Source of Histological Diagnosis Yes n1

Patient Procedure Codes

1 Operation Status (per episode) n1

Mandatory OPCS procedure coding (up to 12 Operative Procedures per episode)

1 Primary Procedure (OPCS) Yes an4

1 Procedure Date Yes ccyymmdd

1 Procedure Date Status Yes n1

1 2nd Procedure (OPCS) - 12th Procedure(OPCS) items as for Primary Procedure (OPCS)

Yes (up to4thprocedurefor PEDW)

1 Record Type Yes n2

Rating

1=mandatory

2=optional

Format/length

PREGNANCY & DELIVERY DETAILS

1 General Medical Practitioner (code of GMPresponsible for Antenatal care)

Yes an8

1 First Antenatal Assessment Date Yes ccyymmdd

1 First Antenatal Assessment Date Status Yes n1

1 Pregnancy : Total Previous Pregnancies Yes n2

1 Delivery Place Type (actual) Yes n1

1 Delivery Date ccyymmdd

1 Delivery Place Type (intended) Yes n1

1 Delivery Place Change Reason Yes n1

1 Gestation Length Yes n2

1 Labour / Delivery Onset Method Yes n1

1 Delivery Method Yes n1

1 Status of Person Conducting Delivery Yes n1

1 Anaesthetic given during labour/delivery Yes n1

1 Anaesthetic given post labour/delivery Yes n1

1 Number of Babies Yes n1

Birth details (up to 6 births from one pregnancy)

1st Baby

1 Sex Yes n1

1 Birth Order Yes n1

1 Live or Still Birth Yes n1

1 Birth Weight Yes n4

1 Resuscitation Method Yes n1

1 Birth Date (baby) Yes ccyymmdd

1 Birth Date (mother) ccyymmdd

1 Birth Date Status (mother) n1

2nd Baby, 3rd Baby, 4th Baby, 5th Baby and 6thBaby : Items as 1st Baby

Waiting List Details

1 Waiting List Date Yes ccyymmdd

1 Waiting List Date Status Yes n1

Annex 5 – MDS Activity (OP)

Rating

1=mandatory

2=optional

1 Record Id an1

CONTRACT DETAILS

1 Organisation Code (code of Provider) an5

1 Code of Commissioner an5

1 Commissioning Serial Number an6

2 Health Care Contract Line Number an10

1 Commissioners Reference Number an17

PATIENT DETAILS

1 NHS Number n10

1 NHS Number Status Indicator n2 - from April1999

1 Patient's name an70 or structuredname with 2 an35elements

1 Name Format Code n1

1 Patient's Usual Address an175 (5 lineseach an35)

1 Postcode of Usual Address an8

1 Local Health Board of Residence an3

1 Sex n1

2 Carer Support Indicator an2

1 Birth Date ccyymmdd

1 Birth Date Status n1

1 General Medical Practitioner (Code of Registered GMP) an8

2 Code of GP Practice (Registered GMP) an6

1 Local Patient Identifier an10

REFERRAL DETAILS

1 Referrer Code an8

1 Referring Organisation Code an6

1 Service Type Requested n1

Rating

1=mandatory

2=optional

1 Date of Patient Referral ccyymmdd

1 Patient Referral Date Status n1

1 Clinical Referral Date ccyymmdd

1 Clinical Referral Date Status n1

1 Priority Type (new patients) n1

EPISODE DETAILS

1 Source of Referral: Outpatients an2

1 Specialty Function Code n3

1 Consultant Specialty Function Code n3

2 Local Sub-Specialty an3

1 Clinic Purpose an15

1 Consultant Code an8

APPOINTMENT AND ATTENDANCE DETAILS

1 Attendance Identifier an12

1 Administrative Category n2

1 Location Type Code n2

1 Site Code (of Treatment) an5

1 Medical Staff Type Seeing Patient an2

1 Attendance Date ccyymmdd

1 Attendance Date Status n1

1 First Attendance n1

1 Attended or Did Not Attend n1

1 Outcome of Attendance n1

1 Last DNA or Patient Cancelled Date ccyymmdd

1 Last DNA or Patient Cancelled Date Status n1

Patient Diagnostic Codes (optional)

2 Primary (ICD) an6

2 Subsidiary (ICD) an6

2 1st Secondary (ICD) an6

Patient Procedure Codes

1 Operation Status (per attendance) n1

OPCS procedure coding

1 Primary Procedure Code (OPCS) an4

Rating

1=mandatory

2=optional

1 Procedure Code 2 (OPCS) an4

Waiting List Details

1 Waiting List Date ccyymmdd

1 Waiting List Date Status n1

Annex 6 – MDS Waiting List (Elective Admission List)

Rating

1=mandatory

2=optional

Format/length End ofPeriodCensus

EventDuringPeriod(opt. Flow)

CONTRACT DETAILS

1 Organisation Code (code of Provider) an5 * *

1 Code of Commissioner an5 * *

1 Commissioning Serial Number an6 * *

2 Health Care Contract Line Number an10 * *

1 Commissioners Reference Number an17 * *

PATIENT DETAILS

1 NHS Number n10 * *

1 NHS Number Status Indicator n2 - from April1999

1 Patient's name an70 orstructuredname with 2an35 elements

1 Name Format Code n1 * *

1 Patient's Usual Address an175 (5 lineseach an35)

1 Postcode of Usual Address an8 * *

1 Local Health Board of Residence an3 * *

1 Sex n1 * *

2 Carer Support Indicator an2 * *

1 Birth Date ccyymmdd * *

1 Birth Date Status n1 * *

1 General Medical Practitioner (Code ofRegistered GMP)

an8 * *

2 Code of GP Practice (Registered GMP) an6 * *

1 Local Patient Identifier an10 * *

REFERRAL DETAILS

1 Referrer Code an8 * *

1 Referring Organisation Code an6 * *

Rating

1=mandatory

2=optional

ELECTIVE ADMISSION LIST DETAILS

1 Elective Admission List Entry Number an12 * *

1 Elective Admission List Record Type an2 *

1 Administrative Category n2 * *

1 Elective Admission Type n2 * *

1 Date of Patient Referral ccyymmdd * *

1 Patient Referral Date Status n1 * *

1 Decision to Admit Date ccyymmdd * *

1 Decision to Admit Date Status n1 * *

1 Clinical Referral Date ccyymmdd * *

1 Clinical Referral Date Status n1 * *

1 Waiting List Date ccyymmdd * *

1 Waiting List Date Status n1 * *

1 Intended Procedure Status n1 * *

1 Intended Procedure (OPCS) an4 * *

1 Intended Procedure 2 (OPCS) an4 * *

1 Intended Procedure 3 (OPCS) an4 * *

1 Intended Management n1 * *

2 Intended Site Code (of treatment) an5 * *

1 Priority Type n1 * *

1 Elective Admission List Status an2 *

1 Specialty Function Code (main specialty ofconsultant or list specialty)

n3 * *

1 Consultant Specialty Function Code (treatmentspecialty)

n3 * *

2 Local Sub-Specialty an3 * *

1 Consultant Code an8 * *

1 Date of Elective Admission List Census ccyymmdd *

1 Last DNA or Patient Cancelled Date ccyymmdd * *

1 Last DNA or Patient Cancelled Date Status n1 * *

2 Waiting List Entry Last Reviewed Date ccyymmdd * *

2 Waiting List Entry Last Reviewed Date Status n1 * *

Rating

1=mandatory

2=optional

CONTRACT CHANGE DETAILS

2 Service Arrangement Change Type an2 * *

2 Service Arrangement Change Date ccyymmdd * *

2 Service Arrangement Change Date Status n1 * *

SUSPENSION DETAILS

1 Count of Days Suspended n4 *

1 Suspension Start Date ccyymmdd *

1 Suspension Start Date Status n1 *

1 Suspension End Date ccyymmdd *

1 Suspension End Date Status n1 *

OFFER OF ADMISSION DETAILS

1 Agreed Admission Date ccyymmdd * *

1 Agreed Admission Date Status n1 * *

2 Agreed Admission Outcome n1 * *

HEALTHCARE RESOURCE GROUP DETAILS

2 Healthcare Resource Group Code an3

REMOVAL DETAILS

1 Elective Admission List Removal Date ccyymmdd *

1 Elective Admission List Removal Date Status n1 *

1 Elective Admission List Removal Reason n1 *

Annex 7 – MDS Waiting List (Outpatients)

Rating

1=mandatory

2=optional

CONTENT DETAILS

DRAFT DATASET, TO BE FINALISED QTR 1 2006/07

Format/length

Contract Details

Organisation code (of provider) an5

Organisation code (of commissioner) an5

Contract serial number an6

Healthcare contract line number an10

Commissioner’s reference number an17

Patient details

NHS number n10

NHS number status an2

Patient name an70

Name format code an1

Patient usual address an175

Postcode of usual address an8

LHB of residence an3

Sex an1

Carer support indicator an2

Birth date ccyymmdd

Birth date status an1

Registered GMP code an8

Registered GMP practice code an6

Local patient identifier (CRN) an10

Ethnic group an2

Referral details

Referrer code an8

Referring organisation code an6

Outpatient list details

Outpatient list entry number an12

Outpatient list record type an2

Administrative category an2

Rating

1=mandatory

2=optional

CONTENT DETAILS

Format/length

Outpatient type an2

Clinical Referral Date cyymmdd

Clinical Referral Date an1

Waiting List Date ccyymmdd

Waiting List Date status an1

Diagnosis code (ICD10) an6

Intended site code (of treatment) an5

Priority type an1

Outpatient list status an2

Specialty function code an3

Consultant specialty function code an3

Local sub specialty (Wales) an3

Consultant code an8

Date of outpatient list census ccyymmdd

Last DNA or patient cancelled date ccyymmdd

Last DNA or patient cancelled date status an1

Waiting list entry last reviewed date ccyymmdd

Waiting list entry last reviewed date status an1

Contract change details

Service arrangement change type an2

Service arrangement change date ccyymmdd

Service arrangement change date status an1

Suspension details

Count of days suspended n4

Suspension start date ccyymmdd

Suspension start date status an1

Suspension end date ccyymmdd

Suspension end date status an1

Offer of appointment details

Date of first offered appointment ccyymmdd

Attendance date status an1

Appointment offer outcome an1

Rating

1=mandatory

2=optional

CONTENT DETAILS

Format/length

Removal details

Outpatient list removal date ccyymmdd

Outpatient list removal date status an1

Outpatient list removal reason an1

Annex 8 - Aggregate Referral Data

Field Description Short Name Data Type Link to cmds Comment

Return Date CMDSDate Numeric with 8digits in theformat ccyymmdd

Same format ascmds field

ccyy = year withcentury e.g. 2005.

mm = 2 digit monthusing a leading zero ifnecessary.

dd = 2 digit date usinga leading zero ifnecessary. This shouldbe the last day of themonth.

Trust Code TrustCode Alpha-numeric First 3characters ofcmds field

LHB Code LHBCode Alpha-numeric

Main Spec MainSpec Numeric Consultant specialtycode

Local Spec LocalSpec Numeric

Total number of GPreferrals

TotalRefs Numeric If the number ofreferrals is zero, a zeromust be submitted.The fields must not beleft blank.

Annex 9 - MDS Referral

Rating

1=mandatory

2=optional

CONTENT DETAILS

DRAFT DATASET, TO BE FINALISED MARCH 2006

Format/length

Contract Details

1 Organisation code (of provider) an5

1 Organisation code (of purchaser) an5

2 Contract serial number an6

2 Healthcare contract line number an10

2 Purchaser’s reference number an17

1 Organisation Code (code of provider) an5

1 Code of Commissioner an5

Patient details

1 NHS number n10

2 NHS number status an2

1 Patient name an70

1 Name format code an1

1 Patient address an175

1 Postcode of usual address an8

1 HA of residence an3

1 Sex an1

2 Carer support indicator an2

1 Birth date ccyymmdd

2 Birth date status an1

1 Registered GMP code an8

1 Registered GMP practice code an6

1 Local patient identifier (CRN) an10

1 Ethnic group an2

1 NHS Number n10

1 NHS Number Status Indicator n2

1 Patient’s Name n70

1 Patient’s Name Format n1

Rating

1=mandatory

2=optional

CONTENT DETAILS

DRAFT DATASET, TO BE FINALISED MARCH 2006

Format/length

1 Patient’s Usual Address n175

1 Postcode of Usual Address an8 Format-

XX1-XXX,

XX1-XXX

1 Local Health Board of Residence an5

1 Sex an1- Format

1 Male

2 Female

1 Birth Date Status n1

1 General Medical Practitioner (Registered GMP) an8 Format

Gnnnnnnn

1 Code of GP Practice (Registered GMP) An6

Wnnnnn

1 Ethnic Group aa

Referral details

1 Referrer code an8

1 Referring organisation code an6

1 Source of admission an2

1 Referrer code an8

1 Referring Organisation Code an6

1 Source of Referral: Outpatients an2 - Format

1 Outpatient List Entry Number an12

1 Outpatient Referral Status an12

1 Administrative Catergory an2

1 Date Patient Referred ccyymmdd

1 Clinical Referral Date ccyymmdd

1 Intended Site Code (of Treatment) an5

1 Speciality Function Code (Consultant) an3

1 Consultant Code an8

1 Census Date ccyymmdd

1 Priority Type an1

1 Routine

2 Urgent

Annex 10 - Accident & Emergency

Rating

1=mandatory

2=optional

CONTENT DETAILS

FOR THOSE SUBMITTING DATA TO AWISS

Format/length

1 Record ID an1

Contract Details

1 Organisation Code (code of Provider) an5

Patient Details

1 A&E Number an12

2 NHS Number n10

2 NHS Number Status Indicator n2

2 GP Code an8

2 School Attended an30

2 Occupation an30

2 Ethnic Group N2

2 Surname an35

2 Forename an35

2 Date of Birth Ccyymmdd

2 Age N3

1 Sex An1

2 Patient's Usual Address Line 1 an35

1 Postcode of Usual Address an8

2 Referrer an2

2 Arrival Mode n2

2 Ambulance No an10

Rating

1=mandatory

2=optional

CONTENT DETAILS

Format/length

Attendance Details

1 Date of attendance an40

1 Time of attendance an8

2 Date of Incident an20

2 Time of Incident an20

1 Incident Type an3

2 RTA Place an30

2 RTA Location an30

2 RTA Road User an30

2 RTA Safety Device an30

1 Patient Group an2

2 Initial Complaint 1 750

2 Initial Complaint 2 750

2 Additional Incident Details 750

2 Additional Where 750

2 Additional What 750

2 Additional how 750

2 Follow Up Indicator an2

2 Date Seen - Triage Ccyymmdd

Time Seen - Triage

2 Triage Priority Score an2

2 Date Seen – Dr / Practitioner Ccyymmdd

Time Seen – Dr / Practitioner

2 Investigation 1 an2

Rating

1=mandatory

2=optional

CONTENT DETAILS

Format/length

2 Diagnosis 1 an3

2 Diagnosis 2 an3

2 Diagnosis 3 an3

2 Diagnosis 4 an3

2 Diagnosis 5 an3

2 Diagnosis 6 an3

2 Anatomical Site 1 an3

2 Side of Body 1 an1

2 Procedure 1 an2

2 Procedure 2 an2

2 Procedure 3 an2

2 Procedure 4 an2

2 Procedure 5 an2

2 Procedure 6 an2

2 Medication 1 an30

2 Medication 2 an30

2 Medication 3 an30

2 Medication 4 an30

2 Medication 5 an30

Rating

1=mandatory

2=optional

CONTENT DETAILS

Format/length

2 Medication 6 an30

2 Injury Group an3

2 Disposal an2

2 Date Left Department Ccyymmdd

2 Time Left Department Ccyymmdd

1 Attendance Type an1

2 Attending Dr GMC an8

Annex 11 - Minimum Information to be routinely provided by BSC forLHBs

Admitted Patient Care

• Average Length-of-Stay by Specialty.Based on FCE LoS, not Spell LoS.

Analysed by Mean and Median LOS.

• Specialty Activity – Elective and Non Elective

• Top 10 HRGs

• Top 10 ICD10 codes (Primary Diagnosis Code)

• Top 10 OPCS codes (Primary OPCS code)

• Day Case rates as a % of total elective.Based on the SAFF Basket of Procedures

• Discharge analysis by Discharge Method and Discharge Destination.

• Bedday analysis for specialties with lengthy stays.

Out patient Activity

• New to Follow-up ratio by specialty

• DNA rates for New patients

• DNA rates for Follow-up patients

• Source of Referral analysis by Specialty

WHC_2005_102 LTA Information Specification - Health in Wales

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