Change Request
 

NHS Connecting for Health

NHS Data Model and Dictionary Service

Reference: Change Request 1174
Version No:1.0
Subject:NHS Data Model and Dictionary Modelling Changes
Effective Date:Immediate
Reason for Change:Change to Data Standards
Publication Date:23 June 2010

Background:

The NHS Data Model and Dictionary Service are currently working with the Department of Health and the Information Centre for Health and Social Care to develop a number of data sets.

During the business analysis stage it has been identified that these Data Sets cover a number of common areas which are either not currently in the NHS Data Model and Dictionary, or amendments are required to make the current information suitable for use in these Data Sets.

This Information Standards Notice adds common data items and associated data modelling which is required by more than one data set currently in development. The changes are detailed in the Summary of Changes below.

These changes do not need to be implemented in end-user systems until the Information Standards Notice for the specific data sets come into effect. Other specific items will be added to the Data Sets during development.

Summary of changes:

Class Definitions
ACTIVITY GROUP   Changed Attributes
CARE CONTACT   Changed Attributes
PATIENT PATHWAY   Changed Attributes
REFERRAL TO TREATMENT PERIOD   Changed Attributes
SERVICE REQUEST   Changed Attributes
 
Attribute Definitions
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR   New Attribute
CARE PROGRAMME APPROACH LEVEL renamed from CPA LEVEL   Changed Name, Description
LENGTH OF STAY ADJUSTMENT   New Attribute
LENGTH OF STAY ADJUSTMENT REASON   New Attribute
REVIEW TYPE   New Attribute
SOURCE OF REFERRAL FOR MENTAL HEALTH   Changed Description
STATUS OF SERVICE REQUEST FOR MENTAL HEALTH   New Attribute
WAITING TIME MEASUREMENT TYPE   New Attribute
 
Data Elements
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR   New Data Element
CARE PROGRAMME APPROACH LEVEL   New Data Element
LENGTH OF STAY ADJUSTMENT   New Data Element
LENGTH OF STAY ADJUSTMENT REASON   New Data Element
REVIEW DATE   New Data Element
STATUS OF SERVICE REQUEST (MENTAL HEALTH)   New Data Element
WAITING TIME MEASUREMENT TYPE   New Data Element
 

Date:23 June 2010
Sponsor:Ken Lunn, Director of Data Standards and Products, NHS Connecting for Health

Note: New text is shown with a blue background. Deleted text is crossed out. Retired text is shown in grey. Within the Diagrams deleted classes and relationships are red, changed items are blue and new items are green.

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ACTIVITY GROUP

Change to Class: Changed Attributes

Attributes of this Class are:
A and E INCIDENT LOCATION TYPE
A and E PATIENT GROUP
ACTIVITY GROUP TYPE
ADMISSION METHOD
AMI ADMISSION DIAGNOSIS
AMI ADMISSION WARD TYPE
AMI ADMITTING CONSULTANT TYPE
AMI CAUSE OF DEATH IN HOSPITAL
AMI DISCHARGE DIAGNOSIS
AMI HEART RATE
BABY FEEDING METHOD TYPE
BONE SARCOMA LOCATION
BROAD PATIENT GROUP
CANCER REFERRAL TO TREATMENT PERIOD START DATE
CANCER STATUS
CANCER TREATMENT INTENT
CANCER TREATMENT PERIOD START DATE
COPD PRESENT
CORONARY ANGIOGRAPHY PERFORMED
CPA LEVEL
DELIVERY FACILITIES ONLY USED
DELIVERY PLACE CHANGE REASON
DIAGNOSTIC ROUTE
DISCHARGE DESTINATION
DISCHARGE FROM MENTAL HEALTH SERVICE REASON
DISCHARGE METHOD
DISTRIBUTION OF LESIONS PRESENT
ECG DETERMINING TREATMENT
FIRST REGULAR DAY OR NIGHT ADMISSION
FULL POSTNATAL EXAMINATION DATE
GENERAL DENTAL SERVICE INDICATOR
GENETICALLY DETERMINED SKIN CANCER TYPE
GENITOURINARY EPISODE TYPE
INFECTION PROBABLE SOURCE
INITIAL CONTACT TYPE
INTENDED DELIVERY PLACE
INVESTIGATION OR INTERVENTION REFERRAL DATE
LENGTH OF STAY ADJUSTMENT
LENGTH OF STAY ADJUSTMENT REASON
MATERNAL RUBELLA STATUS
MENSTRUAL STATUS
MENTAL HEALTH CARE SPELL END CODE
MIDWIFE EPISODE END REASON
NEONATAL LEVEL OF CARE
NURSING EPISODE END REASON
NUTRITIONAL SUPPORT PROVIDED TYPE
PATIENT CLASSIFICATION
POSSUM SCORE (AFTER SURGERY)
POSSUM SCORE (AT DIAGNOSIS)
PREGNANCY LEAD PROFESSIONAL TYPE
PREGNANCY PREVIOUS CAESAREAN SECTIONS
PREGNANCY PREVIOUS INDUCED ABORTIONS
PREGNANCY TOTAL LIVE BIRTHS
PREGNANCY TOTAL NEONATAL DEATHS
PREGNANCY TOTAL NON-INDUCED ABORTIONS
PREGNANCY TOTAL PREVIOUS PREGNANCIES
PREGNANCY TOTAL STILL BIRTHS
PREVIOUS MATERNAL BLOOD TRANSFUSION
PREVIOUS TREATMENT ELSEWHERE
QUALITY OF LIFE
RADIOTHERAPY INTENT
REHABILITATION REFERRAL
RTA FURTHER ADMISSION PLANNED
SARCOMA CONDITION FIRST SEEN
SARCOMA LARGEST DIAMETER
SARCOMA PART SITE
S CATEGORY FINAL PRETREATMENT
SERUM TUMOUR MARKER PSA
SKIN TCELL CLINICAL VARIANT
SKIN TCELL SURFACE AREA
SOFT TISSUE SARCOMA LOCATION
SOURCE OF ADMISSION
SUPERVISED COMMUNITY TREATMENT END REASON
SUPERVISION REGISTER RISK
TELEPHONE CONTACT INDICATOR
TREATMENT START DATE CANCER
WARD STAY TERMINATION REASON

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CARE CONTACT

Change to Class: Changed Attributes

Attributes of this Class are:
A and E ARRIVAL MODE
A and E ATTENDANCE CATEGORY
A and E ATTENDANCE DISPOSAL
A and E INITIAL ASSESSMENT TRIAGE CATEGORY
A and E STREAM
ACUTE HOME-BASED TELEPHONE CONTACT
ANTENATAL OR POSTNATAL INDICATOR
BREAST CANCER NURSE SEEN
CARE ACTIVITY INFORMATION
CARE CONTACT TYPE
COLPOSCOPY PRIME PROCEDURE TYPE
CONSULTATION MEDIUM USED
CONTRACEPTIVE SERVICE TYPE
CPA REVIEW OUTCOME
DENTAL HAEMORRHAGE SERVICE TYPE
DENTAL REFERRAL INDICATOR
ELIGIBILITY OUTCOME
EMERGENCY TREATMENT FEE
EMERGENCY TREATMENT TYPE
FIRST ATTENDANCE
GENITOURINARY CONTACT TYPE CODE
HEALTH PROMOTION STAFF GROUP
HOME HELP USE
INITIAL CONTACT
INITIAL CONTACT WITHIN FIVE DAYS
IUD APPLICATION DATE
MARKER RESPONSE STATUS
MATERNITY MEDICAL SERVICE TYPE
MATERNITY VISIT CALL REASON
MEDICAL STAFF TYPE SEEING PATIENT
METASTATIC STATUS
NODAL STATUS
NON-NHS COMMUNITY BED USE
NON-NHS DAY CARE FACILITY USE
OUTCOME OF ATTENDANCE
PATIENT INFORMED OF OUTCOME DATE
PATIENT REPORTED SYMPTOMS INDICATOR
PATIENT REPORTED WAIT
PATIENT TRIAL STATUS
PAYMENT FROM PATIENT RECEIVED
POSTNATAL CARE INDICATOR
PRIMARY TUMOUR STATUS
REVIEW TYPE
SETTLED ACCOMMODATION INDICATOR
SHELTERED WORK FACILITY USE
SIGHT TEST DOMICILIARY VISIT TYPE
SIGHT TEST FORM COMPLETED
SIGHT TEST PERSON SUBSIDY TYPE
SKIN TUMOUR STATUS
STATUTORY ASSESSMENT TYPE
SURVEILLANCE RESULT

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PATIENT PATHWAY

Change to Class: Changed Attributes

Attributes of this Class are:
KPATIENT PATHWAY IDENTIFIER
PATIENT PATHWAY START DATE
WAITING TIME MEASUREMENT TYPE

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REFERRAL TO TREATMENT PERIOD

Change to Class: Changed Attributes

Attributes of this Class are:
KREFERRAL TO TREATMENT PERIOD START DATE
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR
REFERRAL TO TREATMENT PERIOD END DATE

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SERVICE REQUEST

Change to Class: Changed Attributes

Attributes of this Class are:
KSERVICE REQUEST IDENTIFIER
APPOINTMENT CLASSIFICATION CODE
APPOINTMENT OFFER VERBAL OR WRITTEN
DECISION TO OFFER AN APPOINTMENT DATE
DIAGNOSTIC SERVICE REQUEST TYPE
ORIGINAL REFERRAL REQUEST RECEIVED DATE
REFERRAL REQUEST CANCELLED DATE
REFERRAL REQUEST RECEIVED DATE
SERVICE REQUEST DATE
SERVICE REQUEST RAISED REASON
SERVICE REQUEST TIME
STATUS OF SERVICE REQUEST FOR MENTAL HEALTH

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ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

An indicator which is used to identify the delivery of First Definitive Treatment to a PATIENT by a multi-disciplinary Allied Health Professional team.  It is only used where multiple REFERRAL TO TREATMENT PERIODS are being measured concurrently within the same PATIENT PATHWAY, one for each type of Allied Health Professional within the multi-disciplinary team.

The ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR should only be recorded where the WAITING TIME MEASUREMENT TYPE is recorded as National Code 02 'Allied Health Professional Referral To Treatment Measurement (Uni-Disciplinary Team)' for ALL the concurrent REFERRAL TO TREATMENT PERIODS within the PATIENT PATHWAY.  This occurs when the Allied Health Professional Multi-Disciplinary Team responsible for the PATIENT do not decide who is to deliver First Definitive Treatment when the CARE PLAN is agreed. 

National codes:

YFirst Definitive Treatment was delivered
NFirst Definitive Treatment was not delivered
 

This attribute is also known by these names:
ContextAlias
pluralALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATORS

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ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

Change to Attribute: New Attribute

ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR
 
Data Elements:
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

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CARE PROGRAMME APPROACH LEVEL  renamed from CPA LEVEL

Change to Attribute: Changed Name, Description

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The level of Care Programme Approach which has been determined as applicable for a PATIENT's Care Programme Approach Episode. Health Care Providers may develop expanded local classifications to meet local requirements. However, local classifications must map back to the national classifications and only National Codes should be used for central reporting.

National Codes:

0No care
1Standard, requires the support or intervention of one agency or discipline; or requires only low key support from more than one agency
2Enhanced, multiple needs, including housing, employment etc, which requires inter-agency coordination
1Non-Care Programme Approach care
2New Care Programme Approach care
 

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LENGTH OF STAY ADJUSTMENT

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

This is the total number of days within a Consultant Episode (Hospital Provider) that a discrete period of activity such as Rehabilitation or Specialist Palliative Care occurred, which requires an adjustment to the total length of stay for Payment by Results purposes. 

The LENGTH OF STAY ADJUSTMENT should be calculated using the Payment by Results rules (i.e. count of midnights).  The LENGTH OF STAY ADJUSTMENT REASON should also be recorded.

Where several discrete periods of applicable activity occur within one Consultant Episode (Hospital Provider), the number of days should be totalled and reported in a single LENGTH OF STAY ADJUSTMENT.

 

This attribute is also known by these names:
ContextAlias
pluralLENGTH OF STAY ADJUSTMENTS

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LENGTH OF STAY ADJUSTMENT

Change to Attribute: New Attribute

LENGTH OF STAY ADJUSTMENT
 
Data Elements:
LENGTH OF STAY ADJUSTMENT

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LENGTH OF STAY ADJUSTMENT REASON

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The reason that a LENGTH OF STAY ADJUSTMENT is required for a Consultant Episode (Hospital Provider). 

National Codes:

01Rehabilitation
02Specialist Palliative Care
 

This attribute is also known by these names:
ContextAlias
pluralLENGTH OF STAY ADJUSTMENT REASONS

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LENGTH OF STAY ADJUSTMENT REASON

Change to Attribute: New Attribute

LENGTH OF STAY ADJUSTMENT REASON
 
Data Elements:
LENGTH OF STAY ADJUSTMENT REASON

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REVIEW TYPE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The type of formal review of care carried out during a CARE CONTACT.

National Codes:

01Care Programme Approach Review
02Mental Health Act Review
036-8 week Review
04Health Review
05Annual Review
99Other review
 

This attribute is also known by these names:
ContextAlias
pluralREVIEW TYPES

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SOURCE OF REFERRAL FOR MENTAL HEALTH

Change to Attribute: Changed Description

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

A classification which identifies the source of referral of a Mental Health Care Spell.

National Codes:

00GENERAL MEDICAL PRACTITIONER
01Self
02Local Authority Social Services
03Accident And Emergency Department
04Employer
05Education Service
06Police
07Other clinical specialty
08Carer
09Courts
10Probation Service
11High security
12Medium security
13Other
20Temporary transfer from mental health unit
21Permanent transfer from mental health unit
22Transfer by graduation from local child and adolescent mental health services
 Primary Health Care
A1GENERAL MEDICAL PRACTITIONER
A2Health Visitor
A3Other Primary Health Care
 Self Referral
B1Self
B2Carer
 Local Authority Services
C1Social Services
C2Education Service
 Employer
D1Employer
 Justice System
E1Police
E2Courts
E3Probation Service
E4Prison
E5Court Liaison and Diversion Service
 Child Health
F1School Nurse
F2Hospital-based Paediatrics
F3Community-based Paediatrics
 Independent/Voluntary Sector
G1Independent sector - Medium Secure Inpatients
G2Independent Sector - Low Secure Inpatients
G3Other Independent Sector Mental Health Services
G4Voluntary Sector
 Acute Secondary Care
H1Accident And Emergency Department
H2Other secondary care specialty
 Other Mental Health NHS Trust
I1Temporary transfer from another Mental Health NHS Trust
I2Permanent transfer from another Mental Health NHS Trust
 Internal referrals  from Community Mental Health Team (within own NHS Trust)
J1Community Mental Health Team (Adult Mental Health)
J2Community Mental Health Team (Older People)
J3Community Mental Health Team (Learning Disabilities)
J4Community Mental Health Team (Child and Adolescent Mental Health)
 Internal referrals from Inpatient Service (within own NHS Trust)
K1Inpatient Service (Adult Mental Health)
K2Inpatient Service (Older People)
K3Inpatient Service (Forensics)
K4Inpatient Service (Child and Adolescent Mental Health)
K5Inpatient Service (Learning Disabilities)
 Transfer by graduation (within own NHS Trust)
L1Transfer by graduation from Child and Adolescent Mental Health Services to Adult Mental Health Services
L2Transfer by graduation from Adult Mental Health Services to Older Peoples Mental Health Services
 Other
M1Asylum Services
M2NHS Direct
M3Out of Area Agency
M4Drug Action Team / Drug Misuse Agency
M5Other service or agency
 

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STATUS OF SERVICE REQUEST FOR MENTAL HEALTH

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The status of a SERVICE REQUEST received by an Adult Mental Health Care Team or Child and Adolescent Mental Health Care Team.

National Codes:

 Pending
01Pending action
 Accepted
02Accepted for immediate action
03Accepted and placed on APPOINTMENT WAITING LIST
 Not Accepted
04SERVICE REQUEST passed back to referrer
05SERVICE REQUEST redirected to another agency
 Closed
06PATIENT declined to be treated
07PATIENT died
 

This attribute is also known by these names:
ContextAlias
pluralSTATUSES OF SERVICE REQUEST FOR MENTAL HEALTH

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STATUS OF SERVICE REQUEST FOR MENTAL HEALTH

Change to Attribute: New Attribute

STATUS OF SERVICE REQUEST FOR MENTAL HEALTH
 
Data Elements:
STATUS OF SERVICE REQUEST (MENTAL HEALTH)

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WAITING TIME MEASUREMENT TYPE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The type of waiting time measurement methodology which may be applied during a PATIENT PATHWAY.  The methodology applied may be for one part of a PATIENT PATHWAY, such as the measurement of a REFERRAL TO TREATMENT PERIOD, or other parts of the PATIENT PATHWAY according to Department of Health policy.

National Codes:

01Referral To Treatment Period Included In 18 Weeks Target
02Allied Health Professional Referral To Treatment Measurement (Uni-Disciplinary Team)
03Allied Health Professional Referral To Treatment Measurement (Multi-Disciplinary Team)
 

This attribute is also known by these names:
ContextAlias
pluralWAITING TIME MEASUREMENT TYPES

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WAITING TIME MEASUREMENT TYPE

Change to Attribute: New Attribute

WAITING TIME MEASUREMENT TYPE
 
Data Elements:
WAITING TIME MEASUREMENT TYPE

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ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

Change to Data Element: New Data Element

Format/length:an1
HES item: 
National Codes:see ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR is the same as attribute ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR.

 

This data element is also known by these names:
ContextAlias
pluralALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATORS

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ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

Change to Data Element: New Data Element

ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR
 
Attribute:
ALLIED HEALTH PROFESSIONAL FIRST DEFINITIVE TREATMENT DELIVERED INDICATOR

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CARE PROGRAMME APPROACH LEVEL

Change to Data Element: New Data Element

Format/length:an1
HES item: 
National Codes:see CARE PROGRAMME APPROACH LEVEL
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

CARE PROGRAMME APPROACH LEVEL is the same as attribute CARE PROGRAMME APPROACH LEVEL.

 

This data element is also known by these names:
ContextAlias
pluralCARE PROGRAMME APPROACH LEVELS

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CARE PROGRAMME APPROACH LEVEL

Change to Data Element: New Data Element

CARE PROGRAMME APPROACH LEVEL
 
Attribute:
CARE PROGRAMME APPROACH LEVEL

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LENGTH OF STAY ADJUSTMENT

Change to Data Element: New Data Element

Format/length:n3
HES item: 
National Codes:see LENGTH OF STAY ADJUSTMENT
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

LENGTH OF STAY ADJUSTMENT is the same as attribute LENGTH OF STAY ADJUSTMENT.

 

This data element is also known by these names:
ContextAlias
pluralLENGTH OF STAY ADJUSTMENTS

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LENGTH OF STAY ADJUSTMENT

Change to Data Element: New Data Element

LENGTH OF STAY ADJUSTMENT
 
Attribute:
LENGTH OF STAY ADJUSTMENT

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LENGTH OF STAY ADJUSTMENT REASON

Change to Data Element: New Data Element

Format/length:an2
HES item: 
National Codes:see LENGTH OF STAY ADJUSTMENT REASON
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

LENGTH OF STAY ADJUSTMENT REASON is the same as attribute LENGTH OF STAY ADJUSTMENT REASON.

 

This data element is also known by these names:
ContextAlias
pluralLENGTH OF STAY ADJUSTMENT REASONS

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LENGTH OF STAY ADJUSTMENT REASON

Change to Data Element: New Data Element

LENGTH OF STAY ADJUSTMENT REASON
 
Attribute:
LENGTH OF STAY ADJUSTMENT REASON

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REVIEW DATE

Change to Data Element: New Data Element

Format/length:see DATE
HES item: 
National Codes: 
Default Codes: 

Notes:
The DATE of a formal review of care carried out during a CARE CONTACT.

 

This data element is also known by these names:
ContextAlias
pluralREVIEW DATES

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STATUS OF SERVICE REQUEST (MENTAL HEALTH)

Change to Data Element: New Data Element

Format/length:an2
HES item: 
National Codes:see STATUS OF SERVICE REQUEST FOR MENTAL HEALTH
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

STATUS OF SERVICE REQUEST (MENTAL HEALTH) is the same as attribute STATUS OF SERVICE REQUEST FOR MENTAL HEALTH.

 

This data element is also known by these names:
ContextAlias
pluralSTATUSES OF SERVICE REQUEST (MENTAL HEALTH)

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STATUS OF SERVICE REQUEST (MENTAL HEALTH)

Change to Data Element: New Data Element

STATUS OF SERVICE REQUEST (MENTAL HEALTH)
 
Attribute:
STATUS OF SERVICE REQUEST FOR MENTAL HEALTH

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WAITING TIME MEASUREMENT TYPE

Change to Data Element: New Data Element

Format/length:an2
HES item: 
National Codes:see WAITING TIME MEASUREMENT TYPE
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes:

WAITING TIME MEASUREMENT TYPE is the same as attribute WAITING TIME MEASUREMENT TYPE.

 

This data element is also known by these names:
ContextAlias
pluralWAITING TIME MEASUREMENT TYPES

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WAITING TIME MEASUREMENT TYPE

Change to Data Element: New Data Element

WAITING TIME MEASUREMENT TYPE
 
Attribute:
WAITING TIME MEASUREMENT TYPE

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For enquiries about this Information Standards Notice, please email datastandards@nhs.net