Change Request

NHS Information Authority

Data Standards Programme

Reference: Change Request 286
Version No:1.0
Subject:DSCN 46/2002 - CDS Addressing Grid
Type of Change:Changes to NHS Data Dictionary & Manual supporting
Effective Date:1 April 2002
Reason for Change:Update the NHS Data Dictionary & Manual supporting information and provide additional user guidance on data flows to be applied to activity from 1st April 2002.

Background:

The CDS Addressing Grid, as published in the NHS Data Dictionary & Manual and the NHS CDS Manual and DSCN 17/2002, details the Prime and Copy Recipients of commissioning data flows. It has been necessary to update this information as there is a need for greater clarity and consistency and in view of the fact that Overseas Visitors resident in England for more than 3 months qualify for GP registration.

The aim was however to make the minimum changes necessary to the original CDS Addressing Grid, to reflect the bulk of commissioning arrangements and support the data flows. This DSCN does not therefore represent a major change to the previous DSCN 17/2002. Department of Health guidance is expected on Establishing Responsible Commissioner which should give further clarification of current commissioning arrangements.

The concepts from DSCN 34/98/A08, giving practical guidance on how to manage secondary care information flows with the introduction of Primary Care Groups (PCGs) in April 1999, remain largely unchanged with the exception of the transition to Primary Care Trusts (PCTs). Hence the main flow diagram assigning a patient to a service agreement has been updated to include PCTs in this DSCN.

Summary of changes:
 
Supporting Information
CONTEXTUAL OVERVIEW   Change to supporting information

Name:Kevin Shine
Date:4 December 2002
Sponsor:Data Standards Team

Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout.


CONTEXTUAL OVERVIEW

Change to Supporting Information: Change to supporting information

CDS, CMDS and HES

CDS, CMDS and HES Contextual Overview

Contextual Overview

    A. Information Requirements
  1. Inormation on care provided by NHS hospitals and Primary Care Trusts is required to:

    Main commissioners need access to data to monitor OUT OF AREA TREATMENT activity as part of the management of their Service Agreements. PRIMARY CARE GROUPS and PRIMARY CARE TRUSTS also need to monitor in-year referrals to investigate the sources and reasons for Out of Area Treatments.

  1. The Department of Health (DH) needs a complete record of all patients admitted to NHS hospitals and Primary Care Trusts, including patients receiving private treatment. Hospital Episode Statistics (HES) are derived from the Admitted Patient Care CDS Types submitted via the NHS-wide Clearing Service (NWCS). These records provide information about hospital and patient management and epidemiological data on patient diagnoses and operative procedures. The HES database has already been used to support every aspect of the new Performance Framework.

    B. Data Flows
  1. HES records are extracted from the NWCS database quarterly. The timely provision of Admitted Patient Care (APC) records to the NWCS, complete with clinical information, is now a performance issue for NHS Trusts.

  1. The strategic direction set out within Information for Health is to develop comprehensive and consistent electronic health records for patients from clinical information flows. In the short term, access to and the analysis of CDS Types/CMDSs will remain important, and the exchange of these data sets should continue on at least a monthly basis.

  1. To determine who receives CDS Types/CMDSs, NHS Trusts and Primary Care Trusts need to take all of the following factors into account, not necessarily in the order specified here:


    The information data flows are shown in the Tables below.
    C. CDS and CMDS Data Flow Definitions
  2. The exchange of individual CDS Types/CMDSs may be mandatory or optional. All Admitted Patient Care CDS Type exchanges, for example, are mandatory, but exchanges of individual CDS Types for accident and emergency attendances are not, and require local agreement between the parties concerned.

  1. To determine who receives CDS Types/CMDSs, NHS Trusts and Primary Care Trusts need to take all of the following factors into account, not necessarily in the order specified here:


    The information data flows are shown in the Tables below.
    C. CDS and CMDS Data Flow Definitions
  1. The exchange of individual CDS Types/CMDSs may be mandatory or optional. All Admitted Patient Care CDS Type exchanges, for example, are mandatory, but exchanges of individual CDS Types for accident and emergency attendances are not, and require local agreement between the parties concerned.

  1. Where CDS Types/CMDSs are exchanged, the data items within the CDS Type/CMDS have a mandatory or optional status. A data item marked as mandatory (M) means that it must be included in the CDS Type; a data item marked as optional (O) means that the data item need only be included if both parties agree to its exchange. Although the exchange of the Accident and Emergency CDS Type may be optional, this does not apply to the status of the data items within this CDS Type.

  1. For records relating to CDS and CMDS activity from the 1st April 2002 see REVISED CDS INFORMATION FLOW ADDRESSING GRID - Activity from 1st April 2002 below.

  1. For records relating to CDS and CMDS activity up to 31st March 2002, see PREVIOUS CDS INFORMATION FLOW ADDRESSING GRID - Activity up to 31st March 2002 below.

    REVISED CDS INFORMATION FLOW ADDRESSING GRID - Activity from 1st April 2002

      CDS PRIME RECIPIENT CDS COPY RECIPIENTS
    Patient/Service Agreement PCG OR PCT OF RESIDENCE PCG OR PCT responsible Main Comm-issioner Organisa-tion to which costs of treatment accrue
    Patient registered with GP with PCG/PCT Service Agreement * *    
    Patient not registered with a GP but resident in an area covered by a PCG/PCT with a PCG/PCT Service Agreement * *    
    Patient registered with GP with PCG/PCT Service Agreement * * *  
    Patient registered with a GP treated as an Out Of Area Treatment (OAT) * * *  
    Patient not registered with a GP treated as an Out Of Area Treatment (OAT) *   *  
    Patient not registered with a GP treated as an Out Of Area Treatment (OAT) * * *  
    Overseas visitor exempt from charges *
    (TDH00)
      *  
    Overseas visitor exempt from charges and not registered with a GP *
    (TDH00)
      *  
    Overseas visitor liable for NHS charges *
    (VPP00)
         
    Overseas visitor exempt from charges and registered with a GP *
    (TDH00)
    * *  
    Overseas visitor liable for NHS charges and not registered with a GP *
    (VPP00)
         
    Overseas visitor liable for NHS charges and registered with a GP *
    (VPP00)
    *    
    Patient registered with GP with a Specialised Services & Other Commissioning Consortia Service Agreement * *   *
    Patient not registered with GP with a Specialised Services & Other Commissioning Consortia Service Agreement *     *
    Patient not registered with GP with a Specialised Services & Other Commissioning Consortia Service Agreement * *   *
    Private Patient * *    

    Notes:

    1. Some flows will be sent for unfinished episodes. For example, a consultant episode may be in progress when a data flow is sent. In such cases the end date is not known and the patient has not been discharged. These data items will therefore not be included in that data flow.
      a. Some flows will be sent for unfinished episodes. For example, a consultant episode may be in progress when a data flow is sent. In such cases the end date is not known and the patient has not been discharged. These data items will therefore not be included in that data flow.

      b. Note that if two recipients are identical (e.g. PCG or PCT of Residence is the same as the Main Commissioner only one data set should be sent to that recipient.

    1. Note that if two recipients are identical (e.g. PCG or PCT of Residence is the same as the Main Commissioner only one data set should be sent to that recipient.

    c. For further information please refer to DSCN 46/2002.

    PREVIOUS CDS INFORMATION FLOW ADDRESSING GRID - Activity up to 31st March 2002

  1. All records relating to CDS and CMDS activity up to 31st March 2002, including unfinished episodes on that date, will use the previous data flow addressing grid irrespective of when the records are actually sent to the NWCS. For example, an admitted patient episode which ended in March 2002 should be addressed to the appropriate HA or PCG/PCT in existence in March 2002 even though the record may not be sent until 1st April 2002 or later.

Patient/Service Agreement PCG/PCT HA responsible for PCG: HA to which PCT is accountable PCG OR PCT OF RESIDENCE HA responsible for PCG OR PCT OF RESIDENCE; Main Comm-issioner Organisa-tion to which costs of treatment accrue HA of Residence Agency acting on behalf of DH
Patient registered with GP with PCG/PCT Service Agreement * *         *  
Patient not registered with GP but resident in area covered by PCG/PCT with PCG/PCT Service Agreement     * *     *  
Patient registered with GP treated as Out of Area Treatment * *     *   *  
Patient not registered with GP treated as Out of Area Treatment     * * *   *  
Overseas visitor exempt from charges         *     *
(TDH00)
Overseas visitor - liable for NHS charges               *

(VPP00)
Patient registered with GP with Specialised Services & Other Commissioning Consortia Service Agreement * *       * *  
Patient not registered with GP with Specialised Services & Other Commissioning Consortia Service Agreement     * *   * *  
Private Patient * *         *  

Notes:

    a. Some flows will be sent for unfinished episodes. For example, a consultant episode may be in progress when a data flow is sent. In such cases the end date is not known and the patient has not been discharged. These data items will therefore not be included in that data flow.

  1. Some flows will be sent for unfinished episodes. For example, a consultant episode may be in progress when a data flow is sent. In such cases the end date is not known and the patient has not been discharged. These data items will therefore not be included in that data flow.
    b. Note that if two recipients are identical (e.g. the HA of Residence is the same as the HA responsible for the patient’s PCG) only one data set should be sent to that recipient.

  1. Note that if two recipients are identical (e.g. the HA of Residence is the same as the HA responsible for the patient’s PCG) only one data set should be sent to that recipient.


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