Change Request

NHS Information Authority

Data Standards Programme

Reference: Change Request 297
Version No:1.3
Subject:DSCN 62/2002 - NHS patients treated in the independent sector and overseas
Type of Change:Changes to the NHS Data Dictionary Version.2
Effective Date:1 April 2003
Reason for Change:NHS data standards to support DSCN 47/2002

Background:

DSCN 47/2002 provided guidance on capturing Commissioning Data Set (CDS) / Hospital Episode Statistics (HES) data for NHS patients who are treated by independent or overseas providers. The guidance was advisory from the date of the DSCN, and mandatory from 1 April 2003.

This DSCN details the changes necessary to NHS data standards in the NHS Data Dictionary Version.2 to support DSCN 47/2002.

Summary of changes:
 
Data Elements
CONSULTANT CODE   Change to description
CONSULTANT SPECIALTY FUNCTION CODE   Change to description
LOCAL PATIENT IDENTIFIER   Change to description
ORGANISATION CODE (CODE OF PROVIDER)   Change to description
PROCEDURE CODING   Change to description
REFERRER CODE   Change to description
SITE CODE (OF TREATMENT)   Change to description
SPECIALTY FUNCTION CODE   Change to description
 
Supporting Information
DEFAULT CODES SUMMARY TABLE   Change to supporting information

Name:Michelle Cambridge
Date:24 February 2003
Sponsor:Data Standards Team

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


CONSULTANT CODE

Change to Data Element: change to description

Format/length: an8
HES item: CONSULT
National Codes:
Default Codes: C9999998 - Consultant code not known
  D9999998 - Dentist code not known
  M9999998 - Not applicable - Midwife
  N9999998 - Not applicable - Nurse

Notes:
This is the GMC code for the CONSULTANT, which is the unique identifier for the consultant as a PERSON, i.e. the PERSON IDENTIFIER TYPE classification 'Consultant Code - GMC'. For GPs working as Consultants, the GP's GMC code should be used, see data item note for GMP (CODE OF REGISTERED OR REFERRING GMP).

The GMC code is an eight character alphanumeric code based on the GMC registration number; the first character will be the letter `C'; characters 2 to 7 will be the doctor's GMC number, see PRACTITIONER CODES.

If a dental consultant is not registered with the GMC, the Dentists' Practice Board number has to be used prefixed with D.

For NHS patients treated overseas, the commissioner of the overseas treatment is responsible for ensuring that the overseas doctor is provided with a GMC code. In the case of overseas doctors the default code C9999998 should only be used where no GMC code has been assigned.

All MIDWIFE EPISODES are identified in the Admitted Patient Care CDS and HES by a pseudo main consultant specialty code, 560, see Speciality Function Codes. A default code is used in the CONSULTANT CODE field to show that a MIDWIFE is the responsible professional. Note that the midwife's own code is not used.

All NURSING EPISODES are identified in the Admitted Patient CDS and HES by a pseudo main consultant specialty code, 950, see Speciality Function Codes. A default code is used in the CONSULTANT CODES field to show that a NURSE is the responsible professional. Note that the nurse's own Nursing and Midwifery Council code is not used.



This data element is also known by these names:
ContextAlias
pluralCONSULTANT CODES


top

CONSULTANT SPECIALTY FUNCTION CODE

Change to Data Element: change to description

Format/length: n3
HES item: TRETSPEF
National Codes:
Default Codes:
199 - Non-UK provider; specialty function not known, treatment mainly surgical
499 - Non-UK provider; specialty function not known, treatment mainly medical


Notes:
This is the specialty under which the PATIENT is treated. It may be the same as the SPECIALTY FUNCTION CODE recorded as the consultant's main SPECIALTY or a different specialty function which will be the consultant's interest specialty. Both the main specialty function and the interest specialty function should be based on one of the Royal College specialties, see Speciality Function Codes.

All MIDWIFE EPISODES and NURSING EPISODES are identified in the Admitted Patient care CDS and HES by a pseudo consultant specialty code of 560 for midwives and 950 for nurses, see Specialty Function Codes.

All MIDWIFE EPISODES and NURSING EPISODES are identified in the Admitted Patient care CDS and HES by a pseudo consultant specialty code of 560 for midwives and 950 for nurses, see Specialty Function Codes. The default codes 199 and 499 are only applicable for overseas health care providers.



This data element is also known by these names:
ContextAlias
pluralCONSULTANT SPECIALTY FUNCTION CODES


top

LOCAL PATIENT IDENTIFIER

Change to Data Element: change to description

Format/length: an10
HES item: LOPATID
National Codes:
Default Codes:


Notes:
This is a number used to identify a PATIENT uniquely within a HEALTH CARE PROVIDER. It may be different from the PATIENT's casenote number and may be assigned automatically by the computer system. This is PERSON IDENTIFIER TYPES classification 'Local Patient Identifier ('PAS' Number)' for a PERSON IDENTIFIER.

Where care for NHS patients is sub-commissioned in the independent sector or overseas, the NHS commissioner local patient identifier should be used. If no NHS local patient identifier has been assigned the independent sector or overseas provider identifier should be used.



This data element is also known by these names:
ContextAlias
pluralLOCAL PATIENT IDENTIFIERS


top

ORGANISATION CODE (CODE OF PROVIDER)

Change to Data Element: change to description

Format/length: an5
HES item: PROCODE
National Codes:
Default Codes:
89997 - UK provider where no organisation code has been issued
89999 - Non-NHS UK provider where no organisation code has been issued


Notes:
This is the ORGANISATION CODE of the ORGANISATION acting as a HEALTH CARE PROVIDER. The code may be derived automatically by NHS IT systems.

Where NHS patient care is sub-commissioned to independent or overseas providers, the NHS SERVICE AGREEMENT should specify that the non-NHS provider has requested an identifying organisation code from the Organisation Codes Service.

See NHS Administrative Codes for a description of ORGANISATION CODES.



This data element is also known by these names:
ContextAlias
pluralORGANISATION CODES (CODE OF PROVIDER)


top

PROCEDURE CODING

Change to Data Element: change to description

Format/length: annn for OPCS-4, an7 for Clinical Terms (The Read Codes)
HES item: OPERATN
National Codes:
Default Codes: X998 - Out-patient procedure carried out but no appropriate OPCS-4 code available
  X999 - No out-patient procedure carried out

Notes:

This is a CLINICAL CLASSIFICATION CODE.

See Clinical Coding for Classification of Surgical Operations and Procedures (OPCS - 4) and Read Coded Clinical Terms.

See the 'Classification of Surgical Operations and Procedures (OPCS-4)' and 'Read Coded Clinical Terms' sections within the Clinical Coding page.

Record any operative procedures carried out, such as an endoscopy or electro-convulsive therapy (ECT), as part of the current consultant episode.

Clinical Terms (The Read Codes) (an7) may be used as an optional addition to OPCS-4.

The recording of procedures using OPCS-4 is now optional for the Out-Patient/Ward Attenders CDS. If required, a default procedure code may be used in the first procedure field and subsequent procedure fields space-filled.

The default codes are classified as entries in the Classification of Surgical Operations and Procedures Fourth Revision Consolidated Version (OPCS-4).

Where providers locally use OPCS-4 codes with a fifth character added, this should be removed before inclusion in the Commissioning Data Set.



This data element is also known by these names:
ContextAlias
pluralPROCEDURE CODINGS


top

REFERRER CODE

Change to Data Element: change to description

Format/length: an8
HES item: REFERRER
National Codes:
Default Codes: R9999981 - Referrer other than GMP, GDP or Consultant
Default Codes:C9999998 - Consultant Code not known
R9999981 - Referrer other than GMP, GDP or Consultant
X9999998 - Not applicable: or not known

Notes:
This requires the code of the PERSON making the referral. This will normally be a HEALTH CARE PROFESSIONAL - a GMP or a consultant.

The intention is for this item to reflect the actual (true) referrer. For example, following a GMP referral, a consultant may subsequently refer the PATIENT to another consultant within the HOSPITAL PROVIDER SPELL. The code of the consultant making the referral and the consultant’s organisation should be recorded in the CDS rather than the code of the GMP referrer. The code of the consultant making the referral and the consultant's organisation should be recorded in the CDS rather than the code of the GMP referrer. This also applies where a CONSULTANT refers an NHS patient to another doctor for NHS-commissioned treatment at another NHS Trust, a non-NHS provider, or an overseas provider. Where the Consultant Code is unknown, the default value C9999998 should be used.

In all other cases, the code of the referring GMP should be recorded, if applicable.

See CONSULTANT CODE and GMP (CODE OF REGISTERED OR REFERRING GMP) for the codes available for consultants and General Medical and Dental Practitioners, MoD and Prison Doctors. See also NHS Administrative Codes.

If the Referrer code is not known or not applicable e.g. the patient has self-presented, the default code (X9999998) should be used. If the Referrer code is not known or not applicable e.g., the patient has self-presented, the default code (X9999998) should be used.



This data element is also known by these names:
ContextAlias
pluralREFERRER CODES


top

SITE CODE (OF TREATMENT)

Change to Data Element: change to description

Format/length: an5
HES item: SITETRET
National Codes:
Default Codes:
Default Codes: 89999 - Not applicable: non-NHS UK provider
89997 - Not applicable: non-UK provider

Notes:
SITE CODE (OF TREATMENT) is the ORGANISATION SITE CODE of ORGANISATION SITE of the provider ORGANISATION.

This identifies the site within the ORGANISATION on which the PATIENT was treated, since facilities may vary on different hospital sites. The code recorded should always be the national code; if the treatment is sub-commissioned to another provider, the site code used should be that of the provider actually carrying out the work.

Each ORGANISATION has a unique ORGANISATION CODE, see NHS Administrative Codes for a description and format of ORGANISATION CODES. However, where an ORGANISATION has more than one site from which it provides services then each site is uniquely identifed. These sites are ORGANISATION SITES and are uniquely identified by ORGANISATION SITE CODE. The ORGANISATION SITE CODE contains the first 3 digits of the ORGANISATION CODE with the last two digits being the site identifier.

Example:

RA700 ORGANISATION CODE of the ORGANISATION
RA701 ORGANISATION SITE CODE of the first identified ORGANISATION SITE within the ORGANISATION
RA702 ORGANISATION SITE CODE of the second identified ORGANISATION SITE within the ORGANISATION

Where treatment for a NHS patient is sub-commissioned to a non-NHS provider and no ORGANISATION SITE CODE has been registered and issued by the Organisation Codes Service, the SITE CODE (OF TREATMENT) should contain the default value of 89999. Where treatment for an NHS patient is sub-commissioned to an independent UK provider the default code of 89999 should be used. Similarly where treatment is sub-commissioned to an overseas provider the default code 89997 is applicable.

For out-patients, activity may take place outside the hospital, such as in the PATIENT’S home; in such cases, raising a site code is impractical. For out-patients, activity may take place outside the hospital, such as in the PATIENT'S home; in such cases, raising a site code is impractical. LOCATION CLASS is used in the CDS message to indicate the classification of the physical location within which the activity occurred.



This data element is also known by these names:
ContextAlias
pluralSITE CODE (OF TREATMENT)


top

SPECIALTY FUNCTION CODE

Change to Data Element: change to description

Format/length: n3
HES item: MAINSPEF
National Codes:
Default Codes:
Default Codes: 199 - Non-UK provider; specialty function not known, treatment mainly surgical
499 - Non-UK provider; specialty function not known, treatment mainly medical


Notes:
SPECIALTY FUNCTION, based on SPECIALTY, classifies clinical work divisions more precisely for a limited number of specialties. See Speciality Function Codes for the full list of codes.

All MIDWIFE EPISODES and NURSING EPISODES are identified in the Admitted Patient care CDS and HES by a pseudo main consultant specialty code of 560 for midwives and 950 for nurses, see Specialty Function Codes.

The default codes 199 and 499 are only applicable for overseas providers.



This data element is also known by these names:
ContextAlias
pluralSPECIALTY FUNCTION CODES


top

DEFAULT CODES SUMMARY TABLE

Change to Supporting Information: Change to supporting information

Default Codes Summary Table

Default Codes Summary Table

DEFAULT CODES SUMMARY

Default (or pseudo) codes may be used:

Default code is used to indicate: Code
Overseas visitor exempt from charges TDH00
Overseas visitor liable for charges VPP00
Private Patient VPP00
GP code is unknown G9999998
No registered GP G9999981
Referrer other than GMP, GDP or consultant R9999981
Locum refers code of GP for whom locum is acting
MoD doctor A9999998
Referrer Code not applicable, eg patient has self-presented, or not known X9999998
Referring Organisation Code not applicable X99998
Referring Organisation Code not known X99999
Prison doctor P9999981
Consultant Code not known C9999998
Midwife default code M9999998
Nurse default code N9999998
Dentist code not known D9999998
Dentist code not applicable (dentist does not have DPB number)D9999981
Code Of GP Practice is unknown V81999
Prison Practice V81998
Dentist Practice V81998
Practice code of MoD doctor V81998
Practice code not applicable V81998
HA Of Residence not known Q9900 or X9800
HA Of Residence code not applicable (eg overseas visitors)

Note: this code must not be used in the CDS header. It is not a default Commissioner code.
X98
Organisation Code (Code of Provider) - non-UK provider where no organisation code has been issued 89997
Organisation Code (Code of Provider) - non-NHS UK provider where no organisation code has been issued 89999
Site Code (Of Treatment) not applicable: non-NHS UK provider89999
Site Code (Of Treatment) not applicable: non-UK provider89997
Site Code (Of Treatment) - not a hospital site (for use on Out-Patient CMDS) R9998
Non-UK provider; specialty function not known, treatment mainly surgical199
Non-UK provider; specialty function not known, treatment mainly medical 499


top