National Cancer Waiting Times Monitoring Data Set Overview

The National Cancer Waiting Times Monitoring Data Set contains the data required for monitoring the cancer waiting time standards introduced by Data Set Change Notice 22/2002, and has been updated to include those introduced by the Cancer Reform Strategy (2007).

The data items are presented in the same order as the Comma Separated Values (.csv) file which can be exported from Provider-based systems and uploaded to the Cancer Waiting Times system. This system is hosted nationally on NHSnet.

The seven columns show whether the data item is Mandatory or Optional for:

• M = Mandatory - the Standard Contract Schedule 5 requires NHS provider ORGANISATIONS to submit this information on a monthly basis.  The Department of Health require the data to be submitted 25 working days after the end of each month or quarter.
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• M* = Mandatory if applicable - the Standard Contract Schedule 5 requires NHS provider ORGANISATIONS to submit this information on a monthly basis, where collection of the item was applicable to them.  The Department of Health require the data to be submitted 25 working days after the end of each month or quarter.
• 
  
• O = Optional
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• O* = Optional if applicable
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• N/A = Not Applicable
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A and E Attendance Conclusion Time is an ACTIVITY DATE TIME TYPE.A and E Attendance Conclusion Time is an ACTIVITY DATE TIME.

The time, recorded using a 24 hour clock, that a PATIENT's Accident And Emergency Attendance concludes or when treatment in Accident and Emergency is completed (whichever is the later).

For those PATIENTS admitted into hospital, the A and E ATTENDANCE CONCLUSION TIME is recorded as the time when the DECISION TO ADMIT was made.

A and E Departure Time is an ACTIVITY DATE TIME TYPE.A and E Departure Time is an ACTIVITY DATE TIME.

The time recorded using a 24 hour clock, that a PATIENT leaves an Accident And Emergency Department after an Accident And Emergency Attendance has concluded.

Notes: This time will be different from the A and E Attendance Conclusion Time for PATIENTS who wait for patient transport or who are LODGED PATIENTS prior to admission to a WARD. The PATIENT may leave the Accident And Emergency Department temporarily during an Accident And Emergency Attendance, e.g. for an X-ray but they remain under the care of an Accident and Emergency CONSULTANT.

A and E Initial Assessment Time is an ACTIVITY DATE TIME TYPE.A and E Initial Assessment Time is an ACTIVITY DATE TIME.

The time a PATIENT is assessed by medical or nursing staff in an Accident And Emergency Department to determine priority for treatment. The assessment should be conducted by medical or nursing staff who have received appropriate training in triage.

PATIENTS will be assessed within 15 minutes of their arrival in the Accident And Emergency Department.

Active Monitoring is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 45 - Active Monitoring.Active Monitoring is an ACTIVITY GROUP.

Active Monitoring will commence when a decision is made (and agreed with the PATIENT) that it is clinically appropriate to start a period of monitoring in secondary care, possibly whilst the PATIENT receives symptomatic support, but without any specific or significant CLINICAL INTERVENTION at this stage. Active Monitoring may be initiated by either a CARE PROFESSIONAL or a PATIENT. The start of Active Monitoring will end a REFERRAL TO TREATMENT PERIOD.

During Active Monitoring the PATIENT will remain under the care of a CONSULTANT although the GENERAL PRACTITIONER will be updated with the progress of their PATIENT.

If a decision to treat is made during Active Monitoring, this will end the Active Monitoring and will start a new REFERRAL TO TREATMENT PERIOD - see REFERRAL TO TREATMENT PERIOD START DATE.

Angiogram Date is an ACTIVITY DATE TIME TYPE.Angiogram Date is an ACTIVITY DATE TIME.

The date on which an angiogram is performed within the Acute Myocardial Infarction Care Spell.

Appointment Date is an ACTIVITY DATE TIME TYPE.Appointment Date is an ACTIVITY DATE TIME.

The date of an APPOINTMENT. In the case of a PATIENT attending an Out-Patient Clinic without prior notice or APPOINTMENT, the PATIENT will given an Out-Patient Appointment.

Arrival At Hospital Time is an ACTIVITY DATE TIME TYPE.Arrival At Hospital Time is an ACTIVITY DATE TIME.

The time the PATIENT arrived at the hospital.

Where the PATIENT arrived in an Ambulance, this is the time of arrival of the Ambulance at the front door as recorded by the ambulance service.Where the PATIENT arrived in an Ambulance, this is the time of arrival of the Ambulance at the front door as recorded by the Ambulance Service.

Where the PATIENT is self referred, this is the time of registration in the Accident And Emergency Department.

Arrival Date is an ACTIVITY DATE TIME TYPE.Arrival Date is an ACTIVITY DATE TIME.

The date of arrival of a PATIENT in the Accident And Emergency Department.

Attendance Date is an ACTIVITY DATE TIME TYPE.Attendance Date is an ACTIVITY DATE TIME.

The date of an attendance or contact, for example at a Consultant Clinic, Nurse Clinic, Accident And Emergency Department or by a Ward Attender.

Breast Assessment Date is an ACTIVITY DATE TIME TYPE.Breast Assessment Date is an ACTIVITY DATE TIME.

The date a breast assessment is performed.

Breast Cancer Care Spell is an ACTIVITY GROUP.A Breast Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Breast Cancer Care Spell is a continuous period of care, including assessment for care, for a PATIENT who has been diagnosed as suffering from breast cancer.

A continuous period of care, including assessment for care, for a PATIENT who has been diagnosed as suffering from breast cancer.

A Breast Cancer Care Spell may be the result of a specific referral for breast assessment.

Information recorded for a Breast Cancer Care Spelll includes:Information recorded for a Breast Cancer Care Spell includes:

References:
National Cancer Dataset

The date on which a pre-treatment dental assessment was done for head and neck cancer.Cancer Dental Assessment Date is an ACTIVITY DATE TIME.

A Cancer Referral To Treatment Period is a REFERRAL TO TREATMENT PERIOD.  The service standard for referral to treatment for cancer is that the PATIENT must receive First Definitive Treatment within 62 days (or 31 days for Acute Leukaemia, testicular, and childrens cancers), rather than within 18 weeks.

A PATIENT will have a Cancer Referral To Treatment Period in the following circumstances:The service standard for referral to treatment for cancer is that thePATIENT must receive First Definitive Treatment within 62 days (or 31 days for Acute Leukaemia, testicular, and childrens cancers), rather than within 18 Weeks.

- The PATIENT was referred to secondary care with suspected cancer by a GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER, where the PRIORITY TYPE of the SERVICE REQUEST was National Code 3 - Two Week WaitA PATIENT will have a Cancer Referral To Treatment Period in the following circumstances:

• The PATIENT was referred to secondary care with suspected cancer by a GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER, where the PRIORITY TYPE of the SERVICE REQUEST was National Code 3 - Two Week Wait
• The PATIENT was referred to secondary care and cancer was not initially suspected, but was subsequently diagnosed, and the PATIENT was referred on to an appropriate specialist

- The PATIENT was referred to secondary care and cancer was not initially suspected, but was subsequently diagnosed, and the PATIENT was referred on to an appropriate specialist

A Cancer Referral To Treatment Period is the period of time between CANCER REFERRAL TO TREATMENT PERIOD START DATE and either:

• the TREATMENT START DATE (CANCER), where a PATIENT diagnosed with a cancer condition (see the Department of Health guidance at Cancer Waiting Times Documentation and Links) receives First Definitive Treatment, or
• the DATE FIRST SEEN where a PATIENT, although referred with suspected cancer by a GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER, is subsequently diagnosed with a non-cancer condition (even if the non-cancer diagnosis is confirmed after the DATE FIRST SEEN), or
• the DATE  the PATIENT declines First Definitive Treatment, or
• the DATE that Active Monitoring (as a First Definitive Treatment) starts.

- the TREATMENT START DATE (CANCER), where a PATIENT diagnosed with a cancer condition (see Department of Health guidance at Cancer Waiting Times Documentation and Links) receives First Definitive Treatment, orA Cancer Referral To Treatment Period does NOT complete automatically if the PATIENT does not attend the first APPOINTMENT during the Cancer Referral To Treatment Period.  WAITING TIME ADJUSTMENT (FIRST SEEN) is used to align waiting times monitoring with the service standard for 18 Weeks.

- the DATE FIRST SEEN where a PATIENT, although referred with suspected cancer by a GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER, is subsequently diagnosed with a non-cancer condition (even if the non-cancer diagnosis is confirmed after the DATE FIRST SEEN), or

- the DATE  the PATIENT declines First Definitive Treatment, or

- the DATE that Active Monitoring (as a First Definitive Treatment) starts.

A Cancer Referral To Treatment Period does NOT complete automatically if the PATIENT does not attend the first Appointments Diagram Overview during the Cancer Referral To Treatment Period.  WAITING TIME ADJUSTMENT (FIRST SEEN) is used to align waiting times monitoring with the service standard for 18 weeks.

Information recorded for a Cancer Referral To Treatment Period includes:

CANCER REFERRAL TO TREATMENT PERIOD START DATE

Care Programme Approach Review Date is an ACTIVITY DATE TIME TYPE.Care Programme Approach Review Date is an ACTIVITY DATE TIME.

The date an established outcome of a Care Programme Approach Review is recorded.

The Commissioning Data Set messages submitted by providers carry information to determine the update method to be used by the Secondary Uses Service in order to update the national database.

These update rules are known as the Commissioning Data Set Submission Protocol and the set of data controls used to indicate this are carried in the Commissioning Data Set Transaction Header Group which must be present and correct in every CDS TYPE submitted to the Secondary Uses Service.

Two Update Mechanisms are available:

• Net Change - to support the management of an individual CDS TYPE in the Secondary Uses Service database and enables Commissioning data to be inserted/ updated or deleted.
  CDS Senders are expected to use the Net Change Update Mechanism wherever possible.
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• Bulk Replacement - to support the management of bulk commissioning data for an identified CDS BULK REPLACEMENT GROUP of data for a specified time period and for a specified CDS PRIME RECIPIENT IDENTITY.
  CDS Senders should only use the Bulk Replacement Update Mechanism in exceptional circumstances.

It is strongly advised that all NHS Trusts should, as a minimum process, commence migration to use the CDS-XML Version 6 Message for weekly Net Change submissions by March 2009 as this is the date mandated by the "NHS Operating Framework".

Net Change:
Net Change processes are managed by specific data settings as defined in the CDS V6 TYPE 005N option of the CDS Transaction Header Group. The Secondary Uses Service uses the following data to manage the database:

• CDS SENDER IDENTITY
• CDS UNIQUE IDENTIFIER
• CDS APPLICABLE DATE
• CDS APPLICABLE TIME

Each CDS TYPE must have a CDS UNIQUE IDENTIFIER which must be uniquely maintained for the life of that Commissioning Data Set record. This is a particular consideration where mergers and/or healthcare systems are changed or upgraded, see CDS Submission and PCT Mergers. Any change to the CDS UNIQUE IDENTIFIER during the "lifetime" of a Commissioning Data Set record will almost certainly result in a duplicate record being lodged in the Secondary Uses Service database.

A Commissioning Data Set record delete transaction must be sent to the Secondary Uses Service database when any previously sent Commissioning Data Set record requires deletion/removal, for example to reflect Commissioner changes etc.

The CDS APPLICABLE DATE and CDS APPLICABLE TIME must be used to ensure that all Commissioning data is updated in the Secondary Uses Service database in the correct chronological order.

The CDS SENDER IDENTITY must not change during the lifetime of the CDS data.
This is particularly significant for multiple and/or merged organisations, and for those services who submit data on behalf of another Primary Care Trust or NHS Trust.

Bulk Replacement
Net Change processes are managed by specific data settings as defined in the CDS V6 TYPE 005B option of the CDS Transaction Header Group.Bulk Replacement processes are managed by specific data settings as defined in the CDS V6 TYPE 005B option of the CDS Transaction Header Group. The Secondary Uses Service uses the following data to manage the database:

• CDS SENDER IDENTITY
• CDS BULK REPLACEMENT GROUP
• CDS EXTRACT DATE
• CDS EXTRACT TIME
• CDS REPORT PERIOD START DATE
• CDS REPORT PERIOD END DATE
• CDS PRIME RECIPIENT IDENTITY

The CDS SENDER IDENTITY must not change during the lifetime of the Commissioning Data Set record. This is particularly significant for multiple and/or merged organisations, and for those services who submit data on behalf of another Primary Care Trust or NHS Trust.

The CDS PRIME RECIPIENT IDENTITY must be identified in each Commissioning Data Set and must not be changed during the lifetime of the Commissioning Data Set record otherwise the data stored in the Secondary Uses Service database may lose its integrity (e.g. duplicate Commissioning data may be stored).

For this reason it is advised that the ORGANISATION CODE (PCT OF RESIDENCE) should always be used to determine the CDS SENDER IDENTITY as detailed in the Commissioning Data Set Addressing Grid. Senders must also be aware that if the ORGANISATION CODE (PCT OF RESIDENCE) is itself derived from the PATIENT's POSTCODE OF USUAL ADDRESS then great care must be taken to manage all elements of this relationship.

If it is necessary to change any of this data during the lifetime of a Commissioning Data Set record, then the Secondary Uses Service help desk should be contacted for advice.

It is strongly advised that users of the Bulk Replacement Mechanism maintain a correctly generated CDS UNIQUE IDENTIFIER within the Commissioning data. This will establish a migration path towards the use of the Net Change Mechanism and will also then minimise the risk of creating duplicate Commissioning Data Set data.

Sub contracting
If a Provider sub-contracts healthcare provision and its associated Commissioning Data Set submission to a second Provider, arrangements to submit the Commissioning Data Set data must be made locally to ensure that only one Provider sends the Commissioning Data Set data to the Secondary Uses Service.

If the second Provider wishes to add other Commissioning data to the Secondary Uses Service database to that already submitted by the first Provider, both parties need to ensure that a different CDS SENDER IDENTITY is used. Often this is done by changing the last 2 digits of the 5 digit code (the Site element of the Organisation Code).

Note: Data sent using the same CDS SENDER IDENTITY by two different parties will most likely overwrite each other's data in the Secondary Uses Service database. Further advice can be obtained from the Secondary Uses Service helpdesk.

Users should be aware of how the 15 character code of their CDS INTERCHANGE SENDER IDENTITY (also known as the EDI Address) is created. this may depend on how their XML interface solution has been set up. It may not be possible to rely on a change to the Provider Code in order to change the CDS INTERCHANGE SENDER IDENTITY should this becomes necessary.

Includes Commissioning Data Set 6-0 and 6-1

For guidance on the new Commissioning Data Set Layout, see the Commissioning Data Set Redesign Guidance Notes on the NHS Data Model and Dictionary website.

Clinical Intervention Date is an ACTIVITY DATE TIME TYPE.Clinical Intervention Date is an ACTIVITY DATE TIME.

Date of the occurrence of the CLINICAL INTERVENTION.The date of the occurrence of the CLINICAL INTERVENTION.

Clinical Status Assessment Date is an ACTIVITY DATE TIME TYPE.Clinical Status Assessment Date is an ACTIVITY DATE TIME.

The date on which a clinical status assessment was performed.

References:
National Cancer Dataset Version 1.3_ISB October 2002

Colorectal Cancer Care Spell is an ACTIVITY GROUP.A Colorectal Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Colorectal Cancer Care Spell is a continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from colorectal cancer.

A continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from colorectal cancer.

References:
National Cancer Dataset

Colorectal or Stoma Nurse Seen Date is an ACTIVITY DATE TIME.

The date when the PATIENT first saw the colorectal nurse or stoma therapist during a Colorectal Cancer Care Spell.

References:
National Cancer Data Set Version 1.3_ISB October 2002

Consultant Upgrade Date is an ACTIVITY DATE TIME TYPE.Consultant Upgrade Date is an ACTIVITY DATE TIME. 

It is the DATE  that the CONSULTANT responsible for the care of the PATIENT (or an authorised member of the CONSULTANT team as defined by local policy) decided that the PATIENT should be upgraded onto an urgent Cancer PATIENT PATHWAY.The DATE that the CONSULTANT responsible for the care of the PATIENT (or an authorised member of the CONSULTANT team as defined by local policy) decided that the PATIENT should be upgraded onto an urgent Cancer PATIENT PATHWAY.

The Consultant Upgrade Date should only be recorded when the PRIORITY TYPE of the original SERVICE REQUEST was not National Code 3 - 'Two Week Wait'.

Consultant upgrades are not allowed for PATIENTS who were urgently referred with suspected cancer from an NHS Cancer Screening Programme (where the SOURCE OF REFERRAL FOR OUT-PATIENTS was National Code 17 - referral from a National Screening Programme, and the PRIORITY TYPE of the SERVICE REQUEST was National Code 2 -Urgent).  Therefore a Consultant Upgrade Date cannot be recorded in these circumstances.

The Consultant Upgrade Date must be on or before the DECISION TO TREAT DATE (if recorded). 

The Consultant Upgrade Date must also be on or before the MULTIDISCIPLINARY TEAM DISCUSSION DATE (CANCER) (if recorded).

Contact Date is an ACTIVITY DATE TIME TYPE.Contact Date is an ACTIVITY DATE TIME.

The date on which a face to face contact or telephone contact takes place.

Coronary Angiography Date is an ACTIVITY DATE TIME TYPE.Coronary Angiography Date is an ACTIVITY DATE TIME.

The date on which a coronary angiography is performed with an Acute Myocardial Infarction Care Spell.The date on which a coronary angiography is performed during an Acute Myocardial Infarction Care Spell.

Date Biopsy Taken is an ACTIVITY DATE TIME TYPE.Date Biopsy Taken is an ACTIVITY DATE TIME.

The date on which the biopsy for analysis was taken.

Date First Seen is an ACTIVITY DATE TIME TYPE.Date First Seen is an ACTIVITY DATE TIME.

This is the date that the PATIENT is first seen in the Trust that receives the first referral.The date that the PATIENT is first seen in the Trust that receives the first referral.

Discharge Date is an ACTIVITY DATE TIME TYPE.Discharge Date is an ACTIVITY DATE TIME.

Date of discharge from a Hospital Provider Spell.The date of discharge from a Hospital Provider Spell.

Discharge Ready Date is an ACTIVITY DATE TIME TYPE.Discharge Ready Date is an ACTIVITY DATE TIME.

The date that a PATIENT was medically ready for discharge from a Hospital Bed but could not be discharged, thereby qualifying for Delayed Discharge Payments under the provisions of the Community Care (Delayed Discharges etc) Act 2003.

The settings from where the discharge may originate are a health service hospital or an independent hospital in pursuance of arrangements made by an NHS body.

Within the Act, the relevant community care services are defined under the National Health Service and Community Care Act 1990 section 46 (3). This in turn refers to provisions of other acts as follows:

"community care services" means services which a local authority may provide or arrange to be provided under any of the following provisions:

(a) Part III of the [1948 c. 29.] National Assistance Act 1948;

(b) section 45 of the [1968 c. 46.] Health Services and Public Health Act 1968;

(c) National Health Service Act 2006; and

(d) section 117 of the [1983 c. 20.] Mental Health Act 1983

Dose Given Date is an ACTIVITY DATE TIME TYPE.Dose Given Date is an ACTIVITY DATE TIME.

Date an immunisation dose is given.The date an immunisation dose is given.

Drug Misuse Agency is an ORGANISATION.

An organisation with drug misuse facilities that provides a service to drug misusers. It encompasses all organisations offering a drug misuse facility, both NHS and non-NHS located within the Primary Care Trust boundary.An ORGANISATION with Drug Misuse Facilities that provides a service to Drug Misusers. It encompasses all ORGANISATIONS offering a Drug Misuse Facility, both NHS and non-NHS located within the Primary Care Trust boundary.

Note: This does not correspond to an 'Agency' defined in the Drug Misuse Database which relates to a drug misuse facility.Note: This does not correspond to an 'Agency' defined in the Drug Misuse Database which relates to a Drug Misuse Facility.

Drug Misuse Episode is an ACTIVITY GROUP.

An episode of care provided to a drug misuser. It begins when a drug misuser uses a drug misuse facility for the first time or returns after a period of at least six months. A user of multiple drug misuse facilities from one Drug Misuse Agency will have multiple Drug Misuse Episodes.An episode of care provided to a Drug Misuser. It begins when a Drug Misuser uses a Drug Misuse Facility for the first time or returns after a period of at least six months. A user of multiple Drug Misuse Facilities from one Drug Misuse Agency will have multiple Drug Misuse Episodes.

There may also be a Community Episode for the PATIENT concerning the substance misused if during the Drug Misuse Episode the PATIENT is in contact with a community psychiatric nurse.

Information recorded for a Drug Misuse Episode includes:

Drug Misuse Facility is a CLINIC OR FACILITY

A facility of one FACILITY TYPE from a Drug Misuse Agency that provides a service to drug misusers.A facility of one FACILITY TYPE from a Drug Misuse Agency that provides a service to Drug Misusers. It encompasses NHS and non-NHS facilities. A user of multiple Drug Misuse Facilities from one Drug Misuse Agency will have multiple Drug Misuse Episodes.

Note: This corresponds to an 'Agency' defined for the Drug Misuse Database.

The e-Government Interoperability Framework (e-GIF) defines the technical policies and specifications governing information flows across government and the public sector. They cover interconnectivity, data integration, e-services access and content management.

A key element in the development in this is an agreed set of data standards which are contained in the Government Data Standards Catalogue.

For further information on the e-Government Interoperability Framework, see the Cabinet Office website.For further information on the e-Government Interoperability Framework, see the Cabinet Office website.

End Date is an ACTIVITY DATE TIME TYPE.End Date is an ACTIVITY DATE TIME.

The end of a stay, an episode, period covered by a plan, or other period of time.

End Time is an ACTIVITY DATE TIME TYPE.End Time is an ACTIVITY DATE TIME.

The end time of a stay, episode, period covered by a plan, or other period of time. The time is expressed on a 24 hour clock basis.

Event Date is an ACTIVITY DATE TIME TYPE.Event Date is an ACTIVITY DATE TIME.

The date on which an activity event was carried out or was planned to be carried out, for example the date on which a Specialist Foot Examination took place.The date on which an ACTIVITY event was carried out or was planned to be carried out, for example the date on which a Specialist Foot Examination took place.

Where the activity event elapses over more than one day then the date will correspond to when the event started or was planned to start.Where the ACTIVITY event elapses over more than one day then the date will correspond to when the event started or was planned to start.

Event Time is an ACTIVITY DATE TIME TYPE.Event Time is an ACTIVITY DATE TIME.

The time when an ACTIVITY event started or was planned to be started.

Expected Delivery Date is an ACTIVITY DATE TIME TYPE.Expected Delivery Date is an ACTIVITY DATE TIME.

The date on which a woman is expected to give birth.

Face To Face Contact Community Care is a CARE CONTACT.

A contact which is made by one or more nurses or community support workers (nursing) with a PATIENT or his/her proxy during a Community Episode. The contact occurs when a PATIENT or their proxy attends a clinic or when the nurse or community support worker (nursing) makes a domiciliary visit to see the PATIENT.

A proxy contact is a single occasion involving contact between a proxy and one or more members of a community nurse staff group within a Nursing In The Community Programme. Contacts with proxies only count if the contact is in lieu of the contact with the PATIENT, and the proxy is able more effectively than the PATIENT to ensure that the specified advice/treatment devised for the PATIENT is followed. This is most likely to be the case where the PATIENT is unable to communicate effectively say for an infant, or for a PERSON who is mentally ill or has learning disabilities.

One or more nurses or community support workers (nursing) in the same or different Nursing In The Community Programmes may be in contact with a PATIENT at the same time.

Contacts should be recorded as follows:

Group activity, where, for example, general advice is given to several PATIENTS at the same time should not be recorded as Nurse or Midwife Contacts.

A Face To Face Contact Community Care may involve activities attributable to a structured programme, such as the following:

For such activities they must be recorded as part of the respective structured programmes as well as attributed to the Nursing In The Community Programmes.

If the PATIENT is currently subject to a Mental Health Care Spell and the contact NURSE is also their allocated care programme approach care coordinator then a Face To Face Contact CPA Care Coordinator should also be recorded.

For domiciliary visits, an indication of whether the Face To Face Contact Community Care is the first occasion on which a PATIENT is seen should be recorded as an initial contact. A LOCATION TYPE should also be recorded.

Information recorded for a Face To Face Contact Community Care includes:

Face To Face Contact CPA Care Coordinator is a CARE CONTACT.

A face to face contact between a PATIENT subject to a Care Programme Approach Episode, and their currently allocated care programme approach care coordinator

In cases where contact arises due to:

• a Professional Staff Group Contact
• or a Face To Face Contact Community Care
• or a Ward Attendance
• or a Clinic Attendance Non-Consultant
• or a Day Care Attendance
• or a Sheltered Work Attendance
• or a face to face Acute Home-Based Contact
• or an Out-Patient Attendance Consultant
  

Each contact must have a Care Programme Approach Care Co-ordinator Allocation.

Information recorded for a Face To Face Contact CPA Care Coordinator includes:

First Antenatal Assessment Date is an ACTIVITY DATE TIME TYPE.First Antenatal Assessment Date is an ACTIVITY DATE TIME.

This is the date on which the pregnant woman was assessed and arrangements made for antenatal care. This is not necessarily the occasion on which arrangements were made for delivery.

Fraction is a CLINICAL INTERVENTION.

A set of exposures delivered or intended to be delivered to a PATIENT in the course of one visit to a radiotherapy room. The HELD OR CANCELLED indicator records those fractions for which appointments have been made, but which did not take place. The HELD OR CANCELLED indicator records those Fractions for which APPOINTMENTS have been made, but which did not take place.

Note: For technical reasons the radiotherapy MACHINE TYPE actually used for each EXPOSURE may differ from that indicated when the Fraction was planned.

Full Postnatal Examination Date is an ACTIVITY DATE TIME TYPE.Full Postnatal Examination Date is an ACTIVITY DATE TIME.

The date on which the full postnatal examination is carried out, terminating the Pregnancy Episode.

The Genitourinary Care Contact Date is the DATE on which a PATIENT attends a CLINIC OR FACILITY to see or be in contact with a CARE PROFESSIONAL as part of a Sexual Health And HIV Episode.Genitourinary Care Contact Date is an ACTIVITY DATE TIME.

Genitourinary Care Contact Date is the same as attribute ACTIVITY DATE of ACTIVITY DATE TIME where the ACTIVITY DATE TIME TYPE is National Code 48 - Genitourinary Care Contact Date.The DATE on which a PATIENT attends a CLINIC OR FACILITY to see or be in contact with a CARE PROFESSIONAL as part of a Sexual Health And HIV Episode.

The Government Data Standards Catalogue sets out the rationale, approach and rules for setting and agreeing the set of Government Data Standards (GDS) to be used in the schemas and other interchange processes. It also contains the standards agreed to date.

For further information on the Government Data Standards Catalogue, see the Cabinet Office website.For further information on the Government Data Standards Catalogue, see the Cabinet Office website.

A Cancer Care Spell.A Gynaecological Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from gynaecological cancer.A Gynaecological Cancer Care Spell is a continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from gynaecological cancer.

References:
National Cancer Dataset

Head And Neck Cancer Care Spell is an ACTIVITY GROUP.A Head And Neck Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Head And Neck Cancer Care Spell is a continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from head or neck cancer.

A continuous period of care, including assessment for care for a PATIENT who has been diagnosed as suffering from head or neck cancer.

References:
National Cancer Dataset

This is the same as ACTIVITY DATE where the CARE CONTACT TYPE is National Code 31 'Registration Health Check' and the ACTIVITY DATE TIME TYPE is National Code 31 'Start Date'.Health Check Examination Date is an ACTIVITY DATE TIME.

The date on which a PATIENT was given a health check examination by a GENERAL MEDICAL PRACTITIONER on behalf of the General Medical Practitioner Practice, as part of the Registration process.

The Health Protection Agency is a Health Authority.

The Health Protection Agency is an independent body that protects the health and well-being of the population. The Health Protection Agency plays a critical role in protecting people from infectious diseases and in preventing harm when hazards involving chemicals, poisons or radiation occur. The Health Protection Agency also prepares for new and emerging threats, such as a bio-terrorist attack or virulent new strain of disease.

For more information on the Health Protection Agency please see their website http://www.hpa.org.ukFor further information on the Health Protection Agency, see the Health Protection Agency website.

Immunisation Completion Date is an ACTIVITY DATE TIME TYPE.Immunisation Completion Date is an ACTIVITY DATE TIME.

The date that a course of immunisation was completed. For example, the date by which all 3 primary course doses have been given for a group C meningococcal disease vaccine.

The Immunisation Programmes Activity Data Set (KC50) requires summary information from Primary Care Trusts about the delivery of Immunisation Programmes for the following VACCINE PREVENTABLE DISEASES:

• Diphtheria, Tetanus and Polio (Td/IPV)
• Measles, Mumps and Rubella (MMR), and
• Tuberculosis (BCG).

The responsible population for the Primary Care Trusts with respect to the delivery of these Immunisation Programmes includes:

• PERSONS registered with a GENERAL MEDICAL PRACTITIONER whose GP Practice is under the responsibility of the Primary Care Trust, regardless of where the child is resident, and
• any PERSONS not registered with a GENERAL MEDICAL PRACTITIONER, who are resident within the Primary Care Trust GEOGRAPHIC AREA.

This does not include PERSONS who are resident within the Primary Care Trust GEOGRAPHIC AREA but registered with a GENERAL MEDICAL PRACTITIONER whose GP Practice is under the responsibility of a different Primary Care Trust.

Reporting

The Immunisation Programmes Activity Data Set (KC50) is reported for each financial year (i.e. between 1st April and 31st March), and must be received no later than the last working day of April. Reporting is via the Omnibus survey collection tool provided by the NHS Information Centre for health and social care. Further information about Omnibus can be found at http://www.omnibus.nhs.uk/omnibus  Reporting is via the Omnibus survey collection tool provided by The NHS Information Centre for health and social care. For further information about Omnibus, see the Omnibus Survey System.

Immunisation Age Group
The IMMUNISATION AGE GROUP reported should reflect the age in year of the PERSON IN PROGRAMME within the REPORTING PERIOD. For example, the IMMUNISATION AGE GROUP of National Code '14 Age 13 years' is used to report Immunisation Programme activity performed on a PERSON who becomes 13 years of age during the REPORTING PERIOD.

Further guidance with respect to the application of IMMUNISATION AGE GROUPS is provided by the NHS Information Centre for health and social care at http://www.ic.nhs.uk/services/omnibus-survey/using-the-service/data-collections/kc50.Further guidance with respect to the application of IMMUNISATION AGE GROUPS is provided by The NHS Information Centre for health and social care and can be found on The NHS Information Centre for health and social care website.

Part A (i): IMMUNISATION PROGRAMME ACTIVITY FOR DIPHTHERIA, TETANUS AND POLIO (Td/IPV)

This group reports Immunisation Programme activity for the offer and delivery of vaccinations for immunisation against Diphtheria, Tetanus and Polio.

It is mandatory to report the ELIGIBLE POPULATION TOTAL (DIPHTHERIA TETANUS AND POLIO) and IMMUNISATION DOSES GIVEN TOTAL (DIPHTHERIA TETANUS AND POLIO) for each IMMUNISATION AGE GROUP (DIPHTHERIA TETANUS AND POLIO).

Where the Primary Care Trust does not offer vaccination for immunisation against Diphtheria, Tetanus and Polio for a specific IMMUNISATION AGE GROUP (DIPHTHERIA TETANUS AND POLIO), the ELIGIBLE POPULATION TOTAL (DIPHTHERIA TETANUS AND POLIO) for that IMMUNISATION AGE GROUP (DIPHTHERIA TETANUS AND POLIO) is reported as zero.

Part A (ii): IMMUNISATION PROGRAMME ACTIVITY FOR MEASLES, MUMPS AND RUBELLA (MMR).

This group reports Immunisation Programme activity for the offer and delivery of vaccinations for immunisation against Measles, Mumps and Rubella (MMR).

It is mandatory to report the ELIGIBLE POPULATION TOTAL (MEASLES MUMPS AND RUBELLA) and IMMUNISATION COURSES COMPLETED TOTAL (MEASLES MUMPS AND RUBELLA) for each IMMUNISATION AGE GROUP (MEASLES MUMPS AND RUBELLA).

Where the Primary Care Trust does not offer vaccination for immunisation against Measles, Mumps and Rubella (MMR) for a specific IMMUNISATION AGE GROUP (MEASLES MUMPS AND RUBELLA), the ELIGIBLE POPULATION TOTAL (MEASLES MUMPS AND RUBELLA) for that IMMUNISATION AGE GROUP (MEASLES MUMPS AND RUBELLA) is reported as zero.

Part B (i): IMMUNISATION PROGRAMME ACTIVITY - MANTOUX TESTS FOR TUBERCULOSIS (BCG).

This group reports the delivery of Mantoux Tests.

It is mandatory to report the MANTOUX TESTS PERFORMED TOTAL (TUBERCULOSIS) for each IMMUNISATION AGE GROUP (TUBERCULOSIS).

Part B (ii): IMMUNISATION PROGRAMME ACTIVITY FOR TUBERCULOSIS (BCG).

This group reports Immunisation Programme activity for the delivery of vaccinations for immunisation against Tuberculosis (BCG).

It is mandatory to report the ELIGIBLE POPULATION TOTAL (TUBERCULOSIS) and IMMUNISATION DOSES GIVEN TOTAL (TUBERCULOSIS) for each IMMUNISATION AGE GROUP (TUBERCULOSIS).

Part C (i): IMMUNISATION PROGRAMME ACTIVITY FOR TUBERCULOSIS (BCG) FOR PERSONS AGED UNDER 1 YEAR.

This group reports Immunisation Programme activity for the offer and delivery of vaccinations for immunisation against Tuberculosis (BCG), for PERSONS aged under 1 year.

It is mandatory to report the ELIGIBLE POPULATION TOTAL (TUBERCULOSIS) for each of the following IMMUNISATION PROGRAMME TYPES (TUBERCULOSIS):

National Codes:

2	Planned programme for infants aged under 1 year, vaccinated routinely
3	Planned programme for infants aged under 1 year, in selective high-risk group

It is mandatory to report the IMMUNISATION DOSES GIVEN TOTAL (TUBERCULOSIS) for each of the following IMMUNISATION PROGRAMME TYPES (TUBERCULOSIS):

National Codes:

2	Planned programme for infants aged under 1 year, vaccinated routinely
3	Planned programme for infants aged under 1 year, in selective high-risk group
4	Other programme

Part C (ii) SUMMARISED IMMUNISATION PROGRAMME ACTIVITY FOR TUBERCULOSIS (BCG) FOR PERSONS AGED UNDER 1 YEAR.
This mandatory group reports the IMMUNISATION DOSES GIVEN TOTAL (TUBERCULOSIS - PERSONS UNDER 1 YEAR) to all PERSONS aged under 1 year.

An Independent Health Care Service Plan is a plan for the provision of a SERVICE.

The type of service and numbers of PATIENTS intended to be provided as part of an independent health care registration.The type of SERVICE and numbers of PATIENTS intended to be provided as part of an independent health care registration.

An Initial Contact is a CARE CONTACT.

An indication of whether the face to face contact is the first occasion on which a PATIENT is seen by any staff group of the Health Care Provider. An Initial Contact begins an episode of care which comprises all the contacts made by the relevant staff of the Health Care Provider regardless of changes of LOCATION.

Initial Patient Contact Date is an ACTIVITY DATE TIME TYPE.Initial Patient Contact Date is an ACTIVITY DATE TIME.

The date when the PATIENT made the initial contact for service relating to an acute myocardial infarction.The date when the PATIENT made the Initial Contact for SERVICE relating to an acute myocardial infarction.

Initial Patient Contact Time is an ACTIVITY DATE TIME TYPE.Initial Patient Contact Time is an ACTIVITY DATE TIME.

The time when the PATIENT made the initial contact for service relating to an acute myocardial infarction.The time when the PATIENT made the Initial Contact for SERVICE relating to an acute myocardial infarction.

The International Health Terminology Standards Development Organisation (IHTSDO) is an ORGANISATION.

The IHTSDO develops and promotes the use of SNOMED CT® (Systematised Nomenclature of Medicine Clinical Terms) to support safe and effective health information exchange.

For further information on the IHTSDO, see the International Health Terminology Standards Development Organisation website.

Intrauterine Device Application Date is an ACTIVITY DATE TIME TYPE.Intrauterine Device Application Date is an ACTIVITY DATE TIME.

The date of application by a PERSON to a GENERAL MEDICAL PRACTITIONER to fit an intrauterine device.

Intrauterine Device Fitted Date is an ACTIVITY DATE TIME TYPE.Intrauterine Device Fitted Date is an ACTIVITY DATE TIME.

The date an intrauterine device was initially fitted or the date on which a replacement device was fitted.

Investigation Transfer Date is an ACTIVITY DATE TIME TYPE.Investigation Transfer Date is an ACTIVITY DATE TIME.

The date on which a transfer took place for an investigation and/or interventional treatment within the same hospital and during an Acute Myocardial Infarction Care Spell.

Last Dosage Date is an ACTIVITY DATE TIME TYPE.Last Dosage Date is an ACTIVITY DATE TIME.

Date of last dose of a Drug Treatment.The date of the last dose of a Drug Treatment.

References:
The Version 1.1 NHS Standard EDIFACT Messages for Pathology Requests and Reports, 2001
The Version 1.0 Trial NHS Standard EDIFACT Messages for GP-Hospital Communications - 17.5.95

Time of last dose of a Drug Treatment.Last Dosage Time is an ACTIVITY DATE TIME.

The time of the last dose of a Drug Treatment.

References:
The Version 1.1 NHS Standard EDIFACT Messages for Pathology Requests and Reports, 2001
The Version 1.0 Trial NHS Standard EDIFACT Messages for GP-Hospital Communications - 17.5.95

Lung Cancer Care Spell is an ACTIVITY GROUP.A Lung Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Lung Cancer Care Spell is a continuous period of care, including assessment for care, for a PATIENT who has been diagnosed as suffering from lung cancer.

A continuous period of care, including assessment for care, for a PATIENT who has been diagnosed as suffering from lung cancer.

References:
National Cancer Dataset

A Measured Referral to Treatment Period is any REFERRAL TO TREATMENT PERIOD. It enables the time to the start of First Definitive Treatment to be measured following a SERVICE REQUEST to

It enables the time to the start of First Definitive Treatment to be measured following a SERVICE REQUEST to

• a Consultant Led Service
• an Interface Service
• a Direct Access Service for Audiology

See REFERRAL TO TREATMENT PERIOD START DATE for details of the types of SERVICE REQUEST which may start a REFERRAL TO TREATMENT PERIOD.

See Referral To Treatment Period Included In 18 Weeks Target for the subset of REFERRAL TO TREATMENT PERIODS included in the 18 weeks target.

Where a referral is made during a Referral To Treatment Period Excluded From Target for the same disease, condition or injury and the referral is to a Consultant Led Service the Referral To Treatment Period Excluded From Target will end with REFERRAL TO TREATMENT PERIOD STATUS of National Code 34 - Decision not to treat and a new REFERRAL TO TREATMENT PERIOD will start.

Mental Health Care Assessment Date is an ACTIVITY DATE TIME TYPE.Mental Health Care Assessment Date is an ACTIVITY DATE TIME.

The date of initial assessment by a mental health professional for a PATIENT who has been referred to specialist mental health services.

Miscarriage Date is an ACTIVITY DATE TIME TYPE.Miscarriage Date is an ACTIVITY DATE TIME.

The date that a woman miscarried during a Pregnancy Episode, where the pregnancy ends in or before the 24th week of gestation, this excludes REGISTERABLE BIRTHS.

ORGANISATIONS such as The NHS Information Centre for health and social care, General Medical Council etc which are included in the NHS Data Model and Dictionary.

• Referenced Organisations:
  • British Psychological Society
  • Care Quality Commission
  • Community Health Partnerships (Scotland)
  • Department for Education
  • Department for Work and Pensions
  • Department for Work and Pensions Overseas Healthcare Team
  • Department of Health
  • Health Protection Agency
  • Information Standards Board for Health and Social Care
  • International Health Terminology Standards Development Organisation
  • Local Health Board (Wales)
  • Local Commissioning Group (Northern Ireland)
  • National Commissioning Group
  • National Institute for Health and Clinical Excellence
  • National Specialised Commissioning Group
  • NHS Dental Services
  • NHS Prescription Services
  • NHS Wales Informatics Service
  • Office for National Statistics
  • Ofsted
  • Organisation Data Service
  • The Casemix Service
  • The NHS Information Centre for health and social care
  • Royal Pharmaceutical Society
  • UK Terminology Centre
• Referenced Organisations:
  • British Psychological Society
  • Care Quality Commission
  • Community Health Partnerships (Scotland)
  • Department for Education
  • Department for Work and Pensions
  • Department for Work and Pensions Overseas Healthcare Team
  • Department of Health
  • Health Protection Agency
  • Information Standards Board for Health and Social Care
  • International Health Terminology Standards Development Organisation
  • Local Health Board (Wales)
  • Local Commissioning Group (Northern Ireland)
  • National Commissioning Group
  • National Institute for Health and Clinical Excellence
  • National Specialised Commissioning Group
  • NHS Dental Services
  • NHS Prescription Services
  • NHS Wales Informatics Service
  • Office for National Statistics
  • Ofsted
  • Organisation Data Service
  • Royal Pharmaceutical Society
  • The Casemix Service
  • The NHS Information Centre for health and social care
  • UK Terminology Centre

• Regulatory Bodies:
  • General Chiropractic Council
  • General Dental Council
  • General Medical Council
  • General Optical Council
  • General Osteopathic Council
  • General Pharmaceutical Council
  • General Social Care Council
  • Health Professions Council
  • Nursing and Midwifery Council
  • Ophthalmic Qualifications Committee

Pathology Result Due Date is an ACTIVITY DATE TIME TYPE.Pathology Result Due Date is an ACTIVITY DATE TIME.

Date by which a requester wishes to receive the result(s) of a Pathology Laboratory Investigation.The date by which a requester wishes to receive the result(s) of a Pathology Laboratory Investigation.

References:
The Version 1.1 NHS Standard EDIFACT Messages for Pathology Requests and Reports, 2001

Pathology Result Due Time is an ACTIVITY DATE TIME TYPE.Pathology Result Due Time is an ACTIVITY DATE TIME.

Time by which a requester wishes to receive the result(s) of a Pathology Laboratory Investigation.The time by which a requester wishes to receive the result(s) of a Pathology Laboratory Investigation.

References:
The Version 1.1 NHS Standard EDIFACT Messages for Pathology Requests and Reports, 2001

Patient Informed Biopsy Result Date is an ACTIVITY DATE TIME TYPE.Patient Informed Biopsy Result Date is an ACTIVITY DATE TIME.

The date the PATIENT was informed in writing of the result of a biopsy taken as a result of a colposcopy Patient Procedure.

Patient Informed Of Outcome Date is an ACTIVITY DATE TIME TYPE.Patient Informed Of Outcome Date is an ACTIVITY DATE TIME.

The date a PATIENT was informed of the outcome of a Mental Health Care Spell assessment or Care Programme Approach Review. The requirement for the PATIENT to be informed of outcomes is laid down in The Patient's Charter - Mental Health Services.

Primary Procedure Date is an ACTIVITY DATE TIME TYPE.Primary Procedure Date is an ACTIVITY DATE TIME.

This is the ACTIVITY DATE of the PRIMARY OPERATION (OPCS-4).

Data Set Change Notice 18/2006 published in December 2006, defined essential new data items required to support the measurement of 18 week REFERRAL TO TREATMENT PERIODS (monitoring of DH PSA target 13 - "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment"). In particular, the Data Set Change Notice 18/2006 introduced the following new data items.

• PATIENT PATHWAY IDENTIFIER
• REFERRAL TO TREATMENT PERIOD START DATE
• REFERRAL TO TREATMENT PERIOD END DATE
• REFERRAL TO TREATMENT STATUS

Strategic reporting of 18 weeks will be undertaken by the Secondary Uses Service using data obtained via the Commissioning Data Sets . The new data items defined in Data Set Change Notice 18/2006 are enabled to flow in Commissioning Data Set version 6-0, 6-1, and will continue to flow in subsequent versions.

However, an event which results in an update to the REFERRAL TO TREATMENT PERIOD STATUS may occur outside the events that are defined in the Commissioning Data Sets (typically Outpatient or Inpatient encounters) and will therefore not flow to the Secondary Uses Service. These types of events have been termed as "administrative events". They can be defined as any communication event between the Health Care Provider and the PATIENT that occurs outside of an outpatient attendance or inpatient admission and that results in the PATIENT's REFERRAL TO TREATMENT PERIOD STATUS being changed to stop the 18 week clock. These events are not face to face consultations and do not necessarily involve clinical staff.

These Referral To Treatment Clock Stop Administrative Events may be carried using the Commissioning Data Set Type 020 Outpatient record type. They are differentiated from PATIENT contact ACTIVITY by the FIRST ATTENDANCE value carried within them. FIRST ATTENDANCE national code 5 "Referral to treatment clock stop administrative event" signifies that an ACTIVITY has taken place which has ended the REFERRAL TO TREATMENT PERIOD and changed the REFERRAL TO TREATMENT PERIOD STATUS to one of the following:

30 Start of First Definitive Treatment

31 Start of Active Monitoring initiated by the PATIENT

32 Start of Active Monitoring initiated by the CARE PROFESSIONAL

34 Decision not to treat - decision not to treat made or no further contact required

35 PATIENT declined offered treatment

36 PATIENT died before treatment

When to Use  Referral To Treatment Clock Stop Administrative Events

These events may happen because:

• The ACTIVITY ending the event does not qualify as a "patient contact" between a clinician and PATIENT, or
• The ACTIVITY occurred in a setting where IT systems cannot produce REFERRAL TO TREATMENT PERIOD data items, or
• The ACTIVITY would be carried in a Commissioning Data Set record type not currently processed by the Secondary Uses Service

Secondary Uses Service Processing

The Secondary Uses Service currently processes the following Commissioning Data Set record types in order to build Referral To Treatment pathways.

• CDS V6 TYPE 020 - OUTPATIENT CDS
• CDS V6 TYPE 130 - ADMITTED PATIENT CARE - FINISHED GENERAL EPISODE CDS
• CDS V6 TYPE 190 - ADMITTED PATIENT CARE - UNFINISHED GENERAL EPISODE CDS

All other types are not currently processed and so if they carry the  REFERRAL TO TREATMENT PERIOD END DATE for a REFERRAL TO TREATMENT PERIOD, a Referral To Treatment Clock Stop Administrative Event must also be sent in order to inform the Secondary Uses Service of the clock stop.

Note that future versions of the Secondary Uses Service will also process:

• CDS V6 TYPE 030 - EAL - END OF PERIOD CENSUS STANDARD CDS
• CDS V6 TYPE 060 - EAL - EVENT DURING PERIOD - ADD CDS
• CDS V6 TYPE 070 - EAL - EVENT DURING PERIOD - REMOVE CDS 
• CDS V6 TYPE 080 - EAL - EVENT DURING PERIOD - OFFER CDS

The dates when ORGANISATIONS submitting REFERRAL TO TREATMENT PERIOD data to the Secondary Uses Service can cease having to also send a Referral To Treatment Clock Stop Administrative Event when a clock stop is carried in one of the Elective Admission List Commissioning Data Set Types, will be notified as part of the Secondary Uses Service release documentation. It is also anticipated that CDS V6 TYPE 021 - FUTURE OUTPATIENT CDS will be processed once piloting is complete and its use is approved by the Information Standards Board for Health and Social Care. A cancelled future Appointments Diagram Overview record could carry a REFERRAL TO TREATMENT PERIOD Clock Stop. A cancelled future APPOINTMENT record could carry a REFERRAL TO TREATMENT PERIOD Clock Stop. Again the timescales will be notified as part of the Secondary Uses Service release documentation.

There are no current plans for the Secondary Uses Service to process the remaining Commissioning Data Set Types:

• CDS V6 TYPE 010 - ACCIDENT AND EMERGENCY CDS 
• CDS V6 TYPE 040 - EAL - END OF PERIOD CENSUS OLD CDS
• CDS V6 TYPE 050 - EAL - END OF PERIOD CENSUS NEW CDS
• CDS V6 TYPE 090 - EAL - EVENT DURING PERIOD - AVAILABLE / UNAVAILABLE CDS
• CDS V6 TYPE 100 - EAL - EVENT DURING PERIOD - OLD SERVICE AGREEMENT CDS
• CDS V6 TYPE 110 - EAL - EVENT DURING PERIOD - NEW SERVICE AGREEMENT CDS
• CDS V6 TYPE 120 - ADMITTED PATIENT CARE - FINISHED BIRTH EPISODE CDS
• CDS V6 TYPE 140 - ADMITTED PATIENT CARE - FINISHED DELIVERY EPISODE CDS
• CDS V6 TYPE 150 - ADMITTED PATIENT CARE - OTHER BIRTH EVENT CDS
• CDS V6 TYPE 160 - ADMITTED PATIENT CARE - OTHER DELIVERY EVENT CDS
• CDS V6 TYPE 170 - ADMITTED PATIENT CARE - DETAINED AND/OR LONG TERM PSYCHIATRIC CENSUS CDS
• CDS V6 TYPE 180 - ADMITTED PATIENT CARE - UNFINISHED BIRTH EPISODE CDS
• CDS V6 TYPE 200 - ADMITTED PATIENT CARE - UNFINISHED DELIVERY EPISODE CDS

This is the because a Referral To Treatment Clock Stop Administrative Event occurring in the scenarios where these record types are generated, would be rare. However this will be reviewed as part of the ongoing maintenance of the Referral To Treatment Clock Stop Administrative Event, and the requirements for the Secondary Uses Service.

When NOT to Use a Referral To Treatment Clock Stop Administrative Event

The Referral To Treatment Clock Stop Administrative Event should NOT be used to correct previously submitted records where a REFERRAL TO TREATMENT PERIOD END DATE was submitted incorrectly to the Secondary Uses Service.

For example, if an Out-Patient Appointment took place where First Definitive Treatment was started, but the REFERRAL TO TREATMENT PERIOD END DATE was not sent in the corresponding CDS V6 TYPE 020 - OUTPATIENT CDS record as it was not entered on the Patient Administration System until later; then the CDS V6 TYPE 020 - OUTPATIENT CDS record should be resubmitted with the correct data. A Referral To Treatment Clock Stop Administrative Event should NOT be used.

Where an ORGANISATION's Patient Administration System supports the submission of cancelled and Did Not Attend appointments in the CDS V6 TYPE 020 - OUTPATIENT CDS, the Referral To Treatment Clock Stop Administrative Event should NOT be used when a PATIENT has a booked Out-Patient Appointment, which is then cancelled because, for example, the PATIENT dies. In these cases the CDS V6 TYPE 020 - OUTPATIENT CDS can carry the details of a cancelled CARE ACTIVITY, including the REFERRAL TO TREATMENT PERIOD END DATE and update to the REFERRAL TO TREATMENT STATUS. (Note - not all Patient Administration Systems provide functionality to create and submit Commissioning Data Set records for cancellations/Did Not Attend's as this is not yet mandated - you should contact your Patient Administration System support team to ascertain whether your Patient Administration System supports this. If not, then it is permissible to send a Referral To Treatment Clock Stop Administrative Event in order to stop the clock in the Secondary Uses Service instead).

Referral To Treatment Clock Stop Administrative Events only require a sub-set of the data elements contained in the CDS V6 TYPE 020 - OUTPATIENT CDS record, to be submitted to the Secondary Uses Service. All other data elements not listed should be omitted from the XML submission of the CDS V6 TYPE 020 - OUTPATIENT CDS record to the Secondary Uses Service. The submission of a Referral To Treatment Clock Stop Administrative Event is not reliant on the use of the Net Changes Commissioning Data Set Submission Protocol to the Secondary Uses Service

The required data elements making up a Referral To Treatment Clock Stop Administrative Event are:

Referral to Treatment Summary Patient Tracking List to support delivery of 18 week waiting times

The national 18 Week Summary Patient Tracking List is intended to collect a set of performance information about PATIENTS with active REFERRAL TO TREATMENT PERIODS that are nearing the 18 week target date. Its main purpose is to focus on those PATIENTS that may potentially breach the 18 week target, providing a structure which enables the most 'at risk' PATIENTS to be clearly identified. The 18 Week Referral To Treatment Summary Patient Tracking List does not cover all the components of a Patient Tracking List that individual Providers and Commissioners may wish to develop and share - especially at PATIENT level. The 18 Week Referral to Treatment Summary Patient Tracking List does not cover all the components of a Patient Tracking List that individual Providers and Commissioners may wish to develop and share - especially at PATIENT level. The sharing of any extended data sets between Providers and Commissioners is subject to local arrangements. Examples of patient-level data sets developed during piloting of this central return, are available from the Department of Health 18 week website (address below).

For most PATIENTS the start of a REFERRAL TO TREATMENT PERIOD begins with a GP REFERRAL REQUEST to a CONSULTANT in secondary care. In addition this data set also covers REFERRAL REQUESTS to CONSULTANTS from:

• GENERAL DENTAL PRACTITIONERS (GDP)
• GENERAL DENTAL PRACTITIONERS (GDP)
• GENERAL PRACTITIONERS (Medical or Dental) with a Special Interest (GPwSIs)
• OPTOMETRIST
• Orthoptists
• Accident And Emergency Departments (where PATIENTS are transferred to an elective pathway)
• Minor injuries units (where PATIENTS are transferred to an elective pathway)
• Walk in centres (WICs) (where PATIENTS are transferred to an elective pathway)
• Genitourinary medicine clinics
• National Screening Programmes (for non-malignant conditions)
• Specialist NURSES or allied health professionals where Primary Care Trusts have approved these mechanisms locally.

Referrals to nurse consultants and allied health professionals are currently out of scope for 18 weeks Referral To Treatment monitoring.

Guidance on the measurement of Referral To Treatment Periods, 18 week clock rules, and Frequently Asked Questions, are all available from the Department of Health 18 week website.Guidance on the measurement of REFERRAL TO TREATMENT PERIODS, 18 week clock rules, and Frequently Asked Questions, are all available from the Department of Health 18 week website. Additional Frequently Asked Questions about 18 weeks are also available from the NHS Data Model and Dictionary website.

The Referral to Treatment Summary Patient Tracking List is in three parts, as follows:The Referral to Treatment Summary Patient Tracking List is in three parts, as follows:

Parts 1A and 1B: Patients where the intent is to treat in an outpatient setting (including PATIENTS where it has not yet been decided whether to admit for treatment or treat in outpatients)

Part 1A should be completed for PATIENTS without a DECISION TO ADMIT for treatment, who have not had an ACTIVITY that ends the REFERRAL TO TREATMENT PERIOD (such as their first definitive treatment, a decision to start active monitoring, or who did not attend their first APPOINTMENT)

AND either

a. do not have a future APPOINTMENT where the anticipated REFERRAL TO TREATMENT PERIOD STATUS is 30

OR

b. do have a future APPOINTMENT where the anticipated REFERRAL TO TREATMENT PERIOD STATUS is 30, but not earlier than the REFERRAL TO TREATMENT PERIOD BREACH DATE.

Part 1B should be completed for PATIENTS without a DECISION TO ADMIT for treatment, who have not had an ACTIVITY that ends the REFERRAL TO TREATMENT PERIOD (such as their first definitive treatment, a decision to start Active Monitoring, or who did not attend their first APPOINTMENT)

AND

whose REFERRAL TO TREATMENT PERIOD BREACH DATE has been reached.

Note that parts 1A and 1B of the 18 Week Referral To Treatment Summary Patient Tracking List are required for submission from 6 January 2008 onwards.

Parts 2A and 2B: Patients where the intent is to admit for treatment

Part 2A should be completed for PATIENTS with a DECISION TO ADMIT for treatment, who have not had an ACTIVITY that ends the REFERRAL TO TREATMENT PERIOD (such as their first definitive treatment, a decision to start Active Monitoring, or who did not attend their first APPOINTMENT)

AND either

a. do not have an agreed OFFERED FOR ADMISSION DATE with an anticipated REFERRAL TO TREATMENT PERIOD STATUS of 30

OR

b. do have an agreed OFFERED FOR ADMISSION DATE with an anticipated REFERRAL TO TREATMENT PERIOD STATUS of 30, but not earlier than the REFERRAL TO TREATMENT PERIOD BREACH DATE.

Part 2B should be completed for PATIENTS with a DECISION TO ADMIT for treatment, who have not had an ACTIVITY that ends the REFERRAL TO TREATMENT PERIOD (such as their first definitive treatment, a decision to start Active Monitoring, or who did not attend their first APPOINTMENT)

AND

whose REFERRAL TO TREATMENT PERIOD BREACH DATE has been reached.

Note that Parts 2A and 2B of the 18 Week Referral To Treatment Summary Patient Tracking List are required for submission from July 2007 onwards.

Part 3 - Patients with a clock stop in the last week (who have either been treated, or whose REFERRAL TO TREATMENT PERIOD ended for other reasons).

This section should be completed for PATIENTS with a REFERRAL TO TREATMENT PERIOD END DATE within the last 7 days.

Note that within Part 3 of the 18 Week Referral To Treatment Summary Patient Tracking List, the three data elements relating to admitted PATIENTS are required for submission from July 2007 onwards; the other three data elements relating to non-admitted PATIENTS are required for submission from 6 January 2008 onwards.

Full guidance on the completion and submission of the 18 Week Referral To Treatment Summary Patient Tracking List, including calculation of waiting times, is available from the Department of Health 18 week website at:
http://www.18weeks.nhs.uk/public/default.aspx?main=true&load=ArticleViewer&ArticleId=947

Review Planned Date is an ACTIVITY DATE TIME.

The date of a planned review within a Professional Staff Group Episode.

Sarcoma Care Spell is an ACTIVITY GROUP.A Sarcoma Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Sarcoma Care Spell is a is a continuous period of care for a PATIENT who has been diagnosed as suffering from sarcoma.

The period of time during which a PATIENT who has been diagnosed as suffering from sarcoma may receive care.

Each Sarcoma Care Spell must be for the care of one tumour at one body site.

References:
National Cancer Dataset

A Scheduled Appointment is an APPOINTMENT BOOKING TYPE.A Scheduled Appointment is an APPOINTMENT.

Scheduled Appointment identifies whether an APPOINTMENT has been prebooked.A Scheduled Appointment identifies whether an APPOINTMENT has been prebooked.

Screening Result Date is an ACTIVITY DATE TIME TYPE.Screening Result Date is an ACTIVITY DATE TIME.

The date on which the result was recorded; if several stages of assessment are necessary in order to arrive at a firm diagnosis, this allows all intermediate results to be stored.

Screening Result Sent Date is an ACTIVITY DATE TIME TYPE.Screening Result Sent Date is an ACTIVITY DATE TIME.

The date on which the result of a cervical smear is sent from the call and recall service.

Screening Test Date is an ACTIVITY DATE TIME TYPE.Screening Test Date is an ACTIVITY DATE TIME.

The date on which the Screening Test was performed. In the case of cervical screening, this is the date the cervical smear was taken.

Second Operation Date is an ACTIVITY DATE TIME TYPE.Second Operation Date is an ACTIVITY DATE TIME.

This is the ACTIVITY DATE of the CLINICAL INTERVENTION which is the second operation.

Sexual Health And HIV Episode is an ACTIVITY GROUP.A Sexual Health And HIV Episode is an ACTIVITY GROUP.

An episode of care, under one Health Care Provider, comprising of one or more attendances, where a CONSULTANT has overall responsibility for the PATIENT who attends for screening, diagnosis and management of sexually transmissible infections and related conditions.

A Sexual Health And HIV Episode is an episode of care, under one Health Care Provider, comprising of one or more attendances, where a CONSULTANT has overall responsibility for the PATIENT who attends for screening, diagnosis and management of sexually transmissible infections and related conditions. The PATIENT may be seen by other CARE PROFESSIONALS, during the same care episode, who are working on behalf of the CONSULTANT.

The episode starts on the date the PATIENT first sees or is in contact with a Care Professional Diagram Overview in respect of a REFERRAL REQUEST from either a Health Care Provider or a self referral.

The episode starts on the date the PATIENT first sees or is in contact with a CARE PROFESSIONAL in respect of a REFERRAL REQUEST from either a Health Care Provider or a self referral.

The episode ends when either the PATIENT is formally discharged or has not had face to face contact with the SERVICE for at least six months.

Each Sexual Health And HIV Episode may be for one or more SEXUAL HEALTH AND HIV ACTIVITY PROPERTY TYPES and each SEXUAL HEALTH AND HIV ACTIVITY PROPERTY TYPE is recorded at a first attendance. The only exception to this is where the PATIENT attends for HIV-related care in which case the relevant SEXUAL HEALTH AND HIV ACTIVITY PROPERTY TYPE should be recorded at every attendance.

Information recorded for a Sexual Health And HIV Episode includes:

Skin Cancer Care Spell is an ACTIVITY GROUP.A Skin Cancer Care Spell is a Cancer Care Spell, which is an ACTIVITY GROUP.

A Cancer Care Spell.A Skin Cancer Care Spell is a continuous period of care for a PATIENT diagnosed as suffering from skin cancer.

The period of time during which a PATIENT may receive care who has been diagnosed as suffering from skin cancer.

For basal cell carcinoma and squamous cell carcinoma, all lesions diagnosed will be included within one Skin Cancer Care Spell.

There will be a new Skin Cancer Care Spell for each malignant melanoma diagnosed, each Kaposi's sarcoma diagnosed and each B-cell or T-cell lymphoma diagnosed.

Each Skin Cancer Care Spell may be the care for one or more skin lesions, or it may also be for one B-Cell or T-Cell lymphoma occurring at one or more Skin Lymphoma morphologies.

Each Skin Cancer Care Spell may be for a malignant melanoma, Karposi's sarcoma, B-Cell or T-Cell lymphoma occurring at one or more Dermatologist Body Sites.

References:
National Cancer Dataset Version 2.1_ISB October 2002

Specialist Palliative Care Date is an ACTIVITY DATE TIME TYPE.Specialist Palliative Care Date is an ACTIVITY DATE TIME.

The date on which the first treatment or support from specialist palliative care was given to a PATIENT with diagnosed cancer.

References:
The NHS National Cancer Waiting Times, Department of Health, Data Set Change Notice 22/2002.

Speech and Swallowing Assessment Date is an ACTIVITY DATE TIME TYPESpeech and Swallowing Assessment Date is an ACTIVITY DATE TIME.

The DATE on which a pre-operative speech, language and swallowing assessment was done for head and neck cancer.The DATE on which a pre-operative speech, language and swallowing assessment was performed during a Head And Neck Cancer Care Spell.

Start Date is an ACTIVITY DATE TIME TYPE.Start Date is an ACTIVITY DATE TIME.

The start of a stay, an episode, period covered by a plan or other time period. This may be used to calculate the length of the period, or to classify by financial year or other time-based criterion.

Start Time is an ACTIVITY DATE TIME TYPE.Start Time is an ACTIVITY DATE TIME.

The start time of a stay, episode, period covered by a plan, or other period of time. The time is expressed on a 24 hour clock basis.

Statutory Assessment Date is an ACTIVITY DATE TIME TYPE.Statutory Assessment Date is an ACTIVITY DATE TIME.

The date a Social Services Statutory Assessment was undertaken.

Symptoms First Noted Date is an ACTIVITY DATE TIME TYPE.Symptoms First Noted Date is an ACTIVITY DATE TIME.

The month and year that the PATIENT first noted any symptoms related to the site of cancer recorded as part of a Cancer Care Spell.