Activity from 1st April 2005

To help determine who has access to Commissioning Data Set data once it has been stored in the Secondary Uses Service, NHS Trusts and Primary Care Trusts need to identify each of those ORGANISATIONS as a CDS COPY RECIPIENT IDENTITY taking all of the following factors into account. Information is required to:

• monitor and manage NHS SERVICE AGREEMENTS;
• develop commissioning plans;
• monitor HEALTH PROGRAMMES;
• underpin clinical governance;
• understand the health needs of the population.

Main commissioners need access to data to monitor Non-Contract Activity as part of the management of their Service Agreements.Main commissioners need access to data to monitor Non-Contract Activity as part of the management of their NHS SERVICE AGREEMENTS.

Primary Care Trusts need to monitor in-year referrals to investigate the sources and reasons for Non-Contract Activity.

Independent Sector Treatment Centres are responsible for providing Admitted Patient Care and Out-Patient Attendance Commissioning Data Set and may submit it on their own behalf or via a third party.

Other Independent Sector activity for NHS PATIENTS is the responsibility of the NHS commissioning body for the provision of the appropriate central returns and data sets.

The Department of Health require a complete record of all PATIENTS admitted to or treated as out-patients by NHS hospitals and Primary Care Trusts, including PATIENTS receiving private treatment. The record also includes NHS PATIENTS treated electively in the independent sector and overseas visitors.

A Patient /Service Agreement entry has been specifically introduced to identify activity commissioned by the National Specialised Commissioning Group (NSCG).A PATIENT / NHS SERVICE AGREEMENT entry has been specifically introduced to identify ACTIVITY commissioned by the National Specialised Commissioning Group (NSCG). The code YDD82 should be used as the ORGANISATION CODE (CODE OF COMMISSIONER) for National Specialised Commissioning Group commissioned activity.

THE CDS ADDRESSING GRID - Activity from 1st April 2005

Key to population codes:
R - Data required for a Commissioning Data Set data flow as part of NHS business rules to meet NHS business requirements.
M - Data is mandatory in the CDS-XML schema and Commissioning Data Set messages will not flow if this data is absent.

Notes:

a) The CDS PRIME RECIPIENT IDENTITY must be allocated on the first creation and submission of a CDS TYPE and must not change even if the ADDRESS or Primary Care Trust of the PATIENT changes during the lifetime of the Commissioning Data Set record otherwise duplicate Commissioning Data Set data may be lodged in the Secondary Uses Service database.

See the supporting information in CDS Submission Protocol for a detailed explanation.See the supporting information in Commissioning Data Set Submission Protocol for a detailed explanation.

b). Note that if two recipients are identical for example, for example, the ORGANISATION CODE (PCT OF RESIDENCE) may be the same as the ORGANISATION CODE (CODE OF COMMISSIONER), only one entry for that organisation should be made for that recipient.b) Note that if two recipients are identical for example, for example, the ORGANISATION CODE (PCT OF RESIDENCE) may be the same as the ORGANISATION CODE (CODE OF COMMISSIONER), only one entry for that ORGANISATIONshould be made for that recipient.

c). For further information please refer to DSCN 06/2005, 19/2005 and DSCN 19/2006.c) For further information please refer to DSCN 06/2005, DSCN 19/2005 and DSCN 19/2006.

The minimum Commissioning Data Set information flow requirement to enable Hospital Episode Statistics, 18 weeks activity reporting, and Payment by Results to be supported by the Secondary Uses Service is shown in the table below.

The Secondary Uses Service supports every CDS TYPE but only a subset is mandated to flow.

Commissioning Data Sets may flow to the Secondary Uses Service using either Net Change or Bulk Replacement Commissioning Data Set Submission Protocols.  Many Standard NHS Contracts between Health Care Providers and the commissioners of their SERVICES, now specify weekly submission of initially-coded data sets to the Secondary Uses Service.  The use of Net Change Commissioning Data Set Submission Protocols is recommended for submissions of this frequency.

In the above data flows, the validation criteria for each data element is shown in the Commissioning Data Set Validation Table.

Files Available

• Metadata files are used by the NHS to validate data. The files facilitate data consistency and quality. The files are:
  • Diagnosis (ICD-10)
  • OPCS Classification of Interventions and Procedures (OPCS-4)
  • NHS Postcode Directory
  • Frozen Postcode Directory
  • Country Pseudo Postcodes.

• The ICD-10 file is issued by NHS Connecting for Health, from whom a specification is available. It is intended to reissue this file in line with the ICD-10 updates.

• The Operation metadata file and specification is issued by the NHS Classifications Service of NHS Connecting for Health to support implementation of new releases; see Contact Details.

• The full and reduced versions of the NHS Postcode Directory are issued every quarter by the Organisation Data Service. Named recipients both inside the NHS and other recipients licensed to use this data in support of the NHS are able to access it through the online distribution service, Terminology Reference Data Update Distribution Service (TRUD) and through the Organisation Data Service pages on NHSnet; see Contact Details.

• A full description of the NHS Postcode Directory and the Organisation Data Service reduced postcode data files, can be found by browsing the Office for National Statistics Data section of the Organisation Data Service pages on NHSnet at:

  • http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/ (NHS Postcode Directory) and
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/postcode/ (reduced files).

• A full description of the NHS Postcode Directory and the Organisation Data Service reduced postcode data files, can be found by browsing the Office for National Statistics Data section of the Organisation Data Service pages on NHSnet at:

  • http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/ (NHS Postcode Directory) and
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/postcode/ (reduced files).

The same descriptions can also be accessed via the Terminology Reference Data Update Distribution Service (TRUD).

• Any area within the NHS taking advantage of the supply of metadata by the Office for National Statistics will be expected to abide by any rules and conditions imposed by the Office for National Statistics Section supplying the metadata.

  Format of Metadata Files

  The following pages give the record layouts and data content for the Operation and Country Pseudo Postcode metadata files.

  Country Pseudo Postcode File DataContent

• This file contains about 130 records. The usual country of residence for short term overseas visitors is derived from the country pseudo postcode. The codes are  available in electronic format on the NHS Postcode Directory ("Gridlink version").

• The expanded area code field contains the country of birth code in characters 1-4 (a repeat of the characters 3-6 in the pseudo postcode). The remainder of the expanded area code is blank except for codes 993C (UK nos) and 993V (no fixed abode) where characters 5-7 are 9space9.

  COUNTRY PSEUDO FILE RECORD LAYOUT

  Start Pos	Size	Data Type	Field Description
  1	11	X	selection indicators
  12	6	X	6 digit postcode (POSTSIX)
  18	1	A	7th digit
  19	6	X	filler
  25	50	X	name of country
  75	5	X	filler
  80	19	X	area details
  99	154	X	filler

• The NHS Postcode Directory is maintained, on behalf of the Department of Health, by the Office for National Statistics. It contains a record for every POSTCODE in the UK, Channel Islands and the Isle of Man, and associates each POSTCODE with a variety of geographic information, including grid references, Primary Care Trusts and Care Trusts (England), Local Health Boards (Wales), Community Health Partnerships (Scotland) and Strategic Health Authority codes. The file also includes pseudo postcodes covering defaults and overseas countries.

• The full and reduced versions of the NHS Postcode Directory are issued every quarter by the Organisation Data Service. Named recipients both inside the NHS and other recipients licensed to use this data in support of the NHS are able to access it through the online distribution service, Terminology Reference Data Update Distribution Service (TRUD) and through the Organisation Data Service pages on NHSnet; see Contact Details.

• A full description of the NHS Postcode Directory and the Organisation Data Service reduced postcode data files, can be found by browsing the Office for National Statistics Data section of the Organisation Data Service pages on NHSnet at:
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/ (NHS Postcode Directory) and
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/postcode/ (reduced files).
• A full description of the NHS Postcode Directory and the Organisation Data Service reduced postcode data files, can be found by browsing the Office for National Statistics Data section of the Organisation Data Service pages on NHSnet at:
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/officenatstats/ (NHS Postcode Directory) and
  • http://nww.connectingforhealth.nhs.uk/ods/downloads/postcode/ (reduced files).

The same descriptions can also be accessed via Terminology Reference Data Update Distribution Service (TRUD).

• The Office for National Statistics will supply, on request and at a cost, copies of the NHS Postcode Directory, on different media, in different formats and for selected extracts. Contact the Office for National Statistics for details and charges; see Contact Details.

Postcodes

• All POSTCODES made available via the Organisation Data Service postcode files have been standardised to the eight character postcode format as used by the Royal Mail's Postal Address File (PAF). All NHS ORGANISATIONS should ensure that they conform to the POSTCODE format.

  POSTCODES are of the general format:

Character Position	1	2	3	4	5	6	7	8
Format	a	a/n	a/n	a/n	space	n	a	a
Coding Frame	Outward Code				space	Inward Code

• The coding frame allows the use of digits 0 (zero) to 9 and the use of upper-case alpha characters; no special characters are allowed.
  
• The fifth character of all standard format POSTCODES is always a space, and separates the outward and inward parts of the POSTCODE. The outward part of the POSTCODE is left-justified and can contain 2, 3 or 4 characters, and is space-filled in character positions 3 and 4 where required. The inward part of the POSTCODE is always 3 characters.

  The following table gives examples of typical POSTCODES:

  Character Position								Allocated by	Notes
  1	2	3	4	5	6	7	8
  W	9				3	X	X	Royal Mail
  D	A	1			5	P	L	Royal Mail
  M	K	4	5		1	T	E	Royal Mail
  Z	Z	9	9		4	L	Z	ODS	Pseudo Postcodes, Defaults and Overseas

• The "Scottish split postcode indicator" field was discontinued from the 1996/1 version of the NHS Postcode Directory. This value used to appear in the 8th character position of the POSTCODES (the postcode field was then only 7 characters in length). The ‘Alternative’ version of the NHS Postcode Directory, showing POSTCODES containing this field, is available from the Office for National Statistics.

Strategic Health Authority/Local Health Board/Health Board Codes

• Strategic Health Authorities in England use three character codes commencing with a 'Q'.

• Local Health Boards in Wales use three character codes commencing with a '7'.

• Health Boards in Scotland use a three character version of the Health Board code (range SA9 - SZ9).

• The four Northern Ireland Health Boards are indicated by their standard codes - ZE0, ZN0, ZS0, ZW0.

• No Strategic Health Authorities exist for the Channel Islands and the Isle of Man so notional (or dummy) Strategic Health Authority codes are used to identify postcodes from these locations. The default Pseudo health authority code of X98 is used to indicate pseudo postcodes (defaults and overseas).

Related Products

• The Office for National Statistics produce annually two related publications : ONS Geography User Guide 9 (The Area of Residence Classification) and ONS Geography User Guide 10 (The NHS Organisation Manual). These show a breakdown of Strategic Health Authorities by Local Government authorities and Electoral Wards. Copies are available from the Office for National Statistics. Electronic copies are also provided by the Organisation Data Service through the online distribution service, Terminology Reference Data Update Distribution Service (TRUD) and through the Organisation Data Service pages on NHSnet, see Contact Details.

• The Office for National Statistics produce a version of the Postcode Directory that is based on a stable area base to facilitate time series analysis - the 1991-based Frozen Postcode Directory. This is available from the Office for National Statistics.

• The Organisation Data Service issues the full manuals through the online distribution service, Terminology Reference Data Update Distribution Service (TRUD) and through the Organisation Data Service pages on NHSnet each quarter; see Contact Details. This ensures that any new customers receive the necessary information.  See Contact Details.

  Changes

• The Office for National Statistics should be notified of any queries relating to the allocation of POSTCODES to Strategic Health Authorities or Primary Care Trusts. All such queries are investigated by Office for National Statistics, and any agreed changes are included in the following edition of the NHS Postcode Directory. The monthly POSTCODE corrections are also included on the NHSnet, see Contact Details.

• Requests and suggestions for improvements to the NHS Postcode Directory or queries relating to its use should be directed to the Organisation Data Service, who are taking the lead on this product on behalf of the NHS; see Contact Details.

A formal agreement between a commissioner ORGANISATION and one or more provider ORGANISATIONS for the provision of patient care services.A formal agreement between a commissioner ORGANISATION and one or more provider ORGANISATIONS for the provision of PATIENT care services.

Services may be commissioned in four ways:

The costs of a Service Agreement accrue to the organisation responsible for commissioning the treatment.The costs of a NHS SERVICE AGREEMENT accrue to the ORGANISATION responsible for commissioning the treatment.

For Commissioning Data Set messages the commissioner is identified in the ORGANISATION CODE (CODE OF COMMISSIONER) field.

Notes:
OVERSEAS VISITORS STATUS CLASSIFICATION is the same as attribute OVERSEAS VISITORS STATUS CLASSIFICATION.

Income Generation Audit (IGA) forms for overseas visitors should be sent to Leeds Primary Care Trust, the agency acting on behalf of the Department of Health. This enables the financial side of reciprocal and international agreements to be supported. It also helps to monitor the treatment of overseas visitors and associated levels of expenditure.

Where the transmission of Commissioning Data Sets identifies reciprocal agreement overseas PATIENTS by the use of TDH00 in the ORGANISATION CODE (CODE OF COMMISSIONER), the Secondary Uses Service will send the ACTIVITY to the Health Care Provider's host commissioner to pay and copy it to Leeds Primary Care Trust - alleviating the need to send a separate Income Generation Audit form.

The OVERSEAS VISITOR STATUS may change while the PATIENT is being treated. All such changes should be recorded so that charges for treatment can be revised accordingly All such changes should be recorded so that charges for treatment can be revised accordingly.