Cancer Care Plan is a CARE PLAN.A Cancer Care Plan is a CARE PLAN.

A CARE PLAN developed within a Cancer Care Spell. There should be at least one Planned Cancer Treatment recorded within a Cancer Care Plan.

References:
National Cancer Dataset

Cancer Care Spell is an ACTIVITY GROUP.A Cancer Care Spell is an ACTIVITY GROUP.

The period of time during which a PATIENT who has been diagnosed as suffering from a single site primary cancer or, in the case of particular skin cancers, one or more lesions may receive care. The Cancer Care Spell starts on the date of the REFERRAL REQUEST from whatever source to the specialist team. It ends when the PATIENT dies.

A recurrence of the original primary cancer at a secondary site is part of the same Cancer Care Spell.

If a PATIENT has another primary cancer this will be a new Cancer Care Spell with the following exceptions.

A PATIENT may have many skin cancer basal cell carcinomas diagnosed at the same time, or consecutively during follow-up, or by re-referral. All these skin cancer basal cell carcinomas will be treated under one Cancer Care Spell.

For skin cancer squamous cell carcinoma (this includes atypical fibroxanthoma, merkel cell tumour and all epidermal cell derived invasive malignancies except basal cell carcinoma), most PATIENTS have a single lesion at presentation, but a significant number will get more primaries over a period of time. All these squamous cell carcinomas will be treated under one Cancer Care Spell.

For each kaposi's sarcoma, malignant melanoma and cutaneous lymphoma diagnosed there will be one Cancer Care Spell.

The Cancer Care Spell may only involve diagnostic procedures leading to a diagnosis, for example in cases where the PATIENT refuses treatment, or it may include treatment and follow-up.

The Cancer Care Spell may be the context for one or more Anti-Cancer Drug Programmes and may involve one or more Cancer Clinical Status Assessments, Endocrine Therapies and PATIENT CLINICAL TRIAL STATUSES.

Information recorded for a Cancer Care Spell includes:

References:
National Cancer Dataset

Endocrine Therapy is a CLINICAL INTERVENTION.

A record of the type of endocrine therapy given to the PATIENT as part of a Cancer Care Spell.A record of the type of Endocrine Therapy given to the PATIENT as part of a Cancer Care Spell.

References: National Cancer Dataset

FEV1 Percentage is a MEASURED PERSON OBSERVATION.

The forced expiratory volume of the lungs in 1 second as a percentage of the predicted value.FEV1 Percentage is the forced expiratory volume of the lungs in 1 second as a percentage of the predicted value.

References:
National Cancer Dataset Version 1.3_ISB October 2002

Further guidance on ending REFERRAL TO TREATMENT PERIODS and first treatments.

Undertaking a procedure is not necessarily in itself the end of a REFERRAL TO TREATMENT PERIOD. For example, outpatient or day case diagnostic CARE ACTIVITIES prior to admission for treatment do not represent the end of the period and, in these cases, are part of the diagnostic process rather than the start of treatment.

Commencement of medication as an outpatient can be the end of a REFERRAL TO TREATMENT PERIOD, if it is intended as the First Definitive Treatment. However, CARE PROFESSIONALS often begin to manage a PATIENT's condition in advance of the first actual treatment taking place, for example by giving pain relief before a surgical procedure takes place. In these cases, the REFERRAL TO TREATMENT PERIOD END DATE is when the First Definitive Treatment (in this example, surgery) has started.

Other CARE ACTIVITIES that may end a REFERRAL TO TREATMENT PERIOD as First Definitive Treatment include:

Planned Cancer Treatment is a PLANNED ACTIVITY.

The identification of a type of treatment to be provided within a Cancer Care Plan.Planned Cancer Treatment is the identification of a type of treatment to be provided within a Cancer Care Plan.

There may be more than one type of treatment in a planned sequence within a Cancer Care Plan.

References:
National Cancer Dataset

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

The method of admission to a Hospital Provider Spell. A detailed definition of Elective Admission is given in ELECTIVE ADMISSION TYPE.

National Codes:

Note: The classification has been listed in logical sequence rather than alphanumeric order.

A classification of the stage of treatment reached during a Cancer PATIENT PATHWAY for primary, recurrent or metastatic cancer.A classification of the stage of treatment reached during a Cancer PATIENT PATHWAY for primary, recurrent or metastatic cancer.

National Codes:

A type of CARE PLAN.

National Codes:

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

A classification of a CATEGORY VALUED PERSON OBSERVATION.

National Codes:

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

One of the NHS Business Definitions listed in the CLINICAL INTERVENTION class as a type of this class.

National Codes:

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

Identifies the communication mechanism used to relay information between the CARE PROFESSIONAL and the PERSON who is the subject of the consultation, during a CARE ACTIVITY.

The telephone or telemedicine consultation should directly support diagnosis and care planning and must replace a face to face Out-Patient Attendance Consultant, Clinic Attendance Nurse or Clinic Attendance Midwife, types of CARE ACTIVITY. A record of the telephone or telemedicine consultation must be retained in the PATIENT's records.

Telephone contacts solely for informing PATIENTS of results are excluded.

National Codes:

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

A World Health Organisation classification indicating a PERSON's status relating to activity / disability.

Note: see PERFORMANCE STATUS FOR YOUNG PEOPLE for codes for a young person of 16 years and under.

National Codes:

An indicator of whether the treatment within an Anti-Cancer Drug Programme was completed as planned, and if not, the reason why.

National Codes:

References:
National Cancer Dataset Version 1.3_ISB October 2002

The SEXUAL ORIENTATION of a PATIENT.

National codes:

Note:
*  Code not to be used for the Genitourinary Medicine Clinic Activity Data Set.

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

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

National Codes:

Notes:

This is the type of care setting where the cancer care relating to the TREATMENT START DATE (CANCER) took place.

Where the care is delivered during a Hospital Provider Spell, distinction is made between care delivered as part of an ordinary admission (where the PATIENT CLASSIFICATION is National Code 1 - Ordinary Admission) and a day case admission (where PATIENT CLASSIFICATION is National Code 2 - Day case admission).

National codes: National Codes:

Notes:
The date on which a pre-treatment dental assessment was done for a Head And Neck Cancer Care Spell.

CANCER DENTAL ASSESSMENT DATE is the same as ACTIVITY DATE of ACTIVITY DATE TIME where the ACTIVITY DATE TIME TYPE is National Code 04 'Cancer Dental Assessment Date'.CANCER DENTAL ASSESSMENT DATE is the same as ACTIVITY DATE of ACTIVITY DATE TIME where the ACTIVITY DATE TIME TYPE is National Code 04 'Cancer Dental Assessment Date'.

Notes:
This is the same as attribute CANCER REFERRAL TO TREATMENT PERIOD START DATE.

Notes:
This is the same as attribute CANCER TREATMENT EVENT TYPE.

CANCER TREATMENT EVENT TYPE is the same as attribute CANCER TREATMENT EVENT TYPE. 

Notes:

This is the same as attribute CANCER TREATMENT PERIOD START DATE.

Notes:
This is the same as attribute DELAY REASON TO TREATMENT (CANCER).

 A DELAY REASON (DECISION TO TREATMENT) must be present in the National Cancer Waiting Times Monitoring Data Set where a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) exists.

Notes:
This is the same as the attribute DELAY REASON TO TREATMENT (CANCER).

A DELAY REASON (DECISION TO TREATMENT) must be present in the National Cancer Waiting Times Monitoring Data Set where a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) exists. 

This data can also be recorded locally for prospective PATIENTS where a full histological diagnosis confirming cancer is not yet available.

Notes:

DELAY REASON COMMENT (CONSULTANT UPGRADE) is the same as attribute DELAY REASON COMMENT. 

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set.  It is applicable and must be recorded if the existing 62 day standard (for referral to treatment) has been breached (after any days adjustments allowed in WAITING TIME ADJUSTMENT (TREATMENT) have been removed).  It is the free text comment that describes why there was a delay experienced between the Consultant Upgrade Date and the TREATMENT START DATE (CANCER).

If DELAY REASON (CONSULTANT UPGRADE) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (CONSULTANT UPGRADE) must explain the full reason for the delay.

Notes:
This is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing 31-day standard (for referral to treatment) has been breached (after any days adjustments allowed in WAITING TIME ADJUSTMENT (TREATMENT) have been removed).  It is the free text comment that describes why the maximum 31 day wait from CANCER TREATMENT PERIOD START DATE to TREATMENT START DATE (CANCER) could not be met. 

If DELAY REASON (DECISION TO TREATMENT) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (DECISION TO TREATMENT) must explain the full reason for the delay.

Notes:
DELAY REASON COMMENT (FIRST SEEN) is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the maximum two week wait fromCANCER REFERRAL TO TREATMENT PERIOD START DATE to DATE FIRST SEEN (less WAITING TIME ADJUSTMENT (FIRST SEEN)) could not be met.

See DATE FIRST SEEN for guidance on determining the appropriate first seen date.

If DELAY REASON REFERRAL TO FIRST SEEN (CANCER OR BREAST SYMPTOMS) is recorded as National Code 99 'Other reason' then DELAY REASON COMMENT (FIRST SEEN) must explain the full reason for the delay.

Notes:
DELAY REASON COMMENT (REFERRAL TO TREATMENT) is the same as the attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the specified maximum 62 day wait from CANCER REFERRAL TO TREATMENT PERIOD START DATE to the TREATMENT START DATE (CANCER), less any adjustments recorded by WAITING TIME ADJUSTMENT (FIRST SEEN) and WAITING TIME ADJUSTMENT (DECISION TO TREAT) and WAITING TIME ADJUSTMENT (TREATMENT), could not be met.

Notes:
See attribute DELAY REASON TO TREATMENT (CANCER) for the National Codes used for recording the DELAY REASON REFERRAL TO TREATMENT (CANCER).DELAY REASON REFERRAL TO TREATMENT (CANCER) is the same as attribute DELAY REASON TO TREATMENT (CANCER).

It is an optional data element and should only be present if a Cancer Care Spell Delay with a DELAY REASON TO TREATMENT (CANCER) has been recorded where the DELAY REASON INDICATOR is classification b. 'delay between urgent GP referral and date of first definitive treatment'.

Cancer Care Spell Delay is a REFERRAL DELAY where REFERRAL DELAY TYPE is National Code 01 'Cancer Care Spell Delay'.

Notes:
EXCISION MARGIN is the same as attribute EXCISION MARGIN.

An indication of whether the Pathology Laboratory Investigation excision margin finding was clear of the tumour and if so, by how much.

Pathology Laboratory Investigation is a CLINICAL INTERVENTION where CLINICAL INTERVENTION TYPE is National Code 24 'Pathology Laboratory Investigation'.

References:
National Cancer Dataset

This is derived from the presence of NUTRITIONAL SUPPORT PROVIDED TYPE.National Codes:

National codes:

References:
National Cancer Dataset Version 1.3_ISB October 2002

Notes:
This is the ORGANISATION CODE of the ORGANISATION commissioning health care.

This should always be the ORGANISATION CODE of the original commissioner for Commissioning Data Sets to support Payment by Results.

The Department of Health document "Who pays? Establishing the Responsible Commissioner" sets out a framework for establishing responsibility for commissioning an individual's care within the NHS, (i.e. determining who pays for a PATIENT’s care.) The guidance is set out in three sections:

1. Section 1: Establishing who pays - sets out the key principles
2. Section 2: Applying the key principles - gives further details about a number of services and situations where further clarification of how the key principles are applied may be helpful
3. Section 3: Exceptions to the key principles - outlines the exceptions to the key principles e.g. prisoners, continuing care arrangements.

This following sections, provides guidance as to which code(s) should be used as the ORGANISATION CODE (CODE OF COMMISSIONER).

General Medical Practitioner Practice Registration (England):

• Where the PATIENT is registered with a General Medical Practitioner Practice, the ORGANISATION CODE (CODE OF COMMISSIONER) will be the 3 digit ORGANISATION CODE of the Primary Care Trust or Care Trust that holds the contract with that General Medical Practitioner Practice.
• If a PATIENT is not registered with a General Medical Practitioner Practice, the ORGANISATION CODE (CODE OF COMMISSIONER) is derived from the PATIENT's POSTCODE OF USUAL ADDRESS, where they reside within the boundary of a:
  • Primary Care Trust
  • Care Trust
  • Local Health Board (Wales)
  • Scottish Health Board
  • Local Commissioning Group (Northern Ireland) Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009
  • Primary Healthcare Directorate (Isle of Man).
• If a PATIENT is not registered with a General Medical Practitioner Practice, the ORGANISATION CODE (CODE OF COMMISSIONER) is derived from the PATIENT's POSTCODE OF USUAL ADDRESS, where they reside within the boundary of a:
  • Primary Care Trust
  • Care Trust
  • Local Health Board (Wales)
  • Scottish Health Board
  • Local Commissioning Group (Northern Ireland)  Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009
  • Primary Healthcare Directorate (Isle of Man).
• 
  
• If a PATIENT is not registered with a General Medical Practitioner Practice and is unable to give an ADDRESS, the ORGANISATION CODE (CODE OF COMMISSIONER) will be the ORGANISATION CODE of the ORGANISATION where the unit providing the treatment is located.

General Medical Practitioner Practice Registration (Wales, Scotland and Northern Ireland):

• For PATIENTS who are resident in England but registered with a General Medical Practitioner Practice in Wales, Scotland or Northern Ireland, the ORGANISATION CODE (CODE OF COMMISSIONER) is the English Primary Care Trust or Care Trust in whose area the PATIENT is resident.

PATIENTS from the Channel Islands:

• The bilateral healthcare agreement between the United Kingdom and the Channel Islands terminated on 31st March 2009.
• Channel Islands visitors to England are therefore liable for the same NHS charges as visitors from any other non-European Economic Area (EEA) country that the United Kingdom has no bilateral agreement with.
• As with all PATIENTS who are Overseas Visitors seeking NHS hospital care in England, they are identified by the OVERSEAS VISITORS STATUS CLASSIFICATION to establish whether they are exempt from payment or liable for fees.
• The Department of Health document Termination of bilateral healthcare agreement with the Channel Islands details these changes.

Overseas PATIENTS: charge-exempt:

• PATIENTS are identified by the OVERSEAS VISITORS STATUS CLASSIFICATION where the National Code is either 1 'Exempt from payment - subject to reciprocal health agreement' or 2 'Exempt from payment - other'.
• PATIENT ACTIVITY is funded via the main (host) commissioner - normally the Primary Care Trust or Care Trust with the highest value of NHS SERVICE AGREEMENTS with the ORGANISATION providing the treatment.
• National Commissioning Group is also responsible for charge-exempt Overseas Visitors who require services covered by the National Commissioning Group commissioning arrangements and funded through the National Commissioning Group central budget.

PATIENTS - liable for charges (Overseas and Private):

• PATIENTS who are Overseas Visitors are identified by the OVERSEAS VISITORS STATUS CLASSIFICATION where the National Code is 4 'To pay all fees'.
• Private PATIENTS are identified by the ADMINISTRATIVE CATEGORY CODE 02 'Private patient, one who uses accommodation or services authorised under section 65 and/or section 66 of the NHS Act 1977 (Section 7(10) of Health and Medicine Act 1988 refers) as amended by section 26 of the National Health Service and Community Care Act 1990'.

VPP00 'Private PATIENTS / Overseas Visitor liable for charge' should be used as the ORGANISATION CODE (CODE OF COMMISSIONER) for these PATIENTS.

Prisoners:

• Since April 2003, GP Practice registration (if any) is disregarded for PERSONS who are detained in prison in England. The Primary Care Trust or Care Trust in which the prison is located is responsible for commissioning NHS services for those prisoners, including NHS dental services.
• For those usually resident outside the United Kingdom, the responsible commissioner will be the Primary Care Trust or Care Trust in which the prison is located.
• PERSONS usually resident overseas held in English prisons are exempt from charges for NHS hospital treatment. There is no centrally held budget for this group and costs should be borne by the Primary Care Trust or Care Trust in which the prison is located.

Ministry of Defence:

• Upon enlistment, Primary Care Trusts and Care Trusts are required to de-register members of the British Armed Forces from their General Medical Practitioner Practice registration list and they should not be able to re-register until they have been discharged. During this time, the Ministry of Defence is responsible for their primary medical services which has specific contractual and entitlement arrangements with the NHS.
• This does not apply to dependants of British Armed Forces members, who can remain registered with a General Medical Practitioner Practice.
• XMD00 'Commissioner Code for Ministry of Defence (MoD) Healthcare' should be used as the ORGANISATION CODE (CODE OF COMMISSIONER) for members of British Armed Forces (not dependants).

Specialised Commissioning (England):

• For episodes funded directly by the National Commissioning Group (NCG), code YDD82 'Episodes funded directly by the National Commissioning Group for England' should be used as the ORGANISATION CODE (CODE OF COMMISSIONER).
• Charge-exempt Overseas Visitors who require SERVICES covered by the  National Commissioning Group arrangements are funded through the National Commissioning Group.

• Primary Care Trust
• Care Trust
• Local Health Board (Wales)
• Scottish Health Board
• Local Commissioning Group (Northern Ireland) Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009
• Local Commissioning Group (Northern Ireland)  Guidance on the use of Northern Ireland codes can be found in Data Set Change Notice 19/2009
• Primary Healthcare Directorate (Isle of Man).

ORGANISATION CODES can be downloaded from the Organisation Data Service website or through the online Terminology Reference Data Update Distribution Service (TRUD). For further information, see Organisation Data Service.

For the purposes of sending Commissioning Data Set messages to the Secondary Uses Service (regardless of how local systems hold the data), it is essential at present to continue using a 3 character field, using the first 3 characters of the ORGANISATION CODE (PCT OF RESIDENCE) and following the same update rules relating to Prime Recipient as are currently in place. This is necessary, primarily to preserve the integrity of the current Commissioning Data Set message and the CDS PRIME RECIPIENT IDENTITY which is derived from the ORGANISATION CODE (PCT OF RESIDENCE).

The Organisation Data Service provides postcode files which link postcodes to the Primary Care Trust. See NHS Postcode Directory.

Notes:
This is the same as attribute TREATMENT START DATE (CANCER).

Notes: 

TREATMENT TYPE (CANCER MORBIDITY) is the same as attribute TREATMENT TYPE.