Acute Myocardial Infarction Care Spell is an ACTIVITY GROUP.An Acute Myocardial Infarction Care Spell is an ACTIVITY GROUP.

The continuous period of care for a PATIENT suffering from an Acute Myocardial Infarction (AMI).An Acute Myocardial Infarction Care Spell is the continuous period of care for a PATIENT suffering from an Acute Myocardial Infarction (AMI).

The Acute Myocardial Infarction Care Spell starts when the PATIENT arrives at the hospital. It ends when either the PATIENT dies, is discharged from the care spell, is not given a further Out-Patient Appointment or does not attend for six months. Information relating to the Acute Myocardial Infarction Care Spell is collected from the time of the initial PATIENT symptoms to the end of the care spell. This will include details of the procedures and treatments carried out during the spell and in particular, the date and time these were carried out. It ends when either:

• the PATIENT dies
• is discharged from the Acute Myocardial Infarction Care Spell
• is not given a further Out-Patient Appointment or
• does not attend for six months.

Information relating to the Acute Myocardial Infarction Care Spell is collected from the time of the initial PATIENT symptoms to the end of the Acute Myocardial Infarction Care Spell. This will include details of the procedures and treatments carried out during the Acute Myocardial Infarction Care Spell and in particular, the date and time these were carried out. Reasons for not carrying out treatments or procedures are also recorded.

If the Acute Myocardial Infarction Care Spell is initiated by the PATIENT the Initial Patient Contact Date And Initial Patient Contact Time should be recorded.If the Acute Myocardial Infarction Care Spell is initiated by the PATIENT the Initial Patient Contact Date and Initial Patient Contact Time should be recorded.

When the PATIENT is discharged from hospital the AMI discharge drug consideration should be recorded.When the PATIENT is discharged from hospital the Acute Myocardial Infarction discharge drug consideration should be recorded.

Cancer Care Spell Delay is a REFERRAL DELAY.A Cancer Care Spell Delay is a REFERRAL DELAY.

A Cancer Care Spell Delay is a delay in either an Out-Patient Appointment or treatment for suspected cancer after a referral has been received.

A Cancer Care Spell Delay should be recorded for each delay.

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.
• 
  
• 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
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.For this reason it is advised that the ORGANISATION CODE (PCT OF RESIDENCE) should always be used to determine the CDS PRIME RECIPIENT 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.

Imaging Or Radiodiagnostic Event is a CLINICAL INTERVENTION.An Imaging or Radiodiagnostic Event is a CLINICAL INTERVENTION.

A test or examination performed using one IMAGING MODALITY, in response to one request and relating to one anatomical site.A test or examination performed using one IMAGING MODALITY, in response to one request and relating to one ANATOMICAL SITE. A test counts as one test if one report is issued regardless of the number of radioactive substances used and the number of days on which counting takes place. It excludes imaging performed as part of radiotherapy planning and Doppler ultrasound examinations without imaging such as is used for peripheral arterial or venous disease or fetal heart studies.

Out-Patient Attendance Consultant is a CARE CONTACT.

An attendance at which a PATIENT is seen by or has contact with (face to face or via telephone/telemedicine) a CONSULTANT, in respect of one referral, that is not a visit to the home of a PATIENT for which a fee is payable under paragraph 140 of the Terms and Conditions of Service. For the purposes of this definition 'CONSULTANT' includes a member of the CONSULTANT's firm or locum for such a member. The attendance will be part of a Consultant Out-Patient Episode.

If a PATIENT is seen by a CONSULTANT at a Consultant Clinic then this will be a Clinic Attendance Consultant. An attendance may involve more than one PERSON (e.g. a family). The number of attendances to be recorded should be the number of PATIENTS for whom the particular CONSULTANT has identifiable individual records and which will be maintained as a result of the attendance.

A visit to the home of a PATIENT made at the instance of a hospital or specialist to review the urgency of a proposed admission to hospital, or to continue to supervise treatment initiated or prescribed at a hospital or clinic is covered by this definition.

Out-Patient Attendance Consultant also includes a PATIENT being seen by a CONSULTANT from a different MAIN SPECIALTY CODE during a Consultant Episode (Hospital Provider) in circumstances where there is no transfer of responsibility for the care of the PATIENT.

If the PATIENT is currently subject to a Mental Health Care Spell and the CONSULTANT they are in contact with during attendance is their allocated Care Programme Approach care coordinator then a Face To Face Contact CPA Care Coordinator should also be recorded.

During the Out-Patient Attendance Consultant, a number of PATIENT DIAGNOSES and Patient Procedures may be recorded.

A series of Out-Patient Attendance Consultant will form a Consultant Out-Patient Episode, generated from a single referral. Note that it is possible to have two Consultant Out-Patient Episodes with the same CONSULTANT for different clinical conditions, if two referrals are made. An attendance may involve more than one PERSON - for example, a family. The number of attendances to be recorded should be the number of PATIENTS for whom the CONSULTANT Out-Patient Attendance Consultant can take place outside a clinic session, and can take place at the PATIENT's normal place of residence. Out-Patient Attendance Consultant can take place outside a clinic session, and can take place at the PATIENT's normal place of residence.

A PATIENT attending a WARD for examination or care will be counted as an Out-Patient Attendance Consultant if he/she is seen by a doctor. If they are only seen by a NURSE, they are a Ward Attendance.

An Out-Patient Attendance Consultant should also be recorded where a PATIENT is seen by a CONSULTANT from a different MAIN SPECIALTY CODE during a Consultant Episode (Hospital Provider) where there is no transfer of responsibility for the care of the PATIENT. For example, a PATIENT who is admitted to hospital under a Gastroenterology specialty following an overdose may be seen while still in hospital by a psychiatrist who has been asked to assess their mental condition. The assessment by the psychiatrist should be recorded as an Out-Patient Attendance Consultant.

Information recorded for an Out-Patient Attendance Consultant includes:

Radiotherapy Machine is a MACHINE.A Radiotherapy Machine is a MACHINE.

A machine in a Radiotherapy Department used for planning courses of treatment, treatment simulation or carrying out radiotherapy treatment procedures.A Radiotherapy Machine in a Radiotherapy Department is used for planning courses of treatment, treatment simulation or carrying out radiotherapy treatment procedures.

Radiotherapy Treatment Course is a CLINICAL INTERVENTION.A Radiotherapy Treatment Course is a CLINICAL INTERVENTION.

A set of Fractions for an individual PATIENT which have been planned and prescribed as a whole. It should be noted that the following all constitute one course of treatment:

a. Set of Fractions planned and prescribed as a whole and using one or more different machines,
b. Set of Fractions planned and prescribed as a whole with a period of no treatment during them (split course),
c. Set of Fractions planned and prescribed as a whole involving machines located on two or more sites. (exceptionally a PATIENT may be transferred between sites possibly due to machine failure)

If a PATIENT has two unrelated diseases both of which require radiotherapy, each course of treatment should be recorded as a primary course. Similarly if a PATIENT has two primary lesions of the same disease, eg two rodent ulcers, the treatment of these comprises two primary courses, unless the lesions are in such close proximity that they are to be treated together. If during a course of treatment, a PATIENT starts a further course, the second course should be separately identified.

Each Radiotherapy Treatment Course has a sub-type of Brachytherapy Treatment Course or Teletherapy Treatment Course or Unsealed Source Treatment Course.Each Radiotherapy Treatment Course has a sub-type of Brachytherapy Treatment Course, Teletherapy Treatment Course or Unsealed Source Treatment Course.

Request for Radiological Procedure is a DIAGNOSTIC TEST REQUEST.A Request for Radiological Procedure is a DIAGNOSTIC TEST REQUEST.

A request for a single radiological procedure on an individual PATIENT or other human source, regardless of the number of views used. This definition includes ultrasound investigations, computer tomography and magnetic resonance imaging.

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

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

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

References:
National Cancer Dataset

Unsealed Source Treatment Course is a CLINICAL INTERVENTION.An Unsealed Source Treatment Course is a CLINICAL INTERVENTION.

A type of Brachytherapy Treatment Course.

A prescribed course of radiotherapy treatment for a PATIENT where an unsealed source of radiation is used.An Unsealed Source Treatment Course is a prescribed course of radiotherapy treatment for a PATIENT where an unsealed source of radiation is used.

Release: March 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1224 (1 April 2011) - ISB 0092 Amd 02/20110 Commissioning Data Set Schema Version 6-1-1
• CR1223 (Immediate) - DDCN 1223/2011 Updates to Family Planning References
• CR1225 (Immediate) - DDCN 1225/2011 Practitioners with Special Interests
• CR1216 (1 April 2011) - ISB 0028 Amd 170/2010 Changes to Treatment Function Codes
• CR1203 (1 April 2011) - ISB 0084 Amd 150/2010 Introduction of OPCS Classification of Interventions and Procedures Version 4.6

Release: January 2011

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1116 (1 April 2010) - ISB 0003 Amd 79/2010 Immunisation Programmes Activity Data Set (KC50)
• CR1112 (1 April 2010) - ISB 1511 Amd 26/2010 NHS Continuing Healthcare and NHS Funded Nursing Care
• CR1068 (Immediate) - ISB 0133 Amd 161/2010 Change To Central Return: Human Papillomavirus (HPV) Immunisation Programme - Vaccine Monitoring Minimum Data Set
• CR1211 (Immediate) - DDCN 1211/2010 Commissioning Data Set Addressing Grid / Organisation Code (Code of Commissioner) Update

Release: December 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1175 (1 April 2011) - ISB 1518 Amd 166/2010 Changes to Sexual and Reproductive Health Activity Data Set
• CR1198 (Immediate) - ISB 1067 Amd 165/2010 National Workforce Data Set
• CR1207 (01 December 2010) - ISB 1573 Amd 168/2010 Mixed-Sex Accommodation
• CR1149 (01 January 2011) - ISB 0139 Amd 99/2010 GUMCAD: Change to Genitourinary (GU) Episode Types

Release: November 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1119 (Immediate) - DDCN 1119/2010 Organisation Codes Update 
• CR1192 (Immediate) - DDCN 1192/2010 Change of name for "Health Solution Wales"
• CR1199 (Immediate) - DDCN 1199/2010 General Pharmaceutical Council and Royal Pharmaceutical Society of Great Britain Update
• CR1189 (Immediate) - DDCN 1189/2010 National Institute for Health and Clinical Excellence
• CR1187 (Immediate) - DDCN 1187/2010 Introduction of the Department for Education

Release: September 2010

Information Standards Notices and Data Dictionary Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1128 (Immediate) - DDCN 1128/2010 Changes to reporting procedures for Overseas Visitors from the European Economic Area and Switzerland
• CR1173 (Immediate) - DDCN 1173/2010 Care Quality Commission Update
• CR1143 (Immediate) - DDCN 1143/2010 General Pharmaceutical Council
• CR1061 (1 October 2010) - ISB 0092/2010 CDS Type 20: Out-patient: Retirement of Default Codes for Out-patient Procedures
• CR1133 (Immediate) - ISB 00289/2010 National Specialty List

Release: August 2010

• The August 2010 Release introduces the NHS Data Model and Dictionary Help Pages.

Release: July 2010

Information Standards Notices and Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1134 (Immediate - ISB 1067/2010 Amd 109/2010 National Workforce Data Set
• CR1082 (Immediate) - ISB 0153/2010 Critical Care Minimum Data Set
• CR1121 (Immediate) - DSCN 17/2010 Retirement of Data Standard KC60 Central Return

Release: May 2010

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR957 (Immediate) - DSCN 19/2010 Central Returns: KA34 Ambulance Services

Release: March 2010

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1123 (1 April 2010) - DSCN 18/2010 Information Standards Notice (ISN)
• CR1139 (Immediate) - DSCN 16/2010 Person Weight
• CR1130 (Immediate) - DSCN 15/2010 Change of name for "The NHS Information Centre for health and social care"
• CR1013 (April 2010) - DSCN 14/2010 Sexual and Reproductive Health Activity Dataset (SRHAD)
• CR1125 (Immediate) - DSCN 13/2010 NHS Data Model and Dictionary Maintenance Update - Policy Definitions
• CR1122 (Immediate) - DSCN 11/2010 Changes to Family Planning References

Release: January 2010

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1115 (Immediate) - DSCN 10/2010 Data Standards: Updating of e-Government Interoperability Framework and Government Data Standards Catalogue References

Release: December 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1100 (Immediate) - DSCN 25/2009 NHS Prescription Services Update
• CR1045 (1 December 2009) - DSCN 17/2009 Referral to Treatment Clock Stop Administrative Event
• CR1003 (1 December 2009) - DSCN 16/2009 Commissioning Data Sets: Mandation of 18 Week Referral To Treatment Data Items

Release: November 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1113 (Immediate) - DSCN 24/2009 Information Standards Board for Health and Social Care Update
• CR1087 (Immediate) - DSCN 23/2009 Health Professions Council Update
• CR1081 (Immediate) - DSCN 22/2009 Data Standards: NHS Data Model and Dictionary Maintenance Update
• CR1019 (27 November 2009) - DSCN 21/2009 Data Standards: Organisation Data Service (ODS) - Optical Sites and Optical Headquarters
• CR1034 (27 November 2009) - DSCN 20/2009 Data Standards: Organisation Data Service (ODS) - Care Homes in England and Wales and their Headquarters

Release: September 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1065 (1 October 2009) - DSCN 15/2009 Data Standards: Organisation Data Service, Local Health Boards

Release: June 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1014 (1 June 2009) - DSCN 13/2009 Religious and Other Belief System Affiliation
• CR1074 (Immediate) - DSCN 12/2009 Data Standards: Care Quality Commission
• CR1056 (Immediate) - DSCN 11/2009 Data Standards: NHS Data Model and Dictionary Maintenance Update
• CR1072 (1 December 2009) - DSCN 10/2009 Data Standards: National Radiotherapy Data Set
• CR1073 (Immediate) - DSCN 09/2009 Central Returns: Diagnostic Waiting Times and Activity Data Set
• CR1066 (Immediate) - DSCN 08/2009 Data Standards: NHS Prescription Services and NHS Dental Services
• CR1047 (1 April 2011) - DSCN 07/2009 Data Standards: Diabetic Retinopathy Screening Dataset v3.6 
• CR1059 (Immediate) - DSCN 06/2009 Data Standard: National Workforce Data Set v2.1
• CR914 (April 2008 (Retrospective)) - DSCN 05/2009 NHS Stop Smoking Services Quarterly Monitoring Return
• CR899 (Immediate) - DSCN 02/2009 NHS Data Model and Dictionary Maintenance Update

Release: March 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1001 (1 April 2009) - DSCN 03/2009 Introduction of Commissioning Data Set Schema Version 6-1 (2008-04-01) and update to Commissioning Data Set Schema Version 6-0 (2008-01-14)
• CR976 (31 March 2009) - DSCN 26/2008 Subject: KP90 - Admissions, Changes in Status and Detentions under the Mental Health Act
• CR1017 (1 April 2009) - DSCN 25/2008 Critical Care Minimum Data Set
• CR1002 (1 April 2009) - DSCN 24/2008 Data Standards: Introduction of Commissioning Dataset Version 6.1
• CR1016 (Immediate) - DSCN 23/2008 4 Byte Version of the Read Codes - Withdrawal

Release: December 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1022 (1 January 2009) - DSCN 29/2008 Data Standards: 18 Weeks Referral to Treatment (RTT) Time, Performance Sharing
• CR901 (Immediate) - DSCN 28/2008 Removal of references to EDIFACT and the NHS Wide Clearing Service (NWCS) 
• CR843 (1 April 2009) - DSCN 22/2008 Data Standards: National Radiotherapy Data Set
• CR1011 (1 January 2009) - DSCN 20/2008 Data Standards: National Cancer Waiting Times Minimum Data Set 

Release: November 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1026 (3 November 2008) - DSCN 21/2008 Information Standard: Mental Health Act 2007 Mental Category

Release: August 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1018 (Immediate) - DSCN 19/2008 Data Standards: Change of Name for National Administrative Code Services (NACS) to Organisation Data Service (ODS)
• CR956 (1 September 2008) - DSCN 18/2008 Central Return: Human Papillomavirus (HPV) Immunisation Programme, Vaccine Monitoring Minimum Dataset
• CR861 (Immediate) - DSCN 16/2008 Central Return:  Hospital and Community Services Complaints and General Practice (including Dental) Complaints - KO41(a) and KO 41(b)
• CR964 (Immediate) - DSCN 14/2008 Central Return: 18 Weeks ‘Adjusted’ Referral to Treatment (RTT) Dataset
• CR965 (Immediate) - DSCN 13/2008 Data Standards: Organisation Data Service (ODS) - Change to the Default Codes Set to Support Changes to GMS Contract
• CR879 (Immediate) - DSCN 12/2008 Data Standards: Quarterly Monitoring: Cancelled Operations Data Set (QMCO)

Release: May 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR502 (Immediate) - DSCN 10/2008 Data Standards: National Workforce Data Definitions (v2.0)
• CR910 (1 April 2008) - DSCN 08/2008 Data Standards: National Direct Access Audiology Patient Tracking List (PTL) and Waiting Times (WT) data sets
• CR900 (Immediate) - DSCN 07/2008 Data Standards: Inter-Provider Transfer Administrative Minimum Data Set
• CR934 (1 April 2008) - DSCN 06/2008 Data Standards: Mental Health Minimum Data Set (version 3.0)
• CR935 (Immediate) - DSCN 05/2008 Data Standards: 18 Weeks Rules Suite
• CR925 (1 September 2008) - DSCN 04/2008 Genitourinary Medicine Clinic Activity Data Set Change to an Information Standard
• CR942 (1 June 2008) - DSCN 03/2008 General Practice and General Medical Practitioner (GMP) - changes resulting from the introduction of the General Medical Services (GMS) Contract

Release: February 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR812 (Immediate) - DSCN 01/2008 Central Return: Diagnostics Waiting Times Census Data Set
• CR881 (31 December 2007) - DSCN 42/2007 Central Return: Referral To Treatment Summary Patient Tracking List
• CR904 (Immediate) - DSCN 41/2007 Data Standards: Admission Intended Procedure Update
• CR824 (1 February 2008) - DSCN 39/2007 Data Standards: 48 Hour Genitourinary Medicine Access Monthly Monitoring (GUMAMM)

Release: November 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR919 (Immediate) - DSCN 38/2007 Data Standards: Mental Health Minimum Data Set Schema
• CR814 (1 April 2008) - DSCN 37/2007 Data Standards: Introduction of Mental Health Minimum Data Set version 2.1
• CR930 (31 December 2007) - DSCN 35/2007 Data Standards: A correction to the version 6 Commissioning Data Set schema
• CR834 (Immediate) - DSCN 34/2007 Data Standards: Referral Request Received Date
• CR875 (Immediate) - DSCN 33/2007 Data Standards: National Administrative Codes Service: Introduction of codes for the new Pan SHAs
• CR880 (Immediate) - DSCN 29/2007 Data Standards: Amendments to Doctor Index Number (DIN) Description

Release: August 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR845 (Immediate) - DSCN 28/2007 Data Standards: Treatment Function Code (Referral to Treatment Period)
• CR831 (1 October 2007) - DSCN 27/2007 Data Standards: Update to Commissioning Data Set XML Schema v5
• CR825 (1 October 2007) - DSCN 16/2007 Data Standards: Source of Referral for Outpatients (18 Weeks)

Release: June 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR799 (31 December 2007) - DSCN 18/2007 Data Standards: Introduction of Commissioning Data Set Version 6
• CR833 (Immediate) - DSCN 17/2007 Data Standards: Introduction of Commissioning Data Set validation table
• CR801 (Immediate) - DSCN 15/2007 Data Standards: Cover of Vaccination Evaluated Rapidly (COVER) Return

Release: May 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR800 (31 December 2007) - DSCN 14/2007 Commissioning Data Set Schema Version 6-0
• CR856 (1 October 2007) - DSCN 13/2007 Data Standards: Discharge Ready Date
• CR869 (Immediate) - DSCN 12/2007 Data Standards: Update to Clinical Coding Introduction
• CR827 (1 October 2007) - DSCN 09/2007 Data Standards: Earliest Reasonable Offer Date
• CR817 (1 October 2007) - DSCN 08/2007 Data Standards: Introduction of Age into Commissioning Data Sets
• CR849 (May 2007) - DSCN 07/2007 National Administrative Codes Service: Introduction of new identification codes for Dental Consultants
• CR822 (Immediate) - DSCN 06/2007 Data Standards: Update to Organisation Codes
• CR850 (Immediate) - DSCN 05/2007 National Administrative Codes Service: Amendments to Default Codes
• CR786 (1 April 2007) - DSCN 04/2007 Quarterly Monitoring Accident and Emergency Services (QMAE) Central Return

Release: February 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR811 (Immediate) - DSCN 03/2007 Diagnostic Waiting Times and Activity
• CR826 (1 October 2007) - DSCN 02/2007 Extension of Treatment Function to Support the Measurement of 18 Week Referral to Treatment Periods
• CR813 (1 April 2007) - DSCN 01/2007 Paediatric Critical Care Minimum Data Set
• CR768 (1 January 2007) - DSCN 18/2006 Changes to the NHS Data Dictionary to support the measurement of 18 week referral to treatment periods
• CR798 (6 November 2006) - DSCN 19/2006 Commissioning Data Set (CDS) Version 5 XML Message Schema
• CR776 (1 October 2006) - DSCN 05/2006 Data Standards: Accident and Emergency Enhancements to Investigation and Treatment Codes

Release: September 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR795 (31 October 2006) - DSCN 22/2006 Organisation Codes / Organisation Site Codes
• CR792 (1 April 2007) - DSCN 15/2006 Neonatal Critical Care
• CR719 (1 April 2006) - DSCN 09/2006 Measuring and Recording of Waiting Times
• CR791 (1 April 2007) - DSCN 13/2006 Priority Type
• CR774 (1 September 2006) - DSCN 12/2006 Person Marital Status

Release: May 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR764 (1 April 2006) - DSCN 08/2006 Diagnostics waiting times and activity
• Correction to menu structure to include Critical Care Minimum Data Set

Release: April 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR608 (1 October 2006) - DSCN 07/2006 Introduction of Commissioning Data Set Version 5 and its associated XML schema into the NHS Data Dictionary.
• CR756 (1 September 2005) - DSCN 19/2005 PbR Commissioning for Out of Area Treatments (OATs) and Charge-Exempt Overseas Visitors
• CR724 (1 April 2006) - DSCN 13/2005 Critical Care Minimum Data Set
• CR754 (1 April 2006) - DSCN 17/2005 Treatment Function and Main Specialty Code Revisions
• CR763 (1 April 2006) - DSCN 20/2005 New Treatment Functions for therapy services and anticoagulant service
• CR767 (Immediate) - DSCN 02/2006 Referral Request Received Date
• CR690 (1 September 2005) - DSCN 16/2005 Marital Status

Release: August 2005

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR555 (1 April 2005) - DSCN 11/2005 Data Standards: COVER - Hepatitis B immunisation for babies
• CR715 (Immediate) - DSCN 10/2005 Data Standards: Treatment Function Codes - correction and clarification of names and descriptions
• CR706 (1 April 2005) - DSCN 09/2005 Data Standards: Cancer Registration Data Set
• CR691 (1 July 2005) - DSCN 06/2005 Data Standards: NSCAG Commissioner Code

For all Information Standards Notices and Data Set Change Notices, see the Information Standards Board for Health and Social Care Website

Additional information about a PERSON PROPERTY. It may be intrinsic to the PERSON PROPERTY, e.g. laterality; an association to another PERSON PROPERTY, e.g. that one PERSON PROPERTY is the basis for establishing another or an association with a CARE ACTIVITY, e.g. that a particular PERSON PROPERTY is the outcome of performing a CARE ACTIVITY.

• laterality
• an association to another PERSON PROPERTY, e.g. that one PERSON PROPERTY is the basis for establishing another or
• an association with a CARE ACTIVITY, e.g. that a PERSON PROPERTY is the outcome of performing a CARE ACTIVITY.

A SERVICE REPORT where the report relates to the treatment of a PATIENT or the response to request for specialist services for a PATIENT by a Health Care Provider. A SERVICE REPORT may be a Pathology Laboratory Service Report Header or a Radiology Service Report Header.

A copy of a SERVICE REPORT may be sent to a party other than the provider or the requester of the SERVICE or the PLANNED ACTIVITY.

SERVICE REPORTS include:

• Pathology Laboratory Service Report
• Radiology Service Report

A classification of how a PATIENT DIAGNOSIS relating to cancer was identified.

National Codes:

References:
National Cancer Dataset Version 1.3_ISB October 2002

The coded type of PATIENT intended to use, or using, a facility.

National Codes:

The date on which the decision was made to refer a PATIENT with suspected cancer to an appropriate cancer specialist. An appropriate specialist is the PERSON or PERSONS who are most able to progress the diagnosis of the primary tumour. This date will be one of the following:

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

The level of resources and intensity of care which it is intended to provide or is provided in a particular WARD.

National Codes:

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

National Codes:

National Code 11 'PATIENT died (non heart beating solid organ donor)' should not be reported nationally until the functionality to do so becomes available in the next release of the Commissioning Data Sets (Version 6-2) and the associated CDS-XML Schema Release. Prior to this release, this code may be recorded locally, however this National Code 11 cannot be transmitted in the current versions of the Commissioning Data Sets (6-0 and 6-1).

This is used to record the type of Isotope Procedure Department, based on the MAIN SPECIALTY CODE of the head of the DEPARTMENT, or the type of Physiological Measurement Department.The type of Isotope Procedure Department, based on the MAIN SPECIALTY CODE of the head of the DEPARTMENT, or the type of Physiological Measurement Department.

National Codes:

One of the business definitions listed in the DIAGNOSTIC TEST REQUEST class as a type of this class.

National Codes:

The ethnicity of a PERSON, as specified by the PERSON.The ethnicity of a PERSON, as specified by the PERSON.

Note: ETHNIC CATEGORY is the classification used for the 2001 census, replacing ETHNIC GROUP in the Commissioning Data Set Flows.

The Office for National Statistics has developed a further breakdown of the group from that given, which may be used locally.

National Codes:

National code Z - Not Stated should be used where the PERSON has been given the opportunity to state their ETHNIC CATEGORY but chose not to.

 This indicates whether this is the PATIENT's first ever contact with a SERVICE.An indication of whether this is the PATIENT's first ever contact with a SERVICE.

 National Codes:National Codes:

Notes:
ADMINISTRATIVE CATEGORY is the same as ADMINISTRATIVE CATEGORY CODE.

A PATIENT who is an Overseas Visitor does not qualify for free NHS healthcare and can choose to pay for NHS treatment or for private treatment. If they pay for NHS treatment then they should be recorded as NHS PATIENTS.

The PATIENT's ADMINISTRATIVE CATEGORY may change during an episode or spell. For example, the PATIENT may opt to change from NHS to private health care. In this case, the start and end dates for each new ADMINISTRATIVE CATEGORY PERIOD (episode or spell) should be recorded.

If the ADMINISTRATIVE CATEGORY changes during a Hospital Provider Spell the ADMINISTRATIVE CATEGORY (ON ADMISSION) is used to derive the 'Category of PATIENT' for Hospital Episode Statistics (HES).

ADMINISTRATIVE CATEGORY will be replaced with ADMINISTRATIVE CATEGORY CODE, which should be used for all new and developing data sets and for XML messages.

Hospital Provider Spell is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 21 'Hospital Provider Spell'.

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

Notes:
ADMINISTRATIVE CATEGORY CODE is the same as ADMINISTRATIVE CATEGORY CODE.

A PATIENT who is an Overseas Visitor does not qualify for free NHS healthcare can choose to pay for NHS treatment or for private treatment. If they pay for NHS treatment then they should be recorded as NHS PATIENTS.

The PATIENT's ADMINISTRATIVE CATEGORY CODE may change during an episode or spell. For example, the PATIENT may opt to change from NHS to private health care. In this case, the start and end dates for each new ADMINISTRATIVE CATEGORY PERIOD (episode or spell) should be recorded.

If the ADMINISTRATIVE CATEGORY CODE changes during a Hospital Provider Spell the ADMINISTRATIVE CATEGORY (ON ADMISSION) is used to derive the 'Category of PATIENT' for Hospital Episode Statistics (HES).

ADMINISTRATIVE CATEGORY CODE replaces ADMINISTRATIVE CATEGORY and should be used for all new and developing data sets and for XML messages.

Hospital Provider Spell is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 21 'Hospital Provider Spell'.

From 01 January 2009, this data element is no longer used in the National Cancer Waiting Times Monitoring Data Set.  It may still be used in other data sets or collected locally if required.

Notes:
CANCER SPECIALIST REFERRAL DATE may be the same date as CANCER REFERRAL DECISION DATE if the initial referral was direct to an appropriate specialist for the cancer.

From 01 January 2009, this data element is no longer used in the National Cancer Waiting Times Monitoring Data Set.  It may still be used in other data sets or collected locally if required.

Notes:
CARE PLAN AGREED DATE is the same as attribute CARE PLAN AGREED DATE.

Notes:
CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) is the same as Care Programme Approach Review.

CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) is an optional data element in the Mental Health Minimum Data Set collection record and should only be present if one or more Care Programme Approach Review within the Adult Mental Health Care Spell has occurred during the REPORTING PERIOD.

It is the total number of such reviews within the Adult Mental Health Care Spell which have occurred within the REPORTING PERIOD. Each such review is recorded by a Care Programme Approach Review and there may be more than one recorded during the course of a REPORTING PERIOD.

There is a Care Programme Approach Review Date for each Care Programme Approach Review and the calculation is based upon those reviews which have occurred during the REPORTING PERIOD.

Adult Mental Health Care Spell is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 23 'Adult Mental Health Care Spell'.

Care Programme Approach Review is a CARE CONTACT where the CARE CONTACT TYPE is National Code 05 'Care Programme Approach Review'.

Notes:
CARE SPELL IDENTIFIER (MENTAL HEALTH) is the same as attribute ACTIVITY IDENTIFIER.

The unique identifier of an Adult Mental Health Care Spell recorded when an Adult Mental Health Care Spell is initiated by a referral, or the temporary or permanent transfer of main responsibility for provision of mental health care for the PATIENT from another Health Care Provider.

This is the CARE SPELL IDENTIFIER of an Adult Mental Health Care Spell.

For purposes of the Mental Health Minimum Data Set collection, a Mental Health Minimum Data Set record will be assembled for each Adult Mental Health Care Spell of an adult (including elderly) PATIENT who has received a continuous period of care or assessment from a Health Care Provider's specialist mental health services within the REPORTING PERIOD. Each MHMDS record will be separately identified, see CARE SPELL NUMBER IN REPORTING PERIOD for further details.

CARE SPELL IDENTIFIER (MENTAL HEALTH) is an optional data item note in the Mental Health Minimum Data Set record and should only be recorded where the Health Care Provider can initiate and maintain Adult Mental Health Care Spell.

CARE SPELL IDENTIFIER (MENTAL HEALTH) is the same as attribute ACTIVITY IDENTIFIER.

Adult Mental Health Care Spell is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 23 'Adult Mental Health Care Spell'.

Notes:
For purposes of the Mental Health Minimum Data Set collection, a Mental Health Minimum Data Set record will be assembled for each Adult Mental Health Care Spell of an adult (including elderly) PATIENT who has received a continuous period of care or assessment from a Health Care Provider's specialist mental health services within the REPORTING PERIOD.

CARE SPELL NUMBER IN REPORTING PERIOD is the sequence number for the assembled Adult Mental Health Care Spell MHMDS record among the set of assembled Adult Mental Health Care Spell MHMDS records for the same PATIENT within the REPORTING PERIOD. The CARE SPELL NUMBER IN REPORTING PERIOD for the first assembled record based on earliest Adult Mental Health Care Spell in the REPORTING PERIOD will be recorded as 01 with it being incremented by 1 for each subsequent assembled record. For example if there are 3 assembled Adult Mental Health Care Spell for the PATIENT within the REPORTING PERIOD then the first would be recorded as 01, the second as 02 and the third as 03.

Use of CARE SPELL NUMBER IN REPORTING PERIOD is an interim measure as not all Health Care Providers can initiate and maintain Adult Mental Health Care Spells and thus create and record unique CARE SPELL IDENTIFIERS.

Adult Mental Health Care Spell is an ACTIVITY GROUP where the ACTIVITY GROUP TYPE is National Code 23 'Adult Mental Health Care Spell'.

Attribute:

END DATE (BRACHYTHERAPY TREATMENT COURSE) is the same as attribute ACTIVITY DATE of ACTIVITY DATE TIME where ACTIVITY DATE TIME TYPE is National Code 'End Date'.END DATE (BRACHYTHERAPY TREATMENT COURSE) is the same as attribute ACTIVITY DATE, where ACTIVITY DATE TIME TYPE is National Code 'End Date'.

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

Notes:
The outcome of the Clinical Investigation which measures the PERSON's haemoglobin concentration in 'g/dl (grammes per decilitre).HAEMOGLOBIN CONCENTRATION is the outcome of the Clinical Investigation which measures the PERSON's haemoglobin concentration in 'g/dl (grammes per decilitre).'

INTENDED CLINICAL CARE INTENSITY is the same as attribute CLINICAL CARE INTENSITY, and the values recorded within the Commissioning Data Set messages are the National Codes contained within the definition of CLINICAL CARE INTENSITY, including additions:

INTENDED CLINICAL CARE INTENSITY will be replaced with INTENDED CLINICAL CARE INTENSITY CODE, which should be used for all new and developing data sets and for XML messages.

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

Notes:
Data Set Change Notice 07/2000 implemented a change to replace the composite data items WARD TYPE AT PSYCHIATRIC CENSUS DATE and WARD TYPE AT START OF EPISODE within Commissioning Data Set by their constituent components. For Commissioning Data Set message purposes therefore the constituent component INTENDED CLINICAL CARE INTENSITY CODE is required to be separately recorded.

INTENDED CLINICAL CARE INTENSITY CODE is the same as attribute CLINICAL CARE INTENSITY and the values recorded are the National Codes contained within the definition of CLINICAL CARE INTENSITY, including additions:

INTENDED CLINICAL CARE INTENSITY CODE replaces INTENDED CLINICAL CARE INTENSITY and should be used for all new and developing data sets and for XML messages.

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

Notes:
INTENDED CLINICAL CARE INTENSITY CODE (MENTAL HEALTH) is the same as attribute CLINICAL CARE INTENSITY, but the only permitted values from the list of National Codes are:

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

Notes:
LEARNING DISABILITY INDICATOR is the same as LEARNING DISABILITY INDICATOR.LEARNING DISABILITY INDICATOR is the same as attribute LEARNING DISABILITY INDICATOR.

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.

LOCATION TYPE will be replaced with ACTIVITY LOCATION TYPE CODE, which should be used for all new and developing data sets and for XML messages.

The codes used for this Data Element are under review.

Permitted National Codes for use in the Commissioning Data Sets:

Use in the Future Outpatient CDS:
If the LOCATION TYPE where treatment is intended to take place is not yet known, this Data Element should be omitted.If the type of LOCATION where treatment is intended to take place is not yet known, this Data Element should be omitted.

Notes:
This is the ORGANISATION CODE of the ORGANISATION commissioning health care.ORGANISATION CODE (CODE OF COMMISSIONER) 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.

Note: There is no obligation for a PERSON to state their place of residence (particularly where an issue of security arises).
Enquiries relating to this document should be directed to the Department of Health, see the Department of Health website for contact details.

The following sections, provide 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 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
• 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.

This value is derived from Weight in kilograms divided by Height in metres squared (kg/m²).

PERSON OBSERVATION (BMI) will be replaced with body PERSON OBSERVATION (BMI), which should be used for all new and developing data sets and for XML messages.PERSON OBSERVATION (BMI) will be replaced with BODY MASS INDEX, which should be used for all new and developing data sets and for XML messages.

Notes:
PERSON OBSERVATION (SERUM CHOLESTEROL LEVEL) is the recorded cholesterol level (Serum Cholesterol Level in mmol/L) of a PATIENT.

This corresponds to MEASURED OBSERVATION VALUE where the MEASURED PERSON OBSERVATION TYPE CODE is 'Serum Cholesterol Level' and the MEASUREMENT VALUE TYPE CODE is 'mmol/L'.

This corresponds to MEASURED OBSERVATION VALUE where the MEASURED PERSON OBSERVATION TYPE CODE is 'Serum Cholesterol Level' and the MEASUREMENT VALUE TYPE CODE is 'mmol/L'.PERSON OBSERVATION (SERUM CHOLESTEROL LEVEL) will be replaced with SERUM CHOLESTEROL which should be used for all new and developing data sets and for XML messages.

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

Notes:
The result of the Clinical Investigation of the count of platelets in a PATIENT's blood sample in 'x10⁹/l (i.e. times ten to the power 9 per litre).PLATELETS COUNT is the result of the Clinical Investigation of the count of platelets in a PATIENT's blood sample in 'x10⁹/l (i.e. times ten to the power 9 per litre).'

Notes:
This is the same as attribute REPORTING PERIOD END DATE.

This is the end date of the REPORTING PERIOD and is used in conjunction with REPORTING PERIOD START DATE to specify the actual period the reported information relates to.REPORTING PERIOD END DATE is the end date of the REPORTING PERIOD and is used in conjunction with REPORTING PERIOD START DATE to specify the actual period the reported information relates to.

The date should not be before the REPORTING PERIOD START DATE although it can be the same if the period being reported only covers 1 day.

Notes:
This is the same as attribute REPORTING PERIOD START DATE.

This is the start date of the REPORTING PERIOD and is used in conjunction with REPORTING PERIOD END DATE to specify the actual period the reported information relates to.REPORTING PERIOD START DATE is the start date of the REPORTING PERIOD and is used in conjunction with REPORTING PERIOD END DATE to specify the actual period the reported information relates to.

The date should not be after the REPORTING PERIOD END DATE although it can be the same if the period being reported only covers 1 day.

Notes:
Derive from CLINICAL INVESTIGATION RESULT ITEM/NUMERICAL VALUE.

A fasting sample ideally taken within 24 hours of admission

Central Cardiac Audit Database (CCAD) item name:
Serum cholesterol

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

Notes:
SERVICE REQUEST DATE is the same as attribute SERVICE REQUEST DATE.

The date on which the referral was made, as recorded on the REFERRAL REQUEST.

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

Notes:
SERVICE REQUEST IDENTIFIER is the same as attribute SERVICE REQUEST IDENTIFIER.

Notes:
SEX is the same as the attribute PERSON GENDER CODE.

The e-Government Interoperability Framework (e-GIF) standard PERSON GENDER CURRENT should be used for all new and developing systems and for XML messages.The e-Government Interoperability Framework (e-GIF) standard PERSON GENDER CODE CURRENT should be used for all new and developing systems and for XML messages.

Notes:
START DATE (EPISODE) is the same as the attribute ACTIVITY DATE where the ACTIVITY DATE TIME TYPE is National Code 'Start Date' of the episode.

Record the start and end dates of the episode to derive the period that the PATIENT was under the care of a particular CONSULTANT, MIDWIFE or NURSE during the Hospital Provider Spell.

Notes:
START DATE (HOSPITAL PROVIDER SPELL) is the same as the attribute ACTIVITY DATE where the ACTIVITY DATE TIME TYPE is National Code 'Start Date' of the Hospital Provider Spell.

The Start Date of the Hospital Provider Spell is the date of admission: the CONSULTANT or MIDWIFE has assumed responsibility for care following the DECISION TO ADMIT the PATIENT.

See Mental Health Act Table for details of how this data item relates to Parts and Sections of the Act.

Permitted National Codes:

STATUS OF PATIENT INCLUDED IN THE PSYCHIATRIC CENSUS will be replaced with STATUS OF PATIENT INCLUDED IN THE PSYCHIATRIC CENSUS CODE, which should be used for all new and developing data sets and for XML messages.

Hospital Provider Spell is an ACTIVITY GROUP where ACTIVITY GROUP TYPE is National Code 21 'Hospital Provider Spell'.

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

Notes:
The information about the current detained status is derived from MENTAL HEALTH ACT LEGAL STATUS CLASSIFICATION CODE (AT CENSUS DATE) and the length of stay in hospital derived from details held about the current Hospital Provider Spell

See Mental Health Act Table for details of how this data item relates to Parts and Sections of the Act.

Permitted National Codes:

STATUS OF PATIENT INCLUDED IN THE PSYCHIATRIC CENSUS CODE replaces STATUS OF PATIENT INCLUDED IN THE PSYCHIATRIC CENSUS, and should be used for all new and developing data sets and for XML messages.

Hospital Provider Spell is an ACTIVITY GROUP where ACTIVITY GROUP TYPE is National Code 21 'Hospital Provider Spell'.

Notes:
STATUS OF PERSON CONDUCTING DELIVERY is the same as the attribute STATUS OF PERSON CONDUCTING DELIVERY.

STATUS OF PERSON CONDUCTING DELIVERY will be replaced with STATUS OF PERSON CONDUCTING DELIVERY CODE, which should be used for all new and developing data sets and for XML messages.

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

Notes:
The outcome of the Clinical Investigation which measures the PERSON's white cell blood count in 'x10⁹/l (i.e. times ten to the power 9 per litre).WHITE BLOOD CELL COUNT is the outcome of the Clinical Investigation which measures the PERSON's white cell blood count in 'x10⁹/l (i.e. times ten to the power 9 per litre).'