Critical Care Minimum Data Set Overview

Critical Care Minimum Data Set excludes neonatal critical care. A subset of this minimum data set is used to derive Adult Critical Care HRGs. The subset is sent in the following Commissioning Data Set messages:

• CDS V6 Type 120 - Admitted Patient Care - Finished Birth Episode CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 140 - Admitted Patient Care - Finished Delivery Episode CDS
• CDS V6 Type 180 - Admitted Patient Care - Unfinished Birth Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 200 - Admitted Patient Care - Unfinished Delivery Episode CDS
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set/CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set/CDS V6-2 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set/CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set/CDS V6-2 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set

Neonatal Critical Care Minimum Data Set Overview

The Neonatal Critical Care Minimum Data Set is sent as a subset in the following Commissioning Data Set messages:

• CDS V6 Type 120 - Admitted Patient Care - Finished Birth Episode CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 180 - Admitted Patient Care - Unfinished Birth Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set/CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set/CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set

Paediatric Critical Care Minimum Data Set Overview

The Paediatric Critical Care Minimum Data Set is sent as a subset in the following Commissioning Data Set messages:

• CDS V6 Type 120 - Admitted Patient Care - Finished Birth Episode CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 140 - Admitted Patient Care - Finished Delivery Episode CDS
• CDS V6 Type 180 - Admitted Patient Care - Unfinished Birth Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 200 - Admitted Patient Care - Unfinished Delivery Episode CDS
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set/CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set/CDS V6-2 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set/CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set/CDS V6-2 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set

The Commissioning Data Set is the basic structure used for the submission of commissioning data to the Secondary Uses Service and is designed to be capable of individually conveying many different Commissioning Data Set structures, encompassing Accident and Emergency Attendances, Out-Patient Attendances, Admitted Patient Care and Elective Admission List.

Commissioning Data Set Messages have been defined in specific components known as a CDS TYPE.

Specific notation is used to indicate the requirements of the CDS-XML Message Schema Design conditions for submission of data in the Commissioning Data Sets.

The structure of the Commissioning Data Set message is shown by the use of Data Groups and Sub Groups within those Data Groups.  For each Data Group, Sub Group and individual Data Element, the allowed cardinality at each level is also shown in the "Status" and "Repeats" columns.

The CDS TYPE specifications must therefore be read in this hierarchy, using the Status and Repeat conditions within the Data Groups and Sub Groups, to determine the requirements for the individual Data Elements.

Status Column Notation

The Notation used for the "STATUS" column is as follows:

Repeats Column Notation

The Notation used for the "REPEATS" column is as follows:

Rules Column Notation

An entry in the "Rules" column shows that a specific Rule applies to submission of an individual Data Element.

The meaning of these Rules can be found in Commissioning Data Set Business Rules.

Notation Examples

The following are examples of some common scenarios.

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

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

Two Update Mechanisms are available:

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

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

Net Change:
Net Change processes are managed by specific data settings as defined in the CDS V6-1 Type 005N - Commissioning Data Set Transaction Header Group - Net Change Protocol / CDS V6-2 Type 005N - Commissioning Data Set Transaction Header Group - Net Change Protocol 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 Organisation 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. 

From Commissioning Data Set version 6-2 onwards, the process for submitting Net Change records carrying a CDS UPDATE TYPE 1 (to indicate a CDS deletion or cancellation) changes.  In previous CDS versions, it was necessary to send the original mandatory content of the deleted record in the CDS TYPE attached to the CDS V6-1 Type 005N - Commissioning Data Set Transaction Header Group - Net Change Protocol.  From Commissioning Data Set version 6-2, an empty XML element called 'Delete Transaction' can be used instead of the original CDS TYPE, after the CDS V6-2 Type 005N - CDS Transaction Header Group - Net Change Protocol.  Note that CDS UPDATE TYPE code 1 should still be used to indicate a delete/cancellation when this mechanism is used.

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 V6-1 Type 005B - Commissioning Data Set Transaction Header Group - Bulk Update Protocol / CDS V6-2 Type 005B - Commissioning Data Set Transaction Header Group - Bulk Update Protocol 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-XML schema version 6-1-1) / CDS BULK REPLACEMENT GROUP CODE (CDS_XML schema version 6-2)
• CDS BULK REPLACEMENT GROUP (CDS-XML schema version 6-1-1) / CDS BULK REPLACEMENT GROUP CODE (CDS-XML schema version 6-2)
• 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 ORGANISATION.

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) (CDS-XML schema version 6-1-1) or ORGANISATION CODE (RESIDENCE RESPONSIBILITY) (CDS-XML schema version 6-2) 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) or ORGANISATION CODE (RESIDENCE RESPONSIBILITY) 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 Health Care Provider sub-contracts healthcare provision and its associated Commissioning Data Set submission to a second ORGANISATION (eg a different Health Care Provider or a Shared Services Organisation), arrangements to submit the Commissioning Data Set data must be made locally to ensure that only one ORGANISATION sends the Commissioning Data Set data to the Secondary Uses Service.

If the second ORGANISATION wishes to add other Commissioning data to the Secondary Uses Service database to that already submitted by the first ORGANISATION, 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 ORGANISATION CODE (CODE OF PROVIDER) in order to change the CDS INTERCHANGE SENDER IDENTITY should this become necessary.

The primary purpose of national data sets is to enable conformant health information to be generated across the country, independent of the ORGANISATION or system that maintains it. In achieving this, the Health and Social Care Information Centre will enable healthcare professionals to measure and compare the delivery and quality of care provided and to support them in sharing information with other health professionals and ORGANISATIONS.

Information Requirements

• monitor and manage NHS SERVICE AGREEMENTS;
• develop commissioning plans;
• support the Payment by Results processes;
• support NHS Comparators;
• monitor Health Improvement Programmes;
• underpin clinical governance;
• understand the health needs of the population.
• support reporting against 18 week wait targets

Information on care provided for all PATIENTS by NHS Hospitals and Primary Care Trusts and Independent Sector Providers (for NHS PATIENTS only) is specified in the Commissioning Data Sets and must be submitted to the Secondary Uses Service according to issued guidelines.

Independent Sector Treatment Centres (TC) are responsible for providing Admitted Patient Care and Out-Patient Attendance Commissioning Data Sets and may submit this data 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 requires accurate data of all PATIENTS admitted to or treated as out-patients, or treated as an Accident and Emergency Attendance by NHS Hospital Providers and Primary Care Trusts, including PATIENTS receiving private treatment. The data also includes NHS PATIENTS treated electively in the independent sector and overseas. These Hospital Episode Statistics (HES) are derived from the Admitted Patient Care, Out-Patient Attendance and Accident and Emergency Attendance Commissioning Data Sets as stored in the Secondary Uses Service. This data provides information about hospital and PATIENT management, epidemiological data on PATIENT DIAGNOSES and OPERATIVE PROCEDURES.

Referral To Treatment Clock Stop Administrative Events may also flow using the CDS V6 Type 020 - Outpatient CDS.Referral To Treatment Clock Stop Administrative Events may also flow using the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set. This allows the Secondary Uses Service to build accurate PATIENT PATHWAYS for the reporting of 18 weeks activity.

Commissioning Data Set Data Flow Definitions

CDS TYPES

The Commissioning Data Set is the basic structure used for the submission of commissioning data to the Secondary Uses Service and is designed to be capable of individually conveying many different Commissioning Data Set structures encompassing Accident and Emergency Attendances, Out-Patient Attendances, Future Attendances, Admitted Patient Care and Elective Admission List data etc.

Commissioning Data Set Messages have been defined in specific components known as a CDS TYPE. Each Commissioning Data Set Type as configured into the Commissioning Data Set Message carries only one specific Commissioning Data Set Type, an examples being the Finished Consultant Episode Commissioning Data Set Type etc.

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

• PATIENT PATHWAY IDENTIFIER
• REFERRAL TO TREATMENT PERIOD START DATE
• REFERRAL TO TREATMENT PERIOD END DATE
• REFERRAL TO TREATMENT STATUS (replaced with REFERRAL TO TREATMENT PERIOD STATUS at CDS V6-2)

Strategic reporting of 18 weeks will be undertaken by the Secondary Uses Service using data obtained via the Commissioning Data Sets . The new data items defined in Data Set Change Notice 18/2006 are enabled to flow in Commissioning Data Set versions 6-1 and 6-2, and will continue to flow in subsequent versions.

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

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

• 30 Start of First Definitive Treatment
• 31 Start of Active Monitoring initiated by the PATIENT
• 32 Start of Active Monitoring initiated by the CARE PROFESSIONAL
• 34 Decision not to treat - decision not to treat made or no further contact required
• 35 PATIENT declined offered treatment
• 36 PATIENT died before treatment

When to Use Referral To Treatment Clock Stop Administrative Events

These events may happen because:

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

Secondary Uses Service Processing

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

• CDS V6-1 Type 020 - Outpatient CDS / CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode CDS / CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode CDS / CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set

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

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

• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) CDS / CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) CDS / CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) CDS / CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) CDS / CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

The dates when ORGANISATIONS submitting REFERRAL TO TREATMENT PERIOD data to the Secondary Uses Service can cease having to also send a Referral To Treatment Clock Stop Administrative Event when a clock stop is carried in one of the Elective Admission List Commissioning Data Set Types, will be notified as part of the Secondary Uses Service release documentation. It is also anticipated that CDS V6-2 Type 021 - Future Outpatient CDS will be processed once piloting is complete and its use is approved by the Information Standards Board for Health and Social Care. A cancelled future APPOINTMENT record could carry a REFERRAL TO TREATMENT PERIOD Clock Stop. Again the timescales will be notified as part of the Secondary Uses Service release documentation.

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

• CDS V6-1 Type 010 - Accident and Emergency CDS / CDS V6-2 Type 010 - Accident and Emergency Commissioning Data Set
• CDS V6-1 Type 040 - Elective Admission List - End Of Period Census (Old) CDS / CDS V6-2 Type 040 - Elective Admission List - End Of Period Census (Old) Commissioning Data Set
• CDS V6-1 Type 050 - Elective Admission List - End Of Period Census (New) CDS / CDS V6-2 Type 050 - Elective Admission List - End Of Period Census (New) Commissioning Data Set
• CDS V6-1 Type 090 - Elective Admission List - Event During Period (Available / Unavailable) CDS / CDS V6-2 Type 090 - Elective Admission List - Event During Period (Available or Unavailable) Commissioning Data Set
• CDS V6-1 Type 100 - Elective Admission List - Event During Period (Old Service Agreement) CDS / CDS V6-2 Type 100 - Elective Admission List - Event During Period (Old Service Agreement) Commissioning Data Set
• CDS V6-1 Type 110 - Elective Admission List - Event During Period (New Service Agreement) CDS / CDS V6-2 Type 110 - Elective Admission List - Event During Period (New Service Agreement) Commissioning Data Set
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode CDS / CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 140 - Admitted Patient Care - Finished Delivery Episode CDS / CDS V6-2 Type 140 - Admitted Patient Care - Finished Delivery Episode Commissioning Data Set
• CDS V6-1 Type 150 - Admitted Patient Care - Other Birth Event CDS / CDS V6-2 Type 150 - Admitted Patient Care - Other Birth Event Commissioning Data Set
• CDS V6-1 Type 160 - Admitted Patient Care - Other Delivery Event CDS / CDS V6-2 Type 160 - Admitted Patient Care - Other Delivery Event Commissioning Data Set
• CDS V6-1 Type 170 - Admitted Patient Care - Detained and/or Long Term Psychiatric Census CDS / CDS V6-2 Type 170 - Admitted Patient Care - Detained and or Long Term Psychiatric Census Commissioning Data Set
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode CDS / CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set
• CDS V6-1 Type 200 - Admitted Patient Care - Unfinished Delivery Episode CDS / CDS V6-2 Type 200 - Admitted Patient Care - Unfinished Delivery Episode Commissioning Data Set

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

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

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

For example, if an Out-Patient Appointment took place where First Definitive Treatment was started, but the REFERRAL TO TREATMENT PERIOD END DATE was not sent in the corresponding CDS V6-2 Type 020 - Outpatient Commissioning Data Set record as it was not entered on the Patient Administration System until later; then the CDS V6-2 Type 020 - Outpatient Commissioning Data Set record should be resubmitted with the correct data.For example, if an Out-Patient Appointment took place where First Definitive Treatment was started, but the REFERRAL TO TREATMENT PERIOD END DATE was not sent in the corresponding CDS V6-1 Type 020 - Outpatient Commissioning Data Set/ CDS V6-2 Type 020 - Outpatient Commissioning Data Set record as it was not entered on the Patient Administration System until later; then the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set record should be resubmitted with the correct data. A Referral To Treatment Clock Stop Administrative Event should NOT be used.

Where an ORGANISATION's Patient Administration System supports the submission of cancelled and Did Not Attend appointments in the CDS V6-2 Type 020 - Outpatient Commissioning Data Set, the Referral To Treatment Clock Stop Administrative Event should NOT be used when a PATIENT has a booked Out-Patient Appointment, which is then cancelled because, for example, the PATIENT dies. In these cases the CDS V6-2 Type 020 - Outpatient Commissioning Data Set can carry the details of a cancelled CARE ACTIVITY, including the REFERRAL TO TREATMENT PERIOD END DATE and update to the REFERRAL TO TREATMENT PERIOD STATUS.Where an ORGANISATION's Patient Administration System supports the submission of cancelled and Did Not Attend appointments in the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set, the Referral To Treatment Clock Stop Administrative Event should NOT be used when a PATIENT has a booked Out-Patient Appointment, which is then cancelled because, for example, the PATIENT dies. In these cases the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set can carry the details of a cancelled CARE ACTIVITY, including the REFERRAL TO TREATMENT PERIOD END DATE and update to the REFERRAL TO TREATMENT PERIOD STATUS. (Note - not all Patient Administration Systems provide functionality to create and submit Commissioning Data Set records for cancellations/Did Not Attend's as this is not yet mandated - you should contact your Patient Administration System support team to ascertain whether your Patient Administration System supports this. If not, then it is permissible to send a Referral To Treatment Clock Stop Administrative Event in order to stop the clock in the Secondary Uses Service instead).

Referral To Treatment Clock Stop Administrative Events only require a sub-set of the data elements contained in the CDS V6-1 Type 020 - Outpatient Commissioning Data Set / CDS V6-2 Type 020 - Outpatient Commissioning Data Set record, to be submitted to the Secondary Uses Service. All other data elements not listed should be omitted from the XML submission of the CDS V6 Type 020 - Outpatient CDS record to the Secondary Uses Service. All other data elements not listed should be omitted from the XML submission of the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set record to the Secondary Uses Service. The submission of a Referral To Treatment Clock Stop Administrative Event is not reliant on the use of the Net Change Commissioning Data Set Submission Protocol to the Secondary Uses Service

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

This indicates whether a PATIENT is making a first attendance or contact; or a follow-up attendance or contact.

National Codes:

*Referral to Treatment Clock Stop Administrative Event allows the Secondary Uses Service to build accurate PATIENT PATHWAYS for the reporting of 18 weeks activity. It flows through the CDS V6 Type 020 - Outpatient CDS structure. It flows through the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set structure. See Referral To Treatment Clock Stop Administrative Event.

Usage in the CDS:
The Outpatient and Future Outpatient CDS Types use the APPOINTMENT DATE as the "CDS ORIGINATING DATE" as a mandatory requirement of the CDS Exchange Protocol, see CDS ACTIVITY DATE.

For the Future Outpatient CDS where no APPOINTMENT DATE is available from the healthcare system, a default date value of 2999-12-31 may be applied.

Care must be taken to generate the correct CDS Exchange Protocol when using this default value.

When submitting a Referral To Treatment Clock Stop Administrative Event via the CDS V6 Type 020 - Outpatient CDS, APPOINTMENT DATE is equivalent to the REFERRAL TO TREATMENT PERIOD END DATE carried in the record.When submitting a Referral To Treatment Clock Stop Administrative Event via the CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set, APPOINTMENT DATE is equivalent to the REFERRAL TO TREATMENT PERIOD END DATE carried in the record.

When exchanging Commissioning Data Set data, this is an optional data element and when used is a unique number generated by the sender and inserted into the Commissioning Data Set data to enable senders and recipients to be able to cross-match and uniquely identify each and every Commissioning Data Set record.

The CDS RECORD IDENTIFIER consists of the following components:

* This data item is configured as an14 format element, but a maximum value of 9999999 is permitted in the format of n7.

Usage:

CDS-XML Interchanges:

The CDS V6 Type 170 - Admitted Patient Care - Detained and/or Long Term Psychiatric Census CDS must be submitted annually to the Secondary Uses Service using a date of 31 March for the year of the census.The CDS V6-1 Type 170 - Admitted Patient Care - Detained and/or Long Term Psychiatric Census Commissioning Data Set/CDS V6-2 Type 170 - Admitted Patient Care - Detained and or Long Term Psychiatric Census Commissioning Data Set must be submitted annually to the Secondary Uses Service using a date of 31 March for the year of the census.

See the CDS Mandated Data Flows for further information.

By local agreement, other submissions may be made and where this is undertaken, the date chosen must also be compatible with the CDS Submission Protocol used.

A FIRST ATTENDANCE is the first in a series, or only attendance of an APPOINTMENT which took place regardless of how many previous APPOINTMENTS were made which did not take place for whatever reason. All subsequent attendances in the series which take place should be recorded as follow-up.

FIRST ATTENDANCE National Code 5 - "Referral to Treatment Clock Stop Administrative Event" allows the Secondary Uses Service to build accurate PATIENT PATHWAYS for the reporting of 18 weeks activity. It flows through the CDS V6 Type 020 - Outpatient CDS structure. It flows through the CDS V6-1 Type 021 - Future Outpatient CDS structure. See Referral To Treatment Clock Stop Administrative Event.

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

FIRST ATTENDANCE CODE indicates whether a PATIENT is making a FIRST ATTENDANCE or follow-up attendance or contact and whether the CONSULTATION MEDIUM USED national code was 'Face to face communication', 'Telephone' or 'Telemedicine web camera'.

A FIRST ATTENDANCE is the first in a series, or only attendance of an APPOINTMENT which took place regardless of how many previous APPOINTMENTS were made which did not take place for whatever reason. All subsequent attendances in the series which take place should be recorded as follow-up.

FIRST ATTENDANCE National Code 5 - "Referral to Treatment Clock Stop Administrative Event" allows the Secondary Uses Service to build accurate PATIENT PATHWAYS for the reporting of 18 weeks activity. It flows through the CDS V6 Type 020 - Outpatient CDS structure. It flows through the CDS V6-2 Type 020 - Outpatient CDS structure. See Referral To Treatment Clock Stop Administrative Event.

FIRST ATTENDANCE CODE replaces FIRST ATTENDANCE, and should be used for all new and developing data sets and for XML messages.

ORGANISATION CODE (PATIENT PATHWAY IDENTIFIER ISSUER) is  the ORGANISATION CODE of the ORGANISATION issuing the PATIENT PATHWAY IDENTIFIER. 

Where Choose and Book has been used, the ORGANISATION CODE for NHS Connecting For Health (X09) should be used.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set/CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set/CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set/CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set/CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then ORGANISATION CODE (PATIENT PATHWAY IDENTIFIER ISSUER) must be present in the Commissioning Data Set PATIENT PATHWAY Data Group. 

Notes:
PATIENT PATHWAY IDENTIFIER is the same as PATIENT PATHWAY IDENTIFIER.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient Commissioning Data Set
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set/CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set/CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set/CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set/CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then either UNIQUE BOOKING REFERENCE NUMBER (CONVERTED) or PATIENT PATHWAY IDENTIFIER must be present in the Commissioning Data Set PATIENT PATHWAY Data Group. 

PATIENT USUAL ADDRESS (MOTHER) is the PATIENT USUAL ADDRESS where it relates to the mother of the PATIENT.

Use in the Commissioning Data Set:

PATIENT USUAL ADDRESS (MOTHER) records the mother's usual address within:

• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 150 - Admitted Patient Care - Other Birth Event Commissioning Data Set and
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set.
• CDS V6-1 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set/CDS V6-2 Type 120 - Admitted Patient Care - Finished Birth Episode Commissioning Data Set
• CDS V6-1 Type 150 - Admitted Patient Care - Other Birth Event Commissioning Data Set/CDS V6-2 Type 150 - Admitted Patient Care - Other Birth Event Commissioning Data Set and
• CDS V6-1 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set/CDS V6-2 Type 180 - Admitted Patient Care - Unfinished Birth Episode Commissioning Data Set.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set/CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set/CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set/CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set/CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then REFERRAL TO TREATMENT PERIOD END DATE must be present in the Commissioning Data Set PATIENT PATHWAY Data Group, where the REFERRAL TO TREATMENT PERIOD has ended.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set/CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set/CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set/CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set/CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then REFERRAL TO TREATMENT PERIOD START DATE must be present in the Commissioning Data Set PATIENT PATHWAY Data Group. 

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then REFERRAL TO TREATMENT PERIOD STATUS must be present in the Commissioning Data Set PATIENT PATHWAY Data Group. 

REFERRAL TO TREATMENT PERIOD STATUS replaces REFERRAL TO TREATMENT STATUS and should be used for all new and developing data sets and for XML messages.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then REFERRAL TO TREATMENT STATUS must be present in the Commissioning Data Set PATIENT PATHWAY Data Group. 

REFERRAL TO TREATMENT STATUS will be replaced with REFERRAL TO TREATMENT PERIOD STATUS, which should be used for all new and developing data sets and for XML messages.

Use in Commissioning Data Set version 6-0 onwards

If the Commissioning Data Set record relates to a Referral To Treatment Period Included In Referral To Treatment Consultant-Led Waiting Times Measurement, and is of the following Commissioning Data Set Types:

• CDS V6 Type 020 - Outpatient CDS
• CDS V6 Type 130 - Admitted Patient Care - Finished General Episode CDS
• CDS V6 Type 190 - Admitted Patient Care - Unfinished General Episode CDS
• CDS V6 Type 030 - EAL - End of Period Census Standard CDS
• CDS V6 Type 060 - EAL - Event During Period - Add CDS
• CDS V6 Type 070 - EAL - Event During Period - Remove CDS
• CDS V6 Type 080 - EAL - Event During Period - Offer CDS
• CDS V6-1 Type 020 - Outpatient Commissioning Data Set/CDS V6-2 Type 020 - Outpatient Commissioning Data Set
• CDS V6-1 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set/CDS V6-2 Type 130 - Admitted Patient Care - Finished General Episode Commissioning Data Set
• CDS V6-1 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set/CDS V6-2 Type 190 - Admitted Patient Care - Unfinished General Episode Commissioning Data Set
• CDS V6-1 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set/CDS V6-2 Type 030 - Elective Admission List - End of Period Census (Standard) Commissioning Data Set
• CDS V6-1 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set/CDS V6-2 Type 060 - Elective Admission List - Event During Period (Add) Commissioning Data Set
• CDS V6-1 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set/CDS V6-2 Type 070 - Elective Admission List - Event During Period (Remove) Commissioning Data Set
• CDS V6-1 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set/CDS V6-2 Type 080 - Elective Admission List - Event During Period (Offer) Commissioning Data Set

then either UNIQUE BOOKING REFERENCE NUMBER (CONVERTED) or PATIENT PATHWAY IDENTIFIER must be present in the Commissioning Data Set PATIENT PATHWAY Data Group.