1 SUS R13 PbR Technical Guidance Published 2nd April 2013
2 We are the trusted source of authoritative data and information relating to health and care.
3 Contents Introduction 5 SUS PbR R13 5 This document 5 Inherited Liabilities 6 Inherited liabilities in SUS R13 6 Spells closed before 1 st April Open spells starting before 1 st April Outpatients and Emergency Medicine 6 Spells starting after 1 st April Open Spells extract for inherited liabilities 7 Open Spells extract 7 CCG access to inherited readmissions pathways 7 Implementation in SUS R13 7 Dummy record derivation and structure 7 Payment by Results 9 Implementation of PbR policy 9 DH PbR 2013/14 changes in SUS R13 9 Unbundled outpatient diagnostic imaging 9 Diagnostic imaging in APC 10 Accessing unbundled outpatient diagnostic imaging information 10 Application of APC exclusions to CDS 160 data flows 10 New tariffs for regular attenders 10 Regular attender definition 10 New regular attender tariff 10 Maternity pathway payment system 11 Grouper Update 12 Inclusion of HRG4 2013/14 Local Payment Grouper design 12 Use of new CDS 6.2 fields in grouping 12 Specialist Palliative Care and Rehabilitation Days 12 Location in extracts 13 PbR final adjusted length of stay calculation 13 Calculation example 13 Copyright 2013, Health and Social Care Information Centre. All rights reserved. 3
4 Commissioning Data Sets version CDS Withdrawal of CDS Additional data items 14 Removed data items 14 Renamed data items 14 New data item values 14 CDS 6.2 data items in the online PbR mart 15 CDS 6.2 ward stay data items 15 CDS 6.2 extract in additional extracts 15 CDS 6.2 extract 15 New data items linked to existing repeating groups 16 Overseas visitor status data items 16 Non-repeating CDS 6.2 data items 16 Usability Improvements 17 Applications tab 17 Extract Configuration Screen 18 Reason for access 18 Financial period 18 Data Extracts screen (My Documents Tab) 19 Date Range extract type 19 Schedules tab 20 Scheduled Extract Details 21 Further Information 22 DH Payment by Results (PbR) 22 Secondary Uses Service (SUS) 22 Healthcare Resource Groups (HRGs) 22 4 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
5 Introduction SUS PbR R13 Secondary Uses Service Payment by Results Release 13 (SUS PbR R13) supports healthcare providers, commissioners and other users in reconciliation, payment and performance monitoring for the 2013/14 financial year. Key changes have been incorporated to support delivery of Department of Health 2013/14 PbR policy, extend functionality and improve usability. R13 reflects grouper updates, includes CDS 6.2 changes and contains new features to assist with transition from Primary Care Trusts (PCTs) to Clinical Commissioning Groups (CCGs). This document This document identifies technical changes in SUS PbR R13 and highlights policy updates, technical amendments and usability improvements which may impact on SUS users. R13 responds to the changing NHS landscape, incorporates PbR Policy and includes updates to the SUS Grouper and Commissioning Data Sets. The following key areas affect functionality and output in R13. Corresponding sections in this document provide information about how these changes have been implemented. Inherited Liabilities R13 supports the transition from Primary Care Trusts to Clinical Commissioning Groups by providing new extracts and functionality to assist the newly created CCGs in understanding their inherited liability for patients and activity from the decommissioned PCTs. Payment by Results PbR policy for 2013/14, as specified in the DH PbR Guidance, has been implemented within SUS R13. Grouper Update The SUS Grouper in R13 uses the HRG4 2013/14 Local Payment Grouper design. The HRG classification is updated annually by the National Casemix Office at the HSCIC, to provide optimal performance in supporting PbR policy requirements and to ensure continued clinical relevance. Commissioning Data Sets version 6.2 (CDS 6.2) Commissioning Data Sets version 6.2 contains changes to support new and changing national policy and legislative requirements, support commissioning and meet wider needs of the NHS. Data item additions and removals allow CDS 6.2 to better support DH policy. Usability Improvements This includes screen label changes to marts and extracts and the addition of the new date period selection functionality. Copyright 2013, Health and Social Care Information Centre. All rights reserved. 5
6 Inherited Liabilities Inherited liabilities in SUS R13 The newly formed Clinical Commissioning Groups (CCGs) need to be able to assess their inherited liabilities from the decommissioned Primary Care Trusts (PCTs) for open spells, starting before 1st April Similarly, Local Area Teams (LAT) will require access to the activity inherited from the Strategic Health Authorities (SHA). SUS R13 does this by deriving the required organisation codes in additional processing, using new organisation reference tables. Spells closed before 1 st April 2013 Identification of Organisation of Responsibility for spells that closed before 1 st April 2013 is already covered by functionality implemented within in SUS Release 12. In R12 derivation an Organisation of Responsibility is determined using the Personal Demographics Service (PDS) record to assign GP Practice code based on the submitted NHS Number of the first spell episode. Where corresponding relational data items used for this derivation do not match, the submitted GP Practice Code is used for the derivation. For activity completed before 1 st April 2013, the derived Organisation of Responsibility will be a PCT. Open spells starting before 1 st April 2013 New functionality has been introduced to SUS in R13 to account for spells with an admission date before 1 st April 2013 and a discharge date on or after 1 st April For these open spells starting before 1 st April 2013, an additional processing step uses new organisation reference tables to re-derive and assign the CCG Code as Organisation of Responsibility in place of the old PCT code. Alongside this process, the historical Strategic Health Authority (SHA) is also replaced with the derived, corresponding Local Area Team (LAT), using organisation reference tables within SUS. In Managed Service and Online Service extracts, spare fields are populated with the original, derived PCT and SHA codes. Spare 3 is used to display PCT code Spare 4 is used to display SHA code The R13 PbR Extract Specification workbook contains full details of extract content. The additional processing ensures that CCGs and LATs can access the required activity and correctly assess their inherited liabilities. Outpatients and Emergency Medicine The new derivation process applies only to APC spells that contain a discharge date and therefore does not apply to Outpatients or Emergency Medicine. Spells starting after 1 st April 2013 Spells whose first episode admission date is on or after 1 st April 2013 will have a CCG code derived. Records submitted using old codes R13 does not contain functionality to resolve records submitted in error using old PCT codes. 6 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
7 Open Spells extract for inherited liabilities Open Spells extract In addition to requiring information about spells that have ended before 1 st April 2013, covered in R12 functionality, CCGs also need to be able to access information about patients that were in hospital at 1 st April A new Open Spells extract has been created to deliver this requirement. This extract can be used throughout the 2013/14 financial year to inform commissioners and providers about patients for whom they have responsibility or are providing care. Details of the extract structure can be found in the R13 PbR Extract Specification workbook on the PbR APC Open Spells worksheet. The extract will provide: Commissioner Extract based on Organisation Code (Code of Commissioner) Provider Extract based on Organisation Code (Code of Provider) CCG access to inherited readmissions pathways The newly formed CCGs must be able to access the Readmissions Pathways (RAP) inherited from the decommissioned PCTs. In order to see a Readmission Pathway, an organisation needs to be present on that pathway. Existing processing, introduced in R11, combined with new processing in SUS R13, allows CCGs full access to their inherited readmission pathways. Implementation in SUS R13 To enable CCG access to inherited readmissions pathways, a dummy record, containing the new CCG code, is inserted as the first record in each pathway. The CCG code is determined using the R12 derivation process. The presence of the CCG code within the Readmissions Pathway now allows CCGs to view the entire pathway using functionality introduced in R11 which allows access for all organisations recorded within the pathway. A dummy record is also inserted for new pathways created after 1 st April 2013 for events with a spell source before 1 st April Events creating pathways starting on or after 1 st April 2013 will already have a CCG code derived. The dummy record appears in all Readmissions extracts with a sequence value of zero. The Spell that was used to derive the CCG can be identified in the Readmissions extract under data item RAP Parent Spell Identifier. Dummy record derivation and structure The GP Practice Code from the final spell in a pathway, that satisfies qualifying criteria, is used to derive the Organisation Code (Code of Commissioner). If no match is found, a default value of Q99 is assigned. If no record fulfils the criteria, no dummy record is created. Copyright 2013, Health and Social Care Information Centre. All rights reserved. 7
8 Readmissions pathway (RAP) dummy record structure Data Item Description Value RAP Identifier Unique Readmission Pathway ID RAP being processed RAP Sequence Number Sequence of Spell within each RAP '0' (ZERO) RAP Eligible Parent - NULL RAP Eligible Child - NULL RAP DH Tariff Adjustment Parent - NULL RAP DH Tariff Adjustment Child - NULL RAP Spell Type - ERROR RAP Parent Spell Identifier Spell ID of GP Practice code used for CCG code derivation RAP Spell Source - NULL Organisation Code (Code of Commissioner) Derived CCG code CCG Code 8 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
9 Payment by Results Implementation of PbR policy Activity from 1 st April 2013 is processed in line with 2013/14 Payment by Results (PbR) policy. This includes pricing, adjustments and application of exclusions. Previous financial year activity is processed according to PbR policy for the relevant financial year. SUS PbR only processes current year and two previous financial years, so activity from 2010/11 or before, submitted after 1 st April 2013 will not be processed in the PbR marts. 2013/14 Payment by Results Guidance can be found on the Department of Health Payment by Results website. ayment-by-results-pbr-operationalguidance-and-tariffs DH PbR 2013/14 changes in SUS R13 The key PbR policy changes that affect SUS R13 are: Unbundled outpatient diagnostic imaging Application of APC exclusions to CDS 160 data flows Other changes which have less impact with regard to SUS are: New tariffs for regular attenders Introduction of mandatory maternity pathway payment system Unbundled outpatient diagnostic imaging DIAGNOSTIC IMAGING: Treatment Function Code: 812 Description: The production and interpretation of high quality images of the body to diagnose injuries and disease, e.g. x-rays, Ultrasound Scan, MRI Scan, PET Scan or CT Scan. From April 2013, unbundled diagnostic imaging, carried out within an outpatient attendance, qualifies for a separate unbundled tariff. These costs were previously included in the outpatient attendance tariffs. It is hoped that providing separate diagnostic imaging tariffs in outpatients will also help to promote greater clinical integration and development of clinical pathways between primary and secondary care. In R13 unbundled outpatient diagnostic imaging is paid in addition to any core HRG tariff where the Core HRG is: or An attendance-based HRG (Subchapter WF, Non-admitted Consultations) A procedure-based HRG (not in- Subchapter WF) that does not have a mandatory tariff Where activity is reported as a procedure based HRG (not in Subchapter WF) with a mandatory tariff, no additional unbundled diagnostic imaging is payable. The application of these rules in SUS PbR R13 is consistent with PbR policy, as detailed in the Department of Health 2013/14 Payment by Results Guidance. Copyright 2013, Health and Social Care Information Centre. All rights reserved. 9
10 Diagnostic imaging in APC Unbundled diagnostic imaging activity reported in Admitted Patient Care data is not used for tariffing. Accessing unbundled outpatient diagnostic imaging information Outpatient Diagnostic Imaging activity is captured in the Unbundled HRG data item in extracts. Further information can be found in the R13 PbR Extract Specification workbook Application of APC exclusions to CDS 160 data flows It is a requirement that all records that flow into SUS PbR need to be passed through the various pre and post grouper exclusions. Historically, records that flowed from CDS160 (Other Delivery Event) into SUS did not have the normal APC exclusions applied. As a result of these records being passed directly into the pricing process, records that fulfil the requirements for being excluded were not only flagged as qualifying for tariff but also received tariff and needed to be resolved through local negotiation. SUS R13 resolves this inconsistency in PbR processing and ensures that the appropriate APC exclusions are applied. New tariffs for regular attenders All activity for regular attenders was previously outside of the scope of PbR and was excluded from SUS PbR based on Patient Classification (CLASSPAT) values 3 (regular day admission) and 4 (regular night admission). In line with PbR s commitment to extending coverage of new types of activity, new tariffs have been developed for chemotherapy delivery and external beam radiotherapy. Regular attender definition A regular attender is defined by the following rules: An Elective Admission with Patient Classification 3 (regular day admission) with an Episode Length of Stay of less than 1 or Patient Classification 4 (regular night admission) with an Episode Length of Stay of less than 2 All records that qualify as regular attender (REG) form single episode spells. All Patient Classifications of 3 or 4 that do not qualify as regular attender continue to be excluded from SUS PbR. New regular attender tariff Renal dialysis for chronic kidney disease will continue to use the national renal dataset which is currently outside of SUS. As the mandatory tariffs for the unbundled chemotherapy delivery and external beam radiotherapy activity have been introduced in a staged way, SUS PbR will not apply a mandatory tariff to this activity. The only mandatory tariffs for regular attender activity are where the core HRG is one of the five zero priced ( 0) HRGs. These will be priced in SUS PbR and are shown below. LA08E, Chronic Kidney Disease with length of stay 1 day or less associated with Renal Dialysis PB03Z, Healthy Baby SB97Z, Same Day Chemotherapy Admission or Attendance 10 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
11 SC97Z, Same Day External Beam Radiotherapy Admission or Attendance UZ01Z, Data Invalid for Grouping All other core HRG activity for regular day and night attenders, will continue to be negotiated locally, as in previous years. For further information please refer to the 2013/14 Payment by Results Guidance available on the Department of Health PbR website. ayment-by-results-pbr-operationalguidance-and-tariffs Maternity pathway payment system PbR has introduced a new maternity pathway system from 2013/14. This system splits activity into 3 modules: Antenatal Delivery / Birth Postnatal The Antenatal and Postnatal modules are based on the new maternity dataset and as such the activity will not be priced in SUS PbR. The Delivery / Birth module will however continue to be priced in SUS PbR as in previous years. For further information please refer to the 2013/14 Payment by Results Guidance available on the Department of Health PbR website. ayment-by-results-pbr-operationalguidance-and-tariffs Copyright 2013, Health and Social Care Information Centre. All rights reserved. 11
12 Grouper Update Inclusion of HRG4 2013/14 Local Payment Grouper design Activity from 1st April 2013 will be grouped using the HRG4 2013/14 Local Payment Grouper design. Activity relating to previous financial years will be grouped according to the HRG design for the corresponding financial year. The HRG4 2013/14 Local Payment Grouper Design includes the following key changes: Base design The HRG4 2013/14 Local Payment Grouper design is based on the HRG4 2010/11 Reference Costs design and this should be taken into consideration when comparing designs. 3% increase in the number of HRGs The number of HRGs has increased by 49 (+3.2%) from 1,527 in the HRG4 2012/13 Local Payment Grouper to 1,576 in the HRG4 2013/14 Local Payment Grouper to accommodate DH policy requirements, reflect clinical practice and support service redesign. Subchapter updates All Subchapters have been reviewed for clinical relevance and accuracy. This has resulted in a number of code remaps between existing HRGs, Procedure Hierarchy changes, and list and flag updates. SUS Grouper and HRG4 2013/14 Local Payment Grouper The SUS Grouper is based on the HRG4 2013/14 Local Payment Grouper and has been assured as part of the testing process that, when presented with the same data and conditions, it produces the same output as the Local Payment Grouper. For more information about the HRG4 2013/14 Local Payment Grouper design, please refer to the National Casemix Office page of the HSCIC website. Use of new CDS 6.2 fields in grouping Specialist Palliative Care and Rehabilitation Days SPC Days (Specialist Palliative Care) and REHAB Days (Rehabilitation) are new CDS 6.2 data items that are now used in grouping to derive PbR Final Adjusted Length of Stay. Data item values are reported at episode level and the sum of the values for all episodes within the spell is used to calculate PbR Final Adjusted Length of Stay. Subchapter redesigns A number of subchapters have been redesigned following analysis and clinical review. Revision of HRG4 labels and flags Labels and flags have been revised to clarify clinical content and remove ambiguity. 12 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
13 Location in extracts The new SPC Days and REHAB Days CDS 6.2 data items have been incorporated into the APC Episodes and APC Spells Managed Service Extracts and APC Full Online Service Extracts using the Spare 1 and Spare 2 data items. Spare 1 is used to display REHAB Days Spare 2 is used to display SPC Days Details of location and extract sequence position are displayed in the table below. Service Extract Seq. No Display Name CDS 6.2 Data Item Managed Service PbR APC Spells 194 Spare 1 REHAB Days Managed Service PbR APC Spells 195 Spare 2 SPC Days Managed Service PbR APC Episode 176 Spare 1 REHAB Days Managed Service PbR APC Episode 177 Spare 2 SPC Days Online Service APC Full 468 Spare 1 REHAB Days Online Service APC Full 469 Spare 2 SPC Days PbR final adjusted length of stay calculation The derived data item, PbR Final Adjusted Length of Stay is the sum of all included episode length of stay durations, minus the PbR included episode values for Adult, Paediatric and Neonatal Critical Care Days, REHAB Days and SPC Days. Values from PbR excluded activity are not considered. If this calculation results in a negative value, a floor value of zero is returned. A spell with no episodes will have a value of zero. PbR Final Adjusted Length of Stay will be calculated in this way for all closed spells from April 2013 onwards. Under the same input conditions, the PbR Final Adjusted Length of Stay value generated by the R13 SUS Grouper will always match the output of the HRG4 2013/14 Local Payment Grouper because it uses the same grouping process. Calculation example Example spell A below contains two episodes. The first episode is entirely within Critical Care and the second episode contains an element of Rehabilitation that needs to be identified for PbR purposes. Inclusion of the Critical Care episode is derived from submitted data. The rehabilitation element is taken directly from new CDS 6.2 data item Rehab Days. Episode 1 PbR Final Adjusted Length of Stay = Duration (10 days) minus Adjustment for Critical Care (10 days) = 0 days Episode 2 PbR Final Adjusted Length of Stay = Duration (40 days) minus Adjustment for Rehabilitation (12 days) = 28 days Spell PbR Final Adjusted Length of Stay = Episode 1 PbR Final Adjusted Length of Stay (0 days) plus Episode 2 PbR Final Adjusted Length of Stay (28 days) = 28 days Spell Episode LoS Adjustment Reason Adjustment PbR Final Adjusted LoS A 1 10 Critical Care 10 0 A 2 40 Rehabilitation Totals Copyright 2013, Health and Social Care Information Centre. All rights reserved. 13
14 Commissioning Data Sets version 6.2 CDS 6.2 Commissioning Data Sets (CDS) version 6.2 incorporates changes which support national policy, commissioning and the wider needs of the NHS. In SUS R13, CDS 6.2 data item additions and removals improve support for PbR, while code label changes add clarity and consistency across CDS schema versions. Providers have been able to submit data to SUS using CDS 6.2 since the release of R12 in November All providers should be submitting data to SUS using CDS 6.2 from April 2013 and must be fully conformant by April 2014, including the capture and flow of any new mandatory or required data items. Full details of CDS 6.2 changes, including details of Additional, Removed and Renamed Data items and New Data Item Values can be found in the CDS 6.2 Human Behavioural, Organisational and Technical Guidance on the ISB website. Withdrawal of CDS 6.0 CDS version 6.0 has been withdrawn and the NHS has been informed of this through the SUS programme. Full CDS version transition details can be found in the CDS 6.2 Implementation Plan on the ISB website. Additional data items SUS R13 accepts and outputs all additional data items introduced in CDS version 6.2, and uses certain data items in processing. Although not all new CDS 6.2 data items are currently utilised, their inclusion provides the flexibility to do so in future SUS PbR releases and can be used to add value to performance and analysis reporting. Removed data items CDS 6.1 data items that have been removed from CDS 6.2 will remain in the PbR mart in order to allow submission using either CDS version during 2013/14. This will also support historical two year analysis and reporting requirements. Renamed data items Renamed data items continue to use existing data item names in extracts to reduce the need for user extract processing amendments. Therefore, display names in extracts appear in the same way as in R11. For example, the renamed data item: ORGANISATION CODE (RESIDENCE RESPONSIBILITY) will continue to appear as ORGANISATION CODE (PCT OF RESIDENCE) in SUS R13 extracts. Descriptions for all new data items are provided in the R13 PbR Extract Specification workbook. New data item values CDS 6.2 introduces new Data Item Values for the following Data Items ADMISSION METHOD (HOSPITAL PROVIDER SPELL) TREATMENT FUNCTION CODE CRITICAL CARE DISCHARGE STATUS System changes, applied in R12, allow SUS to accept and verify the new values in XML processing. However, before the inclusion of PbR reference data updates, HRG Code UZ01Z. Data Invalid for Grouping would have been assigned. 14 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
15 In R13 the inclusion of PbR reference data updates ensures that the new data values will be accepted for processing in SUS and the appropriate HRG code will be assigned. CDS 6.2 data items in the online PbR mart All new and changed CDS 6.2 data items are included in the Online PbR Mart, irrespective of whether they are used in PbR processing. This is to ensure that all incoming data is available to support existing and future system or extract processing. CDS 6.2 ward stay data items CDS 6.2 data items relating to ward stays have been added to the ward stay extracts. New CDS 6.2 Ward Stay Data Items Ward Code Activity Location Type Code Ward Security Level Stay Start Time Ward Stay 'n' Stay End Time Ward Stay 'n' Ward Stay Extracts APC Episode Extract - Ward Stay Data (APC Ep Ward Stay) APC Episode Extract - Ward Stay Full Online (APC Ep Ward Stay Full Online) Details can be found in the R13 PbR Extract Specification workbook. unbundled HRGs, which exceed the allowed limit for the Admitted Patient Care Episodes, Outpatients or Emergency Medicine extracts. For example, the Admitted Patient Care Episodes extract allows for a maximum of 12 instances of secondary diagnosis being recorded. Where these repeating groups exceed the maximum allowed within the main extract, the excess instances are provided via the Supplementary Extract. Error Extracts include every error that can occur throughout the process, including grouping, spell construction, tariff and exclusions. Episode level error extracts can be produced in conjunction with APC Episodes, Emergency Medicine or Outpatients extract types. CDS 6.2 extract SUS R13 introduces a new CDS 6.2 Extract which contains all additional CDS 6.2 data items, with the exception of SPC Days and REHAB Days, which have been incorporated within the main extracts using the Spare 1 and Spare 2 data items, and ward stay data items which have been added to the ward stay extracts. CDS 6.2 extract in additional extracts The Additional Extracts tab in the PbR Configure Extract screen has enabled users to request Supplementary Extracts and Error Extracts alongside Main Extracts. Supplementary Extracts contain data items which capture potential multiple recorded instances, such as multiple secondary diagnoses, procedures or Copyright 2013, Health and Social Care Information Centre. All rights reserved. 15
16 The CDS 6.2 Extract is essentially an additional supplementary extract that is linked and produced in the same way as the Supplementary and Error extracts. Selecting Yes from the drop-down box will produce the additional extract alongside the main extract. The main Admitted Patient Care, Outpatient and Emergency Medicine extracts have not been changed so that users will not need to amend existing processes to account for the addition of the new CDS 6.2 data items. The CDS 6.2 Extract contains all current CDS Types and Schema versions. Data items common to CDS 6.1 and CDS 6.2 are populated for all records contained in the main extract. For example, an APC Episode Extract with 500 CDS 6.2 records and 500 CDS 6.1 records would produce a CDS 6.2 Extract with 1000 records, thus enabling clear reconciliation between the main APC Episodes extract and its supplementary CDS 6.2 Extract. Overseas visitor status data items The Overseas Visitor Status data items (below) are recorded as potentially repeating groups. However, within SUS, a fixed limit of 5 instances for each item is applied and exported in the supplementary CDS 6.2 Extract. OVERSEAS VISITOR STATUS CLASSIFICATION OVERSEAS VISITOR STATUS START DATE OVERSEAS VISITOR STATUS END DATE Non-repeating CDS 6.2 data items All other non-repeating CDS 6.2 data items are included in the new CDS 6.2 Extract. New data items linked to existing repeating groups Repeating groups are data items with potential multiple recorded instances such as procedures, diagnoses and ward stays. Several new data items have been introduced that are linked to existing repeating groups that are already included in extracts. For example, new CDS 6.2 data item Present on Admission Indicator is a repeating group indicating that a recorded diagnosis was present on admission. This data item is linked to secondary diagnosis and a corresponding record will exist for every instance. These repeating 6.2 data items have been added to the Supplementary and Ward Stays extracts. Further information can be found in the R13 PbR Extract Specification workbook. 16 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
17 Usability Improvements R13 includes a number of improvements to user interface and extracts. These have been made to improve clarity and usability, and add more intuitive functionality and features. Applications tab The existing 2012/2013 PbR application folder has been renamed to PbR. This is because 2012/13 and 2013/14 PbR Extracts use the same processing so both 2012/13 and 2013/14 extracts are now accessed from the single PbR folder. Copyright 2013, Health and Social Care Information Centre. All rights reserved. 17
18 Extract Configuration Screen Again, the Configure Extract screen title has been changed from 2012/2013 PbR Extracts to PbR Extracts because it caters for PbR Extracts for both 2012/2013 and 2013/14 financial years. Reason for access The Reason for Access drop down has been updated to reflect the change from PCT of Residence Code to Organisation of Residence Code. Financial period The Financial Period drop down has been extended to include the 12 additional periods for the 2013/14 Financial Year. CDS 6.2 extract The CDS 6.2 Extract is available as a selectable option on the Additional Extracts tab with any Financial Period selected. 18 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
19 Data Extracts screen (My Documents Tab) PbR 2012/2013 Output Format has been renamed to PbR Output Format in the Data Extracts Application search area and Application column. Date Range extract type The updated Date Range functionality now allows users to select date ranges between either 01/04/2012 and 31/03/2013 or 01/04/2013 and 31/03/2014. Date selections outside of or across these parameters are not allowed. For example, an extract with date parameters from 01/06/2012 to 01/06/2013 would not be allowed as it crosses the two financial years. When Date Range is selected from the Extract Type drop down menu, From Date and To Date fields appear below it, allowing user selection via a pop-up calendar. Copyright 2013, Health and Social Care Information Centre. All rights reserved. 19
20 Schedules tab Extracts requested via the Configure Extract screen now display the Extract Name as displayed in the Name column in the Data Extracts page. This helps to make the two entries easier to reconcile. 20 Copyright 2013, Health and Social Care Information Centre. All rights reserved.
2011/12 SUS Payment by Results (PbR) Release 9 Webinars - Questions and Answers This document contains the Questions and Answers from the five Release 9 webinar sessions run by BT. The answers to the questions
Data quality checks performed on SUS and HES data Author: HES Data Quality Team Date: 24 th February 2014 1 Copyright 2013, Health and Social Care Information Centre. Version Control Version Date Author
Prescribed Specialised Services 2015/16 Shadow Monitoring Tool Published May 2015 We are the trusted national provider of high-quality information, data and IT systems for health and social care. www.hscic.gov.uk
www.gov.uk/monitor The maternity pathway payment system: Supplementary guidance Contents Introduction... 3 Inclusions and exclusions from the pathway payments... 4 Early pregnancy unit and emergency gynaecology
Reference costs 2011-12 DH INFORMATION READER BOX Policy Clinical Estates HR / Workforce Commissioner Development IM & T Management Provider Development Finance Planning / Performance Improvement and Efficiency
2015/16 National Tariff Payment System: A consultation notice Annex 4a: Additional information on currencies with national prices 26 November 2014 Monitor publication code IRCP 14/14 NHS England Publications
HRG4 Grouper Reference Manual HRG4 Grouper Reference Manual v3.0 The Health and Social Care Information Centre is England s central, authoritative source of health and social care information The National
2014/15 National Tariff Payment System Annex 4A: Additional information on currencies with national prices 17 December 2013 Publications Gateway Reference 00883 Annex 4A: Additional information on currencies
2014/15 National Tariff Payment System Annex 7A: Specified services for acute services for local pricing 17 December 2013 Publications Gateway Reference 00883 Annex 7A: Specified services for acute services
A simple guide to Payment by Results DH INFORMATION READER BOX Policy Clinical Estates HR / Workforce Commissioner Development IM & T Management Provider Development Finance Planning / Performance Improvement
National Child Measurement Programme 2015/16 IT System User Guide Part 3 Pupil Data Management Published May 2016 Version 2.1 We are the trusted source of authoritative data and information relating to
Version No: 4.0 Issue Date: 13 February 2009 Page 1 of 33 GUIDE TO UNBUNDLING - CONTENTS 1 INTRODUCTION...3 2 OUTLINE OF UNBUNDLING...3 3 WHY UNBUNDLE?...3 4 WORKED EXAMPLE...4 5 WHAT COMPONENTS ARE UNBUNDLED?...4
The Year of Care Funding Model Sir John Oldham (c)sir John Oldham 2013 Multimorbidity is common in Scotland The majority of over-65s have 2 or more conditions, and the majority of over-75s have 3 or more
The quality of clinical coding in the NHS Payment by Results data assurance framework September 2014 Contents 3 Summary 4 Checklist to improve the quality of clinical coded data 5 Background and approach
Civica Health & Social Care Focus on > SLAM for Healthcare Providers Improved communications with commissioners, leading to clarity and better relationships Civica Focus on> The solution SLAM is the ideal
Hospital Episode Statistics Accident and Emergency Attendances in England 2012-13 28 th January 2014 1 Copyright 2014, Health and Social Care Information Centre. This product may be of interest to members
Gloucestershire Hospitals NHS Foundation Trust TRUST POLICY DATA QUALITY FAST FIND: For information on the Trust s Data Quality standards, see Section 7. For information on the Trust s computer systems,
NHS Improving Quality Unbundling recovery: Recovery, rehabilitation and reablement national audit report Implementing capitated budgets within long term conditions for people with complex needs LTC Year
The NHS payment system: reforms to support integrated care Anita Charlesworth Chief Economist 14 February 2014 The NHS Payment System following the 2012 Health and Social Care Act NHS England and 211 clinical
Programme NPFIT Document Record ID Key Sub-Prog / Project Secondary Uses Service Prog. Director J Thorp Version 5.1 Owner Status Author Craig Watson Version Oct- 12 Date Secondary Uses Service Guidance
` Payment by results data assurance framework Report on the local audit programme for Surrey and Sussex Healthcare NHS Trust May 2013 For the 2012/13 PbR data assurance programme reporting on local work
KO41(a) - Hospital & Community Health Services Complaints A guide to completing the collection using the Omnibus system Copyright 2013, The Health and Social Care Information Centre. All Rights Reserved.
HRG4 Summary of Changes: HRG4 2014/15 Payment Grouper from HRG4 2013/14 Local Payment Grouper The National Casemix Office Published February 2014 We are the trusted source of authoritative data and information
Bupa By You Summary Find the cover that s right for you There s a lot to take in when purchasing health insurance that s why we ve created this easy to use guide which summarises the cover that s available
Title Emergency Care Weekly Situation Report Specification Document ID ISB 1607 Specification Sponsor Sarah Butler, DH Status FINAL Developer Paul Steele Version 1.0 Author Paul Steele Version Date 19/03/2014
BMI Werndale Hospital Quality Accounts April 2013 to March 2014 Chief Executive s Statement Welcome to our Quality Accounts 2014, the fifth year we have published this data. The information presented here
Haslemere Health Centre & Grayshott Surgery Commissioning Data Quality Audit Report October 2010: Results from historic analysis This report covers the findings of a pilot which we were commissioned to
NHS Dental Statistics for England: 2013-14, Second Quarterly Report 12 th February 2014 Statement of relevance to patients: This publication may be of interest to members of the public and other stakeholders
Associates Private Medical Trust Guide Effective from 1 April 2012 Welcome to the Honda Associates Private Medical Trust This guide provides an overview of the benefits available to you under your Private
allscripts.com ALLSCRIPTS PATIENT ADMINISTRATION SYSTEM (PAS) Allscripts PAS is a part of our product family that covers all aspects of patient management and care PATIENT ADMINISTRATION SYSTEM (PAS) Allscripts
Trust Policy Department / Service: Information Department Originator: Information Governance Manager Accountable Director: Director of Finance/SIRO Approved by: Trust Management Committee Date of approval:
Role Based Access Control What is RBAC? SUS is a part of the NHS Care Record Service (NCRS) application from the National Programme for IT (NPfIT) and is accessed from the NHS national data network, the
Payment by Results Guidance for 2013-14 DH INFORMATION READER BOX Policy Clinical Estates HR / Workforce Commissioner Development IM & T Management Provider Development Finance Planning / Performance Improvement
Post discharge tariffs in the English NHS Martin Campbell Department of Health 4th June 2013 Contents Rationale and objectives Non payment for avoidable readmissions Development of post discharge tariffs
Transforming Cancer Services for London Commissioning cancer survivorship - an overview Paul Chiles, Programme Manager, Transforming Cancer Services for London programme, NHS England email@example.com
Measuring quality along care pathways Sarah Jonas, Clinical Fellow, The King s Fund Veena Raleigh, Senior Fellow, The King s Fund Catherine Foot, Senior Fellow, The King s Fund James Mountford, Director
Patient Access Policy NON-CLINICAL POLICY ACE 522 Version Number: 2 Policy Owner: Lead Director: Assistant Director of Operations Director of Operations Date Approved: Approved By: Management Executive
Patient Choice Strategy Page 1 of 14 Contents Page 1 Background 4 2 Putting Patients and the Public at the Heart of Health and 5 Healthcare in West Lancashire 3 Where are we now and where do we need to
The English NHS payment system: reforms to support efficiency and integrated care Anita Charlesworth Chief Economist 7 th April 2014 The NHS Payment System following the 2012 Health and Social Care Act
April 2014 AVOIDING UNPLANNED ADMISSIONS ENHANCED SERVICE: PROACTIVE CASE FINDING AND CARE REVIEW FOR VULNERABLE PEOPLE GUIDANCE AND AUDIT REQUIREMENTS A programme of action for general practice and clinical
File Name: Document Reference No: Version: 1.0 Status: Final Issue Date: January 2013 Author: J. Clough SUS Data Quality Dashboards Survey September 2012 For more information on the status of this document,
www.gov.uk/monitor 2016/17 National Tariff Payment System Contents 1. Introduction... 4 2. Scope of the 2016/17 National Tariff Payment System... 5 2.1. Public health services... 5 2.2. Primary care services...
NHS Sickness Absence Rates January 2014 to March 2014 and Annual Summary 2009-10 to 2013-14 Published 22 July 2014 We are the trusted source of authoritative data and information relating to health and
White Paper Clinical Coding The path to the adoption of ICD-10 diagnosis coding for the independent sector. Peter Connor Managing Director Healthcode Ltd Frances Murphy ACC Clinical Coding Consultant Healthcode
Information Governance A Clinician s Guide to Record Standards Part 1: Why standardise the structure and content of medical records? Contents Page 3 A guide for clinicians Pages 4 and 5 Why have standards
An introduction to Information Services Division s administrative datasets This document is a useful starting point for anyone unfamiliar with Information Services Division administrative data. Detailed
Health National report November 2006 Payment by results assurance framework Pilot results and recommendations Final report to the Department of Health The Audit Commission is an independent body responsible
Education Module for Health Record Practice Module 6 - Hospital Health Record Computer Applications The development of automated patient information services to enable the efficient retrieval of information
Briefing note: July 2012 The importance of nurse leadership in securing quality, safety and patient experience in CCGs Introduction For the NHS to meet the challenges ahead, decisions about health services
Consultation on amendments to the Compliance Framework Dated 31 January 2008 1. Introduction 1.1. Developing the regulatory framework Monitor continues to develop a regulatory framework within which boards
Paper NHSE130903 BOARD PAPER - NHS ENGLAND Title: Publication of Directions to Health and Social Care Information Centre for the collection of primary care data Clearance: Tim Kelsey, Director of Patients
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE CENTRE FOR CLINICAL PRACTICE QUALITY STANDARDS PROGRAMME standard topic: Specialist neonatal care Output: standard advice to the Secretary of State
HES: Deaths within 30 days of a hospital procedure or of an emergency admission to hospital - Financial year 2010-2011 Copyright 2013, The Health and Social Care Information Centre. All Rights Reserved.
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions AMEX International Healthcare Plan Benefits schedule Effective 1 April 2015 46.06.933.1-EUAM D (4/15) Your flexible
Commissioning Policy (EMSCGP005V2) Defining the boundaries between NHS and Private Healthcare Although Primary Care Trusts (PCTs) and East Midlands Specialised Commissioning Group (EMSCG) were abolished
Using Medicare Hospitalization Information and the MedPAR Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota MedPAR Medicare Provider Analysis and Review Includes information
UB-04 Claim Form Instructions FORM LOCATOR NAME 1. Billing Provider Name & Address INSTRUCTIONS Enter the name and address of the hospital/facility submitting the claim. 2. Pay to Address Pay to address
PATIENT ACCESS POLICY V3 State whether the document is: x Trust wide Business Group Local State Document Type: x Policy Standard Operating Procedure Guideline Protocol APPROVAL & VALIDATION Assurance Risk
Financial Planning Templates 2014/15 to 2018/19 - Guidance for Direct Commissioning Contents 1. Introduction... 2 2. Cover... 2 3. Area Team Summary... 3 4. Financial Plan Summary... 3 5. Allocations...
Improving data quality in the NHS Executive summary Health 2010 The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better
Guidance on NHS patients who wish to pay for additional private care DH INFORMATION READER BOX Policy HR / Workforce Management Planning / Clinical Document Purpose Gateway Reference Title Author Publication
Launch of the National Clinical Utilisation Review Framework Guide for Clinical Commissioning Groups Publications Gateway Number: 03917 Launch of the National Clinical Utilisation Review Framework Guide
The Way Forward: Strategic clinical networks The Way Forward Strategic clinical networks First published: 26 July 2012 Prepared by NHS Commissioning Board, a special health authority Contents Foreword...
briefing November 2012 Issue 256 NHS continuing healthcare Detailing what NHS organisations need to know and do Key points From April 2013, CCGs will be legally responsible for commissioning and assessing
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Conditions of accreditation Version number: 1.5 Final version Review date: December 2015 Accreditation: Terms and conditions 1 of 9 Background 1. The National
Patient Reported Outcome Measures (PROMs) Standards A. Information Governance Requirement This Information Governance Requirement Standard covers four Areas: 1. NHS Systems Requirements, 2. Data Sharing,
Who Pays? Determining responsibility for payments to providers August 2013 Page 1 of 43 NHS England INFORMATION READER BOX Directorate Medical Operations Patients and Information Nursing Policy Commissioning
Information Governance and Risk Stratification: Advice and Options for CCGs and GPs 1 NHS England INFORMATION READER BOX Directorate Medical Operations Patients and Information Nursing Policy Commissioning
DISCHARGE ABSTRACTS DATABASE (HOSPITAL SEPARATIONS) DATA DICTIONARY Includes discharges, transfers and deaths of in-patients from acute care hospitals in BC, including day surgeries. Fields are available
Fast Track Pathway Tool for NHS Continuing Healthcare DH INFORMATION READER BOX Policy Clinical Estates HR / Workforce Commissioner Development IM & T Management Provider Development Finance Planning /
Clinical Coding Training and Audit Prospectus An NCS Clinical Coding Academy Welcome Clinical Coding Training and Audit High quality data is crucial for informing strategic and local decisions for capacity
DH Cardiac Rehabilitation Commissioning Pack: highlights and process Prof Patrick Doherty BACR conference Liverpool 2010 CR commissioning pack working groups: led by SCDU and NHS Improvement 1. A reference
Measures for the Australian health system Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Two sets of indicators The National Safety and Quality Indicators Performance
ANNEX F London Focus Group Tender - Commissioning Support Services ITT Clarification Questions: FINAL Summary7 Srl. Question Response 1 According to the memorandum of information, the draft ITT was supposed
NHS outcomes framework and CCG outcomes indicators: Data availability table December 2012 NHS OF objectives Preventing people from dying prematurely DOMAIN 1: preventing people from dying prematurely Potential
NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST PATIENT DATA QUALITY POLICY Documentation Control Reference GG/INF/019 Approving Body Directors Group Date Approved 16 Implementation Date 16 Summary of Changes
Human Behavioural Guidance Version No: 0.1 Purpose of this document This document comprises the Human Behavioural Guidance for NHS Organisations in relation to the changes to the Main Specialty and Treatment