AHP MSK Waiting Times Dataset. Version 1.5. This paper should be considered in conjunction with 4 Week Rapid Access to AHP MSK (version 5)

Transcription

1 AHP SK Waiting Times Dataset Version 1.5 This paper should be considered in conjunction with 4 Week Rapid Access to AHP SK (version 5)

2 Document Control: Document Control Version AHP SK Waiting Times Data Set. Version 1.5 Date Issued Contributing Author(s) Liz itchell AHP Advisor ISD Amy ckeon Principal Information Analyst ISD Fiona Webster Principal Information Development anager ISD Senga Cree SK National Lead Sarah itchell AHP NDP Lead AHP SK leads, For Circulation to Comments to SK Informatics Steering Group, AHP Directors, AHP SK leads, Information Leads. Document History Version Date Comment Author(s) V1.0 Jan 2014 Following consultation on SK Developmental Heat Target & KPI indicators v0.10 an agreement to proceed by splitting waiting times from KPI to enable finalising the data set for submission to the data warehouse. KPIs will be a separate data set and submitted separately. V1.1 Feb 2014 Feedback from SK Leads on What is a new patient Guidance on Urgency Liz itchell Amy ckeon Senga Cree Sarah itchell Liz itchell Request to have SK as a source of referral V1.2 April 2014 Changes to Urgency Guidance Liz itchell V1.3 ay 2014 Definitions for Podiatry & rthotic Service added Update of mandatory fields Tidy up Liz itchell Senga Cree V1.4 ay 2014 inor change to dataset table Amy ckeon V1.5 ay 2014 Added wording re. new codes to page 9 Liz itchell 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 1

3 1. PURPSE The Scottish Government defined the future vision for Allied Health Professionals (AHP s) and the services they deliver in The National Delivery Plan for Allied Health Professionals in Scotland, 2012 to ne of the elements of this plan was the development of a National AHP usculoskeletal (SK) 4 Week Target. The target states From 1st April 2016, the maximum wait for AHP SK Services from referral to first clinical out-patient appointment will be 4 weeks (for 90% of patients). First clinical appointment may be by telephone, video or face to face. The term musculoskeletal problems 1 includes a diversity of complaints and diseases localised in joints, bones, cartilage, ligaments, tendons, tendon sheaths, bursa and muscles. SK problems also include out- patient pre or post orthopaedic surgery, peripheral nerve lesions (e.g. carpal tunnel, sciatica) or complication of fracture/dislocation/trauma). This document contains an overview of data standards required by NHS National Service Scotland (PHI) to report nationally on adjusted waiting times for this 4 week target. This information will flow from NHS boards and be captured in the National Waiting Times Warehouse for analysis and national reporting. The Waiting Times Recording anual is available from NHS Information anagers or IT department and gives the full specifications. The current version already has changes specifically for the SK service and will be updated with the Body Part data item in due course. ther SK deliverables from the NDP will be documented and collected separately from waiting times by ISD. A separate document is being developed will detail the dataset for capturing other SK key performance indicators and deliverables from the NDP. A quick guide to adjusted waiting times i.e. stopping and starting the clock, is included in this document (see appendix I) but is not an alternative to training. For the purposes of this target: Start - is the date when a referral is received from a patient or health or social care professional Stop - is the date of first clinical out-patient appointment (which could be by telephone, video-link or face to face). 1 Source: usculoskeletal Problems and Functional Limitation - Indicators for onitoring usculoskeletal Problems and Conditions - The Great Public Health Challenge for the 21 st Century - EURPEAN CISSIN DIRECTRATE-GENERAL HEALTH & CNSUER PRTECTIN DIRECTRATE GENERAL PUBLIC HEALTH UNIVERSITY F SL DEPARTENT F GENERAL PRACTICE AND CUNITY EDICINE THE BNE AND JINT DECADE slo, ctober /05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 2

4 2. DELIVERABLES National quarterly reporting of AHP SK adjusted waiting times from Date of Receipt of Date of 1 st Clinical ut-patient Appointment. 1. SK Adjusted Waiting Times including: 1.1 Completed waits This is patients who had their first clinical outpatient appointment (which could be by telephone, video-link or face to face) during the period eg. month, quarter. The number of patients seen and the time they waited would be calculated. 1.2 ngoing waits This is patients waiting for their first clinical outpatient appointment (which could be by telephone, videolink or face to face) as at a census point (eg. end of each month). The number of patients waiting and the time they had been waiting would be calculated 2. SK Demand incl. Self 3. SK Did Not Attend 4. SK Could Not Attend 5. SK New patient a) Health Board x b) Locality c) AHP Specialty d) Body Part 3. SCPE Inclusions s to: AHP SK Adults Where SK is the primary reason for referral. ccupational Health AHP SK Services The following AHP SK Professions only- Specialty Code R5 R4 R1 RF2 Speciality Value Physiotherapy ccupational Therapy Chiropody/Podiatry rthotics The rthotics SK service is described as: registered practitioners who provide gait analysis and engineering solutions to patients with problems of the neuro, muscular and skeletal systems. Patients frequently present with co-morbidities but the focus of the treatment is almost always to improve neuro muscular skeletal performance. All orthotic referrals are therefore included in the target definition. 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 3

5 A Podiatry SK Service includes the following conditions: Exclusions All other AHP professions In-Patients Domiciliary (home visit) patients Non NHS Funded patients. Service exclusions: Specialist Chronic Pain services are excluded. Woman s Health SK services are excluded. ut-patient AHP Specialist rheumatology services are excluded SK Children s services are excluded These service exclusions will be considered in a future phase. 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 4

6 4. DATASET AND DEFINITINS New AHP Patient A New AHP Patient is described in ISD Data Dictionary as...a patient attending for the first time in an AHP episode. It is not a new patient if the patient returns about the same episode. If it is a new episode of the old problem this is a new patient. New AHP SK Items Body Part Definition: The region of the body where the problem is present. Code Value Inclusions 01 Lumbar Spine, Lumbosacral, Sacral, Sacroiliac Joint, Low Back Sacrococcygeal 02 ccipito-atlanto-axial, Cervical Spine, Head/Skull. Neck Cervicothoracic 03 Thorax Ribs, Trunk, Thoracic Spine, Sternocostal joints, Sternum 04 Abdomen 05 Hip Hip Joint, Buttock, Thigh, Femur, Pelvis, Groin 06 Knee Knee Joint, Patellofemoral, Fibula, Tibia, Lower Leg 07 Foot/ankle Ankle Joint, ther Foot Joints, etatarsus, Tarsus, Toes 08 Glenohumeral Joint, Acromioclavicular Joint, Sternoclavicular Shoulder Joint, Scapula, Clavicle, Humerus, Upper Arm 09 Elbow Joint, Forearm, Radius, Ulna, Wrist Joint, Carpus, Elbow/wrist/hand Fingers, etacarpus, Hand Joints 10 ultiple 11 Body part not specified/not known Patient Contact: ode Source ISD Scotland Data Dictionary Code Value Definition 01 face to face a meeting between a healthcare profession and a patient/carer 02 letter (inc. ) 2 a letter is written to a patient or carer 03 telephone a contact by means of a telephone conversation (see definition here) 04 video link A contact is by means of a video link (e.g. telemedicine) 2 This option should not be used to record contact mode of 1 st attended AHP SK appointment 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 5

7 AHP SK Adjusted Waiting Times Data Items NDP 6.2 NDP 3.1 The following table is a list of items required to capture adjusted waiting times for AHP SK services. The Waiting Times Data Recording anual supports full data standard and functional requirements for each of these items. Some items have been amendments specifically for AHP SK use e.g. WT 4 Waiting Times Standard code added for SK and GEN 11 a new specialty code was created for rthotics. Two new items will be added for Body Part and Contact ode. These data standard and functional requirements have been out for consultation and will be added to the next update of the Waiting Times Recording anual. The following key is used to describe the different items in the dataset: = andatory item = ptional item NDP = Covers another deliverable from the NDP DS = AHP inimum Data Set item (v2011) see NDP 6.1 ID Variable Description Key WT1 WT2 WT3 Date of to Service Date of Receipt of Date Decision Taken to Place on Waiting List The date the patient was referred to the service. The date the referral was received by the service, from the GP. (This would be used as start of waiting time for HEAT target measure) The date the service decided to put the patient onto the waiting list. should this be about date referral accepted DS WT4 Waiting Time Standard Applied A code denoting the waiting time target that was applied. (Exclusions from target would be provided) WT5 Urgency Category The clinical decision on how quickly the patient needs to be seen/treated. (Urgent, soon, routine). Note - This differs from Referrer urgency category (WT31), which identifies the urgency category allocated by the referrer based on their clinical decision on how quickly the patient needs to be seen or treated. See recording guidance below for further information WT6 ffer type Type of offer of appointment made to the patient (Written/verbal/Patient Focussed Booking letter of invitation) WT7 ffer date The date any offer of appointment is made to the patient or the date the PFB letter of invitation was sent. WT8 Appointment Date Date(s) of proposed appointment DS WT9 Response Received Date Date when the service receives a response from the patient to the proposed appointment WT10 ffer utcome The patient s response to the offer of an appointment date WT11 WT12 Availability for Appointment at Short Notice inimum Days Notice Required for Admission/ Appointment Date To identify whether the patient is available to attend an appointment in less than the minimum 7 days notice required (If the patient declines an offer given at short notice then this will not count against them) The minimum number of days notice required by a patient prior to the appointment date. 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 6

8 ID Variable Description Key WT13 WT14 WT15 Suitability of patient to be considered part of pooled list Patient willing to change clinician Patient willing to change Health Board Decision as to whether the patient could be seen as part of a generic list or clinically requires to remain on the original healthcare professional s list. For local use to assist in scheduling. The response to this question impacts on the information recorded against Patient willing to change clinician. To identify whether a patient is willing to be seen by another healthcare professional. To identify whether a patient is willing to be seen at another Health Board WT16 Non-attendance category DNA, CNA, Cancelled by service WT17 Non-attendance date The date the patient did not attend, date the patient cancelled their appointment or the date the service cancelled the appointment WT18 Explanatory text or code An explanation, if available, as to why the patient has not (for non-attendance) attended an appointment (optional) WT19 WT20 WT21 WT22 Non-attendance outcome Waiting time clock pause (unavailability) start date Waiting time clock pause type Explanatory text or code for clock pause To identify whether a patient has been removed or has been retained on a waiting list after they cancelled or failed to attend their appointment or after the service cancelled the patient s appointment. pause start date To identify the reason for a period of waiting time clock pause, for example whether the unavailability is due to medical or patient advised unavailability Explanation as to why the patient s waiting time clock has paused DS WT23 Planned review date The date on which any planned review of clock pauses should take place WT24 Waiting time clock The date on which the clock pause ends pause (unavailability) end date WT25 Review date The actual date the review of clock pause takes place. WT26 Review outcome The outcome of the review of the patient s clock pause (now available, new review planned, removed from list) WT27 Date of Removal from List The date the patient was removed from the waiting list. WT28 Reason for Removal Indicates why the patient has been removed from the waiting list (eg. attended, referred back to GP) WT29 Patient Status To identify the stage that the patient has reached in their current journey (eg. awaiting appointment, awaiting diagnostic result). This is for local use for patient and waiting list management. WT30 Patient Type A code identifying whether the patient is a New utpatient or Return utpatient. WT31 Referrer Urgency Category The referrer s clinical assessment on how quickly the patient needs to be seen/treated (Urgent, soon or routine). See note in description of WT5. DS DS DS 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 7

9 ID Variable Description Key GEN1 Surname The patient s family name (surname). GEN2 Forename The patient s given name (forename/initial). GEN3 Date of Birth The patient s date of birth GEN4 Gender A code denoting the patient s current gender. GEN5 Patient CHI Number Community Health Index (CHI) Number DS GEN6 Health Record Unique Health Record Identifier/Case Reference Number for Identifier/CRN the treatment. GEN7 Patient Postcode The postcode of the patient. GEN8 Ethnic Group A code denoting the patient s ethnic group. GEN9 GP Practice Code A code identifying the practice that the patient is registered to. GEN10 Location code A Location is any building or set of buildings where consultation/treatment is expected to take place. Locations include hospitals, health centres, GP surgeries, clinics, nursing homes and schools. Each location has a Location code. GEN11 GEN12 Specialty/ Discipline Consultant/HCP Responsible for Care A code denoting the specialty/discipline that the patient is being treated under. The code for the Consultant/HCP responsible for the patient s care. GEN 13 Patient Category A code identifying the patient category, e.g. NHS, paying, overseas visitor GEN14 Source A code denoting the source of the referral, e.g. GP. NHS24 would need to be added in as new category GEN15 Provider Code The code the provider of treatment. The Provider Code should be directly linked to the Location Code. GEN16 ain Condition A code denoting the main condition that the patient is being treated for. GEN 17 ther Condition A code denoting any other condition that the patient is being treated for. GEN 18 ain peration A code denoting the main operation that the patient is on the waiting list for. tbc Body Part New Variable to be added for AHPs see below NEW tbc Contact ode New Variable to be added for AHPs see below NEW DS NDP 5.2 DS DS NDP 6.3 NB: The full data set including codes, values are held in the Waiting Times Data Recording anual that you can obtain via your NHS Board IT department. It does not yet contain the details for Body Part or Contact ode. The Data Recording anual is in draft form and may evolve over time as ISD/SG continue with Board visits to collect the data. 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 8

10 New codes added specific to AHP SK waiting times WT4 - Waiting Time Standard Code for AHP SK An additional WT4 code (080 - AHP SK Service) has been created to identify the AHP SK Service from all other waiting times coming into the Waiting Times Data Warehouse. GEN11 - Specialty code for rthotics A new specialty code RF2 was created for rthotics as previously this had been one code for Prosthetics/rthotics. A new code was also developed for Prosthetics but not required for the SK Service. GEN14 Source of AHP A new AHP code has been requested (we are awaiting confirmation) in order to monitor the demand into the SK Service from other AHP Service e.g. Dieticians, Neurology etc. 5. RECRDING GUIDANCE WT 5 Urgency Category When the WT 4 Urgent Category is used the following recording guidance must be applied to ensure standardised data recording across health boards and professions. ISD s Service Access Team will be able to indicate waiting times for patients categorised as urgent separate from non urgent. The guidance below is derived from Prof. Tracey Howe s research regarding Urgency of SK appointments for physiotherapy and a consultation of AHP SK leads: There is no plan to capture the details below but provides information guidance on what is permissible to deem Urgent for waiting times for each discipline. rthotics There is no expectation for any out patient orthotic appointment to be categorised as urgent. Podiatry The urgent category can only be applied for podiatry SK patients who are also known to have one or more of the following diabetes an infective foot condition individual's ambulation is compromised to the point where they are absent from work Physiotherapy and ccupational Therapy The patient has been signed off work or unable to maintain carer responsibilities due to the SK problem Unremitting Pain Sleep function reduced due to the SK condition Recent/acute injury(within the last 12 weeks) including orthopaedic surgery or PP removal Veteran where a SK condition is a direct result of active service These guidelines for physiotherapy will be reviewed ay/june 2014 following a pilot test in NHS Greater Glasgow & Clyde and may be reduced to recent orthopaedic surgery. 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 9

11 APPENDIX I - QUICK GUIDE T AHP ADJUSTED WAITING TIES NATINAL GUIDANCE Allied Health Professions usculoskeletal Waiting Times Quick Guide starts Starts Received The Waiting Times - New Ways Waiting Time ffer made Patient Accepts offer 1 st Contact Stops Waiting Times Codes WT 1 Date of to Service WT2 Date of Receipt of WT3 Date Placed on Waiting List WT4 SK Wait. times stand. applied WT5 Urgency WT6 ffer Type WT7 ffer Date WT8 Appointment Date WT9 Response Received Date WT10 ffer utcome WT27 Date Removed from List WT28 Reason for Removal WT30 Patient Type starts Received ffer made Patient Accepts offer 1 st Contact Waiting Times Codes WT20 pause start date WT21 pause type WT23 Planned review date WT24 pause end date WT25 Review date WT26 Review outcome WT27 Date of Removal from List WT28 Reason for Removal WT30 Patient Type Adjusting for Periods of Unavailability Starts Waiting Time Received Pause Patient Unavailable For treatment Restart Waiting Time Appointment Attended Stops NB Patient has already accepted an offer Resetting the with Non-attendance Starts Received ffer made Patient Accepts offer Reset to Zero Patient DNA or CNA Waiting Time New ffer made Patient Accepts offer 1 st Contact Stops Waiting Times Codes WT16 Non-attendance category WT17 Non-attendance date WT19 Non-attendance outcome WT27 Date of Removal from List WT28 Reason for Removal WT29 Patient Status WT30 Patient Type Further details about National Adjusted waiting times guidance information can be found at 16/05/2014 AHP SK Waiting Times Data Set. V 1.5 Page 10