Waiting Times Recording Manual published March 2016 Title: Waiting Times Recording Manual Date Published: March 2016 Version: V5.1 Document status: Final Author: Martin McCoy Owner: Service Access Waiting Times, ISD Approver: Fiona MacKenzie Revision History: Version: Date: Summary of Changes: V1.0 December 2007 No previous version V4.0 November 2009 Notes and cross checks updated WT4 - New code added for Cataract (1-stop clinic) V4.1 October 2010 WT4 - New code added for Exceptional Aesthetic Procedures (not released) V4.2 January 2012 WT4 New code added for One-stop clinic (excluding cataracts) New Ways guidance section removed V5.0 December 2014 TTG compliant update. Amended booking practice principles incorporated. V5.1 March 2016 WT4 new code added for local Health Board use. 1
Contents Waiting Times Recording Manual... 1 Introduction... 4 Purpose of this document... 4 Data Items... 4 WT1 Referral Date... 5 WT2 Referral Received Date... 6 WT3 Waiting List Date... 7 WT4 Waiting Time Standard... 8 WT5 Urgency Category... 10 WT6 Offer Type... 11 WT7 Offer Date... 12 WT8 Appt/Admission Date... 13 WT9 Response Received Date... 14 WT10 Offer Outcome... 15 WT11 Availability for admission/appointment at short notice... 16 WT12 Minimum days notice required admission/appointment... 17 WT13 Suitability of patient to be considered part of pooled list... 18 WT14 Patient willing to change clinician... 19 WT15 Patient willing to change Health Board... 20 WT16 Non-attendance category... 21 WT17 Non-Attendance Date... 23 WT19 Non-attendance Outcome... 26 WT20 Unavailability Start Date... 27 WT21 Unavailability Type... 28 WT23 Planned Review Date... 31 WT24 Unavailability End Date... 32 WT25 Review Date... 33 WT26 Review Outcome... 34 WT27 Removal Date... 35 WT28 Removal Reason... 36 WT29 Patient Status... 37 WT30 Patient Type... 38 WT31 Referrer Urgency Category... 39 GEN1 Surname... 40 GEN2 Forename... 41 GEN3 Date of Birth... 42 GEN4 Gender... 43 GEN5 CHI... 44 GEN6 Case Reference Number... 45 GEN7 Postcode... 46 GEN8 Ethnic Group... 48 2
GEN9 GP Practice Code... 49 GEN10 Location... 50 GEN11 Specialty... 51 GEN12 Consultant/HCP... 52 GEN13 Patient Category... 53 GEN14 Referral Source... 54 GEN15 Provider code... 55 GEN16 Main Condition... 56 GEN17 Other Condition... 57 Data Collection... 59 Recording Rules... 59 Offers of Appointments or Admission... 59 Non-attendance... 59 Unavailability... 60 Unavailability and Patient Focused Booking... 60 Calculation of Waiting Time... 60 National Data Submission... 62 Data Extraction and Validation... 62 Coverage... 62 Types of Records... 62 Access to Data... 62 Quality Assurance of Waiting Times Data... 62 Appendix A: List of Data Items... 64 3
Introduction Waiting times are important to patients and are a measure of how the NHS is responding to demands for services. Measuring and regular reporting of waiting times highlights where there are delays in the system and enables monitoring of the effectiveness of NHSScotland s performance. ISD Scotland continues to be committed to improving the information on waiting times along with our key stakeholders, the NHS Boards and Scottish Government. From 01 January 2008, the New Ways of monitoring and measuring waiting times was implemented and subsequently updated in April 2010. More recently, the Patient Rights (Scotland) Act 2011 established a 12 week maximum Treatment Time Guarantee (TTG) for eligible patients who are due to receive planned inpatient or day case treatment. Eligible patients must start to receive that treatment within 12 weeks (84 days) of the treatment being agreed. In addition Scottish Government and NHS Boards have agreed to manage outpatients under the same guidance. On the whole this does not affect outpatient reporting. However, it could affect the calculation of wait for outpatients i.e. NHS Boards previously applying a Could Not Attend (CNA)/Did Not Attend (DNA) to a patients record would have resulted in a patients clock being reset. Now there is an option to allow the flexibility, meaning a clock should only be reset if it is reasonable and clinically appropriate to do so. Purpose of this document This recording manual is designed to cover the 18 weeks Referral to Treatment standard, the New Ways Stage of Treatment standard, and the Treatment Time Guarantee. It is intended for staff involved in collecting, extracting and submitting information to the national Data Warehouse for patients on stage of treatment pathways (outpatients, inpatients, day cases and return outpatients). This guidance provides recording information and rules around the waiting times and generic data items that are submitted to the national Data Warehouse. Supporting Documentation Document NHS Scotland Waiting Time Guidance July 2012 Waiting Time Validation Manual Waiting Time Calculation Manual Owner SG ISD ISD Data Items 4
WT1 Formal name: Referral Date Common Name(s): Date of referral, Date of patient referral Priority: S for new outpatients; M for Waiting Time Standard 080 and 081 Definition: A referral date is the date on which a referral is made to a healthcare service. 1. A referral date should be recorded for all new outpatients. 2. Where a referral is made by letter, the date on the letter should be recorded as the referral date. 3. Where an electronic referral is made, the date the referral was made should be recorded as the referral date. 4. Where a referral has been made by telephone and then followed by written confirmation the date of the telephone referral takes precedence and should be recorded as the referral date. 5. The referral date (WT1) must be on or before the extract submission date. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. The referral date (WT1) may be the same date as the referral received date (WT2). 1. The referral date will be used to monitor the time taken between the referral date (WT1) and referral received date (WT2). 2. This item may be used in the future in conjunction with other waiting times data items to measure the patient journey. 1. Referral date (WT1) to the service must be on or before the referral received date (WT2). 5
WT2 Formal Name: Referral Received Date Common Name: Referral receipt date, Date of receipt of referral, Date referral received Priority: M for new outpatients Definition: Referral received date is the date on which a healthcare service receives a referral. 1. The referral received date must be recorded for all new outpatients. 2. If a written referral has been made this is the date the referral letter was received/stamped and not the date it reaches the relevant department, service, team or person. 3. Where a referral has been made by telephone and then followed by written confirmation the date of the telephone referral takes precedence and should be recorded as the referral received date. 4. If the waiting times standard (WT4) is ART the definition of this field is the date tertiary care agree the patient should have treatment. 5. The referral received date must be on or before the extract submission date. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. The referral received date (WT2) can be the same date as the referral date (WT1). 2. New outpatient records cannot be submitted where the referral received date is before 01 April 2009. 1. The referral received date is used to calculate the waiting time for new outpatients. 2. The referral received date will be used to monitor the time taken between the referral date (WT1) and referral received date (WT2). 3. This item may be used in the future in conjunction with other waiting times data items to measure the patient journey. 1. The referral received date (WT2) must be on or after the referral date (WT1) to the service. 2. Offer Date (WT7) must be on or after the referral received date for new outpatients. 3. Unavailability end date (WT24) must not fall before the referral received date for new outpatients. 4. Non-attendance date (WT17) must be on or after the referral received date for new outpatients. 6
WT3 Formal Name: Waiting List Date Common Name: Date added to waiting list Priority: M for day cases, inpatients and outpatients for procedure Definition: Waiting List Date is the date that a decision is made, by the healthcare professional responsible for the patient s care, to put the patient on a waiting list. 1. Waiting list date must be recorded for inpatients, day cases and outpatients for procedure. 2. Waiting list date must be on or before the extract submission date. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. Waiting list date is not mandatory for new outpatients because referral received date (WT2) will be used to calculate waiting times information. 1. Waiting list date is used to measure the time a patient waits for admission for day cases, inpatients and return outpatients for procedure. 2. This item may be used in the future in conjunction with other waiting times data items to measure the patient journey. 1. Offer date (WT7) must be on or after the waiting list date for inpatients, day cases and return outpatients. 2. Non-attendance date (WT17) must be on or after the waiting list date for inpatients, day cases and return outpatients. 3. The unavailability end date (WT24) must not fall before the waiting list date for inpatients, day cases and return outpatients. 4. Removal date (WT27) must be on or after the waiting list date. 7
WT4 Formal name: Waiting Time Standard Common name: Waiting Type, Waiting Times Standard Applied Priority: S Definition: The waiting time target or standard against which the waiting time will be measured. 1. Waiting time standard should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Code 081 is for the ART HEAT target. Code 071 should be used for TTG exclusions. Coded - 3 characters The following new Waiting Time Standard codes will be introduced to allow NHS Boards to identify patients who belong to treatment groups which will be excluded from the TTG. TARGET/GUARANTEE CODE General Outpatient 010 Outpatient Procedure 011 General Inpatient/Day Case 020 Cancer 040 Diagnostic Test 050 Diagnostics (Other key tests) 051 Other Diagnostics (excluding 050 and 051) 052 Exceptional Aesthetic Procedure 060 Assisted Reproduction 071 Obstetric Services 072 Organ, Tissue or Cell Transplantation 073 Surgical Intervention of Spinal Scoliosis 074 Spinal Treatment by Injection or Surgical Intervention 075 AHP MSK 080 ART 081 Non WT record (local use) 090 1. If the patient is covered by two guarantees, the waiting times standard code used should be that which reflects the most specific (and shortest) target wait. 2. Current TTG exclusions are codes Codes 071,072 and 073. 3. Code 074 is only excluded for records with Initial Start Date < 01October 2014. 4. Code 075 is only excluded for records with an Initial Start Date < 01 April 2014. 1. The waiting time standard will allow specific waiting times targets/standards to be monitored. 2. This item may be used in the future in conjunction with other waiting times data items to measure the patient journey. 8
None 9
WT5 Formal Name: Urgency Category Common Name: Urgency Priority: S Definition: The clinical decision on how quickly the patient needs to be seen/treated: URGENT: the patient requires an appointment at the earliest possible opportunity. SOON: a patient requires an earlier appointment than he/she would receive if given the next available routine appointment. ROUTINE: a patient requires the next available routine appointment. 1. Urgency category should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Urgency category may be altered if the receiving healthcare professional considers the patient s condition to have changed prior to the patient s admission. Coded - 2 characters CATEGORY CODE Urgent 01 Soon 02 Routine 03 1. This variable 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. 1. The urgency category can be used for scheduling and prioritising patients. 10
WT6 Formal Name: Offer Type Common Name: Type(s) of Offer(s) Priority: M (optional for AHP) Definition: Type of offer of appointment or admission made to the patient. 1. Offer type must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Offer type must be recorded for all offers made. 3. Where a written offer has been made and is then followed by a verbal confirmation by the patient that they can attend, the written offer should be recorded as the offer type 4. For PFB invitations the offer type should be recorded as code 03 (Patient Focussed Booking letter of invitation). A new appointment record should be created when the patient contacts the service to arrange an appointment with the offer type as code 02 (Verbal offer). 5. PFB invitations can only be applied to non-ttg patients i.e. outpatients, diagnostic tests and AHP (MSK). Coded - 2 characters OFFER TYPE CODE Written offer 01 Verbal offer 02 Patient Focussed Booking letter of invitation 03 1. An appt/admission date (WT8) must be recorded for every written or verbal offer. 2. If a PFB letter of invitation (code 03) has been recorded with an offer date (WT7) there should be no associated appt/admission date (WT8) recorded. 3. A reminder / confirmation system should be in place to ensure patients are given a second notification of their appointment date and time 1. Offer type can be used in conjunction with other variables to monitor patient scheduling and the management of patient appointments. 1. Offer type (WT6) must be present when an offer date of appointment or admission (WT7) is entered. 2. Where the offer type (WT6) is written (01) or verbal (02) the offer outcome (WT10) must not be responded to PFB invite (50, 60). 3. Where the offer type is PFB (03) the offer outcome (WT10) can only be responded to PFB invite (50, 60) or no response (70, 80, 90). 11
WT7 Formal Name: Offer Date Common Name: Date(s) of offer(s) Priority: M Definition: The date any offer of appointment/admission is made to the patient or the date the PFB letter of invitation was sent. 1. Offer date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Offer date (WT7) must be recorded when type of offer (WT6) is specified. 3. For written offers, the date the letter was sent should be recorded as the offer date. 4. For PFB invitations the date of the invitation letter should be recorded as the offer date. When the patient contacts the service to arrange an appointment a new appointment record should be created with the date of the contact as the offer date and the offer type (WT6) recorded as verbal (code 02). 5. The offer date must be on or before the extract submission date. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: Ten characters 1. Where the system generates a letter of appointment/admission/pfb invitation the date may be generated automatically. 2. Multiple offers can be recorded. At least the two most recent offer dates must be held on the system. 3. This is the date that a written offer, verbal offer or a PFB letter of invitation is sent to the patient and not the appt/admission date (WT8). 4. It is not appropriate to give 7 days notice when offering dates of appointment or admission if the patient has been recorded as needing treatment urgently (WT5). 1. Offer date can be used in conjunction with other variables to monitor patient scheduling and the management of patient appointments. 2. Offer date can be used to determine if the offer of appt/admission is a reasonable or a short notice offer. 1. Offer date (WT7) must occur on or after the waiting list date (WT3) for day cases, inpatients and return outpatients for procedure. 2. Offer date (WT7) must occur on or after the referral received date (WT2) for new outpatients. 3. Appt/admission date (WT8) must be on or after the offer date (WT7). 4. Response received date (WT9) must be on or after the offer date (WT7). 12
WT8 Formal Name: Appt/Admission Date Common Name: Date(s) of proposed appointment/admission Priority: M for written or verbal offers, excluding PFB invitation Definition: Date(s) of appointment or admission offered to the patient. 1. The appt/admission date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The appt/admission date must be recorded for all written and verbal offers recorded in WT6. 3. The appt/admission date should not be recorded when the type of offer is PFB (see WT7 recording rule 4). 4. The appt/admission date cannot be within any defined periods of unavailability unless associated with a non-attendance category (WT16). 5. Where the waiting times standard code (WT4) is ART the date of proposed appointment/admission is the date of screening. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. A record may be completed for every appt/admission date offered. Under the Reasonable Offer rule, under most circumstances, recording two refused dates prior to an acceptance will result in the waiting time clock being reset to the date when the patient refused the second appointment. Unless the urgency category (WT5) is classed as Urgent, where the next available appointment should be offered. 2. Short notice appointment dates (i.e. less than 7 days notice) can be offered. If the patient accepts such an offer, then it is deemed to be a reasonable offer of appointment. However, if the patient declines such a short notice offer, they must not be disadvantaged, and must be made a reasonable offer of a further two or more different dates of appointment within the waiting times standards and treatment time guarantee. 3. It is not appropriate to give 7 days notice when offering appt/admission dates if the patient has been recorded as needing treatment urgently (WT5). 1. Appt/admission date is used to monitor reasonable offers in conjunction with offer date (WT7). 1. Appt/admission date (WT8) must be on or after the offer date of appointment or admission (WT7). 2. The response received date (WT9) must be on or before the appt/admission date (WT8). 13
WT9 Formal Name: Response Received Date Common Name: Date(s) of receipt of response(s) Priority: M Definition: Date when the service receives a response from the patient to the proposed appointment/admission offer(s) or invitation to make contact (PFB). 1. Response received date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Response received date should be recorded for all offers of appointment or admission. 3. If the response received date (WT9) is recorded the offer outcome (WT10) must be entered. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. Subsequent offers cannot be made before the response received date (WT9) of the current offer. 1. Response received date (WT9) can be used in conjunction with the offer date (WT7) to monitor the time taken to respond to an offer. 1. The response received date (WT9) must be on or before the appt/admission date (WT8). 2. The response received date (WT9) must be on or before the removal date (WT27). 3. The response received date must be on or after the offer date (WT7). 14
WT10 Formal Name: Offer Outcome Common Name: Outcome of offer Priority: M Definition: The patient s response to the offer of an appointment or admission date or for outpatients only - PFB letter of invitation. 1. Offer outcome must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Offer outcome code must be applied to each offer of an appointment or admission (WT7). 3. Only one code must be recorded for each date of proposed appointment or admission. 4. Offer outcome (WT10) can only be codes 70, 80 or 90 when the response received date (WT9) has not been entered. 5. Offer outcome (WT10) must be codes 10, 20, 30, 40, 50 or 60 when the response received date (WT9) has been entered. Coded - 2 character OUTCOME CODE Accepted 10 Declined New offer made/to be made 20 Declined Removed from list 30 Declined Awaiting decision 40 Responded to PFB invite offer of appointment made/to be made 50 Responded to PFB invite invitation declined/not wanting appointment 60 No response Awaiting decision 70 No response New offer made/to be made 80 No response Removed from list 90 1. If the patient has declined two offers and a further offer is made or to be made their waiting time clock will be reset to the date they declined the second offer (note: the date the PFB letter of invitation for outpatients was sent is not included in waiting times calculations as an offer). Unless the urgency category (WT5) is classed as Urgent, where the next available appointment should be offered. 1. Provides evidence of response/non response to offer(s) of appointment/admission. 1. When offer type (WT6) is written (01) or verbal (02) the offer outcome (W10) must not be responded to PFB invite. 2. When offer type (WT6) is PFB (03) the offer outcome (WT10) can only be responded to PFB invite (50, 60) or no response (70, 80, 90). 3. Where the Removal Reason (WT28) is 10 (attended/admitted) then the offer outcome (WT10) of the most recent appointment date must be 10 (accepted). 15
WT11 Formal Name: Availability for admission/appointment at short notice Common Name: Short notice availability Priority: O Definition: To identify whether the patient can be available to be admitted or attend an appointment in less than the minimum 7 days notice required. 1. Availability for admission or appointment at short notice can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Coded 1 character AVAILABILITY CODE Available 1 Not available 2 Not known 9 1. If the patient declines an offer given at short notice then this will not count against them, i.e. it will not affect their right to a reasonable offer. 1. WT11 can be used to identify if the patient is willing to attend an appointment at short notice. 2. The information can be used locally to assist in scheduling. 16
WT12 Formal Name: Minimum days notice required admission/appointment Common Name: Minimum notice required Priority: O Definition: The minimum number of day s notice that the patient requires for date of appointment or admission. 1. Minimum days notice should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The number of days is automatically calculated and populated by the system but the entry can be over written in cases where less than 7 days notice is accepted by the patient. 3. The default should be 7 days. Number between 0 and 7. 1. For an offer to be considered as reasonable the date of appointment or admission offered must give at least 7 days notice from the date the offer is made (unless the patient is considered urgent or accepts a short notice appointment). 2. Appointments and admissions with less than 7 days notice can be offered and will be considered reasonable if the patient accepts. 3. If the patient declines an offer given at short notice then this will not count against them, i.e. it will not affect their right to a reasonable offer. 1. The information can be used locally to assist in scheduling. 2. The minimum days notice required (WT12) in conjunction with the availability for admission/appointment at short notice (WT11) can be used to identify patients who are willing to attend at short notice and if so the amount of notice they require. 17
WT13 Formal Name: Suitability of patient to be considered part of pooled list Common Name: Suitability for pooled list Priority: O Definition: Decision as to whether the patient could be seen as part of a generic list or clinically required to remain on the specific/original healthcare professional s list. 1. The suitability of the patient to be considered part of a pooled list should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The information should be recorded when a decision is made as to whether a patient can be considered part of a pooled list. Coded 1 character SUITABILITY CODE Suitable 1 Not suitable 2 Not known 9 1. The response to this question impacts on the information recorded against Patient willing to change clinician (WT14), i.e. WT14 only becomes relevant if the patient is suitable to be considered part of a pooled list. 1. For local use to assist in scheduling. 18
WT14 Formal Name: Patient willing to change clinician Common Name: Willing to change clinician Priority: O Definition: To identify whether a patient is willing to be seen by another healthcare professional. 1. Patient willing to change clinician should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Coded 1 character WILLING TO CHANGE CODE Willing to change 1 Not willing to change 2 Not known 9 1. For local use to assist in scheduling. 19
WT15 Formal Name: Patient willing to change Health Board Common Name: Willing to change HB Priority: O Definition: To identify whether a patient is willing to be seen at another Health Board, GJNH or private sector. 1. Patient willing to change Health Board should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Coded 1 character WILLING TO CHANGE CODE Willing to change 1 Not willing to change 2 Not known 9 1. Where arrangements are in place for the patient to be seen at another provider, a list of available hospitals/clinics should be detailed in the local access policy. 1. The information can be used locally to assist in scheduling. 20
WT16 Formal Name: Non-attendance category Common Name: Priority: M Definition: DID NOT ATTEND: The patient may be categorised as did not attend (DNA) when he/she did not attend a previously accepted appointment and gave the hospital no prior warning of the non attendance. COULD NOT ATTEND: The patient may be categorised as could not attend (CNA) when the hospital is notified in advance that he/she will not attend a previously accepted appointment. Time limit on advanced notice should be detailed in the local access policy. CANCELLED BY SERVICE: Admission and appointment dates may be cancelled by the service for a variety of reasons, for example, if staff are not available to deliver the service or the location is unavailable. Patients may receive short notice of the cancellation. 1. Non-attendance category must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. One non-attendance category code must be recorded for each non-attendance. 3. All DNAs, CNAs and cancellations by service must be recorded. 4. Non-attendance category (WT16) should only be recorded when a non-attendance date (WT17) or the code denoting removed/remained on the list (WT19) has been supplied. 5. Non-attendance category (WT16) cannot be recorded where an offer has not been accepted. Coded 1 character CATEGORY CODE Could Not Attend 2 Did Not Attend 3 Cancelled by Service 5 Could Not Attend (wait unaffected) 6 Did Not Attend (wait unaffected) 7 1. Further appointment/admission dates can be offered according to local and national guidance. 2. If the patient cancelled their appointment (CNA) their waiting time clock may be unaffected where it is reasonable and clinically appropriate to do so. 3. If the patient failed to attend (DNA) for their appointment their waiting time clock may be unaffected where it is reasonable and clinically appropriate to do so. 4. Admission or appointment arrangements cancelled by the hospital will not adversely affect the waiting period for the patient. The waiting time clock will not be reset. 5. The clock is only reset for a non-attendance which occurs when the adjusted wait to that point is 84 days or less. 21
1. Local use as part of patient s attendance history. None 22
WT17 Formal Name: Non-Attendance Date Common Name: Non-attendance date(s) Priority: M Definition: The date the patient did not attend, date the patient cancelled their appointment or admission or the date the hospital cancelled the appointment or admission arrangements. 1. Non-Attendance Date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. A Non-Attendance Date (WT17) must be recorded when a non-attendance category (WT16) code has been recorded. 3. Non-Attendance Date (WT17) cannot be recorded where an offer has not been accepted. 4. Non-attendance date must be on or before the removal date (WT27). 5. Non-attendance date must be on or after the referral received date (WT2) for new outpatients and the waiting list date (WT3) for inpatients, day cases and return outpatients. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. If the patient cancels their appointment (CNA) their waiting time clock will be reset to zero from the date they cancelled the appointment if it is reasonable and clinically appropriate to do so. 2. If the patient fails to attend (DNA) for their appointment their waiting time clock will be reset to zero from the date of the appointment if it is reasonable and clinically appropriate to do so. 3. Admission or appointment arrangements cancelled by the hospital will not adversely affect the waiting period for the patient. The waiting time clock will not be reset. 4. The clock is only reset after a non-attendance which occurs when the adjusted wait to that point is 84 days or less. 1. The date recorded will be used in the calculation of the patient s waiting time. 1. Non-attendance date (WT17) must be equal to the appt/admission date (WT8) for a nonattendance category (WT16) of Did Not Attend (code 3) or Did Not Attend (wait unaffected) (code 7). 2. Non-attendance date (WT17) must be on or before the appt/admission date (WT8) for a non-attendance category (WT16) of Cancelled by Service (code 5), Could Not Attend (code 2) or Could Not Attend- wait unaffected (code 6). 3. Non-Attendance Date must be on or after the Response Received Date where the Non- Attendance Category is Could Not Attend or Could Not Attend- wait unaffected. 23
3. Non-attendance date must be on or before the extract submission date where the attendance category (WT16) is Did Not Attend (code 3). 24
WT18 Formal Name: Explanatory text or code (for non-attendance) Common Name: Explanatory text or code Priority: O Definition: An explanation, if available, as to why the patient has not attended an appointment. 1. An explanation of why the patient has not attended can be recorded for new outpatients, inpatients, day cases and return outpatients. 2. This item is for local use only and would only need to be recorded when a non-attendance date (WT17) has been recorded. According to local instructions. 1. This information will not be loaded into the data warehouse and will therefore not be accessible using Business Objects or other reporting tools. 1. Local use only. 25
WT19 Formal Name: Non-attendance Outcome Common Name: Removed/retained on list Priority: M Definition: 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. 1. The non-attendance outcome must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The non-attendance outcome must be recorded when a non-attendance category (WT16) has been entered. 3. The non-attendance outcome cannot be recorded where an offer has not been accepted. Coded 2 characters OUTCOME CODE Removed 10 Remained 20 To be confirmed 90 1. If the patient is retained on the list (code 20) after they cancelled their appointment (CNA) their waiting time clock will be reset to zero from the date they cancelled the appointment if it is reasonable and clinically appropriate to do so. 2. If the patient is retained on the list (code 20) after they failed to attend (DNA) their waiting time clock will be reset to zero from the date of the appointment if it is reasonable and clinically appropriate to do so. 3. The patient will be retained on the list (code 20) after the service cancels the patient s appointment or admission arrangements. The patient s waiting time clock will not be affected. 4. The clock will not be reset for any attendance type after a non-attendance where patients have waited over 84 days. 1. This item can be used to ensure that patients who do not attend are being managed. 2. Code 90 To be confirmed can be used as a 'holding' code where the service is awaiting a clinical decision on whether to remove the patient from the list. The waiting time clock would be reset to zero from the date the patient cancelled their appointment or did not attend an appointment but would continue until a decision has been made. 26
WT20 Formal Name: Unavailability Start Date Common Name: Start of clock pause; Start Date(s) for period(s) of unavailability Priority: M Definition: Date the unavailability commences and clock pauses. 1. Unavailability start date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Unavailability start date must be recorded when the patient becomes unavailable for medical, patient advised or patient requested reasons. 3. Unavailability start date must be recorded when the patient has not responded to a PFB letter within seven days for outpatients and diagnostics only. 4. Unavailability periods cannot overlap even if the unavailability is due to different reasons. One unavailability period must finish before another can be applied. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. There may be more than one period of unavailability. 2. Unavailability periods are inclusive of the start and end date. 3. All unavailability periods for medical, patient advised or patient requested reasons applied before the patient has waited 84 days will be deducted in the calculation of the patient s waiting time. 4. Unavailability will not be deducted from a patients wait if it occurs when the patient has been on the list for over 84 days. 4. All unavailability periods resulting from a failure to respond to a PFB letter of invitation will be deducted irrespective of how many days have been recorded for outpatients and diagnostics. This should be monitored locally and nationally in line with guidance on maximum unavailability period. 5. If consecutive periods of unavailability are recorded for the same reason the time recorded for the clock pauses will be aggregated and one period of unavailability will be recorded when analysing waiting times information. 1. The unavailability start date (WT20) will be used in conjunction with the unavailability end date (WT24) in the calculation of waiting times. WT21 WT24 WT25 27
WT21 Formal Name: Unavailability Type Common Name: Type(s) of unavailability Priority: M Definition: To identify the reason, for example whether the unavailability is due to medical, patient advised or patient requested reasons. Or for outpatients and diagnostics, a period of unavailability has resulted from a delay in responding to a PFB letter of invitation. 1. Unavailability type must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The unavailability type must be recorded for every period of unavailability. 2. Unavailability type is recorded when it is known that the patient is unavailable for a known period of time or are indefinitely unavailable. 3. Only one unavailability type code must be recorded for each period of unavailability. Code 2 characters Unavailability Type Code 1A 1B 1C 1D 1E 1F 1G 1H 1I 1J 1K 2A 2B 3A 3B Unavailability Type Description Patient Advised - on holiday Patient Advised - personal commitment Patient Advised - work commitment Patient Advised - carer commitment Patient Advised - academic commitment Patient Advised - jury duty Patient Requested - wishes named Consultant Patient Requested - wishes to be treated within local Health Board Patient Advised - Visiting Consultant Service wishes to be seen at next scheduled service within Health Board of residence Patient Advised - following severe weather cancellation of Visiting Consultant Service, wishes to be treated within local Health Board Patient Advised - indefinitely unavailable Medical - other medical condition Medical - indefinitely unavailable Suspension due to exceptional circumstances Non-TTG no response to PFB offer of appointment 1. All unavailability periods for medical, patient advised or patient requested reasons applied before the patient has waited 84 days will be deducted in the calculation of the patient s wait. 2. Unavailability will not be deducted from a patients wait if it occurs when the patient has been on the list for over 84 days. 28
3. All periods of unavailability resulting from a failure to respond to a PFB letter of invitation will be deducted irrespective of how many days have been recorded for outpatients and diagnostics only. This should be monitored locally and nationally in line with guidance on maximum unavailability period. 4. If consecutive periods of unavailability are recorded for the same reason the time recorded for the period of unavailability will be aggregated and one derived period of unavailability will be deducted. 5. Following a period of indefinite unavailability the patients waiting time clock will be reset to the day after the unavailability end date (WT24) provided that the patients adjusted wait up to this point has not exceeded 84 days. 1. This item may be used in conjunction with other waiting times data items to facilitate patient management. WT20, WT24 29
WT22 Formal Name: Explanatory text or code for unavailability Common Name: Explanatory text or code Priority: O Definition: Explanation as to why the patient is unavailable. 1. An explanation as to why the patient is unavailable can be recorded for new outpatients, inpatients, day cases and return outpatients. According to local instructions. None 1. Allows the recording of specific reasons for periods of unavailability used by clinicians, to make judgements on what to do regarding the patient s treatment. 30
WT23 Formal Name: Planned Review Date Common Name: Planned review of unavailability, Date of any planned review(s) Priority: O Definition: The date on which any planned review of unavailability should take place. 1. The planned review date can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. This may not be the actual review date (WT25), but is the date that the review is planned to take place (WT23). 1. This item may be used in conjunction with other waiting times data items to facilitate patient management. None 31
WT24 Formal Name: Unavailability End Date Common Name: End date(s) of the period(s) of unavailability Priority: M Definition: The date on which the period of unavailability ends. 1. The unavailability end date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. The unavailability end date must be supplied for all periods of definite unavailability. 3. The unavailability end date must be supplied for all but the final period of indefinite unavailability. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. The patient is not available on the unavailability end date. 2. The unavailability period is inclusive of the start and end date. 3. All unavailability periods for medical, patient advised or patient requested reasons applied before the patient has waited 84 days will be deducted in the calculation of the patient s waiting time. 4. For outpatients and diagnostics, all periods of unavailability resulting from a failure to respond to a PFB letter of invitation will be deducted irrespective of how many days have been recorded. This should be monitored locally and nationally in line with guidance on maximum unavailability period. 5. Unavailability will not be deducted from a patients wait if it occurs when the patient has been on the list for over 84 days. 6. If consecutive unavailability periods are recorded for the same reason, the time recorded will be aggregated and one derived clock pause will be used for analytical purposes. 1. Along with the unavailability start date (WT20) the date will be used in the calculation of waiting times. 1. The unavailability end date (WT24) must be on or after the unavailability start date (WT20). 2. The unavailability end date (WT24) should not be before the referral received date (WT2) for new outpatients. 3. The unavailability end date (WT24) should not be before the waiting list date (WT3) for inpatients, day cases and return outpatients. 32
WT25 Formal Name: Review Date Common Name: Date of review Priority: O Definition: The date when the actual review of the unavailability takes place. 1. Review date can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. This item may be used in conjunction with other waiting times data items to facilitate patient management. 33
WT26 Formal Name: Review Outcome Common Name: Outcome of review(s) Priority: M Definition: The outcome of the review of the patient s period of unavailability. 1. Review outcome can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure Coded 2 characters OUTCOME CODE Now available 10 New review planned 20 Removed from list 90 1. This item may be used in conjunction with other waiting times data items to facilitate patient management. 34
WT27 Formal Name: Removal Date Common Name: Date of removal from list Priority: M Definition: The date a patient is removed from a waiting list. 1. Removal date must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure 2. Removal date (WT27) must be entered when a removal reason (WT28) has been entered. 3. Where the waiting times standard code (WT4) is ART the date of removal from list is the date of screening. 4. Removal date must be on or before the extract submission date. Day, month and year recorded as one item, to indicate when an event occurs. CCYY-MM-DD Field length: 10 characters 1. Removal date must not be within a period of unavailability when the removal reason (WT28) is 10; 11; 12 or 13. 1. The information can be used to monitor the time the patient was on a waiting list. 1. Removal date (WT27) must be on or after the referral received date (WT2) for new outpatients. 2. Removal date (WT27) must be on or after the waiting list date (WT3) for inpatients, day cases and return outpatients. 35
WT28 Formal Name: Removal Reason Common Name: Reason for removal from list Priority: M Definition: Indicates why the patient has been removed from the waiting list. 1. Removal reason must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure 2. All patients who are removed from the waiting list, i.e. have a removal date recorded (WT27), must have a removal reason code (WT28) recorded. Coded 2 characters REMOVAL REASON CODE Attended/admitted 10 Attended/admitted at GJNH 11 Attended/admitted at SRTC 12 Attended/admitted at private sector 13 Referred back to GP Patient Advised unavailability 20 Referred back to GP Medical unavailability 21 Referred back to GP Could Not Attend 37 Referred back to GP Did Not Attend 38 Referred back to GP Refused reasonable offer 40 Referred back to GP No response to offer 41 Referred back to GP Inappropriate referral 42 Inappropriate addition to list 43 Transferred same HB area, different specialty 50 Transferred within NHS Board area to another hospital 51 Transferred to another NHS Board area 59 Treatment no longer required 80 Died 90 1. Currently only patients who attended or were admitted as planned (codes 10,11,12,13) will be used in routine waiting time calculations for completed waits. 2. Where the waiting times standard (WT4) is AHP MSK patients who attended or were admitted as planned (code 10) is the first clinical out-patient appointment (which could be by telephone, video-link or face to face). 1. The information can be used to monitor reasons for a patient s removal from a waiting list and in the calculation of waiting times. 1. Removal date (WT27) must not be within a period of unavailability when the removal reason is 10; 11; 12 or 13. 2. Where the removal reason is Attended/admitted (codes 10,11,12 or 13) the offer outcome (WT10) of the most recent offer must be accepted (code 10). 36
WT29 Formal Name: Patient Status Common Name: Current Status of Patient Priority: M Definition: To identify the stage that the patient has reached in their current journey. 1. The patient status must be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Patients who have not or cannot be offered an appointment or admission have a code applied to denote status. 3. Patient status must be removed from list (code 40) where the removal date (WT27) has been entered. 4. Awaiting appointment/admission date (code 10) should be used when the patient is added to a waiting list and is waiting for an appointment or admission date. If the results of a diagnostic test or other specialty report are needed before an appointment date can be offered the appropriate code should be used to give a more specific indication of the reason the patient has not yet been offered an appointment. 5. When the patient has been offered an appointment (date of offer is completed) no code should be recorded. Coded 2 characters STATUS CODE Awaiting appointment/admission date 10 Awaiting diagnostic result(s) 20 Awaiting other specialty report(s) 30 Removed from list 40 1. 1. For local use for patient and waiting list management. 37
WT30 Formal Name: Patient Type Common Name: Patient type Priority: M Definition: To identify the expected management of the patient, i.e. is the patient a new outpatient, inpatient, day case or return outpatient for procedure. 1. Patient type must be recorded for all new outpatients, inpatients, day cases and return outpatients for procedure. 2. There is no requirement to record, measure and report 'general' return outpatients returning for a review appointment. There is a requirement, however, to record, measure and report patients waiting who return for procedures as outpatients in exactly the same way as treated as inpatients or day cases. Coded 2 characters PATIENT TYPE CODE Inpatient 01 Day case 11 New outpatient 21 Return outpatient 23 1. Patient type will be used to identify how the patient wait should be analysed; referral date (WT1)/referral received date (WT2) will be used to measure a new outpatient wait and waiting list date (WT3) will be used for inpatients, day cases and return outpatients for procedure. 1. This item may be used in conjunction with other waiting times data items to facilitate patient management. 38
WT31 Formal Name: Referrer Urgency Category Common Name: Priority: S Definition: The referrer s clinical assessment on how quickly the patient needs to be seen/treated. URGENT - For clinical reasons, the patient requires an appointment at the earliest possible opportunity. SOON - For clinical reasons, the patient requires an earlier appointment than he/she would receive if given the next available routine appointment. ROUTINE - The patient requires the next available routine appointment. 1. The referrer urgency category should be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. 2. Referrer urgency category may differ from Urgency Category (WT5) but must not be changed, i.e. the urgency recorded on the GP letter must be recorded. Code 2 characters CATEGORY CODE Urgent 01 Soon 02 Routine 03 1. Referrer urgency category identifies the referrer s classification of how urgently the patient needs to be seen and may differ from the code chosen by the healthcare professional to whom the patient has been referred. 1. Used to identify how quickly the patient requires an appointment or admission based on the referrer s assessment. 39
GEN1 Formal Name: Surname Common Name: Priority: O Definition: The surname of the person represents the part of the name which indicates the family group of which the person is part. 1. Surname can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Field length: 35 characters maximum 1. Although surname will be submitted as part of the extract to ISD the information that appears in the data warehouse will be taken from the CHI patient reference table. 2. Validation around surname has been turned off. 40
GEN2 Formal Name: Forename Common Name: First forename Priority: O Definition: The forename of the patient represents that part of the name of the patient which, after the Surname (GEN1), is the principal identifier of the person. 1. Forename can be recorded for new outpatients, inpatients, day cases and return outpatients for procedure. Field length: 35 characters maximum 1. Although forename will be submitted as part of the extract to ISD the information that appears in the data warehouse will be taken from the CHI patient reference table. 2. Validation around forename has been turned off. 41