NHS Information Standards Board

DSC Notice: 29/2002 Date of Issue: September 2002 NHS Information Standards Board Subject: Data Standards: Mental Health Minimum Data Set Implementation Date: 1 st April 2003 DATA SET CHANGE CONTROL PROCEDURE This paper gives notification of changes to be included in the NHS Data Dictionary & Manual and the NHS CDS Manual as appropriate. These will be consolidated into the publications in due course. Summary of Changes: Changes to the NHS Data Dictionary & Manual to support collection of the Mental Health Minimum Data Set, via the NHS-wide Clearing Service. Change Proposal Reference No: CP 23/02 The NHS Information Standards Board (NHS ISB) is responsible for approving information standards. The NHS ISB is supported by the Management Information Standards Board, the Clinical Information Standards Board and the Technical Standards Board. The packaging of standards document is under review. Any changes will be notified in due course. Please note that the website address has changed, and that Data Set Change Notices are now located at: http://www.nhsia.nhs.uk/dscn/pages/default.asp and on the NHSnet at: http://nww.nhsia.nhs.uk/dscn/pages/default.asp

DATA SET CHANGE NOTICE 29/2002 Reference: CP 23/02 - DG1107/08/02 v 1.8 Subject: Type of Change: Data Standards to support the Mental Health Minimum Data Set Revision of NHS data standards Effective Date: 1 April 2003 Reason for Change: Implementation of the collection of the Mental Health Minimum Data Set via the NHS-wide Clearing Service Background: National implementation of the Mental Health Minimum Data Set, followed the ratification of the Mental Health Minimum Data Set (MHMDS) by CRIR in September 1999 and is still continuing. The MHMDS is to be electronically collected from NHS Trusts via the NHS-wide Clearing Service for storage in a database from which the Department of Health will produce routine reports. Please note this collection of the MHMDS does not replace any other collection of mental health data such as the Admitted Patient Care CDS Type Detained and /or Long Term Psychiatric Census, which should continue to be collected. The first quarterly collection of the MHMDS via the NWCS is scheduled for the end of Quarter 1-2003 (end of June). In order to implement the electronic data flow, the data item notes which comprise the MHMDS itself have been specified and incorporated within the NHS Data Dictionary & Manual. In addition, a number of changes to existing data standards have also been made in order to fully support the MHMDS data item notes. This DSCN identifies changes to the NHS Data Dictionary & Manual to specify and incorporate the data item notes; and changes to previously existing data standards to support derivation of the data item notes. Summary of Changes: Entity Definitions ACUTE HOME-BASED CONTACT CARE PROGRAMME APPROACH EPISODE CARE PROGRAMME APPROACH REVIEW CLINIC ATTENDANCE NON-CONSULTANT CONSULTANT EPISODE (ACUTE HOME-BASED) CPA KEY WORKER ALLOCATION Change entity type description and relationships Change entity type description and relationships Change entity type description and attributes Change entity type description Change entity type description Change entity type name, Page 2 of 81

DAY CARE ATTENDANCE FACE TO FACE CONTACT COMMUNITY CARE FACE TO FACE CONTACT CPA KEY WORKER FACE TO FACE CONTACT SOCIAL WORKER FINANCIAL PERIOD LEGAL STATUS CLASSIFICATION MENTAL HEALTH CARE SPELL MENTAL HEALTH CARE TEAM MENTAL HEALTH CARE TEAM MEMBER ORGANISATION ORGANISATION FINANCIAL PERIOD OUT-PATIENT ATTENDANCE CONSULTANT PATIENT PROFESSIONAL STAFF GROUP CONTACT REPORTING PERIOD RESPONSIBLE MENTAL HEALTH CARE TEAM SERVICE POINT IN PERIOD SHELTERED WORK ATTENDANCE TELEPHONE CONTACT NHS DIRECT (MENTAL HEALTH) WARD ATTENDANCE description and relationships Change entity type description Change entity type description and relationships Change entity type name, description and relationships Change entity type description and relationships Change entity type description, attributes and relationships Change entity type attributes Change entity type description and relationships Change entity type relationships Change entity type relationships Change entity type relationships Change entity type name, description and relationships Change entity type description Change entity type relationships Change entity type description and relationships New entity type New entity type Change entity type descriptions and relationships Change entity type description New entity type Change entity type description Attribute Definitions CLINICAL CARE INTENSITY CPA LEVEL LEGAL STATUS CLASSIFICATION CODE LEGAL STATUS RESTRICTIVENESS MEDICAL TEAM MEMBER GRADE Change attribute description Change attribute description Change attribute description New attribute Change attribute description Page 3 of 81

MENTAL HEALTH CARE SPELL END CODE MHCS SUSPENSION REASON PERIOD SOCIAL WORKER CONTACT SOURCE OF REFERRAL FOR MENTAL HEALTH Change attribute description Change attribute description Change attribute description Change attribute name Change attribute description Data item note Notes ADMISSIONS (MENTAL HEALTH) BED DAYS (MENTAL HEALTH INTENSIVE) BED DAYS (MENTAL HEALTH MEDIUM SECURE) BED DAYS (MENTAL HEALTH) BED DAYS (MENTAL HEALTH NHS COMMUNITY CARE) CARE DAYS (ACUTE HOME-BASED) CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) CARE SPELL IDENTIFIER (MENTAL HEALTH) CARE SPELL NUMBER IN REPORTING PERIOD COMMUNITY SURVIVAL TIMES LIST (MENTAL HEALTH) CONTACTS (CLINICAL PSYCHOLOGIST) CONTACTS (COMMUNITY PSYCHIATRIC NURSE) CONTACTS (CONSULTANT PSYCHOTHERAPY) CONTACTS (NHS DIRECT MENTAL HEALTH) CONTACTS (OCCUPATIONAL THERAPIST) CONTACTS (PHYSIOTHERAPIST) CONTACTS (SOCIAL WORKER) CPA ENHANCED DAYS CPA LEVEL (AT END OF REPORTING PERIOD) CPA STANDARD DAYS DATE LAST SEEN (CPA CARE COORDINATOR) DAY CARE ATTENDANCE (MENTAL HEALTH NHS SITE) DAY CARE ATTENDANCE MH NON-NHS SITE INDICATOR DAY CARE DID NOT ATTENDS (MENTAL HEALTH NHS SITE) DAYS LIABLE FOR DETENTION DAYS OF SUPERVISED DISCHARGE DIAGNOSIS (ICD EIGHTH MOST RECENT) DIAGNOSIS (ICD ELEVENTH MOST RECENT) Page 4 of 81

DIAGNOSIS (ICD FIFTH MOST RECENT) DIAGNOSIS (ICD FIRST MOST RECENT) DIAGNOSIS (ICD FOURTH MOST RECENT) DIAGNOSIS (ICD NINTH MOST RECENT) DIAGNOSIS (ICD SECOND MOST RECENT) DIAGNOSIS (ICD SEVENTH MOST RECENT) DIAGNOSIS (ICD SIXTH MOST RECENT) DIAGNOSIS (ICD TENTH MOST RECENT) DIAGNOSIS (ICD THIRD MOST RECENT) DIAGNOSIS (ICD TWELFTH MOST RECENT) DISCHARGES (MENTAL HEALTH) ELECTORAL WARD OF USUAL ADDRESS END DATE (MENTAL HEALTH CARE SPELL) FIRST CONTACT TIMES LIST (MENTAL HEALTH) HOME HELP VISIT INDICATOR HONOS RATING (BEST IN LAST TWELVE MONTHS) HONOS RATING (FIRST IN MHCS) HONOS RATING (MOST RECENT IN MHCS) HONOS RATING (WORST EVER RECORDED) HONOS SCORE DATE (BEST IN LAST TWELVE MONTHS) HONOS SCORE DATE (FIRST IN MHCS) HONOS SCORE DATE (MOST RECENT IN MHCS) HONOS SCORE DATE (WORST EVER RECORDED) HOSPITAL STAYS LIST (MENTAL HEALTH) LEGAL STATUS CLASSIFICATION CODE (AT END OF REPORTING PERIOD) LEGAL STATUS RESTRICTIVENESS (HIGHEST IN REPORTING PERIOD) MENTAL HEALTH CARE AND LEGAL STATUS HISTORY MENTAL HEALTH CARE SPELL END CODE MENTAL HEALTH CARE TEAM TYPE (AT END OF REPORTING PERIOD) MHC WITHOUT PATIENT CONSENT IN REPORTING PERIOD MHCS SUSPENSION REASON (AT END OF REPORTING PERIOD) OCCUPATION (CPA CARE COORDINATOR) ORGANISATION CODE (PCT OF GP PRACTICE) OUT-PATIENT ATTENDANCE CONSULTANT (MENTAL HEALTH) OUT-PATIENT DID NOT ATTENDS (MENTAL HEALTH) PROCEDURE (ECT TREATMENTS Page 5 of 81

ADMINISTERED) PROCEDURE (READ EIGHTH MOST RECENT) PROCEDURE (READ ELEVENTH MOST RECENT) PROCEDURE (READ FIFTH MOST RECENT) PROCEDURE (READ FIRST MOST RECENT) PROCEDURE (READ FOURTH MOST RECENT) PROCEDURE (READ NINTH MOST RECENT) PROCEDURE (READ SECOND MOST RECENT) PROCEDURE (READ SEVENTH MOST RECENT) PROCEDURE (READ SIXTH MOST RECENT) PROCEDURE (READ TENTH MOST RECENT) PROCEDURE (READ THIRD MOST RECENT) PROCEDURE (READ TWELFTH MOST RECENT) REPORTING PERIOD (MENTAL HEALTH) RESIDENTIAL MH NON-NHS COMMUNITY CARE INDICATOR SHELTERED WORK ATTENDANCE INDICATOR SOCIAL SERVICES CLIENT IDENTIFIER SOCIAL WORKER INVOLVEMENT SOURCE OF REFERRAL FOR MENTAL HEALTH SPECIALTY FUNCTION CODE (MENTAL HEALTH) SPELL DAYS IN REPORTING PERIOD SPELL DEFINITION TYPE (ASSEMBLER MHCS) SSSA (NUMBER FOR COMMUNITY CARE) SSSA (NUMBER FOR DETENTION) START DATE (MENTAL HEALTH CARE SPELL) SUSPENDED DAYS IN REPORTING PERIOD YEAR OF FIRST KNOWN PSYCHIATRIC CARE Data Set MENTAL HEALTH MINIMUM DATA SET New data set Model View Diagram MH020 Model View Diagram MH020 Model View Diagram Overview Change model view diagrams Change model view diagram Page 6 of 81

MH030 Model View Diagram MH030 Model View Diagram Overview overview text Change model view diagram contents Change model view diagram overview text Page 7 of 81

CHANGES Change entity type description and relationships ACUTE HOME-BASED CONTACT A contact made with a PATIENT for delivery of acute home-based care within a CONSULTANT EPISODE (ACUTE HOME-BASED). The contact, whether face to face or via telephone, will be made with the PATIENT at their normal place of residence. Telephone contact should only be made where it is determined that the PATIENT is either approaching readiness for ending the period of care or is in a period of trial withdrawal from acute home-based care. When the MENTAL HEALTH CARE TEAM MEMBER is also the allocated Care Programme Approach key worker care coordinator for the PATIENT and the contact is face to face, then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The attributes are unchanged. Each ACUTE HOME-BASED CONTACT K must be a contact within one and only one CONSULTANT EPISODE (ACUTE HOME-BASED) must be a contact made by one and only one MENTAL HEALTH CARE TEAM MEMBER may be for the contact by one and only one CPA KEY WORKER CARE COORDINATOR ALLOCATION Change entity type description and relationships CARE PROGRAMME APPROACH EPISODE A period of care provided as part of the Care Programme Approach for an adult (including elderly) PATIENT. The CARE PROGRAMME APPROACH EPISODE forms part of a MENTAL HEALTH CARE SPELL. The first CARE PROGRAMME APPROACH EPISODE starts when the MENTAL HEALTH CARE SPELL initial assessment of the PATIENT determines that a plan of care or treatment is required which will be delivered under the Care Programme Approach. The CARE PROGRAMME APPROACH EPISODE ends when one of the following occurs: - a review determines that no further care need be provided - a different level of Care Programme Approach is required Page 8 of 81

- a PATIENT transfers to another HEALTH CARE PROVIDER with main responsibility for provision of mental health care also being transferred - death of the PATIENT A Care Programme Approach must involve all of the following key elements: a. An assessment of the PATIENT's health and social care needs b. A written care plan to meet the assessed needs, the PATIENT being involved in drawing up the care plan c. Regular reviews of the PATIENT's care plan d. A named mental health worker, called a key worker care coordinator, who is responsible for the PATIENT care under the Care Programme Approach There are two levels of Care Programme Approach; simple and complex standard and enhanced. References: HC(90)23, LSSL(90)11 "Caring for People", The Care Programme Approach for People with Mental illness referred to the Specialist Psychiatric Services. (Renewed September 1995) The Health of the Nation Key Area Handbook: Mental Illness, 2nd Edition, HMSO 1994, Appendix 9.3 H51/011 1406 1P January 97 The Patient's Charter - Mental Health Services Effective Care Co-ordination in Mental Health Services, Modernising the Care Programme Approach, a Policy Booklet, catalogue number 16736, October 1999. The attributes are unchanged. Each CARE PROGRAMME APPROACH EPISODE must be associated with one or more CPA KEY WORKER CARE COORDINATOR ALLOCATIONS The remaining relationships are unchanged. Change entity type description and attributes CARE PROGRAMME APPROACH REVIEW A clinical review of the health and social needs of a PATIENT who is the subject of a CARE PROGRAMME APPROACH EPISODE. The review may take the form of a single meeting of interested parties, usually including the allocated key worker care coordinator and the PATIENT or it may comprise a series of meetings and discussions over a number of days. The CARE PROGRAMME APPROACH REVIEW ends when a definite outcome is established and recorded. The date when this is recorded will be taken as the CPA REVIEW DATE. The outcome will determine whether the CARE PROGRAMME APPROACH EPISODE continues or is ended. Page 9 of 81

The review will also include the assessment and recording of the HoNOS score and the assessment or re-assessment of the need for a SUPERVISION REGISTER EPISODE. Attributes of this entity type are: SOCIAL WORKER CONTACT INVOLVEMENT if involvement or face to face contacts with social worker planned The remaining attributes are unchanged. The relationships are unchanged. Change entity type description CLINIC ATTENDANCE NON-CONSULTANT An attendance at a NURSE CLINIC, MIDWIFE CLINIC or FAMILY PLANNING CLINIC. This may have been as a result of an OUT-PATIENT APPOINTMENT NON-CONSULTANT. If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and the nurse they are in contact with during the attendance is their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. Note: Attendances at clinics run by Paramedics are PROFESSIONAL STAFF GROUP CONTACTS. The attributes and relationships are unchanged. Change entity type description CONSULTANT EPISODE (ACUTE HOME-BASED) The time a PATIENT who is subject to a MENTAL HEALTH CARE SPELL, spends in the continuous care of one CONSULTANT using the PATIENT's normal place of residence instead of admission to an acute hospital bed. A CONSULTANT EPISODE (ACUTE HOME-BASED) must satisfy the following criteria: - there should be a specified start date for the episode - the PATIENT should be judged by the CONSULTANT to be sufficiently ill to warrant admission to an acute hospital bed but that it is deemed more beneficial for the PATIENT for care to occur at their normal place of residence - nursing and medical staff should be available to the PATIENT 24 hours a day - there should be face to face contact with nursing or medical staff at least once in every nursing shift unless; i. the patient is approaching readiness for ending period of care, in which case at night, contact may be via telephone, or Page 10 of 81

ii. the patient is in a period of trial withdrawal comparable to LEAVE OF ABSENCE within a CONSULTANT EPISODE (HOSPITAL PROVIDER) - there should be a unit operational policy governing the maximum capacity which implies a staff to patient ratio of not less than 1 to 1 A PATIENT may not have concurrent CONSULTANT EPISODES (ACUTE HOME- BASED) or CONSULTANT EPISODES (HOSPITAL PROVIDER) but can have CONSULTANT OUT-PATIENT EPISODES overlapping with a CONSULTANT EPISODE (ACUTE HOME-BASED). The start of a CONSULTANT EPISODE (ACUTE HOME-BASED) will initiate a series of contacts at the PATIENT's normal place of residence to deliver care, each of which will be recorded as an ACUTE HOME-BASED CONTACT. Where face to face contact occurs with the allocated key worker care coordinator, a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR will also be recorded. In circumstances of the PATIENT approaching readiness for ending the period of care or are in a period of trial withdrawal, contact may be by telephone. The CONSULTANT EPISODE (ACUTE HOME-BASED) will be ended when the CONSULTANT determines no further acute home-based care is required. When responsibility for a PATIENT transfers from one CONSULTANT to another, then one CONSULTANT EPISODE (ACUTE HOME-BASED) will be ended and another one will be started The attributes and relationships are unchanged. Change entity type name, description and relationships CPA KEY WORKER CARE COORDINATOR ALLOCATION An association of a MENTAL HEALTH CARE TEAM MEMBER and a CARE PROGRAMME APPROACH EPISODE for the purpose of allocating a named key worker care coordinator. A key worker care coordinator is a professional member of staff working in specialist mental health services, who has been named and allocated as a key worker care coordinator to a PATIENT currently the subject of a CARE PROGRAMME APPROACH EPISODE. In most cases, there will be only one key worker care coordinator allocated to a PATIENT at any one time. However, assertive community treatment teams may assign two key workers at the same time. The attributes are unchanged. Each CPA KEY WORKER CARE COORDINATOR ALLOCATION Page 11 of 81

may be the contact for one or more FACE TO FACE CONTACTS CPA KEY WORKER CARE COORDINATOR The remaining relationships are unchanged. Change entity type description DAY CARE ATTENDANCE One attendance, or expected attendance, by a PATIENT at a particular DAY CARE SESSION. This will either be by a regular attender or by a PATIENT currently using a hospital bed (including HOME LEAVE and LEAVE OF ABSENCE for a period of 28 days or less). If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and during attendance at the facility is in contact with the HEALTH CARE PRACTITIONER who is their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The attributes and relationships are unchanged. Change entity type description and relationships FACE TO FACE CONTACT COMMUNITY CARE If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and the contact nurse is also their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The remaining description is unchanged. The attributes are unchanged. Each FACE TO FACE CONTACT COMMUNITY CARE may be for the contact by one and only one CPA KEY WORKER CARE COORDINATOR ALLOCATION The remaining relationships are unchanged. Change entity type name, description and relationships FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR A face to face contact between a PATIENT subject to a CARE PROGRAMME APPROACH EPISODE, and their currently allocated Care Programme Approach key worker care coordinator. If more than one key worker has been allocated, and the contact involves the presence of more than one key worker at the same time, then it is still considered as a single occurrence of a face to face contact. Page 12 of 81

In cases where contact arises due to: - a PROFESSIONAL STAFF GROUP CONTACT - or a FACE TO FACE CONTACT COMMUNITY CARE - or a WARD ATTENDANCE - or a CLINIC ATTENDANCE NON-CONSULTANT - or a DAY CARE ATTENDANCE - or a SHELTERED WORK ATTENDANCE - or a face to face ACUTE HOME-BASED CONTACT - or an OUT-PATIENT ATTENDANCE CONSULTANT both the FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR and the other contact or attendance should be recorded. The attributes are unchanged. Each FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR K must be for the contact by one and only one CPA KEY WORKER CARE COORDINATOR ALLOCATION Change entity type description and relationships FACE TO FACE CONTACT SOCIAL WORKER When the Social Worker is also the allocated Care Programme Approach key worker care coordinator for the PATIENT then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The remaining description is unchanged. The attributes are unchanged. Each FACE TO FACE CONTACT SOCIAL WORKER may be for the contact by one and only one CPA KEY WORKER CARE COORDINATOR ALLOCATION The remaining relationships are unchanged. Change entity type description, attributes and relationships FINANCIAL PERIOD A type of REPORTING PERIOD. A period of time, defined within a particular financial year. Page 13 of 81

Attributes of this entity type are: K PERIOD END DATE PERIOD TYPE Each FINANCIAL PERIOD may be related to one or more ORGANISATION FINANCIAL PERIODS The remaining relationships are unchanged Change entity type attributes LEGAL STATUS CLASSIFICATION The description is unchanged Attributes of this entity type are: K LEGAL STATUS CLASSIFICATION CODE LEGAL STATUS RESTRICTIVENESS The relationships are unchanged Change entity type description and relationships MENTAL HEALTH CARE SPELL A type of CARE SPELL. A continuous period of care or assessment for an adult (including elderly) PATIENT provided by a HEALTH CARE PROVIDER's specialist mental health services. This includes the care or assessment of adult and elderly PATIENTS with drug or alcohol dependence but excludes child and adolescent psychiatry PATIENTS and PATIENTS with learning disabilities whose only mental disorder is a learning disability. The specialist mental health services are delivered by mental health professionals, some of whom may receive referrals directly. Examples of mental health professionals would include consultants, clinical psychologists, community psychiatric nurses and mental health social workers any of whom could be nominated and allocated as the key worker care coordinator to the PATIENT. The remaining description is unchanged. The attributes are unchanged. Each MENTAL HEALTH CARE SPELL must be provided by one and only one MENTAL HEALTH CARE TEAM may be provided by one or more RESPONSIBLE MENTAL HEALTH CARE TEAM may be associated with contact by one or more TELEPHONE CONTACTS NHS DIRECT (MENTAL HEALTH) The remaining relationships are unchanged. Page 14 of 81

Change entity type relationships MENTAL HEALTH CARE TEAM The description and attributes are unchanged. Each MENTAL HEALTH CARE TEAM may be responsible for one or more MENTAL HEALTH CARE SPELLS may be responsible for one or more RESPONSIBLE MENTAL HEALTH CARE TEAM The remaining relationships are unchanged. Change entity type relationships MENTAL HEALTH CARE TEAM MEMBER The description and attributes are unchanged. Each MENTAL HEALTH CARE TEAM MEMBER may be the named key worker care coordinator for one or more CPA KEY WORKER CARE COORDINATOR ALLOCATION The remaining relationships are unchanged. Change entity type description and attributes ORGANISATION The description and attributes are unchanged. Each ORGANISATION may be related to one or more ORGANISATION FINANCIAL PERIODS may be related to one or more ORGANISATION REPORTING PERIODS The remaining relationships are unchanged. Change entity type name description and relationships ORGANISATION FINANCIAL REPORTING PERIOD The link between an ORGANISATION and a FINANCIAL REPORTING PERIOD for which centrally returned information has been recorded. The attributes are unchanged. Each ORGANISATION FINANCIAL REPORTING PERIOD K must be related to one and only one FINANCIAL PERIOD K must be related to one and only one REPORTING PERIOD Page 15 of 81

The remaining relationships are unchanged. Change entity type description OUT-PATIENT ATTENDANCE CONSULTANT If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and the consultant they are in contact with during the attendance is their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The remaining description is unchanged. The attributes and relationships are unchanged. Change entity type relationships PATIENT Each PATIENT may have one or more TELEPHONE CONTACTS NHS DIRECT (MENTAL HEALTH) Change entity type description and relationships PROFESSIONAL STAFF GROUP CONTACT If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and the member of the professional staff group discipline in contact is also their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The remaining description is unchanged. The attributes are unchanged. Each PROFESSIONAL STAFF GROUP CONTACT may be for the contact by one and only one CPA KEY WORKER CARE COORDINATOR ALLOCATION The remaining relationships are unchanged. New entity type REPORTING PERIOD Page 16 of 81

A period of time within an ORGANISATION in which data or information applicable to the period is reported or collected. FINANCIAL PERIOD is a subtype of REPORTING PERIOD. Attributes of this entity type are: K PERIOD START DATE END DATE Each REPORTING PERIOD may be related to one or more ORGANISATION REPORTING PERIODS New entity type RESPONSIBLE MENTAL HEALTH CARE TEAM An assignment of responsibility of a MENTAL HEALTH CARE TEAM to a MENTAL HEALTH CARE SPELL for a period of time. There may be one or more MENTAL HEALTH CARE TEAMS involved with a PATIENT at any one time but only one MENTAL HEATH CARE TEAM has responsibility at any one time. The assignments of responsibility may change during the course of a MENTAL HEALTH CARE SPELL, though not necessarily at the time of a CARE PROGRAMME APPROACH REVIEW. Attributes of this entity type are: K START DATE K START TIME O END DATE O END TIME Each RESPONSIBLE MENTAL HEALTH CARE TEAM K must be an assignment of one and only one MENTAL HEALTH CARE TEAM must be an assignment within one and only one MENTAL HEALTH CARE SPELL Change entity type description and relationships SERVICE POINT IN PERIOD A SERVICE POINT identified in a FINANCIAL REPORTING PERIOD for statistical data collection. The attributes are unchanged. Each SERVICE POINT IN PERIOD K must be related to one and only one ORGANISATION FINANCIAL PERIOD K must be related to one and only one ORGANISATION REPORTING PERIOD The remaining relationships are unchanged. Page 17 of 81

Change entity type description SHELTERED WORK ATTENDANCE One attendance of a PATIENT at a particular SHELTERED WORK SESSION. If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and during attendance at the facility are in contact with their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The attributes and relationships are unchanged. New entity type TELEPHONE CONTACT NHS DIRECT (MENTAL HEALTH) A telephone contact between a PATIENT subject to a MENTAL HEALTH CARE SPELL and NHS Direct which is related to the PATIENT s mental illness. This refers to any contacts that are required to be shared between NHS Direct and a Mental Health NHS Trust according to local and nationally agreed protocols on information sharing. Each contact should be recorded by NHS Direct and the details of the contact made known to the specialist mental health service responsible for the PATIENT. Attributes of this entity type are: K CONTACT NUMBER CONTACT DATE Each TELEPHONE CONTACT NHS DIRECT (MENTAL HEALTH) K must be for contact within one and only one MENTAL HEALTH CARE SPELL must be contact with one and only one PATIENT Change entity type description WARD ATTENDANCE If the PATIENT is currently subject to a MENTAL HEALTH CARE SPELL and during attendance is in contact with the nurse who is their allocated Care Programme Approach key worker care coordinator then a FACE TO FACE CONTACT CPA KEY WORKER CARE COORDINATOR should also be recorded. The remaining description is unchanged. The attributes and relationships are unchanged. Change attribute description Page 18 of 81

CLINICAL CARE INTENSITY The level of resources and intensity of care which it is intended to provide or is provided in a particular WARD. For patients with mental illness 51 for intensive care: a designated or interim secure unit specially designated ward for patients needing containment and more intensive management. This is not to be confused with intensive nursing where a patient may require one to one nursing while on a standard ward 52 for short stay: patients intended to stay less than a year 53 for long stay: patients intended to stay a year or more The remaining national codes are unchanged. Change attribute description CPA LEVEL The level of Care Programme Approach which has been determined as applicable for a PATIENT's CARE PROGRAMME APPROACH EPISODE. HEALTH CARE PROVIDERS may develop expanded local classifications to meet local requirements. However, local classifications must map back to the national classifications and only national classifications National Codes should be used for central reporting Classification: a. Simple, only one mental health care team member involved b. Complex, more than one mental health care team member involved 1 Standard, requires the support or intervention of one agency or discipline; or requires only low key support from more one agency 2 Enhanced, multiple needs, including housing, employment etc, which requires interagency coordination Change attribute description LEGAL STATUS CLASSIFICATION CODE A classification of LEGAL STATUS CLASSIFICATION. The classification 'informal' is used for those PATIENTS who are not formally detained or not receiving supervised aftercare. 01 Informal 02 Formally detained under Mental Health Act Section 2 03 Formally detained under Mental Health Act Section 3 04 Formally detained under Mental Health Act Section 4 05 Formally detained under Mental Health Act Section 5(2) 06 Formally detained under Mental Health Act Section 5(4) 07 Formally detained under Mental Health Act Section 35 Page 19 of 81

08 Formally detained under Mental Health Act Section 36 09 Formally detained under Mental Health Act Section 37 with section 41 restrictions 10 Formally detained under Mental Health Act Section 37 excluding section 37(4) 11 Formally detained under Mental Health Act Section 37(4) 12 Formally detained under Mental Health Act Section 38 13 Formally detained under Mental Health Act Section 44 14 Formally detained under Mental Health Act Section 46 15 Formally detained under Mental Health Act Section 47 with section 49 restrictions 16 Formally detained under Mental Health Act Section 47 17 Formally detained under Mental Health Act Section 48 with section 49 restrictions 18 Formally detained under Mental Health Act Section 48 19 Formally detained under Mental Health Act Section 135 20 Formally detained under Mental Health Act Section 136 30 Formally detained under previous legislation (fifth schedule) 31 Formally detained under Criminal Procedure(Insanity) Act 1964 as amended by the Criminal Procedures (Insanity and Unfitness to Plead) Act 1991 32 Formally detained under other acts 33 Supervised Discharge (Mental Health (Patients in the Community) Act 1995) 34 Formally detained under Mental Health Act Section 45A 35 Subject to guardianship under Mental Health Act Section 7 36 Subject to guardianship under Mental Health Act Section 37 New attribute LEGAL STATUS RESTRICTIVENESS A scoring which identifies the restrictiveness of a LEGAL STATUS CLASSIFICATION CODE in ascending score of restrictiveness. The first column is the restrictiveness score starting at 00.0 for the lowest level of restrictiveness. The second column is the National Code for each LEGAL STATUS CLASSIFICATION CODE followed by its description. It is possible for different LEGAL STATUS CLASSIFICATION CODES to have the same score of restrictiveness. 00.0 01 Informal 01.0 06 Formally detained under Mental Health Act Section 5(4) 02.0 05 Formally detained under Mental Health Act Section 5(2) 03.0 19 Formally detained under Mental Health Act Section 135 04.0 20 Formally detained under Mental Health Act Section 136 05.0 04 Formally detained under Mental Health Act Section 4 06.0 02 Formally detained under Mental Health Act Section 2 06.5 35 Subject to guardianship under Mental Health Act Section 7 07.0 33 Supervised Discharge (Mental Health (Patients in the Community) Act 1995 08.0 03 Formally detained under Mental Health Act Section 3 15.0 32 Formally detained under other acts 20.0 07 Formally detained under Mental Health Act Section 35 21.0 08 Formally detained under Mental Health Act Section 36 21.5 36 Subject to guardianship under Mental Health Act Section 37 22.0 12 Formally detained under Mental Health Act Section 38 23.0 10 Formally detained under Mental Health Act Section 37 Page 20 of 81

23.0 31 Formally detained under Criminal Procedure(Insanity) Act 1964 as amended by the Criminal Procedures (Insanity and Unfitness to Plead) Act 1991 24.0 18 Formally detained under Mental Health Act Section 48 25.0 16 Formally detained under Mental Health Act Section 47 26.0 13 Formally detained under Mental Health Act Section 44 27.0 14 Formally detained under Mental Health Act Section 46 28.0 09 Formally detained under Mental Health Act Section 37 with section 41 restrictions 29.0 17 Formally detained under Mental Health Act Section 48 with section 49 restrictions 30.0 15 Formally detained under Mental Health Act Section 47 with section 49 restrictions 31.0 34 Formally detained under Mental Health Act Section 45A Change attribute description MEDICAL TEAM MEMBER GRADE The grade of medical staff acting as a MENTAL HEALTH CARE TEAM MEMBER who is the named key worker care coordinator in a CARE PROGRAMME APPROACH EPISODE. The classifications are unchanged. Change attribute MENTAL HEALTH CARE SPELL END CODE A classification which identifies the reason for the ending of a MENTAL HEALTH CARE SPELL. Classification: a. Care or treatment finished in accord with professional advice b. Care or treatment ended against professional advice c. Care or treatment ended due to patient non-attendance d. Patient death e. Care or treatment transferred permanently to a medium secure Health Care Provider f. Care or treatment transferred permanently to a high security Health Care Provider g. Care or treatment transferred permanently to another Health Care Provider 00 Finished on professional advice 01 Finished against professional advice 02 Finished by patient s non-attendance 03 Patient died 21 Transfer to medium secure 23 Transfer to high secure 25 Transfer to other health provider Change attribute description MHCS SUSPENSION REASON Page 21 of 81

A classification which identifies the reason for suspending a MENTAL HEALTH CARE SPELL. Classification: a. Care or treatment transferred temporarily to a medium secure Health Care Provider b. Care or treatment transferred temporarily to a high security Health Care Provider c. Care or treatment transferred temporarily to another Health Care Provider 1 Unavailability of bed 2 Specialist care available in another NHS Trust 3 Patient temporarily resident elsewhere Change attribute description PERIOD A unique identifier of a FINANCIAL REPORTING PERIOD Change attribute name and description SOCIAL WORKER CONTACT INVOLVEMENT An indication of whether or not a patient's care plan, established during a CARE PROGRAMME APPROACH REVIEW, includes face to face contacts or involvement with local authority social services social workers. Classification: a. Yes b. No 0 no involvement of social worker 1 involvement of social worker Change attribute description SOURCE OF REFERRAL FOR MENTAL HEALTH A classification which identifies the source of referral of a MENTAL HEALTH CARE SPELL. Classification: a. General Medical Practitioner b. A&E department c. Other specialist clinical department d. Social Services e. Education Service f. Self g. Carer h. Police i. Criminal Justice System, e.g. prison, remand centres, etc. j. High security psychiatric accommodation of an NHS trust approved to provide high Page 22 of 81

security psychiatric services, England k. High Security Psychiatric Hospital, Scotland l. Medium Secure Services m. Graduation for relating child and adolescent mental health services n. Transferred temporarily from another Health Care Provider o. Transferred permanently from another Health Care Provider, other than graduating from relating child and adolescent mental health services p. Housing Service q. Voluntary or Private Agency r. Other 00 General Medical Practitioner 01 Self 02 Local Authority Social Services 03 A&E Department 04 Employer 05 Education Service 06 Police 07 Other clinical specialty 08 Carer 09 Courts 10 Probation Service 11 High security 12 Medium security 13 Other 20 Temporary transfer from mental health unit 21 Permanent transfer from mental health unit 22 Transfer by graduation from local child and adolescent mental health services ADMISSIONS (MENTAL HEALTH) n3 ADMISSIONS (MENTAL HEALTH) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if: a. one or more HOSPITAL PROVIDER SPELL within the MENTAL HEALTH CARE SPELL has a START DATE within the REPORTING PERIOD and b. where the HOSPITAL PROVIDER SPELL contains at least one CONSULTANT EPISODE (HOSPITAL PROVIDER) and/or NURSING HOME STAY (CONSULTANT CARE) where the main CONSULTANT SPECIALTY FUNCTION of the CONSULTANT is for an adult Page 23 of 81

or mental illness SPECIALTY FUNCTION. The adult or mental illness SPECIALTY FUNCTIONS being 700, 710,712, 713 and 715. It is the total number of such HOSPITAL PROVIDER SPELLS started within the REPORTING PERIOD. BED DAYS (MENTAL HEALTH INTENSIVE) n3 BED DAYS (MENTAL HEALTH INTENSIVE) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if: a. one or more CONSULTANT EPISODES (HOSPITAL PROVIDER) and/or NURSING HOME STAYS (CONSULTANT CARE) within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD and b. where the main CONSULTANT SPECIALTY FUNCTION of the CONSULTANT is for an adult or mental illness SPECIALTY FUNCTION. The adult or mental illness SPECIALTY FUNCTIONS being 700, 710,712, 713 and 715. and c. where the PATIENT was admitted to a bed in a WARD with a CLINICAL CARE INTENSITY National Code 51 Specially designated ward for patients needing containment and more intensive management. This is not to be confused with intensive nursing where a patient may require one to one nursing while on a standard ward. It is the total number of bed days within the REPORTING PERIOD. Each period of bed days is recorded by a CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) within a HOSPITAL PROVIDER SPELL and there may be more than one such episode or stay during the course of a MENTAL HEALTH CARE SPELL. This excludes any admissions to HOSPITAL PROVIDER SPELLS where the PATIENT CLASSIFICATION is National Code 2 Day case admission. There is a START DATE and END DATE for each CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) and the calculation is based upon those bed days which have occurred during the Page 24 of 81

REPORTING PERIOD adjusted for where periods of bed days overlap the START DATE and/or END DATE of the REPORTING PERIOD (this includes where the period of bed days has not yet ended). Where such overlaps occur the START DATE and/or END DATE of the REPORTING PERIOD should be used instead of that of the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE). BED DAYS (MENTAL HEALTH INTENSIVE) is the sum of the calculated periods of bed days and should be recorded left justified with leading zeros. The calculation should be adjusted for any periods of LEAVE OF ABSENCE or ABSENCE WITHOUT LEAVE of 28 days or less. A PATIENT going on HOME LEAVE, or LEAVE OF ABSENCE for 28 days or less, or who has a current period of ABSENCE WITHOUT LEAVE of 28 days or less, does not interrupt the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) but are not using a bed during their period of absence. BED DAYS (MENTAL HEALTH MEDIUM SECURE) n3 BED DAYS (MENTAL HEALTH MEDIUM SECURE) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if: a. one or more CONSULTANT EPISODES (HOSPITAL PROVIDER) and/or NURSING HOME STAYS (CONSULTANT CARE) within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD and b. where the main CONSULTANT SPECIALTY FUNCTION of the CONSULTANT is for an adult or mental illness SPECIALTY FUNCTION. The adult or mental illness SPECIALTY FUNCTIONS being 700, 710,712, 713 and 715. and c. where the PATIENT was admitted to an ORGANISATION SITE, SERVICE POINT or WARD with a SECURE ACCOMMODATION TYPE classification b. Medium secure accommodation, a secure facility providing care at a regional level under the care of a forensic psychiatrist. This excludes Page 25 of 81

high security accommodation in HOSPITAL SITES approved to provide high security psychiatric services. It is the total number of bed days within the REPORTING PERIOD. Each period of bed days is recorded by a CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) within a HOSPITAL PROVIDER SPELL and there may be more than one such episode or stay during the course of a MENTAL HEALTH CARE SPELL. This excludes any admissions to HOSPITAL PROVIDER SPELLS where the PATIENT CLASSIFICATION is National Code 2 Day case admission. There is a START DATE and END DATE for each CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) and the calculation is based upon those bed days which have occurred during the REPORTING PERIOD adjusted for where periods of bed days overlap the START DATE and/or END DATE of the REPORTING PERIOD (this includes where the period of bed days has not yet ended). Where such overlaps occur the START DATE and/or END DATE of the REPORTING PERIOD should be used instead of that of the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE). BED DAYS (MENTAL HEALTH MEDIUM SECURE) is the sum of the calculated periods of bed days and should be recorded left justified with leading zeros. The calculation should be adjusted for any periods of LEAVE OF ABSENCE or ABSENCE WITHOUT LEAVE of 28 days or less. A PATIENT going on HOME LEAVE, or LEAVE OF ABSENCE for 28 days or less, or who has a current period of ABSENCE WITHOUT LEAVE of 28 days or less, does not interrupt the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) but are not using a bed during their period of absence. BED DAYS (MENTAL HEALTH) n3 BED DAYS (MENTAL HEALTH) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if: a. one or more CONSULTANT EPISODES (HOSPITAL PROVIDER) and/or NURSING HOME STAYS (CONSULTANT CARE) within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD and Page 26 of 81

b. where the main CONSULTANT SPECIALTY FUNCTION of the CONSULTANT is for an adult or mental illness SPECIALTY FUNCTION. The adult or mental illness SPECIALTY FUNCTIONS being 700, 710,712, 713 and 715. It is the total number of bed days within the REPORTING PERIOD. Each period of bed days is recorded by a CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) within a HOSPITAL PROVIDER SPELL and there may be more than one such episode or stay during the course of a MENTAL HEALTH CARE SPELL. This excludes any admissions to HOSPITAL PROVIDER SPELLS where the PATIENT CLASSIFICATION is National Code 2 Day case admission. There is a START DATE and END DATE for each CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) and the calculation is based upon those bed days which have occurred during the REPORTING PERIOD adjusted for where periods of bed days overlap the START DATE and/or END DATE of the REPORTING PERIOD (this includes where the period of bed days has not yet ended). Where such overlaps occur the START DATE and/or END DATE of the REPORTING PERIOD should be used instead of that of the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE). BED DAYS (MENTAL HEALTH) is the sum of the calculated periods of bed days and should be recorded left justified with leading zeros. The calculation should be adjusted for any periods of LEAVE OF ABSENCE or ABSENCE WITHOUT LEAVE of 28 days or less. A PATIENT going on HOME LEAVE, or LEAVE OF ABSENCE for 28 days or less, or who has a current period of ABSENCE WITHOUT LEAVE of 28 days or less, does not interrupt the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) but are not using a bed during their period of absence. BED DAYS (MENTAL HEALTH NHS COMMUNITY CARE) n3 BED DAYS (MENTAL HEALTH NHS COMMUNITY CARE ) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if: Page 27 of 81

a. one or more NURSING HOME STAYS (NURSING CARE) and/or RESIDENTIAL CARE OR GROUP HOME STAY within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD and b. where the BROAD PATIENT GROUP is National Code 5 Patients with mental illness and c. where the NURSING HOME, RESIDENTIAL CARE or GROUP HOME operated and managed by an NHS ORGANISATION as classified by ORGANISATION TYPE It is the total number of bed days within the REPORTING PERIOD. Each period of bed days is recorded by a NURSING HOME STAY (NURSING CARE) or RESIDENTIAL CARE OR GROUP HOME STAY and there may be more than one such stay during the course of a MENTAL HEALTH CARE SPELL. There is a START DATE and END DATE for each NURSING HOME STAY (NURSING CARE) or RESIDENTIAL CARE OR GROUP HOME STAY and the calculation is based upon those bed days which have occurred during the REPORTING PERIOD adjusted for where periods of bed days overlap the START DATE and/or END DATE of the REPORTING PERIOD (this includes where the period of bed days has not yet ended). Where such overlaps occur the START DATE and/or END DATE of the REPORTING PERIOD should be used instead of that of the NURSING HOME STAY (NURSING CARE) or RESIDENTIAL CARE OR GROUP HOME STAY. BED DAYS (MENTAL HEALTH NHS COMMUNITY CARE) is the sum of the calculated periods of bed days and should be recorded left justified with leading zeros. The calculation should be adjusted for any periods of LEAVE OF ABSENCE or ABSENCE WITHOUT LEAVE of 28 days or less. A PATIENT going on HOME LEAVE, or LEAVE OF ABSENCE for 28 days or less, or who has a current period of ABSENCE WITHOUT LEAVE of 28 days or less, does not interrupt the CONSULTANT EPISODE (HOSPITAL PROVIDER) or NURSING HOME STAY (CONSULTANT CARE) but are not using a bed during their period of absence. CARE DAYS (ACUTE HOME-BASED) N3 Page 28 of 81

CARE DAYS (ACUTE HOME-BASED) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record. It should only be present if one or more CONSULTANT EPISODES (ACUTE HOME-BASED) within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD. It is the total number of care days within the REPORTING PERIOD. Each period of care days is recorded by a CONSULTANT EPISODE (ACUTE HOME-BASED) and there may be more than one such episode during the course of a MENTAL HEALTH CARE SPELL. There is a START DATE and END DATE for each CONSULTANT EPISODE (ACUTE HOME-BASED) and the calculation is based upon those care days which have occurred during the REPORTING PERIOD adjusted for where periods of care days overlap the START DATE and/or END DATE of the REPORTING PERIOD (this includes where the period of care days has not yet ended). Where such overlaps occur the START DATE and/or END DATE of the REPORTING PERIOD should be used instead of that of the CONSULTANT EPISODE (ACUTE HOME-BASED). CARE DAYS (ACUTE HOME-BASED) is the sum of the calculated periods of care days and should be recorded left justified with leading zeros. CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) n3 CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) is the same as entity type CARE PROGRAMME APPROACH REVIEW. CARE PROGRAMME APPROACH REVIEWS (IN REPORTING PERIOD) is an optional data item note in the Mental Health Minimum Data Set (MHMDS) collection record and should only be present if one or more CARE PROGRAMME APPROACH REVIEWS within the MENTAL HEALTH CARE SPELL has occurred during the REPORTING PERIOD. It is the total number of such reviews within the MENTAL HEALTH CARE SPELL which have occurred within the REPORTING PERIOD. Each such review is recorded by a CARE PROGRAMME APPROACH REVIEW and there may be more than one recorded during the course of a REPORTING PERIOD. There is a CPA REVIEW DATE for each CARE PROGRAMME APPROACH REVIEW and the calculation is based upon those reviews which have occurred during the REPORTING PERIOD. Page 29 of 81

CARE SPELL IDENTIFIER (MENTAL HEALTH) an12 The unique identifier of a MENTAL HEALTH CARE SPELL recorded when a MENTAL HEALTH CARE SPELL is initiated by a referral, or the temporary or permanent transfer of main responsibility for provision of mental health care for the PATIENT from another HEALTH CARE PROVIDER. This is the CARE SPELL IDENTIFIER of a CARE SPELL with the MENTAL HEALTH CARE SPELL being a subtype of the CARE SPELL. For purposes of the Mental Health Minimum Data Set (MHMDS) collection, a MHMDS record will be assembled for each MENTAL HEALTH CARE SPELL of an adult (including elderly) PATIENT who has received a continuous period of care or assessment from a HEALTH CARE PROVIDER's specialist mental health services within the REPORTING PERIOD. Each MHMDS record will be separately identified, see CARE SPELL NUMBER IN REPORTING PERIOD for further details. CARE SPELL IDENTIFIER (MENTAL HEALTH) is an optional data item note in the MHMDS record and should only be recorded where the HEALTH CARE PROVIDER can initiate and maintain MENTAL HEALTH CARE SPELLS. CARE SPELL NUMBER IN REPORTING PERIOD n2 For purposes of the Mental Health Minimum Data Set (MHMDS) collection, a MHMDS record will be assembled for each MENTAL HEALTH CARE SPELL of an adult (including elderly) PATIENT who has received a continuous period of care or assessment from a HEALTH CARE PROVIDER's specialist mental health services within the REPORTING PERIOD. CARE SPELL NUMBER IN REPORTING PERIOD is the sequence number for the assembled MENTAL HEALTH CARE SPELL MHMDS record among the set of assembled MENTAL HEALTH CARE SPELL MHMDS records for the same Page 30 of 81