Allied Health Professionals Operational Measures Dataset

Allied Health Professionals Operational Measures Dataset May 2017 Dataset Consultation Document Version: 1.0

Contents Contents... 2 Acknowledgements... 4 Introduction... 4 The Development & Implementation of a Allied Health Profession Operational Measures Dataset... 5 Proposed Dataset... 8 Future Developments... 8 Guidance on this Consultation... 9 Next steps... 10 What happens following Consultation?... 10 Structure of this Consultation Document... 11 AHP Operational Measures Data Summary... 11 SECTION 1: Person Demographics... 12 1.1 Person ID... 12 1.2 Community Health Index (CHI)... 12 1.3 Surname... 13 1.4 Forename... 13 1.5 Date of Birth (DOB)... 14 1.6 Postcode... 14 1.7 Gender... 14 1.8 Ethnicity... 15 SECTION 2: Episode and Request for Assistance/Referral Information... 17 2.1 Date Request for Assistance/Referral Received... 17 2.2 Source of Request for Assistance/Referral... 17 2.3 Date of Discharge..... 19 2.4 Discharge Reason...... 19 2.5 Episode ID.... 20 SECTION 3: Contact Information... 21 3.1 Contact ID... 21 3.2 AHP Profession... 21 3.3 Date of Contact... 22 3.4 Attendance Status... 23 3.5 Time Contact Started... 24 3.6 Time Contact Ended... 24 3.7 Duration of Contact... 25 3.8 Location ID... 25 3.9 Location of Contact... 26 3.10 Contact Purpose... 27 3.11 Service Type... 28 3.12 Contact Activity Related To... 28 3.13 Contact Type... 30 2

3.14 Contact Category... 31 3.15 Contact Mode... 31 3.16 Joint Contact... 32 3.17-3.21 Joint Contact Attendees... 33 3.22 Reason for Joint Contact... 35 Appendix 1 - Respondent Information and Consultation Response Form... 36 Section 1: Demographics... 37 Section 2: Episode and Request for Assistance/ Referral Information... 38 Section 3: Contact Details... 40 General Questions... 48 3

Acknowledgements We would like to thank the Local Authorities, NHS Boards and other stakeholders who have helped the project team in developing the draft dataset. We would like to extend our thanks to everyone who attended our workshops in February / March. We appreciate the time and effort that you have spent with us and your contributions are greatly valued. We look forward to working with you to refine and agree the dataset in the coming months. Introduction In May 2015 the Minister of Public Health agreed in parliament the requirement for a continued AHP national programme to build upon the successes of the AHP National Delivery Plan (NDP) 2012-2015 1 and provide an ongoing strategic focus for the significant contribution AHPs make to the health and wellbeing of the Scottish population. It was agreed that this would be called the Active and Independent Living Improvement Programme 2 (AILIP) and would be closely aligned to the 2020 Vision and the broader policy context across Health, Social Care and Third Sector. One of the challenges inherited by AILIP from the NDP was the lack of consistent e-health support across Scotland in recording and management of AHP data (including waiting times information) to demonstrate impact and to support service planning. This work continues as a major objective within the AILIP portfolio. Approximately 13,500 AHPs work in health care in Scotland (September 2016) with around 500 working in social care. They support, educate and rehabilitate individuals towards an active and independent life by helping them meet their personal outcomes, delivering services in a huge variety of locations and formats. A range of information sources are currently used to effectively manage and plan services locally. However the breadth, depth and quality of information available both locally and at a nationally comparative level need to be enhanced in order that; The significant and increasing contribution AHPs make to the health and wellbeing of the people of Scotland can be systematically demonstrated 1 AHPs as agents of change in health and social care - The National Delivery Plan for the Allied Health Professions in Scotland, 2012-2015 http://www.gov.scot/publications/2012/06/9095 2 AHPs in Scotland : Active and Independent Living Improvement Programme http://www.knowledge.scot.nhs.uk/ahpcommunity/ailip.aspx 4

AHPs have an empirical basis for service review and improvement. The Scottish Government Chief Health Professions Officer recognised the existing incompleteness, inconsistency and partial inaccuracy of national AHP data and during the NDP, draft Operational Measures for AHP Services across Scotland 2015 were developed. These Operational Measures (AHPOMs) were built on extensive previous work to develop an agreed national minimum dataset for AHPs and outlined the measures proposed for capture from local AHP data systems. Later in 2015, National Services Scotland (NSS) Information Services Division (ISD) was commissioned to lead a phased data development project to define the minimum dataset for AHPOMs through wide engagement with AHPs and formal consultation followed by extensive testing with real data extracted from a selection of partner organisation information systems in both health and social care. The Development & Implementation of a Allied Health Profession Operational Measures Dataset Scottish AHP Data - The Journey So Far 2016 2015 2017 2012 2014 Need for AHP data included as item 6.1 of NDP National survey of AHP IT systems AHP Operational Measures Phase 1 Feasibility AHP Operational Measures Phase 2 Define and Test Measures to be included in AILIP If you don t count, you don t count! 5

The current stage of the AHPOMs project (Phase 2) aims to define and specify the national minimum dataset through widespread user engagement and a formal consultation process. Subsequent to this, the agreed dataset will be used to inform one-off data extraction from a broad, representative range of partners in both health and social care to allow testing, analytical output development and to help understand data supplier readiness. This dataset is specifically aimed at defining supporting data for the AHPOMs Key Performance Indicators (KPIs): Service User Referral Individual Service User Clinical Activity Episode of Care The full set of KPIs 3 also includes information on Waiting Times, Workforce and Other Clinically Related Activity. Parallel work streams concerning AHP Workforce / Workload and the ongoing development of AHP MSK Waiting Times will provide the basis for including relevant KPIs in the future. It is planned that the AHPOMs reporting platform / dashboard will receive data feeds from these national sources when mature to allow presentation of all the KPIs in a single place. The project seeks to minimise data collection burden by using existing local sources of data from health board and local authority systems. As this depends upon the existence of appropriate electronic systems locally, the work of this project is aligned with the AILIP e-health work stream to help organisations prepare for the implementation of AHPOMs in future. The project will also be managed with due regard for information governance and data security safeguards. The objectives of the current phase of the project do not include implementation at local level. The findings of phase 2 will be incorporated into a business case for a later phase(s) which will focus on the technical development of the national dataset, a reporting platform and the roll out of local implementation. In the future, nationally implemented AHPOMs will provide a source of standardised AHP data recorded consistently and regularly to enable service review and planning. Specific benefits for AHP services will include; The potential to benchmark against peers to identify areas for service improvement Demonstrating the significant contribution AHPs make to the health and wellbeing of the Scottish population 3 Full KPIs are available on our website http://www.isdscotland.org/products-and-services/data-definitions-and- References/Allied-Health-Professionals-National-Dataset/_docs/AHP_Operational_Measures_v1_0.pdf 6

An evidence base for quality improvement The potential to analyse trends and enable predictive modeling A source of AHP data which can be used within the wider public health environment It is also anticipated that, in future, AHP Operational Measures data would be routinely linked to other national data sources such as prescribing data and Scottish Morbidity Record (SMR) admission and discharge data. This would enable full pathway and outcome analysis and opportunities for research. This consultation builds on extensive user engagement conducted in February and March 2017 through 6 definitional workshops across Scotland. All 12 AHP professions were represented across these events covering health, social care and the third sector. The valuable feedback recorded has been processed and translated into the formal consultation presented on the following pages. AHP Operational Measures Project Team NSS Information Services Scotland May 2017 7

Proposed Dataset The proposed Allied Health Professionals Operational Measures (AHPOM) dataset is grouped into three sections: 1. Demographics 2. Episode and Request for Assistance/Referral Information 3. Contact Information All Health and Social Care AHP data should be included in this dataset. This includes students or support workers that have a current caseload. We have aligned where possible to other ISD datasets and our coding reflects this. We are aware that the 12 Allied Health Professions across Health and Social Care may not record the same information or use the same terminology. As a National dataset, we hope that the proposed data items and definitions can be seen as a best fit for all. It is envisaged that relevant data will be collected on a quarterly basis via a secure file transfer facility. The consultation document asks for each data item to be reviewed and where appropriate commented upon along with some general questions to assist us in producing a valuable minimum dataset. The definitions in this consultation will use the word person when referring to the individual patient / client / service user. Future Developments Throughout conversations held with AHPs and from the workshops, it was acknowledged that the following areas were important and should be considered in future phases: Other clinically related activity (including public health) Personal Outcomes Named Person Requests/ Referrals 8

Guidance on this Consultation The AHPOM team would welcome responses to this consultation by Friday 16 th June 2017. This consultation document provides an opportunity for relevant organisations and individuals to offer their views on the proposed AHPOM dataset, and associated definitions, in order to ensure that the data collected and associated outputs will meet your needs. It is crucial that key stakeholders be involved in and shape this work, and to this end we welcome suggestions for amendments, improvements and feedback on any issues. A list of the proposed data items is provided on page 11 for ease of reference. Some of the key things we would like you to consider when reviewing the data standards include: Are there any data items included here that are superfluous or beyond the scope of a core national dataset? The definitions of data items are they clear, consistent and fit for purpose? Are there other common terms used to describe these items? The format of data items (e.g. integer, alpha numeric, field length) The mutual exclusivity of code sets (i.e. absence of overlap or clear boundaries between code values within a code set) We would be grateful if you would use the Respondent Information and Consultation Response Form for collation of your comments. This is provided as Appendix 1 of the document. Completion of the form will aid our analysis of the responses received. Please send your completed Respondent Information and Consultation Response Form to: NSS.AHPmeasures@nhs.net Allied Health Professional Operational Measures Area 151C, Data Management Information Services Division National Services Scotland Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB 9

Next steps What happens following Consultation? Following the closing date (Friday 16 th June 2017) all responses will be reviewed and considered along with any other available evidence to help us refine the AHPOM dataset. We will issue a feedback report on this consultation which will be published on the ISD website at: http://www.isdscotland.org/products-and-services/data-definitions-and-references/allied-health- Professionals-National-Dataset/Operational-Measures.asp by October 2017. Following this consultation, the nationally agreed dataset will be tested and a report formulated with suggestions for Phase 3 (and beyond) which will lead the development project into an implementation phase. The Phase 2 project and output reports are planned for completion by May 2018 Comments If you have any comments about how this consultation exercise has been conducted, please send them to: Name: Address: Email: Richard Hunter, Information Consultant Area 159e National Services Scotland Public Health and Intelligence Information Services Division Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB richard.hunter@nhs.net 10

Structure of this Consultation Document This consultation document is organised into three sections and is supported by questions and appendices: 1. Demographics 2. Episode and Request for Assistance/Referral Information 3. Contact Information Appendix 1 Respondent Information and Consultation Response Form AHP Operational Measures Data Summary Section 1: Person Demographics 1.1 Person ID 1.2 Community Health Index (CHI) 1.3 Surname 1.4 Forename 1.5 Date of Birth (DOB) 1.6 Postcode 1.7 Gender 1.8 Ethnicity Section 2: Episode and Request for Assistance/Referral Information 2.1 Date Request for Assistance/Referral Received 2.2 Source of Request for Assistance/ Referral 2.3 Date of Discharge 2.4 Discharge Reason 2.5 Episode ID Section 3: Contact Information 3.1 Contact ID 3.2 AHP Profession 3.3 Date of Contact 3.4 Attendance Status 3.5 Time Contact Started 3.6 Time Contact Ended 3.7 Duration of Contact 3.8 Location ID 3.9 Location of Contact 3.10 Contact Purpose 3.11 Service Type 3.12 Contact Activity Related To 3.13 Contact Type 3.14 Contact Category 3.15 Contact Mode 3.16 Joint Contact 3.17 3.21 Joint Contact Attendees 3.22 Reason for Joint Contact 11

SECTION 1: Person Demographics AHP Operational Measures Consultation Demographic data will be returned for all persons who have had a contact with an Allied Health Professional within the reporting period or where a request for assistance/referral has been received within the reporting period. Demographics will be required for every submission. 1.1 Person ID Optional Common Names: A unique reference number which may be used across multiple systems to identify an individual. This number may be national or local to each area. Patient/Client ID, System Number/ID, Unique Identifier, Social Care ID. Alpha Numeric Field Length: 20 1.2 Community Health Index (CHI) Required The Community Health Index (CHI) is a population register which is used in Scotland for health care purposes. The CHI number uniquely identifies a person on the index. Numeric Field Length: 10 Recording Guidance: CHI is a required field when 1.3 Surname, 1.4 Forename, 1.5 DOB, 1.6 Postcode & 1.7 Gender are not recorded. 12

1.3 Surname Required Common Names The surname of a person represents that part of the name of a person which indicates the family group of which the person is part. This will be the surname at point of contact. Second Name; Family Name; Last Name. Alpha Free Text Field Length: 35 Recording Guidance: Required if 1.2 CHI is not recorded. 1.4 Forename Required Common Name: The first forename of a person represents that part of the name of a person which after the surname is the principal identifier of a person. This will be the forename at point of contact. First Name; Given Name. Alpha Free Text Field Length: 35 Recording Guidance: Required if 1.2 CHI is not recorded. 13

1.5 Date of Birth (DOB) Required The date on which a person was born or is officially deemed to have been born. Date DDMMCC Field Length: 8 Recording Guidance: Required if 1.2 CHI is not recorded. 1.6 Postcode Required The postcode is a basic unit for identifying geographic locations. A postcode is associated with each address in the UK. This will be the place of residence at time of contact for the person. Alpha Numeric Field Length: 8 Recording Guidance: Required if 1.2 CHI is not recorded. 1.7 Gender Required Common Name: A statement by the individual about the gender they currently identify themselves to be. This will be the gender at point of contact. Sex. Numeric Field Length: 1 Recording Guidance: Required if 1.2 CHI is not recorded. 14

1.7 Gender - Codes and Values Code Value Explanatory Notes 0 Not Known The gender of the person cannot be determined for physical reasons, e.g. a new born or unborn baby, indeterminate gender or intersex. 1 Male 2 Female 9 Not Specified The gender of the person is not provided in the personal details i.e. the data has not been supplied and sex cannot be ascertained from the data provided. 1.8 Ethnicity Optional A statement made by the person about their current ethnic group. This will be the ethnicity at point of contact. Alpha Numeric Field Length: 2 Codes and Values Code Value White 1A 1B 1C 1K 1L 1Z Scottish Other British Irish Gypsy/Traveller Polish Other white ethnic group 15

1.8 Ethnicity - Codes and Values Continued Mixed of Multiple Ethnic Groups Code 2A Value Any mixed or multiple ethnic groups Asian, Asian Scottish or Asian British 3F 3G 3H 3J 3Z Pakistani, Pakistani Scottish or Pakistani British Indian, Indian Scottish or Indian British Bangladeshi, Bangladeshi Scottish or Bangladeshi British Chinese, Chinese Scottish or Chinese British Other Asian, Asian Scottish or Asian British African 4D 4 African, African Scottish or African British Other African Caribbean or Black 5C 5D 5 Caribbean, Caribbean Scottish or Caribbean British Black, Black Scottish or Black British Other Caribbean or Black Other Ethnic Group 6A 6Z Arab, Arab Scottish or Arab British Other ethnic group Other 98 Refused/Not provided 99 Not Known 16

SECTION 2: Episode and Request for Assistance/Referral Information AHP Operational Measures Consultation An AHP episode is the care provided to a person over a period of time by an AHP. The care may take place in any setting. The episode comprises of one or a series of contacts which are initiated by an AHP request for assistance/referral or re-request/referral and ended by an AHP discharge. A request for assistance/referral is a request to an AHP to provide appropriate health or social care to a person. A request/referral may be made by an individual on behalf of a person, or a person may refer themselves. We would request data on all requests/referrals received by the AHP, if they were inappropriate then you would complete the appropriate discharge information. 2.1 Date Request for Assistance/Referral Received Required The date on which the profession receives a request for assistance/referral. Date - DDMMCC Field Length: 8 2.2 Source of Request for Assistance/Referral Required The person or service that initiated a request or referral. Alpha Numeric Field Length: 2 Recording Guidance: The request/referral is from the point of request /referral and not the point where the person is assigned / triaged. 17

2.2 Source of Request for Assistance/Referral - Codes and Values Code Value Explanatory Notes 1 GP Includes: GPs only. Exclude all other GP Practice staff. 5 Self Includes: the Person; Immediate Family Unit; Guardian. 7 Criminal Justice Service Includes: Forensics; Custody; Courts. B C D Optometrist/Optician Allied Health Professional (AHP) Dental Practitioner Includes: Arts Therapies; Dietitians; Occupational Therapist; Orthotists; Orthoptists; Physiotherapists; Podiatrists; Prosthetists; Diagnostic Radiographers; Therapeutic Radiographers; Speech and Language Therapists; Paramedics. Includes: Private AHP; Blanket or Assertive request / referrals ; Non registered AHP staff. F Medic Includes: Consultants; Hospital Doctors; Registrars; Surgeons; Psychiatrists; Ophthalmologists. Excludes: GPs. G Government Service Includes: Department for Work and Pensions (DWP); Elected Officials. M Nursing & Midwifery Includes: Acute and Community Nurses & Midwives; Health Visiting; Specialist Nursing; District Nurses; School Nurses. P Personal Includes: Other Relations; Friends; Childminder; Carers; Power of Attorney; Leisure or other activity on behalf of the person. S Social Care Includes: Social Work. U Education Includes: Nurseries; Schools; Colleges; Universities; Educational Psychology. 18

2.2 Source of Request for Assistance/Referral - Codes and Values Continued Code Value Explanatory Notes V Voluntary/Third Sector/Private Includes: Independent sector. X Emergency Services Includes: Non-paramedic SAS; Fire; Police; Mountain Rescue. Housing Includes: Care Homes; Housing Associations; Residential Care Homes; Private Care Homes. Z Clinical Psychology/Psychology 2.3 Date of Discharge Required The date on which a person is discharged from an AHP episode of care. Date DDMMCC Field Length: 8 Recording Guidance: Only required once discharge occurs. 2.4 Discharge Reason Required The reason why the person is discharged from AHP care. Integer Field Length: 2 Recording Guidance: Only required once discharge occurs. 19

2. 4 Discharge Reason - Codes and Values Code Value Explanatory Notes 01 Maximum benefit gained 02 Person did not attend 03 Person unable to attend/ could not attend 06 Inappropriate request/referral 07 Care transferred to other service/profession Includes: Onward referral. 10 Planned course of contacts complete 11 Care no longer appropriate Includes: Inappropriate behavior; non- compliance. 12 Deceased 2.5 Episode ID Required A system generated code to uniquely identify an episode of care. Alpha-Numeric Field Length: 10 Recording Guidance: This is required to link contact information to an episode. 20

SECTION 3: Contact Information A contact is any interaction between an AHP and a person (direct contact) or with another individual regarding the person (indirect contact). This includes any interaction with other professionals about a specified person (e.g. case conferences, Multi-Disciplinary Team (MDT) meeting). A contact can be face to face or via other communication channels (e.g. telephone, video conference, email). Any interaction attributed to the care of an identifiable person should be recorded as a contact, this includes report writing. 3.1 Contact ID Required A system generated code to uniquely identify a contact. Alpha-Numeric Field Length: 10 Recording Guidance: This is required to uniquely identify a contact. 3.2 AHP Profession Required AHP Profession that the person is interacting with. Alpha Numeric Field Length: 3 Recording Guidance: All un-registered AHP staff would be included under their overall profession. Codes and Values Code RU Value Arts Therapies 21

3.2 AHP Profession - Codes and Values Continued Code R3 R4 RF2 RJ R5 R1 RF1 RK RL R6 RP Value Dietitians Occupational Therapists Orthotists Orthoptists Physiotherapists Podiatrists Prosthetists Diagnostic Radiographers Therapeutic Radiographers Speech and Language Therapists Paramedics 99 None Specified 3.3 Date of Contact Required The date that the contact occurred. Date - DDMMCC Field Length: 8 22

3.4 Attendance Status Optional Indicates whether the person attended / was seen. Integer Field Length: 1 Recording Guidance: Attendance Status is only applicable for pre-arranged contacts between an AHP and the person or with another individual on that person s behalf. Codes and Values Code Value Explanatory Notes 1 Person Was Seen 2 Person Cancelled Includes: Unable To Attend (UTA); Could Not Attend (CNA). 4 Staff Cancelled Includes: Appointment cancelled due to staff sickness; emergency personal circumstances; unforeseen travel disruptions; service needs or urgent clinical situations elsewhere. 5 Person Attended but was not seen (CNW: could not wait) 8 Person Did Not Attend (DNA) Includes: Failed visits at persons home. 23

3.5 Time Contact Started Optional Common Name: A record of the time the contact began. Time of Visit, Time Visit Started. hh:mm (24hr clock) Field Length: 5 Recording Guidance: Do not include travel time. If 3.5 Time Contact Started and 3.6 Time Contact Ended is provided there is no requirement for 3.7 Duration of Contact to be completed. 3.6 Time Contact Ended Optional Common Name: A record of the time the contact ended. Time Visit Ended. hh:mm (24hr clock) Field Length: 5 Recording Guidance: Do not include travel time. If 3.5 Time Contact Started and 3.6 Time Contact Ended is provided there is no requirement for 3.7 Duration of Contact to be completed. 24

3.7 Duration of Contact Optional Common Name: The length of time contact occurred. Length of Contact, Length of Visit. mmm (minutes) Field Length: 3 Recording Guidance: Duration of contact includes preparation and notes. Do not include travel time. Duration of contact should be completed if 3.5 Time Contact Started and 3.6 Time Contact Ended is not recorded. 3.8 Location ID Optional Each location in Scotland, at which events pertinent to public service take place, is allocated a location code. Locations include hospitals, health centres, clinics, NHS board offices, private nursing homes, homes for the elderly, Local Government buildings, children s homes and schools. Common Names: Location Code. Alpha Numeric Field Length: 5 Recording Guidance: If not in the same location, complete the location of the AHP. http://www.natref.scot.nhs.uk/location_search.aspx 25

3.9 Location of Contact Required The location where the contact took place. Alpha numeric Field Length: 1 Recording Guidance: If not in the same location, complete the location of the AHP. Codes and Values Code Value Explanatory Notes 1 Hospital Includes: Day Hospitals. 2 Health Centre Includes: GP Surgery. 4 Clinic Out with hospitals. 5 Nursing Home / Care Home 6 Person s home / residence Includes: Carer s/ relative s residence 7 Day Centre C Community Location Includes: Leisure Centre; Community Centre; Cafes; Street. L Local Authority Building Includes Social Workers offices (excludes schools). W Work Place / Job Centre / Employment Services Includes: Educational Institutions such as Schools or Colleges. 26

3.10 Contact Purpose Required Common Name: The agreed high level purpose of a contact between the AHP and person / carer/ other individuals. Reason for Contact; Aim of Contact. Integer Field Length: 2 Recording Guidance: Please select the main purpose of the contact. This would be the purpose of the actual contact, not the previously planned purpose. Codes and Values Code Value Explanatory Notes 01 Diagnose/Investigate/Assess Includes: Assess; Evaluate; Needs Analysis; Initial Conversation leading to assessment; Re-evaluate/review. 03 Educate Includes: Communicate; Liaise; Reinforce or Retrain; Self - Management; Signposting to relevant information; Providing Advice; Reassurance; Supporting. 04 Enable/Facilitate Includes: Facilitate Change; Self-caring and Self- Management; Motivate; Empower; Maintain / Sustain; Manage or Crisis Intervention; Rehabilitation; Improve; Reablement; Wound Management; Housing Adaptations. 08 Resolve Includes: Cure; Resolve Symptoms. 09 Prevent Includes: Anticipatory Care Planning; Admission Prevention; Stabilise; Maintain. 10 Palliative/End of Life Includes: Improve Quality of Life; Make comfortable; Comfort. 27

3.11 Service Type Required Service type seeing the person. Integer Field Length: 1 Recording Guidance This refers to the service provided regardless of the patient s age (e.g. 20 year old with Developmental Coordination Disorder being seen within the children s service because of required skills of the professional) or a person who is yet to transition to adult services. Codes and Values Code Value Explanatory Notes 1 Children and oung People Includes: Paediatrics. 2 Adult Services 3 Older Person Includes: Geriatric, Elderly. 3.12 Contact Activity Related To Required The service/specialty that the contact activity is related to. Integer Field Length: 2 Recording Guidance: Please record the main category. Codes and Values Code Value Explanatory Notes 01 Audiology 28

3.12 Contact Activity Related To - Codes and Values Code Value Explanatory Notes 02 Burns 03 Cardiovascular Includes: Angina; Amputation; Heart attack; Vascular. 04 Dermatology Includes: Tissue Viability. 05 Developmental Includes: Developmental Delay; Developmental Coordination Disorder 06 Falls 07 Frailty 08 Gastroenterology 09 Mental Health Includes: Addiction; Chronic Fatigue Syndrome; Dementia; Self Harm; Suicidal. 10 MSK Includes: Soft tissue injury; Osteoarthritis; Postural Management. 11 Neo-Natal 12 Neurology Includes: Stroke; Parkinson s Disease; Cerebral Palsy; Multiple Sclerosis (MS); Motor - Neuron Disease (MND). 13 Nutritional Health and Wellbeing Includes: Nutrition; Food Allergy; Weight Management. 14 Obstetrics and Gynaecology 15 Ophthalmology 16 Oncology Includes: All Cancer Services. 17 Orthopaedics Includes: Fractures and Broken Bones. 18 Palliative / End of Life Care Includes: End of life support; Bereavement Services. 19 Respiratory Includes: Chronic Obstructive Pulmonary Disease; Cystic Fibrosis; Respiratory Tract Infections; Pneumonia. 29

3.12 Contact Activity Related To - Codes and Values Continued Code Value Explanatory Notes 20 Rheumatology 21 Surgery Includes: Plastic Surgery; Ear Nose & Throat (ENT); Immediate Recovery Post Surgery. 22 Urology 3.13 Contact Type Optional How a contact between the AHP and a person / carer / other individual was delivered. Integer Field Length: 1 Codes and Values Code Value Explanatory Notes 1 Individual A one to one contact with a person or representative. A carer / befriender may be present. 2 Group A contact as part of an arranged group session with other persons and / or carers. 3 Family A contact with a person, carer, family member(s) as part of a specific family session. 4 Professional Activity A contact with other professionals to discuss the care of the person. Includes: Case Conferences; Multi Disciplinary Team (MDT) Meetings; Documentation 30

3.14 Contact Category Required A contact may be categorised as direct or indirect. Integer Field Length: 1 Codes and Values Code Value Explanatory Notes 1 Direct A contact between an AHP and a person. This may be done face to face, over the phone, video link, email or via any other medium. 2 Indirect Also known as a 'proxy' contact. A contact between an AHP and another individual on behalf of, or about, a person, e.g. parent, carer (excluding the person). This may be done in person, over the phone, video link, email or via any other medium. This includes interactions with other professions and report writing. 3.15 Contact Mode Required Common Names Method of contact. Type of Contact. Numeric Field Length: 2 31

3.15 Contact Mode - Codes and Values Code Value Explanatory Notes 1 Face to Face 2 Letter Includes: Other documentation writing 3 Telephone By means of a telephone conversation (this does not include arranging appointments). 4 Video Link By means of a video link e.g. telemedicine (use of telecommunication to provide health care at a distance) 6 Telehealth Remote exchange of data between a patient at home and their clinician to assist in diagnosis and monitoring of their condition i.e. Blood Glucose Monitoring. 7 Email 3.16 Joint Contact Optional A contact where multiple people are required. Integer Field Length: 1 Recording Guidance: This does not include staff training, shadowing or other development. Codes and Values Code Value 0 No 1 es 32

3.17-3.21 Joint Contact Attendees Optional Other individuals present at the contact. Integer Field Length: 2 Recording Guidance: Record up to five additional attendees. Include only those individuals who are present for the person s need. A family member should only be recorded if they are assisting with the intervention. Any prison officer(s) in attendance should not be recorded as they are required for legal reasons. Does not include staff training, shadowing or other development. If students are actively involved in the care, they should be recorded under their profession. Codes and Values Code Value Explanatory Notes 01 Arts Therapies 02 Dietitians 03 Occupational Therapists 04 Orthotists 05 Orthoptists 06 Physiotherapists 07 Podiatrists 08 Prosthetists 09 Diagnostic Radiographers 10 Therapeutic Radiographers 11 Speech and Language Therapists 33

3.17 3.21 Joint Contact Attendees - Codes and Values Continued Code Value Explanatory Notes 12 Paramedics 13 AHP Support workers Includes: AHP Health Care Support Worker; AHP Technical 14 GPs Instructor and AHP Therapy Assistants. 15 Medics Includes: Consultants; Hospital Doctors; Registrars; Surgeons; Psychiatrists; Ophthalmologists. 16 Personal Help Includes: Immediate Family Unit; Guardian; Other Relations; Friends; Childminder; Carers; Power of Attorney; Leisure or other activity on behalf of the person. 17 Criminal Justice Service Includes: Forensics; Custody; Courts. 18 Optometrists / Opticians 19 Dental Practitioners 20 Government Service Includes: Department for Work and Pensions (DWP); Elected Officials. 21 Nurses / Midwives Includes: Acute and Community Nurses & Midwives; Health 22 Social Care Includes: Social Work. Visiting; Specialist Nursing; District Nurses; School Nurses. 23 Education Includes: Nurseries; Schools; Colleges; Universities; Educational Psychology. 24 Voluntary / Third Sector/ Private Includes: Independent sector. 25 Emergency Services Includes: Non-paramedic SAS; Fire; Police; Mountain Rescue. 26 Housing Includes: Care Homes; Housing Associations; Residential 27 Clinical Psychology/Psychology Care Homes; Private Care Homes. 34

3.22 Reason for Joint Contact Optional Reason for a joint contact to be undertaken. Integer Field Length: 1 Codes and Values Code Value Explanatory Notes 1 Manual Handling Multiple individuals required to support person. 2 Multi-Professional Input Multiple professionals required for assessment or intervention. 3 Other staff or person need Excluding students, shadowing. 35

Appendix 1 - Respondent Information and Consultation Response Form Respondent Information Details Allied Health Professionals Operational Measures Dataset Please note this form must be returned with your Consultation Response Form to ensure that we handle your reply appropriately. We would appreciate if you could complete the form as comprehensively as possible. Organisation Name: Profession: Job Title: Surname: Forename: The British Dietetic Association Professional Body for UK Dietitians Policy Officer Professional Development Elliott Kiri Tel Number: 0121 2008068 Email: System used to record data (includes spreadsheets, paper records): k.elliott@bda.uk.com All are used by dietitians working within NHS services across Scotland it is common for a single dietitian to use more than one of these method within their service: digital records, electronic spreadsheets and paper. 36

Section 1: Demographics Data Item Have you Do you accept the Do you currently Details of any suggested alterations, additions or reviewed this data proposed standard record this data clarifications. item? (/N) definition for this item / could submit data item? (/N) this data item? (/N) 1.1 Person ID 1.2 Community Health Index (CHI) 1.3 Surname 1.4 Forename 1.5 Date of Birth (DOB) 1.6 Postcode 1.7 Gender 1.8 Ethnicity 37

Section 2: Episode and Request for Assistance/ Referral Information Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) 2.1 Date Request for Assistance/Referral Received 2.2 Source of Request for Assistance/ Referral Refers to Arts Therapies and the rest are professionals e.g. dietitians What about Community Pharmacists? I would not categorise care homes under Housing 2.3 Date of Discharge 2.4 Discharge Reason Need to be careful here. Ready to Act makes a clear distinction between request for assistance and referral whereby the former may not lead to opening a duty of care. 38

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) 2.5 Episode ID 39

Section 3: Contact Details Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) 3.1 Contact ID 3.2 AHP Profession? Practitioner Psychologists. Also the CAHPO in England has just taken on osteopaths into her remit as AHPs- if integration increases?may osteopaths refer in future? As 2.2 profession vs professional. 3.3 Date of Contact 3.4 Attendance Status 3.5 Time Contact Started 3.6 Time Contact Ended 40

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) 3.7 Duration of Contact Clarification would need to be given to clinicians here (or with section 3.14 Direct or indirect). If a clinician did consultation and had to make several actions to coordinate care/ implement plan (e.g. liaise to and fro with other MDT/ carers/ feed company/ write letters emails e.t.c) there may need clarification as to what would need to be recorded as an indirect contact and what would just be included in the overall contact duration box where things like documentation seems to be absorbed. For AHPs, the patient related activities that are not clearly defined as direct or indirect contact can make up a significant amount of time and this often goes under the radar (BDA safe staffing doc addresses this with dietetic activities). Also at what point is contact duration recorded because if a clinician writes record as soon as 41

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) possible after a contact but still has outstanding actions they may not know final contact duration Might they have to add this at a later date when actions complete?. 3.8 Location ID Add community pharmacy, third sector. 3.9 Location of Contact 3.10 Contact Purpose What if contact is to carry out a procedure? E.g. place insulin pump/ band fill/ pass Naso gastric tube/ feeding tube change/ feeding tube cleaning? would these fit in 04 or 05? Clarification would be needed. This important particularly with the roles of Dietitians advancing and extending. The idea of a procedure-type measure would be good, and I imagine other AHPs would be looking for 42

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) similar e.g. Chest physios that suction secretions. Presumably each contact with a person can have a different contact code, as opposed to sticking to the code from the first point of contact. For situations where patients are seen as a one-off the purpose could be for prevention (09)/resolve symptom (08) but part of this will inevitably require diagnosis, assessment (01), providing advice (03) and facilitating change (04). Different practitioners will likely score these differently for similar cases, which will lead to dilution bias and will require detailed clarification of what is expected. 43

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) With 12 AHP professions this probably needs to be kept as a higher level measure as if it becomes more detailed it will become unmanageable quite quickly. However a measure for capturing the banding of staff doing different jobs measured against contacts might be good for workforce planning? 3.11 Service Type Are services based on age enough here - Does there need to be a code for Mental health services or anything else? Children, Adults and Older Adult seems a bit restrictive in terms of service type, Mental Health was also the one that came to my mind and presumably there would be others. There also doesn't appear to 44

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) be a way to easily distinguish between Acute and Community activity (unless I have missed it). 3.12 Contact Activity Related To Guidance says choose main category - for a Dietitian, would this always be Nutritional Health and Wellbeing? If not, nutrition spans all of the other activities. Exploring this issue further Do specialist practitioners mark themselves in this box or under their specialty (e.g. gastroenterology). In terms of pulling out data to review ones own service activity one would probably advise staff to record their speciality, as the fact that they are Dietitians is recorded elsewhere and this method would allow one to get more specific information. However in terms of 45

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) reporting to Healthboards, Government e.t.c would this make it appear that there is no Nutritional Health activity for these specialities? Also endocrinology (diabetes), learning disabilities and non-clinical don t seem to be covered. What if a patient has been referred to Dietitian (or AHP) and they hve more than one condition in more than one speciality and the clinical reasoning of the dietitian (or AHP) finds the conditions have an equal weighting -which speciality would they choose? 3.13 Contact Type 3.14 Contact Category 46

Data Item Have you reviewed Do you accept the Do you currently Details of any suggested alterations, additions or this data item? proposed standard record this data clarifications. (/N) definition for this item / could submit data item? (/N) this data item?? (/N) 3.15 Contact Mode Another presumption but understanding from the intro is that the data will be pulled from electronic systems (e.g. Trakcare, EMIS) to measure activity. In Glasgow we are building towards this by adding in Trak clinics to record home visits, phone calls etc however I cannot imagine us doing this for emails, which are a fairly substantial piece of our activity. I would be interested to know how they would plan to capture email activity. 3.16 Joint Contact 3.17-3.21 Joint Contact Attendees 3.22 Reason for Joint Contact 47

General Questions It would be extremely helpful if you could provide answers to the question(s) provided below: Q1: Do you feel this dataset represents your profession? Comments: 3.12 is a problem at the moment as described above Q2: The dataset asks for both 2.5 Episode ID and 3.1 Contact ID as system generated numbers. Is it feasible to provide these unique identifiers? Comments: Q3: Data items 3.11 Service Area and 3.12 Contact Activity Related To these have been included to represent the breadth of AHP activity. As an example it would show that 100 hours of physiotherapy activity was 20% children s, 40% adult, 40% older persons, and that 10% was orthopaedic work. Do you feel these items are needed and represent a breakdown you would use? Comments: Please see the comments in the box. The activities currently listed are very problematic for recording dietetic input due to number 48

13 (Nutritional Health and Wellbeing) and clarity is needed here. The input of the Dietitian is likely to always be something that could be described as Nutritional Health and Wellbeing and this therefore causes confusion as to whether to select this or another specialty. Q4: Data Item 3.12 Contact Activity Related To are there any categories that you feel would be a catch all for a service / profession to record them? What additional options are required to stop it being used in this way? Comments: 13 Nutritional Health and Wellbeing is the catch all. Additional options/ solutions to stop it being a catch all would be 1) Clear explanation as to how the data from that box is going to be used. What is it the information from this box of the data set going to be fed into clear information about this would enable training to be given on a local level as to how dietitians complete the record however achieving consistency across Scotland via such training may be laborious. 2) Another solution could be all dietitians & dietetic assistants could tick box 13 but they must tick another box too. This would have to be a compulsory setting. Perhaps the data processing could then do a split as required? This would allow other non-dietetic staff completing the record to tick the nutritional health and wellbeing box for example when providing screening or first line nutrition care when a dietitian is not directly involved, 49

Q5: Would it be adequate to have the number of attendees as a joint contact or more beneficial to have a breakdown of the professions / specialties in attendance? Space is provided for up to five attendees, is this sufficient? Comments: Professions breakdown would be useful. This could help demonstrate a piece of the MDT jigsaw is missing or where there are gaps in services. The contribution of each profession brings something unique to the care of a patient, total numbers alone does not give very much information. Please enter any other comments you may have regarding this dataset here: 50

Please send your completed Respondent Information and Consultation Response Form to: NSS.AHPmeasures@nhs.net Allied Health Professional Operational Measures Area 151C, Data Management Information Services Division National Services Scotland Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Thank you for taking the time to read the Consultation Paper and completing the Consultation Response Form. 51