SMR CHANGE CONTROL Still Birth

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					                                           SMR DATA CHANGE NOTICE (DCN)



          SPECIFICATION OF SMR CHANGE                                    SMR Change Ref. No.
                                                                         1004/01

                                                                         Classification

Record Type /       All SMRs                                             Target Implementation Date
Data Item(s)                                                             optional 01/04/10
Applicable To       Admission Transfer From                              mandatory 01/10/10
                    Discharge Transfer To


DETAILS OF CHANGE
In the recent Data Change Notice (0904/04) References to ‘NHS Board’, ‘Provider unit’, ‘NHS Provider
unit’ and ‘Trust’ were replaced with ‘Health Board/ Health Care Provider’

When considering these changes to the relevant data items it was noticed that further changes should
be made to the descriptive text for consistency and clarity.


Changes to SMR Data Manual:

Admission/Transfer From

Current text

40 Transfer from the same Health Board/ Health Care Provider - no additional detail added
49 Transfer from the same Health Board/ Health Care Provider - specialty not known
50 Transfer from other Health Board/ Health Care Provider - no additional detail added
59 Transfer from other Health Board/ Health Care Provider - specialty not known

To be replaced with

40 Transfer within the same Health Board/ Health Care Provider - no additional detail added
49 Transfer within the same Health Board/ Health Care Provider - specialty not known
50 Transfer from another Health Board/ Health Care Provider - no additional detail added
59 Transfer from another Health Board/ Health Care Provider - specialty not known

http://www.datadictionaryadmin.scot.nhs.uk/isddd/1971.html

Admission Transfer From – Codes

Current text

40 Transfer from the same Health Board/ Health Care Provider - no additional detail added
49 Transfer from the same Health Board/ Health Care Provider - specialty not known
50 Transfer from other Health Board/ Health Care Provider - no additional detail added
59 Transfer from other Health Board/ Health Care Provider - specialty not known

To be replaced with

40 Transfer within the same Health Board/ Health Care Provider - no additional detail added
49 Transfer within the same Health Board/ Health Care Provider - specialty not known
50 Transfer from another Health Board/ Health Care Provider - no additional detail added
59 Transfer from another Health Board/ Health Care Provider - specialty not known

http://www.datadictionaryadmin.scot.nhs.uk/isddd/11039.html
                                                  1
                                           SMR DATA CHANGE NOTICE (DCN)


Discharge/transfer to

Current text

59 Transfer to other Health Board/ Health Care Provider - specialty not known

To be replaced with

59 Transfer to another Health Board/ Health Care Provider - specialty not known

http://www.datadictionaryadmin.scot.nhs.uk/isddd/1855.html



Discharge Transfer To – Codes

Current text

40 Transfer from the same Health Board/ Health Care Provider - no additional detail added
49 Transfer from the same Health Board/ Health Care Provider - specialty not known
50 Transfer from other Health Board/ Health Care Provider - no additional detail added
59 Transfer from other Health Board/ Health Care Provider - specialty not known

To be replaced with

40 Transfer within the same Health Board/ Health Care Provider - no additional detail added
49 Transfer within the same Health Board/ Health Care Provider - specialty not known
50 Transfer to another Health Board/ Health Care Provider - no additional detail added
59 Transfer to another Health Board/ Health Care Provider - specialty not known

http://www.datadictionaryadmin.scot.nhs.uk/isddd/11042.html


Changes affect:

 NHS Health & Social Care Data Dictionary           SMR Definitions and codes                
 SMR Validation                                    X SMR Reference Files                      


                                            ISD USE ONLY

Changes to SMR Lookup tables
SMR look up table: adtf

SMR look up table: adtf detail

SMR look up table: Discharge type




                                                  2
                                             SMR DATA CHANGE NOTICE (DCN)



              SPECIFICATION OF SMR CHANGE                                SMR Change Ref. No.
                                                                         1004/03

                                                                         Classification

Record Type        All SMRs                                              Target Implementation Date
/                                                                        optional 01/04/10
Data Item(s)       Ethnicity code/ Ethnic Group                          mandatory 01/10/10
Applicable
To

Details of change
Amend the definition of Ethnicity code/ Ethnic Group, and replace the current (2001) Ethnicity codes
with New Scottish Census Ethnicity Categories 2011

Changes to SMR Data Manual:

Ethnicity code/ Ethnic Group

Current text

Definition:

The following list is representative of the codes used in the 2001 census. These should be used by NHS
Scotland organisations for local and SMR return purposes.”

To be replaced with

Definition:

The following list is representative of 2011 Scottish Census Ethnicity Categories. These should be used by NHS
Scotland organisations for local and SMR return purposes. Local systems may record more detailed codes as
required but these must map to 2011 Scottish Census categories for SMR return purposes.


Changes to SMR Data Manual:
Current text

A - White
1A Scottish
1B Other British
1C Irish
1D Any other White background

B - Mixed
2A Any mixed background

C - Asian, Asian Scottish or Asian British
3A Indian
3B Pakistani
3C Bangladeshi
3D Chinese
3E Any other Asian background

D - Black, Black Scottish or Black British
4A Caribbean

                                                  3
                                          SMR DATA CHANGE NOTICE (DCN)
4B African
4C Any other Black background

E - Other Ethnic Background
5A Any other ethnic background

F - Refused/Not provided by patient
98 Refused/Not provided by patient

G - Not Known
99 Not Known

To be replaced with

A - White
1A Scottish
1E English
1F Welsh
1G Northern Irish
1H British
1J Irish
1K Gypsy/ Traveller
1L Polish
1Z Any other white ethnic group

B – Mixed or multiple ethnic groups
2A Any mixed or multiple ethnic groups

C - Asian, Asian Scottish or Asian British
3F Pakistani, Pakistani Scottish or Pakistani British
3G Indian, Indian Scottish or Indian British
3H Bangladeshi, Bangladeshi Scottish or Bangladeshi British
3J Chinese, Chinese Scottish or Chinese British
3Z Other

D - African, Caribbean or Black
4D African, African Scottish or African British
4E Caribbean, Caribbean Scottish or Caribbean British
4F Black, Black Scottish or Black British
4Z Other

E - Other ethnic group
5B Arab
5Z Other

F - Refused/Not provided by patient
98 Refused/Not provided by patient

G - Not Known
99 Not Known

http://www.datadictionaryadmin.scot.nhs.uk/isddd/1781.html
http://www.datadictionaryadmin.scot.nhs.uk/isddd/10489.html

Changes affect:

 NHS Health & Social Care Data Dictionary          SMR Definitions and codes   
 SMR Validation                                   X SMR Reference Files         


                                            ISD USE ONLY
Changes to SMR Lookup tables
SMR look up table: ethnic_group
                                                 4
                                              SMR DATA CHANGE NOTICE (DCN)

           SPECIFICATION OF SMR CHANGE                                       SMR Change Ref. No.
                                                                             1004/04

                                                                             Classification

Record Type         All SMRs                                                 Target Implementation Date
/                                                                            optional 01/04/10
Data Item(s)        Main and Other                                           mandatory 01/10/10
Applicable          Operation/Treatment/Investigative
To                  Procedure

Details of change
The Clinical Coding Review Group have decided that relatively new ‘O’ codes should be valid in a ‘b’
position (as well as ‘Y’, ‘Z’ and ‘S’ codes) in the OPCS data collection fields.
This will allow coders to accurately identify the correct site of the body involved in a procedure.



Change to SMR Validation
Main and Other Operation/Treatment/Investigative Procedure – Section 4 (E2721)

Current text

If the second code does not begin with ‘Y’, ‘Z’ or ‘S’, the operation must exist as a pair code (record type 8) on
the OPCS4 reference file

Error Message: Main/Operation pair code not valid

Flag: Main/ Operation

To be replaced with

If the second code does not begin with ‘Y’, ‘Z’, ‘S’ or ‘O’, the operation must exist as a pair code (record type 8)
on the OPCS4 reference file

Error Message: Main/Operation pair code not valid

Flag: Main/ Operation


http://www.datadictionaryadmin.scot.nhs.uk/isddd/10319.html

Changes affect:

 NHS Health & Social Care Data Dictionary              SMR Definitions and codes                                 X
 SMR Validation                                        SMR Reference Files                                       X




                                                     5
                                           SMR DATA CHANGE NOTICE (DCN)



          SPECIFICATION OF SMR CHANGE                                      SMR Change Ref. No.
                                                                           1004/05

                                                                           Classification

Record Type       All SMRs                                                 Target Implementation Date
/                                                                          optional 01/04/10
Data Item(s)      Provider code                                            mandatory 01/10/10
Applicable
To

Details of change

NHS Trusts are discontinued as providers and should therefore no longer be recorded as provider
codes on SMR returns.

Change to SMR Validation
Contract Identifier – Section 1 (E1500, E0328)

Current text

A valid Provider Code of Organisation Type A, B, C, D or 7 must be present.

Error Message: Provider Code missing Provider Code invalid

Flag: Provider Code

To be replaced with

A valid Provider Code of Organisation Type A, B, D or 7 must be present.

Error Message: Provider Code missing Provider Code invalid

Flag: Provider Code


http://www.datadictionaryadmin.scot.nhs.uk/isddd/10241.html



Changes affect:

 NHS Health & Social Care Data Dictionary           SMR Definitions and codes                          X
 SMR Validation                                     SMR Reference Files                                


                                            ISD USE ONLY

Change to ISD Reference files

At mandatory date date 01/10/10

SMR reference files: purchpro, consprov and provlocs

End dates to be added NHS trust code records.


                                                  6
                                           SMR DATA CHANGE NOTICE (DCN)

           SPECIFICATION OF SMR CHANGE                                   SMR Change Ref. No.
                                                                         1004/06

                                                                         Classification

Record Type        All SMRs                                              Target Implementation Date
/                                                                        optional 01/04/10
Data Item(s)       Provider code                                         mandatory 01/10/10
Applicable
To

Details of change
Current validation rules state that if ‘Outcome of Pregnancy’ = 2 (stillbirth), then any value entered in
‘Resuscitation’ is not valid and an error message is produced.

It is possible for ‘Outcome of Pregnancy’ = 2 and for resuscitation to occur.

Validation rules are therefore amended to produce a query, rather than an error, if any value is entered in
‘Resuscitation’ when ‘Outcome of Pregnancy’ = 2.



Changes to SMR Validation Manual:

Resuscitation (Baby 1 2 3)) – Section 1 (E4450)

Current text

Resuscitation (Baby 1, 2 or 3) must and can only be present if Condition on Discharge = 3 and corresponding
Outcome of Pregnancy (Baby 1, 2 or 3) = 1, 3, 4 or 5.

Error Message: Baby <n> - Resuscitation missing/ inappropriate

Flag: Resuscitation (Baby 1, 2 or 3), Condition on Discharge, Outcome of Pregnancy

To be replaced with

Resuscitation (Baby 1, 2 or 3) must be present if Condition on Discharge = 3 and corresponding Outcome of
Pregnancy (Baby 1, 2 or 3) = 1, 3, 4 or 5.

Error Message: Baby <n> - Resuscitation missing

Flag: Resuscitation (Baby 1, 2 or 3), Condition on Discharge, Outcome of Pregnancy


Current text

Resuscitation (Baby 1 2 3) ) –Section 2 (E4452)

If Resuscitation present, only valid codes are acceptable – see Appendix 2

Error Message: Baby <n> - Resuscitation invalid

Flag: Resuscitation (Baby 1, 2 or 3)



Resuscitation (Baby 1 2 3) ) –Section 5 (E4452)


                                                   7
                                           SMR DATA CHANGE NOTICE (DCN)

If Resuscitation present, only valid codes are acceptable – see Appendix 2

Error Message: Baby <n> - Resuscitation invalid

Flag: Resuscitation (Baby 1, 2 or 3)



New Validation

Resuscitation (Baby 1 2 3) ) –Section 2 (E4454)

Resuscitation (Baby 1, 2 or 3) must be blank if Condition on Discharge = 3 and corresponding Outcome of
Pregnancy (Baby 1, 2 or 3) = 8

Error Message: Baby <n> - Resuscitation inappropriate

Flag: Resuscitation (Baby 1, 2 or 3), Condition on Discharge, Outcome of Pregnancy

Resuscitation (Baby 1 2 3) ) –Section 3 (E4454)

Resuscitation (Baby 1, 2 or 3) must be blank if Condition on Discharge <> 3

Error Message: Baby <n> - Resuscitation inappropriate

Flag: Resuscitation (Baby 1, 2 or 3), Condition on Discharge

Resuscitation (Baby 1 2 3) ) –Section 4 (Q2652)

Resuscitation (Baby 1, 2 or 3) should be blank if Condition on Discharge = 3 and corresponding Outcome of
Pregnancy (Baby 1, 2 or 3) = 2

Query Message: Baby <n> - Resuscitation unlikely for Outcome of Pregnancy

Flag: Resuscitation (Baby 1, 2 or 3), Condition on Discharge, Outcome of Pregnancy


http://www.datadictionaryadmin.scot.nhs.uk/isddd/10421.html



Outcome Code Table

For Outcome of Pregnancy code 2 – (still birth), amend ‘Must not’ to ‘May’, for Resuscitation.

http://www.datadictionaryadmin.scot.nhs.uk/isddd/9702.html



Changes affect:

 NHS Health & Social Care Data Dictionary            SMR Definitions and codes                             X
 SMR Validation                                      SMR Reference Files                                   X




                                                   8
                                            SMR DATA CHANGE NOTICE (DCN)



           SPECIFICATION OF SMR CHANGE                                     SMR Change Ref. No.
                                                                           1004/07

                                                                           Classification

Record Type        SMR01                                                   Target Implementation Date
/                                                                          optional 01/04/10
Data Item(s)       Significant Facility                                    mandatory 01/10/10
Applicable
To

Details of change
Medical emergencies cared for in facilities out with the A&E department (eg within an acute medical unit
(AMU) or similar facility) are currently recorded inconsistently across Scotland.

A new significant facility Acute Medical Unit (AMU) is created to record this activity.




Change to SMR Data Manual

Add a new definition page in the A-Z:

Acute Medical Unit (AMU)


Definition:
The AMU is a dedicated facility for the acute medical care of patients that present to hospital as medical
emergencies or who develop an acute medical problem while in hospital. The units may also carry out some
planned healthcare (Royal College of Physicians London 2007 - http://www.rcplondon.ac.uk/Pages/index.aspx)
Generally these units have both trolleyed areas and staffed beds which form part of the hospitals bed
complement.
NB Acute Medical Unit (AMU) is the preferred term for services previously known as medical/surgical
assessment unit, combined assessment units, clinical assessment units, acute assessment units, paediatric
assessment units.
Patients in these units can be under the care of consultants in both Medical and Surgical specialties.


Notes:
The AMU may be co-located with A&E or may be geographically separate.
Patients can be referred directly to the AMU from primary care or community settings, from A&E and, less
commonly, from within the hospital.
The appropriate specialty of the consultant responsible for the care of the patient should be recorded e.g. acute
medicine (new sub-specialty code available from January 2010); surgical if the AMU is combined surgical and
medical).
Patients generally stay in the AMU for less than a day although clinical management is based on need and stays
of 48-72 hours prior to admission, transfer or discharge may occur.
NB Patients who are admitted to an available staffed bed should be recorded on SMR01.
Patients initially managed in a trolleyed area within an AMU are subject to the A&E four hour guarantee (unless
there is a clinical exception).




                                                    9
                                            SMR DATA CHANGE NOTICE (DCN)
Related items
Emergency admission
http://www.datadictionaryadmin.scot.nhs.uk/isddd/2086.html

Inpatient
http://www.datadictionaryadmin.scot.nhs.uk/isddd/2189.html

Available staffed bed
http://www.datadictionaryadmin.scot.nhs.uk/isddd/2200.html

Bed Complement
http://www.datadictionaryadmin.scot.nhs.uk/isddd/2053.html


Add new Significant Facility code to ‘Acute Medical Unit (AMU)’
Code Description
40   Acute Medical Unit (AMU)

http://www.datadictionaryadmin.scot.nhs.uk/isddd/2187.html

http://www.datadictionaryadmin.scot.nhs.uk/isddd/9773.html

http://www.datadictionaryadmin.scot.nhs.uk/isddd/9774.html



Change to SMR Validation Manual
Add new Significant Facility to ‘Significant Facility and SMR Record Type – Codes’

40    Acute Medical Unit (AMU)

http://www.datadictionaryadmin.scot.nhs.uk/isddd/11046.html


Add new validation for Significant Facility – New section 10 (E1522)

If Significant Facility = 40 and admission date is present then Management of Patient must = 1

Error Message: Acute Medical Units only admit inpatient emergencies.

Flag: Significant Facility, Management of patient, Admission date

http://www.datadictionaryadmin.scot.nhs.uk/isddd/10257.html



Changes affect:

 NHS Health & Social Care Data Dictionary          SMR Definitions and codes                    
 SMR Validation                                    SMR Reference Files                          


                                            ISD USE ONLY

Change to ISD Reference files
At optional date 01/04/10

SMR reference file: SIG/FAC.

Addition of new Significant Facility code


                                                 10
                                          SMR DATA CHANGE NOTICE (DCN)
Code Description
40   Acute Medical Unit (AMU)

SMR reference file: SPEC/FAC.

Addition of new Significant Facility code - valid for all SMR01 specialties.

Sig Fac Description
40    Acute Medical Unit (AMU)


SMR reference file: FAC/SMR.

Addition of new Significant Facility code – valid for SMR01

Sig Fac Description
40    Acute Medical Unit (AMU)

SMR Record Types
01    General Acute Inpatients / Day Cases




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Description: SMR CHANGE CONTROL Still Birth