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Children and Young People’s Health Service (CYPHS) Data Set Stakeholder User Group Friday 23 rd May 2014, Leeds 1 Community and Mental Health Team, Health.

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Presentation on theme: "Children and Young People’s Health Service (CYPHS) Data Set Stakeholder User Group Friday 23 rd May 2014, Leeds 1 Community and Mental Health Team, Health."— Presentation transcript:

1 Children and Young People’s Health Service (CYPHS) Data Set Stakeholder User Group Friday 23 rd May 2014, Leeds 1 Community and Mental Health Team, Health and Social Care Information Centre

2 Welcome and Introduction Nicholas Richman Service Development Manager 2

3 General Update & Status of Delivery Nicholas Richman Service Development Manager 3

4 General update and status of delivery Delay due to difficulty obtaining funding Funding for 2014/15 now approved Number of new additions brought forward from version 2 This initial release now referred to as v1.5 ISN going to November 2014 SCCI Board although may be brought forward Go-live planned for July 2015

5 Introducing Version 1.5 of CYPHS Dataset Nicholas Richman Service Development Manager 5

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8 Overview of main changes in version 1.5 Data set structural changes Clinical coding Childhood disability Scored assessments Multidisciplinary team referrals + Integrated care plans (now planned for v2)

9 Other changes considered for version 1.5 ‘Local Patient ID’ extended to max an20 New organisational codes –‘Educational Establishment’ –‘Local Authority’ + ‘Social Services Client ID’ New end of life pathway items –‘Preferred Death Location Discussed’ –‘Death Not at Preferred Location Reason’ Referral table is no longer mandated

10 Other changes considered for version 1.5 New ‘Onward Referral’ table –‘Onward Referral Date’ –‘Reason for Onward Referral’ –‘Organisation Code (Receiving)’ ‘6-8 Week Examination’ table now generic –‘Infant Physical Examination Type’ new item ‘RTT’ table now only links to ‘Referral’ table –‘Earliest Reasonable Offer Date’ moved –‘Earliest Clinically Appropriate Date’ moved

11 Any further questions?

12 Clinical Coding Nicholas Richman Service Development Manager 12

13 Introduction of Clinical Coding Move to SNOMED CT is a requirement of SCCI approval Following new data tables –Pre-Existing Long Term Condition –Provisional Diagnosis –Primary Diagnosis –Secondary Diagnosis –Coded Observation –Coded Clinical Procedure

14 Pre-Existing Long Term Condition(s) Links to the ‘MPI’ table Conditions NOT diagnosed by service referred to Similar to a medical history Includes following data items: –Diagnosis Scheme in Use (mandatory) ICD 10 Read 2 CTV 3 SNOMED CT –Diagnosis (mandatory) –Diagnosis Date (required)

15 Diagnosis by Service Diagnosed by service referred to ‘Primary Reason for Referral’ staying in ‘Referral’ table

16 Coded Observations and Clinical Procedures ‘Coded Observation’ table includes ‘Numeric Value’ item ‘Observation’ table remaining for this initial release

17 Any further questions?

18 Lunch 18

19 Childhood Disability Tom Latham Senior Datasets Maintenance Analyst 19

20 Childhood disability Text Here

21 Childhood disability requirement New addition to CYPHS data set Liaising with PHE, Royal College of Paediatrics and Child Health (RCPCH), Dr Karen Horridge (Chair, British Academy of Childhood Disability) and other stakeholders RCPCH-led pilot taking place in Sunderland Link to Protected Characteristics Two-pronged approach – clinical codes and patient perception

22 Clinical coding Terminologies produced to cover specific disabilities, with accompanying SNOMED CT codes Categorised under numerous headings, e.g.: o Physical/Motor/Musculoskeletal o Speech, Language, Communication, Feeding & Nutrition o Neuroimaging o Sensory impairments

23 Pre-Existing Long Term Condition(s) Links to the ‘MPI’ table Conditions NOT diagnosed by service referred to Similar to a medical history Includes following data items: –Diagnosis Scheme in Use (mandatory) ICD 10 Read 2 CTV 3 SNOMED CT –Diagnosis (mandatory) –Diagnosis Date (required)

24 Markers of complexity Specific additional markers of complexity on top of any information about diagnoses At risk of death before the age of 18 marker o New ‘Preferred Death Location Discussed’ item o Existing ‘Death Location Type’ (Preferred and Actual) items o New ‘Death Not at Preferred Location Reason Code’ item ‘Requires constant supervision’ marker o ‘Requires Constant Supervision Due To Disability Indicator’ item

25 Technology dependant marker ‘Technology Dependant indicator’ item Technology Dependant To Support Disability Type table – including technology types as values: o Dependent on CPAP (continuous positive airways pressure) o Dependent on ventilator o Tracheostomy o Intrathecal baclofen pump o Vagal nerve stimulator o Deep Brain Stimulator o Nasogastric tube o Gastrostomy o Jejunostomy o Parenteral feeding o Uses alternative communication skill

26 Patient perception - Disability Type table ‘Disability Code’ - gives overarching information regarding type of disability: 01Behaviour and Emotional 02Hearing 03Manual Dexterity 04Memory or ability to concentrate, learn or understand (Learning Disability) 05Mobility and Gross Motor 06Perception of Physical Danger 07Personal, Self Care and Continence 08Progressive Conditions and Physical Health (such as HIV, cancer, multiple sclerosis, fits etc) 09Sight 10Speech XXOther

27 Protected characteristics Disability one of the equality characteristics set out in the Equality Act 2010 Guidance states that question should be asked of patient – how are day-to-day activities affected? Could make the disability type table tie in with protected characteristics by adding a new data item – ‘Impact of Disability (Patient Perception)’: o 01 Yes – limited a lot o 02 Yes – limited a little o 03 No o 04 Prefer not to say

28 Any further questions?

29 Scored Assessments Mo Mayet Higher Datasets Maintenance Analyst 29

30 Scored Assessment table in the data set

31 New Scored Assessment table

32 ASQ-3 Ages and Stages questionnaire New addition to CYPHS data set The request has come from DH and Public Health England (PHE) to include this in a future release of the data set. Completed when the child is between two and two-and- a-half years old as part of the Healthy Child Programme (HCP). Currently there is a pilot underway with 3 care providers who are submitting data to the HSCIC.

33 Example Assessment Assessment Tool Type ASQ-3 Ages and Stages Questionnaire, Third Edition (ASQ-3) Assessment Dimensions 0 - Total Overall Score 1 - Communication 2 - Gross Motor 3 - Fine Motor 4 - Problem Solving 5 - Personal-Social Person Score Numerical value

34 Examples of other scored assessments BSID-III - Bayley Scales of Infant Development (BSID). EQ-5D - Standardised instrument for use as a measure of health outcomes. PHQ-9 - Patient Health Questionnaire - offer clinicians concise, self- administered screening and diagnostic tools for mental health disorders. GAD-7 - Generalised Anxiety Disorder - for screening and severity measuring of generalized anxiety disorder. The Waterlow Score - Used to assess the risk of pressure sores/ulcers. The Wellbeing self-assessment (WEMWBS) - Used to measure wellbeing. COPD Self-Efficacy Scale (CSES) - A 34 item scale used to measure a patients self-efficacy.

35 Any further questions?

36 Multidisciplinary Team Referral Nicholas Richman Service Development Manager 36

37 Multidisciplinary Team Referral Definition MDT referral defined as a referral to a team which is made up of multiple staff types covering multiple specialties within a single organisation

38 Multidisciplinary Team Referral ‘Service Type Referred To’ now in a separate table ‘Care Professional Staff Group’ and ‘Care Professional ID’ items included in ‘Activity’ table ‘Multidisciplinary Team Review’ included as a value in ‘Community Care Activity Type’ item

39 Any further questions?

40 Integrated Care Plans Nicholas Richman Service Development Manager 40

41 Integrated Care Definition Integrated care means “I can plan my care with people who work together to understand me and my carer(s), allowing me control, and bringing together services to achieve the outcomes important to me.” Integrated Care: Our Shared Commitment, DoH, May 2013 Signed by 12 national partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.

42 Integrated Care Plans (CYPHS v2) Not planned for inclusion in CYPHS v1.5 release New item ‘Integrated Care Pathway Indicator’ included in ‘Referral’ table

43 Any further questions?

44 XML Pilot Findings Tony Childs Section Head 44

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46 XML Pilot 6 providers – total of 259,726 patient records received Various sized trusts / submissions

47 XML Pilot Providers asked to send all 20 tables from the data model Best completion rate of 50% NB – only 5 providers had submitted at time above table was produced Provider Number of tables completed Percentage of tables completed 1840% % 41050% 5735%

48 XML Pilot – Patient demographics Gender Ethnicity Date of birth Postcode

49 XML Pilot – Gender All six providers 0.01% = default All other records = valid

50 XML Pilot – Ethnicity

51 XML Pilot – Date of birth 5 providers submitted 100% valid data 1 provider did not submit any Date of birth information

52 XML Pilot – Postcode Postcodes submitted checked against ODS file 5 providers submitted 100% valid data 1 provider did not submit any Postcode information

53 XML Pilot – Service type referred to 88,217 referral records Therefore it would seem no ‘contact’ for 171, % valid 3.6% Invalid – provided as 1 or 2 etc. instead of ‘01’ or ‘02’ 7.6% missing (if PbR no £££)

54 XML Pilot – Primary reason for referral 94,167 records 12.6% valid 70.8% Invalid – provided as 1 or 2 etc. instead of ‘001’ or ‘002’ etc.

55 XML Pilot – overview Number of NULL in Local Patient IDs and in the Master Patient Index table = 0 (all 6 providers) Total number of duplicate records submitted by a provider = 0 (all 6 providers) Number of records in the GP Practice Reg Table that did not appear in the MPI table = 0 (all 6 providers) Make sure submission data matches Data Dictionary (exactly) otherwise cant be used

56 Any further questions?

57 Summary & Close Nicholas Richman Service Development Manager 57

58 Further questions Please send all queries to:


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