Mental Health NHS Providers Event for
New Submitters
Friday 23rd October 2015 Leeds
Community and Mental Health Team,
Health and Social Care Information Centre
Welcome and Introductions
Nicholas Richman
Service Development Manager (Community & Mental Health)
Welcome and introductions
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Welcome
Introductions
Fire exits
Toilets
Agenda for the day
Political context
Introduction to the Dataset
Nicholas Richman
Service Development Manager (Community & Mental Health)
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Once upon a time…
• MHMDS introduced in 1999 in the Mental
Health National Service Framework
• First clinical data set
• Mandated from April 2003
• CAMHS data set was mentioned in the
Children’s National Service Framework in
2004
• Changes of government, shifting priorities
and economic downturn all caused delay!
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ISN Publication and Mandation Dates
• ISN published on 16th July 2015, available here:
www.hscic.gov.uk/isce/publication/SCCI0011
• Supplier compliance by 1st January 2016
• Providers start collection on 1st January 2016
• Providers start submitting from 1st February 2016
• Submission in IDB format not XML yet!
• Will carry out Operational Assurance Testing with providers
• January MHSDS submission 1st – 22nd Feb (tbc)
• Publication of EIP waiting times by the end of March – with
DQ information per provider where data not available
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Useful Documentation
• SCCI website www.hscic.gov.uk/isce/publication/SCCI0011
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Requirements Specification
Change Specification
Implementation Guidance
Information Standards Notice
• HSCIC website www.hscic.gov.uk/mhsds
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Data Model
Enhanced Technical Output Specification
User Guidance
Technical Guidance (Baseline and Planned Future)
BSP Baseline Functionality
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Starting to submit data
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Start small and build up
MS Access Intermediate Data Base (IDB)
Bureau Service Portal (BSP)
Submission windows (Primary and Refresh)
Validation on submission
Pre and post deadline
Provider, commissioner and national extracts
Data quality feedback
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Data Model – What does it all mean?
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The administrative ‘backbone’
Outpatient vs. inpatient activity
Clinical data
Mental Health Act
Clinical terminology
Scored assessments (inc. CYP IAPT)
Care clusters
Identifying the commissioner
Waiting Time Measurement (16 Care Pathways)
10
PK
Local Patient Identifier (Extended)
Organisation Code (Local Patient Identifier)
Organisation Code (Residence Responsibility)
Organisation Code (Educational Establishment)
NHS Number
NHS Number Status Indicator Code
Person Birth Date
Postcode of Usual Address
Postcode of Main Visitor
Person Stated Gender Code
Ethnic Category
Religious or Other Belief System Affiliation Group Code
Language Code (Preferred)
Person Death Date
Clinical Terminology Diagnosis
MHS601 Medical History (Previous Diagnosis)
FK1
Local Patient Identifier (Extended)
Diagnosis Scheme in Use
Previous Diagnosis (Coded Clinical Entry)
Diagnosis Date
MHS603 Provisional Diagnosis
MHS604 Primary Diagnosis
MHS605 Secondary Diagnosis
FK1
Service Request Identifier
Diagnosis Scheme in Use
Provisional Diagnosis (Coded Clinical Entry)
Provisional Diagnosis Date
FK1
Service Request Identifier
Diagnosis Scheme in Use
Primary Diagnosis (Coded Clinical Entry)
Diagnosis Date
FK1
Service Request Identifier
Diagnosis Scheme in Use
Secondary Diagnosis (Coded Clinical Entry)
Diagnosis Date
MHS606 Coded Scored Assessment (Referral)
FK1
MHS101 Service or Team Referral
PK
Service Request Identifier
FK1
Local Patient Identifier (Extended)
Organisation Code (Code of Commissioner)
Referral Request Received Date
Referral Request Received Time
NHS Service Agreement Line Number
Service Request Identifier
Coded Assessment Tool Type (SNOMED CT)
Person Score
Assessment Tool Completion Date
Clinical Terminology Relational Structure
Clinical Terminology Data Structure
SNOMED CT Description
SNOMED CT Code
Health of the Nation Outcome Scale for Children and Adolescents item 1
- disruptive, antisocial or aggressive behaviour (observable entity)
895191000000100
Health of the Nation Outcome Scale for Children and Adolescents item 2
- overactivity, attention and concentration (observable entity)
895211000000101
Health of the Nation Outcome Scale for Children and Adolescents item 3
- non-accidental self injury (observable entity)
895231000000109
Health of the Nation Outcome Scale for Children and Adolescents item 4
- alcohol, substance/solvent misuse (observable entity)
895251000000102
Care Activity Identifier
Coded Assessment
(SNOMED CT)
Assessment Score
12345
895191000000100
1
12345
895211000000101
3
12345
895231000000109
2
12345
895251000000102
4
12350
895191000000100
2
12350
895211000000101
2
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Data Model – What does it all mean?
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The administrative ‘backbone’
Outpatient vs. inpatient activity
Clinical data
Mental Health Act
Clinical terminology
Scored assessments (inc. CYP IAPT)
Care clusters
Identifying the commissioner
Waiting Time Measurement (16 Care Pathways)
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Care Clusters
Data Model – What does it all mean?
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The administrative ‘backbone’
Outpatient vs. inpatient activity
Clinical data
Mental Health Act
Clinical terminology
Scored assessments (inc. CYP IAPT)
Care clusters
Identifying the commissioner
Waiting Time Measurement (16 Care Pathways)
16
Data Model – What does it all mean?
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•
•
•
•
•
•
•
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The administrative ‘backbone’
Outpatient vs. inpatient activity
Clinical data
Mental Health Act
Clinical terminology
Scored assessments (inc. CYP IAPT)
Care clusters
Identifying the commissioner
Waiting Time Measurement (16 Care Pathways)
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16 Care Pathways
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Psychoses incl.Schizophrenia
Bi polar disorder
Depression
Anxiety disorders
Obsessive compulsive disorder
Phobias
Organic brain disorders including Dementia
Alcohol and drug misuse
Somatoform disorders
PTSD
Eating disorders
Perinatal disorders
Personality disorders ( 10)
Self harm behaviours
Conduct disorders in children
Neurodevelopmental conditions
– ADHD
– Autistic spectrum disorders
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Experience of a Care Provider
presented by Sarah Peevers, Clinical Business Analyst, Huntercoombe
MHLDDS – Experience of a
Provider
Sarah Peevers
Clinical Business Analyst
MHLDDS – Experience of a Provider
• The Carenotes EPR System was introduced to The
Huntercombe Group in October 2014
• My first involvement was during the initial intro to MHLDDS
with Advance Systems in January 2015
• Extensive work was needed to map all external codes to each
selection / field in Carenotes during February 2015
• Another Carenotes system upgrade was required to ensure it
is compatible with MHLDDS ahead of the first submission
• Several test reports organised to ensure data needed was in
Carenotes – new system meant many gaps!
• Supporting sites to understand MHLDDS requirements
• Issue with lack of info for patients who have been with us for
several years
MHLDDS – Experience of a Provider
• First submission was scheduled for April 2015 – however
delayed due to issues with the access to the Portal
• Submissions have slowly gotten more complete and
each month a new section of data is added
• HSCIC have been extremely helpful in supporting with
the process, responses to queries are very timely
• Analysis of data post submission can be a little
misleading
• Hurdles have been with the supplier / THG data
collection – not HSCIC
• Now looking to see what MHSDS brings – awaiting new
codes and extract so that testing can start. Timelines are
a little tight..
Questions and Answers
Lunch
12.30 – 13.15
Experience of a System Supplier
presented by Richard Langedijk, Solstice
HSCIC Mental Health Provider Event for New MHSDS Submitters
MHSDS - Experience of a Supplier
Simon Hurley
Richard Langedijk
23rd October 2015
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Agenda
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Introduction
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Setting the scene
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Our Experience
• Our Approach
• Structure
• Format
• Other things to consider
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Introduction Solstice
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Providers of a service user record system (e-MDS) to MH & LD service providers
• Specifically designed to ensure reporting compliance (incl. MHSDS)
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Consultancy Services
• Data Flow Analysis and process optimisation
• System Review & Analysis
• System Integration & Implementation
• Information Governance Compliance / IG Toolkit
• N3 Process
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Setting the scene – Provider Group 1
Those with a service user record system, which provides the option to automatically
generate the MHSDS on the push-of-a-button
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Setting the scene – Provider Group 2
Those with no Service User Record system
Good luck !
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Setting the scene – Provider Group 3
Providers with a system(s), but with the in-house obligation to produce datasets
Option 1
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Data Mart
SQL queries
?
Option 2
MHSDS
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Our experience
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Our Approach
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Our system will generate the MHSDS (end November 2015)
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Get an indication of the scope of the changes as soon as possible
• TUG Meetings, Supplier Meetings
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Two main documents – study them in detail
• Technical Output Specification, User Guidance
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If you have any questions, don’t be afraid to ask the CMH Team
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Structure
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Structure – Service Request ID
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Ward Stays are linked to
• Hospital Spells are linked to
• Service Requests (referrals) are linked to
• Patient Record
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You may need to consider what constitutes a
new referral request
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Structure – Assessment Data
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Each outcome assessment (e.g. HoNOS, CGAS) must now be
linked to a care activity and a care contact
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‘Dummy’ records may be required if your assessments aren’t
linked to care contacts
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Structure – RC Assignments
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A change in MHA section now requires a new RC assignment
record
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Format - SNOMED
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List of outcome assessment SNOMED
codes have now been included within the
Technical Output Specification
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If your system uses SNOMED codes, check
that the codes used match those in the
Specification
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If your system doesn’t use SNOMED
codes, then use the HSCIC list in a
mapping table
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SNOMED codes have not been issued for
interventions or observations (other than
ECT and Smoking Status)
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Other Things to Consider
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GP Assignment Table is now mandatory – use code V81999
where the GP data isn’t available or none of the data will flow
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Data Scope
• Different types of restraint (Chemical, Mechanical, Physical)
• Segregation
• Disability Types
• How is this data collected (if at all)?
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Data Validation
• Check the Technical Output Specification to see what
validation will take place on submission to build data quality
checks into your system
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Other Things to Consider
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Check what outcome assessments are being used in your organisation against
the list in the technical output specification (increase from 7 to c. 40)
Brief Parental Self-Efficacy Scale score
Child Group Session Rating Scale score
Child Outcome Rating Scale total score
Children's global assessment scale score
Clinical Outcomes in Routine Evaluation - 10 clinical score
Commission for Health Improvement Experience of Service Questionnaire
Current View
Eating disorder examination questionnaire
Generalized anxiety disorder 7 item score
Goal Progress Chart - Child/Young Person - goal score
Group Session Rating Scale score
HoNOS (Working Age Adult)
HoNOS 65+
HoNOSCA - Parent, Clinician or Self Rated
HoNOS-LD
HoNOS Secure
How Are Things? Behavioural Difficulties (Oppositional Defiant Disorder)
Index of Family Function and Change - 15
Kessler Psychological Distress Scale 10 score
MAMS (Me and My School) Questionnaire
MHCT Assessments
Outcome Rating Scale total score
Patient health questionnaire 9 (PHQ-9) total score
RCADS (Revised Children's Anxiety and Depression Scale)
Revised Child Impact of Events Scale score
Strengths and Difficulties Questionnaire (2-4, 4-17 or 11-17 self rated)
Session Feedback Questionnaire score
Session Rating Scale score
Sheffield learning disabilities outcome measure score
Short Warwick-Edinburgh Mental Well-being Scale score
Warwick-Edinburgh Mental Well-being Scale score
Young Child Outcome Rating Scale score
Young Person's Clinical Outcomes in Routine Evaluation clinical score
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Not just about ‘systems and codes’
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Organisational structure
• Clear roles and responsibilities
• Single point of accountability
• Visibility across the entire data flow
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Data Quality
• Correct, complete and timely
• Real time validation (“rubbish in, ……”)
• Data Quality reports – pre-submission checks
• Is all data even captured? Available?
• Multiple data entry points and same data recorded twice in
different systems?
• Staff training
©Solstice – suppliers of
“Simple Solutions for Complex Problems”
Bureau Service Portal, DUC and XML
presented by Navin Bose – Higher Datasets Maintenance Analyst
Steps for New MHSDS Providers
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Visit the HSCIC Webpage for MHSDS v1.0 http://www.hscic.gov.uk/mhsds
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Check to see if your service will fall within the scope of the mandated MHSDS v1.0 Data
Set requirements: http://www.hscic.gov.uk/isce/publication/SCCI0011
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Gain NHS Secure N3 Connection: http://n3.nhs.uk/customerinformation/howdoi/
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Register your service with ODS : http://systems.hscic.gov.uk/data/ods
Email: Exeter.helpdesk@hscic.gov.uk requesting that you would like to register for an ODS
code for your organisation.
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Complete IG toolkit: https://www.igt.hscic.gov.uk/
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Register a Caldicott Guardian (CG) for your organisation (requires ODS code):
http://systems.hscic.gov.uk/data/ods/searchtools/caldicott/cg_standard.doc
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Request BSP access using OpenExeter DUC forms (requires CG and ODS code and N3
connection): http://systems.hscic.gov.uk/ssd/prodserv/mhsds.pdf (will be available soon)
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OpenExeter portal login (N3 connection only): https://nww.openexeter.nhs.uk/nhsia/index.jsp
HSCIC Webpage for MHSDS v1.0
Make it a habit to visit the HSCIC Webpage for MHSDS v1.0
http://www.hscic.gov.uk/mhsds regularly!
Wide range of guidance and supporting documents available for MHSDS providers
and System Suppliers.
Submission Guidance Documents:
• MHSDS Data Model
• MHSDS v1.0 User Guidance
• MHSDS v1.0 Technical Guidance
• Baseline Technical Output Specification
• MHSDS v1.0 Technical Output Specification
Planned Future Technical Output Specification(s)
• MHSDS v1.0 Technical Output Specification
Organisational assessment and planning tools
• MHSDS v1.0 Implementation Planning Template
• MHSDS v1.0 Readiness Assessment Tool
• MHSDS v1.0 System Conformance Checklist
Organisation Data Service
http://systems.hscic.gov.uk/data/ods
ODS is provided by the Health and Social Care Information Centre (HSCIC) and is
responsible for the publication of all organisation and practitioner codes and national policy
and standards with regard to the majority of organisation codes.
Registration Process:
ODS Primary Contact Form (OC1) and Site Request Sheet
Organisation site code request sheet (XLS, 25.5kB) - Apply for NHS Trust, Care Trust,
CCG site codes etc.
Form OC1 (DOC, 133.5kB) - Register a new primary contact for an NHS organisation, or
amend details of an existing contact.
Non-NHS Organisation code request form (DOC, 157.0kB) - Apply for Non-NHS
organisation code.
Caldicott Guardian Form
The Caldicott Guardian form which all sites will need to have in place before we
can allocate users to the system
http://systems.hscic.gov.uk/infogov/caldicott
MUST HAVE
“WET”
SIGNATURE OF
CALDICOTT
GUARDIAN
FORMS MUST BE
SENT BY POST
Caldicott Guardian Form
Remember:
Open Exeter web page
The Open Exeter page where all the documents live
http://systems.hscic.gov.uk/ssd/prodserv/vaprodopenexe/
MHSDS
Data User Certificate
The DUC form (Data User Certificate) which the Caldicott Guardian signs to allow
access
Mental Health and Learning Disabilities Data Set (MHMDS/MHLDDS) Data User Certificate
(PDF, 57.7kB)
Data User Certificate
MUST HAVE “WET”
SIGNATURE OF CALDICOTT
GUARDIAN MATCHING
SIGNATURE ON HSCIC’s
CALDICOTT REGISTER
FORMS MUST BE SENT
BY POST
Bureau Service Portal (BSP) Login
BSP – MHSDS Home Page
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BSP – MHSDS – File Upload
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BSP – MHSDS Home Page
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BSP – Download Validation Summary Report
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BSP – Download Pre-Deadline Extract
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MHSDS Extracts in XML Format
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MHSDS Extracts in XML Format
• After processing these tables are transformed
into an xml file
• Can be opened using any Internet Browser,
NotePad++ or any XML tool
• Can be easily imported into Access or SQL
• Retains table structure when imported into
Access
Support for new MHSDS Providers
• The Community & Mental Health Team is
available to support all providers with
MHSDS Submissions
• Queries can be sent via: Enquiries Team
o Email: Enquiries@hscic.gov.uk
o Tel.:0845 300 6016
• For BSP Login/Access issues and portal
performance, please contact:
o exeter.helpdesk@hscic.gov.uk
o Tel.: 0845 371 3671
Feedback You Will Receive
presented by Amina Butt, Senior Information Analyst
Where do I get feedback reports?
• Bureau Service Portal
• Data Quality Notices
• Data Quality Publication
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BSP – Summary Report
• Every submission attempt
• In submission window – Perfect time to
correct!
• Descriptions on portal and in TOS
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BSP – Warnings and Diagnostics
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BSP – Aggregate Counts
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Data Quality Notices
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Every successful submission
2 weeks after window closes
Distributed through Data Depot
Pre-publication
Example records provided
Use along with post processing extracts from
BSP
• Description/Constructions
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Data Quality Notices
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Data Quality Notices - Example records
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A real example
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How could this have been avoided?
• BSP - Warnings
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Also….
• BSP – Diagnostics
• BSP – Aggregate Counts
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Data Quality Measures Publication
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Monthly on both Primary and Refresh
National view and by provider
VODIM
Consistency
Care Spell Volume Time Series
Unclosed Spells
Data Integrity
Rules
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VODIM
• 27 data items
• Our example: Ward Security and Site Code
of Treatment can’t be assessed
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Data Consistency
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Mental Health Act Episodes
Care Programme Approach Episodes
Payment By Results Care Cluster Episodes
Community Treatment Order Episodes
Hospital Provider Spell Episodes
Ward Stay (WRDST) Episodes
• Our example – Ward Stay Episodes is zero
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Data Integrity
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Gatekept admissions
PCT codes
Restraints
Seclusion
Self Harm
Assault
Intervention
• Comparison against known activities and other
collections e.g. KP90, Unify
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Useful Resources
• http://www.hscic.gov.uk/mhldds
• http://www.hscic.gov.uk/mhsds
– Technical Output Specification
– Validation Rules
– Metadata
• Email: mhmds@hscic.gov.uk
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Feedback you will receive
presented by Amina Butt – Senior Information Analyst
Questions and Answers