NHS Information Authority

Data Standards Programme

The convention of using the suffix 8 for 'not applicable', and 9 for 'not known' has been adhered to in the past, where possible. In the case of General Medical Practitioner and General Dental Practitioner the last digit is a check digit based on an algorithm applied to the 6 figure Doctor's Index Number or Dental Practice Board code. This leads to a default code of 9999981 for not applicable, and 9999998 for not known.

Definition Requests sent to the Data Standards Programme raised several issues for clarification on default codes used in Commissioning Data Sets that have been addressed in this DSCN as follows:

GMP (CODE OF REGISTERED OR REFERRING GMP):
The Default Codes Summary includes 'MOD doctor refers' and 'Prison doctor'. This led to queries about whether a prison doctor can be used as the patient's registered GMP as well as a referrer. Whilst both MOD and prison doctors provide general medical services to their communities, they are not GMPs and should not be recorded as Registered GMPs. To clarify this the default code description has been amended to 'MOD doctor' and an additional data item note has been added to the effect that neither MOD nor Prison doctors can be recorded as Registered GMPs.

Dentists without Dental Practice Board codes:
The OCS has a file of dentists, but it only contains Dental Practice Board codes, and not the General Dental Council codes. Where a dentist has no DPB number the code D9999981 should be used, even though the dentist has a GDC code. To clarify this the description of D9999981 has been renamed 'Dentist code not applicable (dentist does not have DPB number)'.

CODE OF GP PRACTICE (REGISTERED GMP):
There is no default code for 'Practice code not applicable' - as this is an optional field, no code is required for the Commissioning Data Set flow. If the Practice Code is not applicable, the field should be omitted from the message.

The Data Standards Programme was asked for a code for 'Practice code not applicable'. Logically it must be V81998 to correspond with V81999 used for 'Code of GP practice is unknown', but V81998 is also used for 'Prison practice', 'Dentist practice', 'Practice code of MOD doctor' and 'no referring doctor, therefore no practice code'.

To support this V81998 has been extended to include 'Practice code not applicable'.

The use of V81998 for 'no referring doctor, therefore no practice code', is irrelevant to Registered GMP and appears superfluous as a Referring organisation code, as there are existing codes for not applicable and not known. This description has therefore been removed.

The reference to V81998 'Practice code of MOD' has been deleted from this data item note, as it is irrelevant to Registered GMP, although it will remain as a default organisation code.

REFERRER CODE:
There are two overlapping default codes: R9999981 - No referring GP and X9999998 - Not applicable, no code available

R9999981 should be used for Referrer other than GMP, GDP or consultant and X9999998 should be used for not applicable, including patients who self-present, or unknown. The text has been changed to make this clearer.

These changes are meant for clarification rather than widespread reform and do not materially alter the use of codes in historical data.

Default codes are maintained by the Organisation Codes Service OCS at nww.nhsia.nhs.uk/ocs/. The paper-based handbook was withdrawn from use in August 2001.

CODE OF GP PRACTICE (REGISTERED GMP)

Format/length:	an6
HES item:	GPPRAC
National Codes:
Default Codes:	V81998 - Practice code of MOD doctor
	V81998 - No referring doctor, therefore no practice code
Default Codes:	V81998 - Practice code not applicable
	V81999 - Practice code is unknown

Notes:
The code of the practice is an ORGANISATION CODE, see Administrative Codes & Classifications: Medical & Dental Practice.

This is the code of the practice of the PATIENT's registered GMP which lets him or her be notified about treatment received by the PATIENT. The registered GMP may or may not be the same as the referring GMP.

This data element is also known by these names:

Context	Alias
plural	CODE OF GP PRACTICE (REGISTERED GMP)

GMP (CODE OF REGISTERED OR REFERRING GMP)

Format/length:	an8
HES item:	REGGMP
National Codes:
Default Codes:	G9999998 - GP code is unknown
	G9999981 - No registered GP
	R9999981 - No referring GP
	R9999981 - Referrer other than GMP, GDP or Consultant
	Other GP Codes
	A9999998 - MOD doctor refers
	P9999981 - Prison doctor

Notes:
This is the code of either the GENERAL MEDICAL PRACTITIONER (GMP) with whom the PATIENT is registered, or for the GP Referral Letters CMDS only it is also the GMP referring the PATIENT. Please note that for HES purposes, the referring GMP is recorded as REFERRER CODE.

A doctor receives a GMC number on qualification. If he/she then chooses to enter general practice, a further number is allocated - the GMP code - by the Department of Health (STATS(W)). This number is passed to the HEALTH AUTHORITY (HA) requesting the number who then liaise with the Prescription Pricing Authority (PPA) on the issue of prescription pads etc. The code of the GMP linked to his/her main practice is included on the Organisation Codes Service (OCS) CD-ROM.

The GMP code is an eight character alphanumeric code, see NHS Administrative Codes - Practitioner Codes, PERSON IDENTIFIER and PERSON IDENTIFIER TYPES.

When a locum refers, use the code of the GP for whom the locum is acting. See PERSON IDENTIFIER TYPEclassification 'Code of General Practitioner - PPA Code'. See PERSON IDENTIFIER TYPE classification 'Code of General Practitioner - PPA Code'.

For GPs working in hospitals, the following codes should be used:

-	if the GP is working as an assistant, use the code of the responsible consultant;
-	if the GP is working as a consultant, use the GP's GMC code.

Whilst both MOD and prison doctors provide general medical services to their communities, they are not GMPs and should not be recorded as Registered GMPs. They can refer (Referrer code).

This data element is also known by these names:

Context	Alias
plural	GMP (CODE OF REGISTERED OR REFERRING GMP)

REFERRER CODE

Format/length:	an8
HES item:	REFERRER
National Codes:
Default Codes:	X9999998 - Not applicable: no code available
Default Codes:	R9999981 - Referrer other than GMP, GDP or Consultant
	X9999998 - Not applicable: or not known

Notes:
This requires the code of the PERSON making the referral. This will normally be a HEALTH CARE PRACTITIONER - a GMP or a consultant.

The intention is for this item to reflect the actual (true) referrer. For example, following a GMP referral, a consultant may subsequently refer the PATIENT to another consultant within the HOSPITAL PROVIDER SPELL. The code of the consultant making the referral and the consultant’s organisation should be recorded in the CDS rather than the code of the GMP referrer. Where the Consultant Code is unknown, the default value C9999998 should be used.

In all other cases, the code of the referring GMP should be recorded, if applicable.

See CONSULTANT CODE and GMP (CODE OF REGISTERED OR REFERRING GMP) for the codes available for consultants and General Medical and Dental Practitioners.See CONSULTANT CODE and GMP (CODE OF REGISTERED OR REFERRING GMP) for the codes available for consultants and General Medical and Dental Practitioners, MoD and Prison Doctors. See also NHS Administrative Codes.

If the referral is not from a GMP, GDP or consultant, e.g. self-referral, the default code (X9999998) should be used.If the Referrer code is not known or not applicable e.g. the patient has self-presented, the default code (X9999998) should be used.

This data element is also known by these names:

Context	Alias
plural	REFERRER CODES
plural	REFERRER CODE

Default Codes Summary Table

Default Codes Summary Table

DEFAULT CODES SUMMARY

Default (or pseudo) codes may be used:

• to indicate an organisation type, such as an MoD doctor or a Prison Practice;
• to indicate that the code value is not known;
• to indicate that a code cannot be supplied (e.g. no referring doctor or dentist).

Please address enquiries about this DSCN to:-

Data Standards Team
NHS Information Authority
Aqueous II
Aston Cross
Rocky Lane
Birmingham
B6 5RQ

Tel: 0121 333 0333