Change Request

NHS Information Authority

Data Standards Programme

Reference: Change Request 257
Version No:1.7
Subject:DSCN 23/2002
Type of Change:Revision of NHS data standards
Effective Date:1 June 2002
Reason for Change:Integration of the Chemotherapy HRGs required to support casemix adjusted costs into the NHS Data Dictionary & Manual

Background:

DSCN 06/2001 introduced the Chemotherapy HRGs that were required to support casemix adjusted costs for the purposes of the National Schedule of Reference Costs (NSRC).

The mandatory collection of Chemotherapy HRGs came into force on 1st October 2001 and the following are changes to the NHS Data Dictionary & Manual to reflect this collection. The changes in this paper have been developed to align with the National Cancer Data Set Project set of data items that have been proposed for integration into NHS data standards.

Summary of changes:
 
Class Definitions
ANTI-CANCER DRUG CYCLE   New Class
ANTI-CANCER DRUG FRACTION   New Class
ANTI-CANCER DRUG PROGRAMME   Change to description
ANTI-CANCER DRUG PROGRAMME   Change to attributes
ANTI-CANCER DRUG PROGRAMME   Change to relationships
ANTI-CANCER DRUG REGIMEN   New Class
CANCER CARE SPELL   New Class
CARE SPELL   Change to relationships
CONSULTANT   Change to relationships
DRUG DOSAGE AND ADMINISTRATION   Change to relationships
HEALTH CARE PROVIDER   Change to relationships
OPERATING THEATRE SESSION   Change to relationships
 
Attribute Definitions
ANTI-CANCER DRUG CYCLE IDENTIFIER   New Attribute
ANTI-CANCER DRUG FRACTION IDENTIFIER   New Attribute
ANTI-CANCER DRUG REGIMEN IDENTIFIER   New Attribute
DRUG REGIMEN ACRONYM   New Attribute
DRUG THERAPY TYPE   New Attribute
 
Diagrams
HP400 CANCER CARE DRUG PROGRAMMES   New NHSDisplayDiagram
 
Supporting Information
HP400   New WebPage

Name:Barbara Fogarty
Date:28 November 2002
Sponsor:Data Standards Team

Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout.


ANTI-CANCER DRUG CYCLE

Change to Class: New Class

ANTI-CANCER DRUG CYCLE

The period of time during which anti-cancer drugs are administered to a PATIENT in an agreed pattern. Cycle is a long-established term used to denote the repeating pattern of many chemotherapy programmes/regimens. A new ANTI-CANCER DRUG CYCLE commences when the original pattern starts again. An ANTI-CANCER DRUG CYCLE may comprise one or more ANTI-CANCER DRUG FRACTIONS of chemotherapy.

References:
National Cancer Data Set Version 1.2 December 2001



This class is also known by these names:
ContextAlias
pluralANTI-CANCER DRUG CYCLES

Attributes of this Class are:
KANTI-CANCER DRUG CYCLE IDENTIFIER
OEND DATE
START DATE

Each ANTI-CANCER DRUG CYCLE
Kmust be administered within one and only one ANTI-CANCER DRUG REGIMEN
may be comprised of one or more ANTI-CANCER DRUG FRACTION


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ANTI-CANCER DRUG FRACTION

Change to Class: New Class

ANTI-CANCER DRUG FRACTION

The actual administration of one or more anti-cancer drugs to a PATIENT. The fraction usually equates to a single contact with a chemotherapy nurse specialist.

References:
National Cancer Data Set Version 1.2 December 2001



This class is also known by these names:
ContextAlias
pluralANTI-CANCER DRUG FRACTIONS

Attributes of this Class are:
KANTI-CANCER DRUG FRACTION IDENTIFIER
START DATE

Each ANTI-CANCER DRUG FRACTION
Kmust be administered within one and only one ANTI-CANCER DRUG CYCLE
may be comprised of one or more DRUG DOSAGE AND ADMINISTRATION


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ANTI-CANCER DRUG PROGRAMME

Change to Class: change to description

A course of anti-cancer drug treatment. This can include chemotherapy, immunotherapy, etc.

Two or more ANTI-CANCER DRUG REGIMENS may be given sequentially as part of a planned ANTI-CANCER DRUG PROGRAMME. The regimens can be considered as separate phases, and examples would include induction followed by consolidation therapy for acute leukaemia.

References:
National Cancer Data Set Version 1.1_ISB October 2001



This class is also known by these names:
ContextAlias
pluralANTI-CANCER DRUG PROGRAMMES


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ANTI-CANCER DRUG PROGRAMME

Change to Class: change to attributes

Attributes of this Class are:
KANTI-CANCER DRUG PROGRAMME IDENTIFIER
DRUG THERAPY TYPE
OEND DATE
START DATE


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ANTI-CANCER DRUG PROGRAMME

Change to Class: change to relationships

Each ANTI-CANCER DRUG PROGRAMME
Kmust be provided in one and only one CARE SPELL
Kmust be provided in one and only one CANCER CARE SPELL
must be the responsibility of one and only one CONSULTANT
must be managed by one and only one HEALTH CARE PROVIDER
may be comprised of one or more ANTI-CANCER DRUG REGIMEN
may be part of one and only one SERVICE PROVIDED


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ANTI-CANCER DRUG REGIMEN

Change to Class: New Class

ANTI-CANCER DRUG REGIMEN

A prescribed systematic form of treatment for a course of drug(s), comprising one or more ANTI-CANCER DRUG CYCLES, provided to a patient suffering from cancer.

References:
National Cancer Data Set Version 1.2 December 2001



This class is also known by these names:
ContextAlias
pluralANTI-CANCER DRUG REGIMENS

Attributes of this Class are:
KANTI-CANCER DRUG REGIMEN IDENTIFIER
DRUG REGIMEN ACRONYM
OEND DATE
START DATE

Each ANTI-CANCER DRUG REGIMEN
Kmust be within one and only one ANTI-CANCER DRUG PROGRAMME
may be a regimen containing one or more ANTI-CANCER DRUG CYCLE


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CANCER CARE SPELL

Change to Class: New Class

CANCER CARE SPELL

A type of CARE SPELL.

The period of time during which a PATIENT who has been diagnosed as suffering from a single site primary cancer may receive care. The CANCER CARE SPELL starts on the date of the REFERRAL REQUEST from whatever source to the specialist team. It ends when the PATIENT dies.

A recurrence of the original primary cancer at a secondary site is part of the same CANCER CARE SPELL.

If a PATIENT has another primary cancer this will be a new CANCER CARE SPELL.

The CANCER CARE SPELL may only involve diagnostic procedures leading to a diagnosis, for example in cases where the patient refuses treatment, or it may include treatment and follow-up.

References:
National Cancer Data Set Version 1.2 December 2001



This class is also known by these names:
ContextAlias
pluralCANCER CARE SPELLS

This class has no attributes.

Each CANCER CARE SPELL
may be the context for one or more ANTI-CANCER DRUG PROGRAMME


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CARE SPELL

Change to Class: change to relationships

Each CARE SPELL
Kmust be for the care or assessment of one and only one PERSON
may be the context for one or more ANTI-CANCER DRUG PROGRAMME
may be the spell that includes one or more CARE PLAN
may be delivered as part of one and only one JOINT INVESTMENT PLAN
may be the context for one or more PALLIATIVE CARE EPISODE
may be the responsibility of one or more RESPONSIBLE HEALTH CARE PROVIDER
may be associated with one or more SERVICE PROVIDED


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CONSULTANT

Change to Class: change to relationships

Each CONSULTANT
must be contracted as main specialty by a provider for one and only one SPECIALTY
may be responsible for one or more ANTI-CANCER DRUG PROGRAMME
may be related to one or more CONSULTANT CLINIC
may be related to one or more CONSULTANT OUT-PATIENT EPISODE
may be related to one or more CONSULTANT REFERRAL REQUEST
may be contracted for one or more CONSULTANT SPECIALTY FUNCTION
may be related to one or more DOMICILIARY CONSULTATION
may be related to one or more ELECTIVE ADMISSION LIST ENTRY
may be responsible for one or more FACE TO FACE CONTACT OPTICAL
may be related to one or more ISOTOPE PROCEDURE DEPARTMENT
may be responsible for one or more NURSING HOME STAY (CONSULTANT CARE)
may be related to one or more OPERATING THEATRE SESSION
may be related to one OPERATING THEATRE SESSION
may be related to one or more PATHOLOGY DEPARTMENT
may be related to one PATIENT PROCEDURE
may be related to one or more PHYSIOLOGICAL MEASUREMENT DEPARTMENT
may be related to one or more RADIOLOGY DEPARTMENT
may be related to one or more REFERRAL REQUEST
may be related to one or more RIGHT OF ADMISSION
may be related to one or more SHARED CARE CONSULTANT
may be related to one or more SHARED CARE OUT-PATIENT CONSULTANT
may be related to one or more SHARED CLINIC CONSULTANT
may be related to one or more THEATRE CASE
may be related to one or more WARD INTENDED BED USE


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DRUG DOSAGE AND ADMINISTRATION

Change to Class: change to relationships

Each DRUG DOSAGE AND ADMINISTRATION
Kmust be related to one and only one DRUG TREATMENT
may be provided in one and only one ANTI-CANCER DRUG FRACTION
may be related to one and only one READ CLASSIFICATION


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HEALTH CARE PROVIDER

Change to Class: change to relationships

Each HEALTH CARE PROVIDER
Kmust be a role of one and only one ORGANISATION
may be the provider of one or more ANTI-CANCER DRUG PROGRAMME
may be related to one or more DENTAL STAFF MEMBER
may be related to one or more DOMICILIARY SERVICE
may be related to one or more ELECTIVE ADMISSION LIST
may be acting as one or more HOSPITAL PROVIDER
may be originating care provider one or more MENTAL HEALTH CARE SPELL
may be the transfer target for one or more MENTAL HEALTH CARE SPELL SUSPENSION
may be related to one or more NURSE OR MIDWIFE CONTACT
may be related to one or more OPERATING THEATRE
may be related to one or more OUT-PATIENT CLINIC
may be related to one or more PATHOLOGY DEPARTMENT
may be connected with one or more PERSON ROLE IN ORGANISATION
may be related to one or more PLANNED SERVICE TO BE PROVIDED
may be related to one or more PROFESSIONAL STAFF GROUP SERVICE
may be the provider in one or more PROVIDER IN SERVICE AGREEMENT
may be the provider in one or more PROVIDER OF OUT OF AREA TREATMENT
may be related to one or more RADIOLOGY DEPARTMENT
may be related to one or more RADIOTHERAPY DEPARTMENT
may be responsible for one or more RESPONSIBLE HEALTH CARE PROVIDER
may be related to one or more RIGHT OF ADMISSION
may be delivering patient treatment or services by one or more SERVICE PROVIDED
may be related to one or more WARD


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OPERATING THEATRE SESSION

Change to Class: change to relationships

Each OPERATING THEATRE SESSION
Kmust be related to one and only one OPERATING THEATRE
may be the actual responsibility of one and only one CONSULTANT
may be planned for one or more CONSULTANT
may be related to one and only one SPECIALTY FUNCTION
may be related to one or more THEATRE CASE
may be cancelled due to one and only one THEATRE SESSION CANCELLATION REASON


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ANTI-CANCER DRUG CYCLE IDENTIFIER

Change to Attribute: New Attribute

ANTI-CANCER DRUG CYCLE IDENTIFIER

A unique identifier for an ANTI-CANCER DRUG CYCLE within an ANTI-CANCER DRUG REGIMEN.

References:
National Cancer Data Set Version 1.1_ISB October 2001


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ANTI-CANCER DRUG FRACTION IDENTIFIER

Change to Attribute: New Attribute

ANTI-CANCER DRUG FRACTION IDENTIFIER

A unique identifier for an ANTI-CANCER DRUG FRACTION within an ANTI-CANCER DRUG CYCLE.

References:
National Cancer Data Set Version 1.1_ISB October 2001


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ANTI-CANCER DRUG REGIMEN IDENTIFIER

Change to Attribute: New Attribute

ANTI-CANCER DRUG REGIMEN IDENTIFIER

A unique identifier for an ANTI-CANCER DRUG REGIMEN within an ANTI-CANCER DRUG PROGRAMME.

References:
National Cancer Data Set Version 1.1_ISB October 2001


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DRUG REGIMEN ACRONYM

Change to Attribute: New Attribute

DRUG REGIMEN ACRONYM

The acronym derived from the drugs used in the ANTI-CANCER DRUG REGIMEN used to identify the drugs used in the regimen. Examples include 'CMF' for a regimen comprising Cyclophosphamide, Methotrexate and 5-Fluorouracil, 'AC' for a regimen comprising Dorubicin and Cyclophosphamide, etc..

References:
National Cancer Data Set Version 1.2 December 2001


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DRUG THERAPY TYPE

Change to Attribute: New Attribute

DRUG THERAPY TYPE

A classification of the type of drug therapy in the ANTI-CANCER DRUG PROGRAMME.

National Codes:
C Chemotherapy
H Hormone / endocrine therapy
I Immunotherapy
O Other

References:
National Cancer Data Set Version 1.2 December 2001


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HP400 CANCER CARE DRUG PROGRAMMES

Change to Diagram: New NHSDisplayDiagram


 HP400 CANCER CARE DRUG PROGRAMMES 


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HP400

Change to Supporting Information: New WebPage

Model View Diagram - Overview

HP400 - Cancer Care Drug Programmes

  1. This diagram shows the class types relevant to chemotherapy interventions in the treatment of cancer.

  1. An ANTI-CANCER DRUG PROGRAMME is planned under the responsibility of a CONSULTANT during a CANCER CARE SPELL and may be comprised of a number of ANTI-CANCER DRUG REGIMENS which run sequentially.

  1. An ANTI-CANCER DRUG REGIMEN may contain a number of ANTI-CANCER DRUG CYCLES.

  1. The actual administration to a PERSON of one or more anti-cancer DRUG DOSAGES AND ADMINISTRATIONS is an ANTI-CANCER DRUG FRACTION.

  1. An ANTI-CANCER DRUG PROGRAMME may be a SERVICE PROVIDED and must be provided by a HEALTH CARE PROVIDER.


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