NHS Information Authority

Data Standards Programme

The National Cancer Plan was published in September 2000. Within the Plan there are a number of commitments and targets relating to waiting times for diagnosis and treatment. The national cancer waiting times data set has been developed as a subset of the national cancer data set, and is described in DSCN 22/2002 - National Cancer Waiting Times Monitoring.

This DSCN details the corresponding changes required to NHS data standards on implementation of the national waiting times data set.

CANCER CARE PLAN

CANCER CARE PLAN

A type of CARE PLAN.

A CARE PLAN developed within a CANCER CARE SPELL. There should be at least one PLANNED CANCER TREATMENT recorded within a CANCER CARE PLAN.

References: National Cancer Data Set Version 1.1_ISB October 2001

This class is also known by these names:

Context	Alias
plural	CANCER CARE PLANS

Attributes of this Class are:

O

MULTIDISCIPLINARY TEAM DISCUSSION DATE

Each CANCER CARE PLAN

	must be a plan originated by decision to treat for by one and only one one and only one HEALTH CARE PROVIDER
	may be a plan with one or more PLANNED CANCER TREATMENT

CANCER CARE SPELL

This class has no attributes. Attributes of this Class are:

		CANCER STATUS
	O	SPECIALIST PALLIATIVE CARE DATE

CANCER CARE SPELL

Each CANCER CARE SPELL

	must be initiated as a result of one and only one REFERRAL REQUEST
	may be the context for one or more ANTI-CANCER DRUG PROGRAMME

CANCER CARE SPELL DELAY

CANCER CARE SPELL DELAY

A delay in either an OUT-PATIENT APPOINTMENT or treatment for suspected cancer after a referral has been received. A CANCER CARE SPELL DELAY should be recorded for each delay.

References:
The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This class is also known by these names:

Context	Alias
plural	CANCER CARE SPELL DELAYS

Attributes of this Class are:

K		CANCER CARE SPELL DELAY NUMBER
	O	DELAY REASON COMMENT
	O	DELAY REASON INDICATOR
	O	DELAY REASON REFERRAL TO FIRST SEEN (CANCER)
		if delay is between referral and first seen and it is an urgent GP referral
	O	DELAY REASON TO TREATMENT (CANCER)
		if delay is between referral and treatment, or decision to treat and treatment
	O	WAITING TIME ADJUSTMENT REASON
		where an adjustment to the waiting time has been made

Each CANCER CARE SPELL DELAY

K	must be a delay for one and only one REFERRAL REQUEST

CARE SPELL

Each CARE SPELL

K	must be for the care or assessment of one and only one PERSON
K	may be the context for one or more PERSON OBSERVATION WITHIN CARE SPELL
	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

CLINICAL INTERVENTION

Attributes of this Class are:

K		CLINICAL INTERVENTION DATE
K		CLINICAL INTERVENTION NUMBER
		CLINICAL INTERVENTION TIME
	O	FIRST DIAGNOSTIC TEST
		for suspected cancer only

GP REFERRAL REQUEST

Attributes of this Class are:

	O	CANCER REFERRAL DECISION DATE
		CANCER REFERRAL PRIORITY TYPE
	O	URGENT CANCER REFERRAL DECISION DATE
	O	URGENT CANCER REFERRAL TYPE
		WRITTEN REFERRAL REQUEST INDICATOR

HEALTH CARE PROVIDER

Each HEALTH CARE PROVIDER

K	must be a role of one and only one ORGANISATION
	may be the provider of one or more ANTI-CANCER DRUG PROGRAMME
	may be originator of a decision to treat one or more CANCER CARE PLAN
	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 originating care provider of 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 provided following decision to treat of one or more PLANNED CANCER TREATMENT
	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

MENTAL HEALTH CARE SPELL

Each MENTAL HEALTH CARE SPELL

	must be provided by one and only one MENTAL HEALTH CARE TEAM
	must be for the care or assessment of one and only one PATIENT
	may be associated with one or more ABSENCE WITHOUT LEAVE
	may be associated with contact by one or more FACE TO FACE CONTACT SOCIAL WORKER
	may be initiated by transfer from another one and only one HEALTH CARE PROVIDER
	may be associated with one or more LEAVE OF ABSENCE
	may be suspended by one or more MENTAL HEALTH CARE SPELL SUSPENSION
	may be associated for the main specialty with one or more MHCS SPECIALTY ASSOCIATION
	may be associated with one or more MHC WITHOUT PATIENT CONSENT

PATIENT DIAGNOSIS

Attributes of this Class are:

	O	PATIENT DIAGNOSIS CODING SIGNIFICANCE
	O	PRIMARY DIAGNOSIS
		TUMOUR LATERALITY
		for cancers only

PERSON OBSERVATION

Each PERSON OBSERVATION

K	must be an observation of one and only one PERSON
K	may be the observation in one or more PERSON OBSERVATION WITHIN CARE SPELL
	must be observed by one and only one HEALTH CARE PRACTITIONER
	or must be observed by one and only one PERSON
	may be related to one and only one SERVICE PROVIDED

PERSON OBSERVATION WITHIN CARE SPELL

PERSON OBSERVATION WITHIN CARE SPELL

The association between a PERSON OBSERVATION and a CARE SPELL. An example of this is a PATIENT DIAGNOSIS related to a CANCER CARE SPELL.

This class is also known by these names:

Context	Alias
plural	PERSON OBSERVATIONS WITHIN CARE SPELLS

This class has no attributes.

Each PERSON OBSERVATION WITHIN CARE SPELL

K	must be made in the context of one and only one CARE SPELL
K	must be related to one and only one PERSON OBSERVATION

PLANNED CANCER TREATMENT

PLANNED CANCER TREATMENT

The identification of a type of treatment to be provided within a CANCER CARE PLAN.

There may be more than one type of treatment in a planned sequence within a CANCER CARE PLAN.

References: National Cancer Data Set Version 1.1_ISB October 2001

This class is also known by these names:

Context	Alias
plural	PLANNED CANCER TREATMENTS

Attributes of this Class are:

K		PLANNED CANCER TREATMENT TYPE
		DECISION TO TREAT DATE
	O	FIRST DEFINITIVE TREATMENT PLANNED
	O	FIRST DEFINITIVE TREATMENT PROVIDED
	O	PLANNED DEFINITIVE TREATMENT
		TREATMENT TYPE SEQUENCE

Each PLANNED CANCER TREATMENT

K	must be a treatment within one and only one CANCER CARE PLAN
	must be a decision to treat one and only one HEALTH CARE PROVIDER
	may be provided by one or more SERVICE PROVIDED

REFERRAL REQUEST

Attributes of this Class are:

K		REQUEST NUMBER
	O	CANCER SPECIALIST REFERRAL DATE
		for suspected cancer only
	O	COLPOSCOPY REFERRAL INDICATION
		colposcopy only
	O	COMMISSIONER REFERENCE NUMBER
	O	FIRST SEEN BY SPECIALIST DATE (CANCER)
		for suspected cancer only
	O	OUT-PATIENT CLINIC REFERRING INDICATOR
		if referral request from an out-patient clinic
		OUT-PATIENT REFERRAL INDICATOR
		PRIORITY TYPE
		REFERRAL DATE
	O	REFERRAL REQUEST CANCELLED DATE
		REFERRAL REQUEST RECEIVED DATE
		SERVICE TYPE REQUESTED
	O	SOURCE OF REFERRAL FOR A+E
		if request is for care by an ACCIDENT AND EMERGENCY DEPARTMENT
	O	SOURCE OF REFERRAL FOR COMMUNITY
		if request is for care by a COMMUNITY NURSE STAFF GROUP
	O	SOURCE OF REFERRAL FOR COMMUNITY DENTAL
		if request is for care by a Community Dental Service
	O	SOURCE OF REFERRAL FOR DRUG MISUSE
		if request is for care at a DRUG MISUSE FACILITY
	O	SOURCE OF REFERRAL FOR MENTAL HEALTH
		if request is for care from specialist mental care services
	O	SOURCE OF REFERRAL FOR OUT-PATIENTS
		if request is for care to be provided as an out-patient
	O	SOURCE OF REFERRAL FOR PROF STAFF GROUP
		if request is for care by a PROFESSIONAL STAFF GROUP SERVICE
	O	SUPRA SERVICE TYPE
	O	TWO WEEK WAIT EXCLUSION INDICATOR
		for suspected cancer only

REFERRAL REQUEST

Each REFERRAL REQUEST

K	must be related to one and only one PATIENT
	must be a referral to one and only one CONSULTANT
	or must be a referral to one and only one SERVICE POINT
	may be the initiator of one or more CANCER CARE SPELL
	may be associated with one or more CANCER CARE SPELL DELAY
	may be related to one and only one LOCAL SUB-SPECIALTY
	may be associated with one or more OUT-PATIENT REFERRAL STATUS
	may be related to one or more PLANNED SERVICE TO BE PROVIDED
	may be a referral with subsequently one or more REFERRAL REQUEST
	may be subsequent to an original one REFERRAL REQUEST
	may be a request for colposcopy from one and only one SCREENING TEST
	may be the initiator of one or more SERVICE PROVIDED
	may be related to one and only one SPECIALTY FUNCTION
	may be related to one or more TRANSPORT REQUIREMENT

SERVICE PROVIDED

An episode of care, treatment or other service provided by a HEALTH CARE PROVIDER which may be chargeable to one or more NHS SERVICE AGREEMENTS. In most cases, the service provided will be for the direct benefit of a PATIENT. For example a SERVICE PROVIDED may be one or more of the following:

a.	CONSULTANT EPISODE (HOSPITAL PROVIDER)
b.	CONSULTANT OUT-PATIENT EPISODE
c.	HEALTHY PERSON STAY
d.	ACCIDENT AND EMERGENCY EPISODE
e.	RADIOTHERAPY TREATMENT COURSE
f.	REQUEST FOR DIAGNOSTIC TEST
g.	REGULAR ATTENDER EPISODE
h.	PROFESSIONAL STAFF GROUP EPISODE
i.	GENITO-URINARY EPISODE
j.	TRANSPORT REQUEST

A SERVICE PROVIDED associated with a CARE SPELL may be treatment carried out by the HEALTH CARE PROVIDER as part of a CARE SPELL for which the lead responsibility is with another HEALTH CARE PROVIDER.

This class is also known by these names:

Context	Alias
plural	SERVICES PROVIDED

SERVICE PROVIDED

Attributes of this Class are:

K		SERVICE PROVIDED NUMBER
		DECISION TO TREAT DATE
		for cancer treatment only
		SELF-REFERRAL OR OPEN ACCESS

SERVICE PROVIDED

Each SERVICE PROVIDED

K	must be a treatment or service provided by one and only one HEALTH CARE PROVIDER
	may be part of one and only one HEALTH PROGRAMME
	or may be related to one and only one SURVEILLANCE PROGRAMME STAGE
	may be related to one or more GROUP SESSION
	or may be related to one or more HEALTH PROMOTION OTHER ACTIVITY
	or may be related to one or more PERSON IN A CONTACT TRACING PROGRAMME
	or may be related to one or more PERSON IN A SCREENING PROGRAMME
	may be related to one or more ACCIDENT AND EMERGENCY DEPARTMENT
	may be related to one or more ACCIDENT AND EMERGENCY EPISODE
	may be related to one or more ADMINISTRATIVE CATEGORY IN EPISODE
	may be related to one or more ADMINISTRATIVE CATEGORY IN SPELL
	may be related to one or more AMBULANCE SERVICE
	may be provided as one or more ANTI-CANCER DRUG PROGRAMME
	may be related to one or more AUDIOLOGY ATTENDANCE
	may be provided within one and only one CARE PLAN
	may be provided as one or more CARE PROGRAMME APPROACH EPISODE
	may be for care responsibility part of one and only one CARE SPELL
	may be related to one or more CLINICAL INTERVENTION
	may be related to one or more CLINIC ATTENDANCE NON-CONSULTANT
	may be related to one or more COMMUNITY EPISODE
	may be provided as one or more CONSULTANT EPISODE (ACUTE HOME-BASED)
	may be related to one or more CONSULTANT EPISODE (HOSPITAL PROVIDER)
	may be provided as one or more CONSULTANT OUT-PATIENT EPISODE
	may be related to one or more DENTAL EPISODE
	may be related to one or more DENTAL STAFF MEMBER IN PROGRAMME
	may be related to one or more DOMICILIARY CONSULTATION
	may be related to one or more DRUG MISUSE EPISODE
	may be related to one or more ELECTIVE ADMISSION LIST ENTRY
	may be related to one or more FACE TO FACE CONTACT OPTICAL
	may be provided as one or more FACE TO FACE CONTACT SOCIAL WORKER
	may be related to one or more FAMILY PLANNING DOMICILIARY VISIT
	may be related to one or more HEALTH PROMOTION ACTIVITY HIV AND AIDS
	may be related to one or more HEALTHY PERSON STAY
	may be related to one or more HOME ASSESSMENT VISIT
	may be related to one or more HOME DIALYSIS EPISODE
	may be provided as one or more HOME HELP VISIT
	may be related to one or more IMMUNISATION PROGRAMME FOR PERSON
	may be related to one or more LABOUR AND DELIVERY
	may be related to one or more LITHOTRIPSY COURSE ATTENDANCE
	may be provided in one and only one LOCATION
	may be related to one or more MATERNITY DOMICILIARY VISIT
	may be related to one or more MIDWIFE EPISODE
	may be related to one or more NHS SERVICE AGREEMENT CHANGE
	may be related to one or more NURSE OR MIDWIFE CONTACT
	may be related to one or more NURSING EPISODE
	may be provided as one or more NURSING HOME STAY (CONSULTANT CARE)
	may be related to one or more NURSING HOME STAY (NURSING CARE)
	may be related to one or more OUT-PATIENT CLINIC
	may be related to one or more OVERSEAS VISITOR STATUS
	may be provided as one or more PALLIATIVE CARE EPISODE
	may be related to one or more PATIENT JOURNEY
	may be related to one or more PERSON IN ADVICE AND SUPPORT PROGRAMME
	may be related to one or more PERSON IN A SURVEILLANCE STAGE
	may be related to one or more PERSON OBSERVATION
	may be providing one or more PERSON SMOKING CESSATION EPISODE
	may be related to one and only one PLANNED CANCER TREATMENT
	may be related to one or more POST MORTEM
	may be related to one or more PROFESSIONAL STAFF GROUP EPISODE
	may be related to one or more PROFESSIONAL STAFF GROUP SERVICE
	may be related to one or more RADIOTHERAPY TREATMENT COURSE
	may be initiated by one and only one REFERRAL REQUEST
	may be provided as one or more REGULAR ATTENDER EPISODE
	may be related to one or more REQUEST FOR DIAGNOSTIC TEST
	may be provided as one or more RESIDENTIAL CARE OR GROUP HOME STAY
	may be subdivided into one or more SERVICE PROVIDED
	may be a subdivision of one SERVICE PROVIDED
	may be related to one or more SERVICE PROVIDED UNDER AGREEMENT
	may be provided at one or more SERVICE PROVISION POINT
	may be related to one or more SERVICE REPORTED
	may be reported by one and only one SERVICE REPORT HEADER
	may be provided as one or more SHELTERED WORK ATTENDANCE
	may be part of one and only one SMOKING CESSATION SERVICE
	may be provided as one or more SOCIAL SERVICES STATUTORY ASSESSMENT
	may be related to one or more VASECTOMY PERFORMED
	may be related to one or more WARD ATTENDANCE
	may be related to one or more WARD STAY

CANCER CARE SPELL DELAY NUMBER

CANCER CARE SPELL DELAY NUMBER

A number allocated to provide a unique identifier for each CANCER CARE SPELL DELAY.

This attribute is also known by these names:

Context	Alias
plural	CANCER CARE SPELL DELAY NUMBERS

CANCER REFERRAL PRIORITY TYPE

A classification of the urgency of a referral of a PATIENT to see a cancer specialist, determined by the GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER making the referral. A classification of the urgency of a referral of a PATIENT to see a cancer specialist, determined by the health care professional making the referral.

National Codes:

1	Non-urgent referral - identified by GP
01	Urgent referral for suspected cancer from a General Medical Practitioner or General Dental Practitioner
2	Urgent cancer referral identified by GP
3	Urgent referral - upgraded from non-urgent by specialist unit
4	Urgency not identified by GP, given 'routine' urgency by consultant
5	Urgency not identified by GP, given 'urgent' urgency by consultant
02	Other referral source or urgency

References:
National Cancer Data Set Version 1.1_ISB October 2001 The NHS National Cancer Waiting Times, DH, DSCN 22/2002

This attribute is also known by these names:

Context	Alias
plural	CANCER REFERRAL PRIORITY TYPES

CANCER SPECIALIST REFERRAL DATE

CANCER SPECIALIST REFERRAL DATE

The date on which the decision was made to refer a PATIENT with suspected cancer to an appropriate cancer specialist. An appropriate specialist is the person or persons who are most able to progress the diagnosis of the primary tumour. This date will be one of the following:

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	CANCER SPECIALIST REFERRAL DATES

CANCER STATUS

CANCER STATUS

This is to identify urgent GP referrals for suspected cancer who are subsequently diagnosed with cancer.

National Codes:

1	suspected cancer
2	diagnosis of cancer confirmed
3	no cancer diagnosis identified by the Trust
4	no cancer diagnosis - determined automatically

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	CANCER STATUSES

CARE PLAN AGREED DATE

The date on which a CARE PLAN was agreed. The date on which a CARE PLAN was agreed with the PATIENT.

This attribute is also known by these names:

Context	Alias
plural	CARE PLAN AGREED DATES

DECISION TO TREAT DATE

The date on which it was decided that the PATIENT required a specific cancer treatment. The date on which it was decided that the PATIENT required a specific PLANNED CANCER TREATMENT. This is the date that the consultation between the PATIENT and the clinician took place and a planned cancer treatment was agreed.

References:
National Cancer Data Set Version 1.1_ISB October 2001

This attribute is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES

DELAY REASON COMMENT

DELAY REASON COMMENT

A comment on the reason why a CANCER CARE SPELL DELAY was experienced with regard to a CANCER CARE SPELL. This must be recorded for each breach of existing standards after any adjustments have been made.

The standards which will be in place at the end of 2002 are:

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	DELAY REASON COMMENTS

DELAY REASON INDICATOR

DELAY REASON INDICATOR

A classification of the delay periods for cancer waiting targets, as specified in the NHS National Cancer Waiting Times.

Classification:

a.	delay between urgent GP referral and date first seen
b.	delay between urgent GP referral and date of first definitive treatment
c.	delay between decision to treat and first treatment

This attribute is also known by these names:

Context	Alias
plural	DELAY REASON INDICATORS

DELAY REASON REFERRAL TO FIRST SEEN (CANCER)

DELAY REASON REFERRAL TO FIRST SEEN (CANCER)

A classification of the reason why a CANCER CARE SPELL DELAY was experienced with regard to a CANCER CARE SPELL if the delay occurred between referral and when the patient was first seen and where the referral was an urgent GP REFERRAL REQUEST for suspected cancer. This is the reason why the Provider was unable to offer a date within the target time.

National Codes:

01	Clinic cancellation
02	Out-patient capacity inadequate (i.e. no cancelled clinic, but not enough slots for this PATIENT
03	Administrative delay (e.g. failed to be rebooked after Did Not Attend, lost referral)
04	Referral not received within 24 hours
99	Other

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	DELAY REASONS REFERRAL TO FIRST SEEN (CANCER)

DELAY REASON TO TREATMENT (CANCER)

DELAY REASON TO TREATMENT (CANCER)

A classification of the reason why a CANCER CARE SPELL DELAY was experienced with regard to a CANCER CARE SPELL. The National Codes to be used are the same for both the delay between referral and treatment for cancer and the delay between the decision to treat and treatment for cancer. This is the reason why the Provider was unable to offer a date within the target time.

National Codes:

1	Clinic cancellation
2	Out-patient capacity inadequate (i.e. no cancelled clinic, but not enough slots for this PATIENT
3	Administrative delay (e.g. failed to be rebooked after Did Not Attend, lost referral)
4	Elective cancellation (for non-medical reason)
5	Elective capacity inadequate (patient unable to be scheduled for treatment within target time)
6	Delay in diagnostic test(s) (delay caused by wait for diagnostic test(s))
7	Complex diagnostic pathway (many, or complex, diagnostic tests required)
8	Delay due to referral between Trusts

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002

This attribute is also known by these names:

Context	Alias
plural	DELAY REASONS TO TREATMENT (CANCER)

FIRST DEFINITIVE TREATMENT PLANNED

FIRST DEFINITIVE TREATMENT PLANNED

This is an indicator that the PLANNED CANCER TREATMENT is the planned first definitive treatment or intervention to be given which is intended to remove or shrink a cancer tumour and/or to palliate the effects of the cancer.

Classification:

a.	first definitive treatment planned
b.	not first definitive treatment planned

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	FIRST DEFINITIVE TREATMENT PLANNED

FIRST DEFINITIVE TREATMENT PROVIDED

FIRST DEFINITIVE TREATMENT PROVIDED

This is an indicator that the PLANNED CANCER TREATMENT was the provided first definitive treatment or intervention given which was intended to remove or shrink a cancer tumour and/or to palliate the effects of the cancer.

Classification:

a.	first definitive treatment provided
b.	not first definitive treatment provided

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	FIRST DEFINITIVE TREATMENT PROVIDED

FIRST DIAGNOSTIC TEST

FIRST DIAGNOSTIC TEST

An indicator of the first major CLINICAL INTERVENTION for the diagnosis of cancer. This is the test that moves the level of suspicion of cancer from "possible or probable (based on history, clinical examination or blood count) to "highly probable or certain". It does not refer to the first intervention undergone, prior to referral to hospital, such as a blood count, chest x-ray or blood tests of liver function.

Classification:

a.	first diagnostic test
b.	not first diagnostic test

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	FIRST DIAGNOSTIC TESTS

FIRST SEEN BY SPECIALIST DATE (CANCER)

FIRST SEEN BY SPECIALIST DATE (CANCER)

This is the date that the patient is first seen by the appropriate specialist for cancer care within a CANCER CARE SPELL. This is the person or persons who are most able to progress the diagnosis of the primary tumour. The date will be one of the following, whichever is the earlier SERVICE PROVIDED related to the CANCER CARE SPELL where the PATIENT saw an appropriate specialist for cancer care:

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	FIRST SEEN BY SPECIALIST DATES (CANCER)

MULTIDISCIPLINARY TEAM DISCUSSION DATE

MULTIDISCIPLINARY TEAM DISCUSSION DATE

The date on which a PATIENTS CANCER CARE PLAN was discussed by a multidisciplinary team specialising in cancer. The CANCER CARE PLAN may be drawn up at the meeting or the meeting may discuss a plan drawn up prior to the meeting. A multidisciplinary team meeting is a regularly held meeting of the group of professionals who together make decisions regarding recommended treatment of individual patients, which can therefore be regarded as multidisciplinary.

References: The NHS Cancer Plan, DH, published September 2000.

This attribute is also known by these names:

Context	Alias
plural	MULTIDISCIPLINARY TEAM DISCUSSION DATES

PLANNED CANCER TREATMENT TYPE

PLANNED CANCER TREATMENT TYPE

A classification of a type of treatment or care which may be planned to be provided within a PLANNED CANCER TREATMENT.

National Codes:

01	Surgery
02	Teletherapy
03	Chemotherapy
04	Hormone therapy
05	Specialist palliative care
06	Brachytherapy
07	Biological
08	Other
09	Active monitoring

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002

This attribute is also known by these names:

Context	Alias
plural	PLANNED CANCER TREATMENT TYPES

PLANNED DEFINITIVE TREATMENT

PLANNED DEFINITIVE TREATMENT

This is an indicator that the PLANNED CANCER TREATMENT is a definitive treatment or intervention given which is intended to remove or shrink a cancer tumour and/or to palliate the effects of the cancer.

Classification:

a.	planned definitive treatment
b.	not definitive treatment

References: The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	PLANNED DEFINITIVE TREATMENTS

SOURCE OF REFERRAL FOR OUT-PATIENTS

A classification which is used to identify the source of referral of each CONSULTANT OUT-PATIENT EPISODE.

National Codes:
The codes 01, 02, 10, 11, and 05 below in italics are not to be used in reporting National Cancer Waiting Times

Initiated by the CONSULTANT responsible for the CONSULTANT OUT-PATIENT EPISODE
01	following an emergency admission
01	following an emergency admission
02	following a domiciliary visit
02	following a domiciliary visit
10	following an A&E attendance
10	following an A&E attendance
11	other
11	other
Not initiated by the CONSULTANT responsible for the CONSULTANT OUT-PATIENT EPISODE
03	referral from General Medical Practitioner
04	referral from an A&E department
05	referral from a Consultant, other than in an A&E department
05	referral from a Consultant, other than in an A&E department
06	self-referral
07	referral from Prosthetist
92	General Dental Practitioner
93	Community Dental Service
08	other source of referral

Note: The classification has been listed in logical sequence rather than alphanumeric order.

References:
National Purchasing Unit for Dental Service Increment For Teaching (SIFT), 1996.
Dental SIFT: Proposal for Minimum Data Set (MDS) requirements 1997/8
The NHS National Cancer Waiting times, DH, DSCN 22/2002

This attribute is also known by these names:

Context	Alias
plural	SOURCE OF REFERRAL FOR OUT-PATIENTS

SPECIALIST PALLIATIVE CARE DATE

SPECIALIST PALLIATIVE CARE DATE

The date on which the first treatment or support from specialist palliative care was given to a PATIENT with diagnosed cancer.

References:
The NHS National Cancer Waiting Times, DH, DSCN 22/2002.

This attribute is also known by these names:

Context	Alias
plural	SPECIALIST PALLIATIVE CARE DATES

TREATMENT TYPE SEQUENCE

TREATMENT TYPE SEQUENCE

A number indicating the sequence of a type of planned treatment within a CANCER CARE PLAN.

References:
National Cancer Data Set version 1.1_ISB October 2001

This attribute is also known by these names:

Context	Alias
plural	TREATMENT TYPE SEQUENCES

TUMOUR LATERALITY

TUMOUR LATERALITY

A classification of the position of a tumour within a person.

National Codes:

L	Left
R	Right
M	Midline
B	Bilateral

References:
National Cancer Data Set Version 1.1_ISB October 2001

This attribute is also known by these names:

Context	Alias
plural	TUMOUR LATERALITIES

TWO WEEK WAIT EXCLUSION INDICATOR

TWO WEEK WAIT EXCLUSION INDICATOR

An indicator that the PATIENT will be excluded from two week wait monitoring of OUT-PATIENT APPOINTMENTS for cancer care as the PATIENT refused an appointment within two weeks before being offered an appointment. These patients will still be included in monitoring of the treatment targets for cancer care.

Classification:

a.	Not excluded
b.	Excluded - PATIENT refused an appointment within 2 weeks before being offered an appointment

References:
The NHS National Cancer Waiting Times, DH, DSCN 22/2002

This attribute is also known by these names:

Context	Alias
plural	TWO WEEK WAIT EXCLUSION INDICATORS

URGENT CANCER REFERRAL DECISION DATE

URGENT CANCER REFERRAL DECISION DATE

CANCER REFERRAL DECISION DATE

URGENT CANCER REFERRAL DECISION DATE

The date on which the GENERAL PRACTITIONER decides to urgently refer a PATIENT with suspected cancer.

This attribute is also known by these names:

Context	Alias
plural	URGENT CANCER REFERRAL DECISION DATES

URGENT CANCER REFERRAL TYPE

The type of suspected cancer for which an urgent referral is made.

Classification: National Codes:

a.	Suspected breast cancer
01	Suspected breast cancer
b.	Suspected children’s cancers
02	Suspected children's cancer*
c.	Suspected lung cancer
03	Suspected lung cancer
d.	Suspected haematological malignancies including leukaemia
04	Suspected haematological malignancies excluding acute leukaemia
	i. Acute leukaemia
05	Suspected acute leukaemia
e.	Suspected upper gastrointestinal cancers
06	Suspected upper gastrointestinal cancers
f.	Suspected lower gastrointestinal cancers
07	Suspected lower gastrointestinal cancers
g.	Suspected skin cancers
08	Suspected skin cancers
h.	Suspected gynaecological cancers
09	Suspected gynaecological cancers
i.	Suspected brain/central nervous system tumours
10	Suspected brain or central nervous system tumours
j.	Suspected urological cancers
11	Suspected urological cancers (excluding testicular)
	i. Testicular cancer
12	Suspected testicular cancer
k.	Suspected head and neck cancers
13	Suspected head and neck cancers
l.	Suspected sarcomas
14	Suspected sarcomas
m.	Other suspected cancer
15	Other suspected cancer

*Children's cancer is defined as a cancer suspected in a patient who is under 16 years at the CANCER REFERRAL DECISION DATE.

This attribute is also known by these names:

Context	Alias
plural	URGENT CANCER REFERRAL TYPES

WAITING TIME ADJUSTMENT REASON

WAITING TIME ADJUSTMENT REASON

The prime reason for an adjustment to waiting time. Where there is more than one adjustment applicable, this should be the reason for the longest adjustment. This item can be derived and the following values are to be used:

National Codes:

Out-patient services
1	No adjustment to waiting time
2	Patient cancellation; OUT-PATIENT APPOINTMENT where the ATTENDED OR DID NOT ATTEND is National Code 2 'Appointment cancelled by the patient'
3	Did Not Attend; OUT-PATIENT APPOINTMENT where the ATTENDED OR DID NOT ATTEND is National Code 3 'Did Not Attend - no advance warning given' or 7 'Patient arrived late and could not be seen'
4	Patient choice - when a patient refuses an appointment within two weeks before an offer of an appointment is made; if the REFERRAL REQUEST has a TWO WEEK WAIT EXCLUSION INDICATOR classification of b. 'Excluded - PATIENT refused an appointment within 2 weeks before being offered an appointment' an adjustment must be made so that the wait is calculated from the DATE FIRST SEEN and not CANCER REFERRAL DECISION DATE i.e. in this case the calculated wait will always be 0 days and the adjustment will be the number of days between CANCER REFERRAL DECISION DATE and DATE FIRST SEEN.
In-patient services
1	No adjustment to waiting time
5	Self deferral; OFFER OF ADMISSION with an ADMISSION OFFER OUTCOME of National Code 2 'Admission cancelled by, or on behalf of, the patient' or 4 'Patient failed to arrive'
6	Suspension - medical reasons; a patient with an ELECTIVE ADMISSION SUSPENSION DETAIL where the ELECTIVE ADMISSION SUSPENSION INITIATOR classification is a. 'Initiated by CONSULTANT for medical reasons including waiting match for tissue/organ transplants'
7	Suspension - patient reasons; a patient with an ELECTIVE ADMISSION SUSPENSION DETAIL where the ELECTIVE ADMISSION SUSPENSION INITIATOR classification is b. 'initiated by PATIENT' because they are unavailable for treatment for a specified period because of family commitments, holidays or other reasons

This attribute is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENT REASONS

CANCER REFERRAL DECISION DATE

CANCER REFERRAL DECISION DATE

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

This data element is also known by these names:

Context	Alias
plural	CANCER REFERRAL DECISION DATES

CANCER REFERRAL PRIORITY TYPE

CANCER REFERRAL PRIORITY TYPE

Format/length:	n2
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:

This data element is also known by these names:

Context	Alias
plural	CANCER REFERRAL PRIORITY TYPES

CANCER SPECIALIST REFERRAL DATE

CANCER SPECIALIST REFERRAL DATE

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
CANCER SPECIALIST REFERRAL DATE may be the same date as CANCER REFERRAL DECISION DATE if the initial referral was direct to an appropriate specialist for the cancer.

This data element is also known by these names:

Context	Alias
plural	CANCER SPECIALIST REFERRAL DATES

CANCER STATUS

CANCER STATUS

Format/length:	n1
HES item:
National Codes:	Press Definition button for the National Codes
Default Codes:

This data element is also known by these names:

Context	Alias
plural	CANCER STATUSES

CLINICAL INTERVENTION DATE (FIRST DIAGNOSTIC TEST)

CLINICAL INTERVENTION DATE (FIRST DIAGNOSTIC TEST)

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
This is the CLINICAL INTERVENTION DATE of the CLINICAL INTERVENTION with FIRST DIAGNOSTIC TEST of classification a. 'first diagnostic test' resulting from the REFERRAL REQUEST.

This data element is also known by these names:

Context	Alias
plural	CLINICAL INTERVENTION DATES (FIRST DIAGNOSTIC TEST)

DATE FIRST SEEN

DATE FIRST SEEN

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes: This is the date that the PATIENT is first seen in the Trust that receives the first referral. This data item is mandatory for patients referred urgently by their GP for suspected cancer but can also be applied to other patients. The date will be one of the following, whichever is the earliest SERVICE PROVIDED relating to the REFERRAL REQUEST:

DATE FIRST SEEN may not be the same as FIRST SEEN BY SPECIALIST DATE (CANCER) which records the first time the PATIENT sees an appropriate specialist in cancer care.

This data element is also known by these names:

Context	Alias
plural	DATES FIRST SEEN

DECISION TO TREAT DATE (ACTIVE MONITORING)

DECISION TO TREAT DATE (ACTIVE MONITORING)

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
DECISION TO TREAT DATE (ACTIVE MONITORING) is the same as attribute DECISION TO TREAT DATE.

This data item is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is active monitoring.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 09 'Active monitoring' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (ACTIVE MONITORING)

DECISION TO TREAT DATE (ANTI-CANCER DRUG REGIMEN)

DECISION TO TREAT DATE (ANTI-CANCER DRUG REGIMEN)

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes: DECISION TO TREAT DATE (ANTI-CANCER DRUG REGIMEN) is the same as attribute DECISION TO TREAT DATE.

This data item is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is chemotherapy or hormone therapy.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 03 'Chemotherapy' or 04 'Hormone therapy' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (ANTI-CANCER DRUG REGIMEN)

DECISION TO TREAT DATE (BRACHYTHERAPY TREATMENT COURSE)

DECISION TO TREAT DATE (BRACHYTHERAPY TREATMENT COURSE)

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
DECISION TO TREAT DATE (BRACHYTHERAPY TREATMENT COURSE) is the same as attribute DECISION TO TREAT DATE.

This data item is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is brachytherapy.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 06 'Brachytherapy' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (BRACHYTHERAPY TREATMENT COURSE)

DECISION TO TREAT DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)

DECISION TO TREAT DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)

 

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
DECISION TO TREAT DATE (SPECIALIST PALLIATIVE TREATMENT COURSE) is the same as attribute DECISION TO TREAT DATE.

This data element is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is specialist palliative care.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 05 'Specialist Palliative Care' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (SPECIALIST PALLIATIVE TREATMENT COURSE)

DECISION TO TREAT DATE (SURGERY)

DECISION TO TREAT DATE (SURGERY)

Format/length:	n8 - ccyymmdd
HES item:
National Codes:
Default Codes:

Notes:
DECISION TO TREAT DATE (SURGERY) is the same as attribute DECISION TO TREAT DATE.

This data item is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is surgery.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 01 'Surgery' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (SURGERY)

DECISION TO TREAT DATE (TELETHERAPY TREATMENT COURSE)

DECISION TO TREAT DATE (TELETHERAPY TREATMENT COURSE)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
DECISION TO TREAT DATE (TELETHERAPY TREATMENT COURSE) is the same as attribute DECISION TO TREAT DATE.

This data item is only mandatory when applicable in the National Cancer Waiting Times Data Set which is when the planned first definitive treatment is teletherapy.

It is the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with a PLANNED CANCER TREATMENT TYPE National Code 02 'Teletherapy' and where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'first definitive treatment planned'.

This data element is also known by these names:

Context	Alias
plural	DECISION TO TREAT DATES (TELETHERAPY TREATMENT COURSE)

DELAY REASON COMMENT (DECISION TO TREATMENT)

DELAY REASON COMMENT (DECISION TO TREATMENT)

Format/length:	an255
HES item:
National codes
Default codes

Notes:
DELAY REASON COMMENT (DECISION TO TREATMENT) is the same as attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the maximum one month wait from the DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT with FIRST DEFINITIVE TREATMENT PLANNED classification of a. 'yes' to the date of the first definitive treatment less WAITING TIME ADJUSTMENT TREATMENT.

This data element is also known by these names:

Context	Alias
plural	DELAY REASON COMMENTS (DECISION TO TREATMENT)

DELAY REASON COMMENT (FIRST SEEN)

DELAY REASON COMMENT (FIRST SEEN)

Format/length:	an255
HES item:
National codes
Default codes

Notes:
DELAY REASON COMMENT (FIRST SEEN) is the same as attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the maximum two week wait from CANCER REFERRAL DECISION DATE to DATE FIRST SEEN less WAITING TIME ADJUSTMENT (FIRST SEEN) could not be met.

See DATE FIRST SEEN for guidance on determining the appropriate first seen date.

This data element is also known by these names:

Context	Alias
plural	DELAY REASON COMMENTS (FIRST SEEN)

DELAY REASON COMMENT (REFERRAL TO TREATMENT)

DELAY REASON COMMENT (REFERRAL TO TREATMENT)

Format/length:	an255
HES item:
National codes
Default codes

Notes:
DELAY REASON COMMENT (REFERRAL TO TREATMENT) is the same as attribute DELAY REASON COMMENT.

This data item is mandatory when applicable in the National Cancer Waiting Times Monitoring Data Set. It is applicable and must be recorded if the existing standards were breached (after any adjustments have been made).

It is the free text comment that describes why the specified maximum wait from CANCER REFERRAL DECISION DATE to the date of the first definitive treatment less WAITING TIME ADJUSTMENT (FIRST SEEN) and WAITING TIME ADJUSTMENT (DECISION TO TREAT) and WAITING TIME ADJUSTMENT (TREATMENT) could not be met.

The date of the first definitive treatment is the appropriate recorded start date of treatment for the PLANNED CANCER TREATMENT with FIRST DEFINITIVE TREATMENT PROVIDED classification of a. 'yes'. See START DATE (TELETHERAPY TREATMENT COURSE) as an example of an appropriate recorded start date for a PLANNED CANCER TREATMENT where the PLANNED CANCER TREATMENT TYPE is National Code 02 'Teletherapy'. There is a decision to treat date and a start date recorded for each PLANNED CANCER TREATMENT TYPE.

This data element is also known by these names:

Context	Alias
plural	DELAY REASON COMMENTS (REFERRAL TO TREATMENT)

DELAY REASON DECISION TO TREATMENT (CANCER)

DELAY REASON DECISION TO TREATMENT (CANCER)

Format/length:	n1
HES item:
National codes
Default codes

Notes: See attribute DELAY REASON TO TREATMENT CANCER for the National Codes used for recording the DELAY REASON DECISION TO TREATMENT (CANCER).

It is an optional data item and should only be present if a CANCER CARE SPELL DELAY with a DELAY REASON TO TREATMENT (CANCER) has been recorded where the DELAY REASON INDICATOR is classification c. 'delay between decision to treat and first treatment'.

This data element is also known by these names:

Context	Alias
plural	DELAY REASONS DECISION TO TREATMENT (CANCER)

DELAY REASON REFERRAL TO FIRST SEEN (CANCER)

DELAY REASON REFERRAL TO FIRST SEEN (CANCER)

Format/length:	n2
HES item:
National codes	Press Definition button for national codes
Default codes

Notes: It is an optional data item and should only be present if a CANCER CARE SPELL DELAY with a DELAY REASON REFERRAL TO FIRST SEEN (CANCER) has been recorded.

This data element is also known by these names:

Context	Alias
plural	DELAY REASON REFERRAL TO FIRST SEEN (CANCER)

DELAY REASON REFERRAL TO TREATMENT (CANCER)

DELAY REASON REFERRAL TO TREATMENT (CANCER)

Format/length:	n1
HES item:
National codes
Default codes

Notes:
See attribute DELAY REASON TO TREATMENT (CANCER) for the National Codes used for recording the DELAY REASON REFERRAL TO TREATMENT (CANCER).

t is an optional data item and should only be present if a CANCER CARE SPELL DELAY with a DELAY REASON TO TREATMENT (CANCER) has been recorded where the DELAY REASON INDICATOR is classification b. 'delay between urgent GP referral and date of first definitive treatment'.

This data element is also known by these names:

Context	Alias
plural	DELAY REASON REFERRALS TO TREATMENT (CANCER)

FIRST SEEN BY SPECIALIST DATE (CANCER)

FIRST SEEN BY SPECIALIST DATE (CANCER)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes: This date may be the same as DATE FIRST SEEN if the initial consultation was with an appropriate cancer specialist in the Trust that receives the first referral.

This data element is also known by these names:

Context	Alias
plural	FIRST SEEN BY SPECIALIST DATES (CANCER)

MDT DISCUSSION INDICATOR

MDT DISCUSSION INDICATOR

Format/length:	a1
HES item:
National codes
Default codes

Notes:
This is an indicator of whether the CANCER CARE PLAN was discussed at a multidisciplinary team meeting. This is indicated by the existence or absence of a recorded MULTIDISCIPLINARY TEAM DISCUSSION DATE.

Recorded as:

This data element is also known by these names:

Context	Alias
plural	MDT DISCUSSION INDICATORS

MULTIDISCIPLINARY TEAM DISCUSSION DATE

MULTIDISCIPLINARY TEAM DISCUSSION DATE

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

This data element is also known by these names:

Context	Alias
plural	MULTIDISCIPLINARY TEAM DISCUSSION DATES

ORGANISATION CODE (PROVIDER DECISION TO TREAT)

ORGANISATION CODE (PROVIDER DECISION TO TREAT)

Format/length:	an5
HES item:
National codes
Default codes

Notes:
This is the ORGANISATION CODE of the ORGANISATION acting as HEALTH CARE PROVIDER where the decision to treat the PATIENT was made which initiated a CANCER CARE PLAN with one or more PLANNED CANCER TREATMENTS. The PLANNED CANCER TREATMENT may be planned and provided by different HEALTH CARE PROVIDER. The code may be derived automatically by NHS IT systems.

See NHS Administrative Codes, NHS Organisation Codes for a description of ORGANISATION CODE.

This data element is also known by these names:

Context	Alias
plural	ORGANISATION CODES (PROVIDER DECISION TO TREAT)

ORGANISATION CODE (PROVIDER FIRST CANCER SPECIALIST)

ORGANISATION CODE (PROVIDER FIRST CANCER SPECIALIST)

Format/length:	an5
HES item:
National codes
Default codes

Notes:
This is the ORGANISATION CODE of the ORGANISATION acting as HEALTH CARE PROVIDER where the PATIENT is first seen by an appropriate cancer specialist on the FIRST SEEN BY SPECIALIST DATE (CANCER). The code may be derived automatically by NHS IT systems.

See NHS Administrative Codes, NHS Organisation Codes for a description of ORGANISATION CODE.

This data element is also known by these names:

Context	Alias
plural	ORGANISATION CODES (PROVIDER FIRST CANCER SPECIALIST)

ORGANISATION CODE (PROVIDER FIRST DIAGNOSTIC TEST)

ORGANISATION CODE (PROVIDER FIRST DIAGNOSTIC TEST)

Format/length:	an5
HES item:
National codes
Default codes

Notes: This is the ORGANISATION CODE of the ORGANISATION acting as a HEALTH CARE PROVIDER where the CLINICAL INTERVENTION with FIRST DIAGNOSTIC TEST classification of a. 'first diagnostic test' takes place. The code may be derived automatically by NHS IT systems.

See NHS Administrative Codes, NHS Organisation Codes for a description of ORGANISATION CODES.

ORGANISATION CODE (PROVIDER FIRST SEEN)

ORGANISATION CODE (PROVIDER FIRST SEEN)

Format/length:	an5
HES item:
National codes
Default codes

Notes:
This is the ORGANISATION CODE of the ORGANISATION acting as a HEALTH CARE PROVIDER where the PATIENT is first seen. That is the HEALTH CARE PROVIDER at the first OUT-PATIENT ATTENDANCE CONSULTANT, IMAGING OR RADIODIAGNOSTIC EVENT, CLINICAL INTERVENTION, HOSPITAL PROVIDER SPELL, ACCIDENT AND EMERGENCY ATTENDANCE or SCREENING TEST whichever is the earlier SERVICE PROVIDED related to the initial REFERRAL REQUEST.

This may be the same HEALTH CARE PROVIDER as for ORGANISATION CODE (PROVIDER FIRST CANCER SPECIALIST) if the PATIENT was first seen by the appropriate specialist for cancer.

The code may be derived automatically by NHS IT systems.

See NHS Administrative Codes, NHS Organisation Codes for a description of ORGANISATION CODE.

This data element is also known by these names:

Context	Alias
plural	ORGANISATION CODES (PROVIDER FIRST SEEN)

ORGANISATION CODE (PROVIDER FIRST TREATMENT)

ORGANISATION CODE (PROVIDER FIRST TREATMENT)

Format/length:	an5
HES item:
National codes
Default codes

Notes:
This is the ORGANISATION CODE of the ORGANISATION acting as a HEALTH CARE PROVIDER where the PATIENT receives the first PLANNED CANCER TREATMENT with FIRST DEFINITIVE TREATMENT PROVIDED classification of a. 'yes'.

The code may be derived automatically by NHS IT systems.

This data element is also known by these names:

Context	Alias
plural	ORGANISATION CODES (PROVIDER FIRST TREATMENT)

PLANNED CANCER TREATMENT TYPE (FIRST DEFINITIVE)

PLANNED CANCER TREATMENT TYPE (FIRST DEFINITIVE)

Format/length:	n2
HES item:
National codes
Default codes	99 Unknown

PLANNED CANCER TREATMENT TYPE (FIRST DEFINITIVE) is the same as attribute PLANNED CANCER TREATMENT TYPE.

This is the PLANNED CANCER TREATMENT TYPE of the PLANNED CANCER TREATMENT with FIRST DEFINITIVE TREATMENT PLANNED classification of a. 'yes'.

For the purposes of the National Cancer Waiting Times Monitoring Data Set National Code 07 'Biological' should be recorded as 03 'Chemotherapy'.

Use of Default Code 99 'Unknown' should be carefully monitored as it is highly unlikely that a treatment plan would be drawn up where the modality of treatment is unknown.

This data element is also known by these names:

Context	Alias
plural	PLANNED CANCER TREATMENT TYPES (FIRST DEFINITIVE)

PRIMARY DIAGNOSIS (ICD)

Format/length:	an6
HES item:
National Codes:
Default Codes:

Notes:
See DIAGNOSTIC CODING for details on coding and PRIMARY DIAGNOSIS for the standardised definition of primary diagnosis.

The National Cancer Waiting Times Monitoring Data Set (22/2002) requires coding to the third digit except for acute leukaemia that requires to be recorded to the 4th digit and stipulates a maximum length of an4.

This data element is also known by these names:

Context	Alias
plural	PRIMARY DIAGNOSIS (ICD)
plural	PRIMARY DIAGNOSES (ICD)

REFERRING ORGANISATION CODE

Format/length:	an6
HES item:
National Codes:
Default Codes:	X99998 - Referring Organisation Code not applicable
	X99999 - Referring Organisation Code not known

Notes:
This is the ORGANISATION CODE of the ORGANISATION from which the referral is made, such as GP Practice or NHS Trust. This information is essential for managing service agreements which are based on patterns of referral.

The National Cancer Waiting Times Monitoring Data Set (22/2002) does not require GP Practices and stipulates a maximum length of an5 to record the appropriate NHS Trust.

See NHS Administrative Codes for a description of ORGANISATION CODES.

This data element is also known by these names:

Context	Alias
plural	REFERRING ORGANISATION CODES

START DATE (ACTIVE MONITORING)

START DATE (ACTIVE MONITORING)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes: START DATE (ACTIVE MONITORING) should be recorded if the first definitive treatment is active monitoring and applies only to prostate cancer.

START DATE (ACTIVE MONITORING) is the CARE PLAN AGREED DATE of the CANCER CARE PLAN where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT TYPE National Code 09 'Active monitoring' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (ACTIVE MONITORING)

START DATE (ANTI-CANCER DRUG REGIMEN)

START DATE (ANTI-CANCER DRUG REGIMEN)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
START DATE (ANTI-CANCER DRUG REGIMEN) is the same as attribute START DATE. This should be recorded if the first definitive treatment is chemotherapy and/or other anti-cancer drug treatments.

START DATE (ANTI-CANCER DRUG REGIMEN) is the START DATE of the ANTI-CANCER DRUG PROGRAMME where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT TYPE National Code 03 'Chemotherapy' or 04 'Hormone therapy' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (ANTI-CANCER DRUG REGIMEN)

START DATE (BRACHYTHERAPY TREATMENT COURSE)

START DATE (BRACHYTHERAPY TREATMENT COURSE)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
START DATE (BRACHYTHERAPY TREATMENT COURSE) is the same as attribute START DATE. This should be recorded if the first definitive treatment is brachytherapy.

START DATE (BRACHYTHERAPY TREATMENT COURSE) is the START DATE of the RADIOTHERAPY TREATMENT COURSE which is a BRACHYTHERAPY TREATMENT COURSE where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT TYPE National Code 06 'Brachytherapy' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (BRACHYTHERAPY TREATMENT COURSE)

START DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)

START DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
START DATE (SPECIALIST PALLIATIVE TREATMENT COURSE) should be recorded if the first definitive treatment is specialist palliative care.

START DATE (SPECIALIST PALLIATIVE TREATMENT COURSE) is the SPECIALIST PALLIATIVE CARE DATE of the CANCER CARE SPELL where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT National Code 05 'Specialist palliatve care' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (SPECIALIST PALLIATIVE TREATMENT COURSE)

START DATE (SURGERY HOSPITAL PROVIDER SPELL)

START DATE (SURGERY HOSPITAL PROVIDER SPELL)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
START DATE (SURGERY HOSPITAL PROVIDER SPELL) is the same as attribute START DATE. This should be recorded if the first definitive treatment is surgery.

START DATE (SURGERY HOSPITAL PROVIDER SPELL) is the START DATE of the HOSPITAL PROVIDER SPELL the PATIENT was admitted to for the anti-cancer surgery to be performed and where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT TYPE National Code 01 'Surgery' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (SURGERY HOSPITAL PROVIDER SPELL)

START DATE (TELETHERAPY TREATMENT COURSE)

START DATE (TELETHERAPY TREATMENT COURSE)

Format/length:	n8 - ccyymmdd
HES item:
National codes
Default codes

Notes:
START DATE (TELETHERAPY TREATMENT COURSE) is the same as attribute START DATE. This should be recorded if the first definitive treatment is teletherapy.

START DATE (TELETHERAPY TREATMENT COURSE) is the START DATE of the RADIOTHERAPY TREATMENT COURSE which is a TELETHERAPY TREATMENT COURSE where the PLANNED CANCER TREATMENT is for PLANNED CANCER TREATMENT TYPE National Code 02 'Teletherapy' and FIRST DEFINITIVE TREATMENT PROVIDED is classification a. 'first definitive treatment provided'.

This data element is also known by these names:

Context	Alias
plural	START DATES (TELETHERAPY TREATMENT COURSE)

TUMOUR LATERALITY

TUMOUR LATERALITY

Format/length:	an1
HES item:
National codes	Press Definition button for the national codes
Default codes	8 - Not applicable
	9 - Not known

This data element is also known by these names:

Context	Alias
plural	TUMOUR LATERALITY

URGENT CANCER REFERRAL TYPE

URGENT CANCER REFERRAL TYPE

Format/length:	n2
HES item:
National codes	Press Definition button for the national codes
Default codes

This data element is also known by these names:

Context	Alias
plural	URGENT CANCER REFERRAL TYPES

WAITING TIME ADJUSTMENT (DECISION TO TREAT)

WAITING TIME ADJUSTMENT (DECISION TO TREAT)

Format/length:	n2
HES item:
National codes	Press Definition button for the national codes
Default codes

Notes:
This is mandatory, whenever an adjustment is appropriate, for all malignancies that came through the urgent GP suspected cancer route, irrespective of whether a target is in place. This records the number of days that should be removed from the derived waiting time between the DATE FIRST SEEN and DECISION TO TREAT DATE of the PLANNED CANCER TREATMENT where the FIRST DEFINITIVE TREATMENT PLANNED is classification a. 'yes'. The adjustment will be due to one or more of the following:

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENTS (DECISION TO TREAT)

WAITING TIME ADJUSTMENT (FIRST SEEN)

WAITING TIME ADJUSTMENT (FIRST SEEN)

Format/length:	n3
HES item:
National codes
Default codes

Notes:
This records the number of days that should be removed from the derived waiting time between the CANCER REFERRAL DECISION DATE and DATE FIRST SEEN. The adjustment will be due to one or more of the following:

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENT (FIRST SEEN)

WAITING TIME ADJUSTMENT (TREATMENT)

WAITING TIME ADJUSTMENT (TREATMENT)

Format/length:	n3
HES item:
National codes
Default codes

Notes:
This records the number of days that should be removed from the derived waiting time between the DECISION TO TREAT DATE and start date of the FIRST DEFINITIVE TREATMENT PROVIDED. The date of the first definitive treatment is the appropriate recorded start date of treatment for the PLANNED CANCER TREATMENT with FIRST DEFINITIVE TREATMENT PROVIDED classification of a. 'yes'. See START DATE (TELETHERAPY TREATMENT COURSE) as an example of an appropriate recorded start date for a PLANNED CANCER TREATMENT where the PLANNED CANCER TREATMENT TYPE is National Code 02 'Teletherapy'. There is a DECISION TO TREAT DATE and a start date recorded for each PLANNED CANCER TREATMENT whether or not it is the FIRST DEFINITIVE TREATMENT PROVIDED.

The adjustment will be due to one or more of the following:

For example:

The ADJUSTMENT TO WAITING TIME (DECISION TO TREAT AND FIRST TREATMENT) is 13 days and the waiting time is 5 days.

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENTS (TREATMENT)

WAITING TIME ADJUSTMENT REASON (DECISION TO TREAT)

WAITING TIME ADJUSTMENT REASON (DECISION TO TREAT)

Format/length:	n1
HES item:
National codes
Default codes

Notes:
WAITING TIME ADJUSTMENT REASON (DECISION TO TREAT) is the same as the attribute WAITING TIME ADJUSTMENT REASON.

This is mandatory, whenever an adjustment is appropriate as calculated and recorded by WAITING TIME ADJUSTMENT REASON (DECISION TO TREAT)). It is the prime reason for the adjustment and where there is more than one adjustment applicable, this should be the reason for the longest calculated adjustment days.

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENT REASONS (DECISION TO TREAT)

WAITING TIME ADJUSTMENT REASON (FIRST SEEN)

WAITING TIME ADJUSTMENT REASON (FIRST SEEN)

Format/length:	n1
HES item:
National codes
Default codes

Notes:
WAITING TIME ADJUSTMENT REASON (FIRST SEEN) is the same as the attribute WAITING TIME ADJUSTMENT REASON.

This is mandatory, whenever an adjustment is appropriate as calculated and recorded by WAITING TIME ADJUSTMENT (FIRST SEEN). It is the prime reason for the adjustment and where there is more than one adjustment applicable, this should be the reason for the longest calculated adjustment days. If however, the PATIENT chooses not to have an appointment within two weeks as recorded by TWO WEEK WAIT EXCLUSION INDICATOR, then WAITING TIME ADJUSTMENT REASON National Code 4 'Patient choice - when a patient refuses an appointment within two weeks before an offer of an appointment is made' should always take precedence over any other code.

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENT REASONS (FIRST SEEN)

WAITING TIME ADJUSTMENT REASON (TREATMENT)

WAITING TIME ADJUSTMENT REASON (TREATMENT)

Format/length:	n1
HES item:
National codes
Default codes

Notes:
WAITING TIME ADJUSTMENT REASON (TREATMENT) is the same as the attribute WAITING TIME ADJUSTMENT REASON.

This is mandatory, whenever an adjustment is appropriate as calculated and recorded by WAITING TIME ADJUSTMENT (TREATMENT). It is the prime reason for the adjustment and where there is more than one adjustment applicable, this should be the reason for the longest calculated adjustment days.

This data element is also known by these names:

Context	Alias
plural	WAITING TIME ADJUSTMENT REASON (TREATMENT)

NATIONAL CANCER WAITING TIMES MONITORING DATA SET

National Cancer Data Set

NATIONAL CANCER WAITING TIMES MONITORING DATA SET

The National Cancer Waiting Times Monitoring Data Set contains the data required for monitoring the cancer waiting time targets.

The data items are presented in the same order as the CSV (Comma Separated Values) file which can be exported from Trust based systems and uploaded to the Cancer Waiting Times system. This system is hosted nationally on NHSnet.

The three columns show whether the Data item is Mandatory or Optional for

• M= MANDATORY


• M* = MANDATORY WHEN APPLICABLE


• O = OPTIONAL


• O* = OPTIONAL WHEN APPLICABLE

Data Item	Trust where first seen if urgent GP referral for suspected cancer	Trust where patient receives first definitive treatment for cancer following a referral other than an urgent GP referral for cancer	Trust where patient receives first definitive treatment for cancer following an urgent GP referral for suspected cancer
NHS NUMBER	M	M	M
SOURCE OF REFERRAL FOR OUT-PATIENTS	M	O	O
CANCER REFERRAL DECISION DATE	M	N/A	M
REFERRAL REQUEST RECEIVED DATE	M	O	N/A
CANCER REFERRAL PRIORITY TYPE	M	O	M
URGENT CANCER REFERRAL TYPE	M	N/A	N/A
DATE FIRST SEEN	M	O	N/A
ORGANISATION CODE (PROVIDER FIRST SEEN)	M	O	O
WAITING TIME ADJUSTMENT (FIRST SEEN)	M*	O*	N/A
WAITING TIME ADJUSTMENT REASON (FIRST SEEN)	M*	O*	N/A
DELAY REASON COMMENT (FIRST SEEN)	M*	O*	N/A
DELAY REASON REFERRAL TO FIRST SEEN (CANCER)	O*	O*	N/A
CANCER SPECIALIST REFERRAL DATE	O	O	O
REFERRING ORGANISATION CODE	O	O	O
FIRST SEEN BY SPECIALIST DATE (CANCER)	O	O	O
ORGANISATION CODE (PROVIDER FIRST CANCER SPECIALIST)	O	O	O
CLINICAL INTERVENTION DATE (FIRST DIAGNOSTIC TEST)	O	O	O
ORGANISATION CODE (PROVIDER FIRST DIAGNOSTIC TEST)	O	O	O
MDT DISCUSSION INDICATOR	O	O	O
MULTIDISCIPLINARY TEAM DISCUSSION DATE	O	O	O
CANCER STATUS	M	O	M
PRIMARY DIAGNOSIS (ICD)	O	M	M
TUMOUR LATERALITY	O	O	O
DECISION TO TREAT DATE (SURGERY)	O	M*	M*
DECISION TO TREAT DATE (ANTI-CANCER DRUG REGIMEN)	O	M*	M*
DECISION TO TREAT DATE (TELETHERAPY TREATMENT COURSE)	O	M*	M*
DECISION TO TREAT DATE (BRACHYTHERAPY TREATMENT COURSE)	O	M*	M*
DECISION TO TREAT DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)	O	M*	M*
DECISION TO TREAT DATE (ACTIVE MONITORING)	O	M*	M*
ORGANISATION CODE (PROVIDER DECISION TO TREAT)	O	O	O
WAITING TIME ADJUSTMENT (DECISION TO TREAT)	N/A	O*	M*
WAITING TIME ADJUSTMENT REASON (DECISION TO TREAT)	N/A	O*	M*
PLANNED CANCER TREATMENT TYPE (FIRST DEFINITIVE)	N/A	O	O
START DATE (SURGERY HOSPITAL PROVIDER SPELL)	N/A	M*	M*
START DATE (ANTI-CANCER DRUG REGIMEN)	N/A	M*	M*
START DATE (TELETHERAPY TREATMENT COURSE)	N/A	M*	M*
START DATE (BRACHYTHERAPY TREATMENT COURSE)	N/A	M*	M*
START DATE (SPECIALIST PALLIATIVE TREATMENT COURSE)	N/A	M*	M*
START DATE (ACTIVE MONITORING)	N/A	M*	M*
ORGANISATION CODE (PROVIDER FIRST TREATMENT)	N/A	M	M
WAITING TIME ADJUSTMENT (TREATMENT)	N/A	M*	M*
WAITING TIME ADJUSTMENT REASON (TREATMENT)	N/A	M*	M*
DELAY REASON COMMENT (DECISION TO TREATMENT)	N/A	M*	M*
DELAY REASON COMMENT (REFERRAL TO TREATMENT)	N/A	O*	M*
DELAY REASON DECISION TO TREATMENT (CANCER)	N/A	O*	O*
DELAY REASON REFERRAL TO TREATMENT (CANCER)	N/A	O*	O*

CANCER SUB

TOP INDEX LEFT PANE

QMCW 1

Central Return Form Guidance

QMCW - Cancer Waiting Times - Monitoring the Targets

Contextual Overview

1. In terms of cancer waiting times, the Department of Health require information on waiting times for all PATIENTS urgently referred by their GENERAL MEDICAL PRACTITIONER or GENERAL DENTAL PRACTITIONER for suspected cancer by tumour site to monitor the following targets:

   	The "two week wait" from the date of decision to refer to the time the patient was seen by cancer specialist services, as described in the White Paper 'The New NHS'.
   	The maximum one month wait from urgent GP referral to treatment for Children's Cancers, Testicular Cancers and Acute Leukaemia and the maximum one month wait from diagnosis to treatment for breast cancer. These targets are described in the NHS Cancer Plan, published in September 2000.