Change Request
 
NHS Information Authority

Data Standards and Information Programme

Reference: Change Request 358
Version No:1.17
Subject:DSCN 37/2003 - Measuring and recording of waiting times for KH07, QF01, QM08 and QM08R
Type of Change:Data Definitions and Central Guidance text
Effective Date:Immediate
Reason for Change:To change existing waiting time information within the NHS Data Dictionary to bring it in line with recent guidance issued by the Department of Health relating to patient transfers, trust mergers and patient procedures being cancelled by hospitals.

Background:

After the National Audit Office Report 'Inappropriate Adjustments to NHS waiting lists' in December 2001, urgent attention was needed to ensure that Trusts were being fair and honest in how they recorded patient waiting times. Guidance on the measuring and recording of waiting times was issued to Chief Executives in August 2002, by Mark Morrison, the Head of Access Delivery, and was initially supported with the issue of two DSCNs. However, these DSCNs (13/2002 and 18/2002) were withdrawn shortly after their release, which resulted in the waiting times guidance not being incorporated into the NHS Data Dictionary.

DSCN 07/2003 has already dealt with the issues around reasonableness for written and verbal appointment and admission offers and some further clarification to this has been made in this DSCN. However, this DSCN will focus mainly on the remaining outstanding issues which were mentioned in Mark Morrison's Chief Executive's letter.

These changes to the waiting times calculations will enable the NHS to better support the question of how long did the NHS keep patients waiting, by placing more emphasis on the Original Referral Date, and the Original Decided to Admit date.

The changes in this DSCN support the principle that the rules for calculating and reporting waiting times should be reasonable to patients. The 'NHS Social Care Bulletin' of 18 July 2002 highlighted that these changes would be made.

Please note that the new waiting time calculation guidance becomes effective immediately, both for all new referrals and for all patients who are already on a waiting lists.

Advice from the Department of Health has also been given on the alignment of the attribute ELECTIVE ADMISSION SUSPENSION INITIATOR with KH07 central return form guidance. Patients should not be suspended from the elective admission list if they are awaiting tissue, but that they should be suspended if they are waiting for an organ transplant or an unrelated bone marrow transplant only.

The Department's Access Directorate will be happy to provide advice on any issues raised by this change notice and can be contacted by e-mail at 'mb-waiting-times@doh.gsi.gov.uk'. General advice to the NHS on these issues can be found on the Department's Waiting Times Website (http://www.doh.gov.uk/waitingtimes), which includes a 'frequently asked questions' page.

Summary of changes:
 
Class Definitions
ELECTIVE ADMISSION LIST ENTRY   Change to Attributes
REFERRAL REQUEST   Change to Attributes
 
Attribute Definitions
ELECTIVE ADMISSION SUSPENSION INITIATOR   Change to Description
ORIGINAL REFERRAL REQUEST RECEIVED DATE   New Attribute
WAITING PERIOD EXCLUSION   New Attribute
 
Data Elements
ADMISSION OFFER OUTCOME   Change to Description
COUNT OF DAYS SUSPENDED   Change to Description
DEFERRED ADMISSION   Change to Description
DURATION OF ELECTIVE WAIT   Change to Description
ELECTIVE ADMISSION LIST REMOVAL REASON   Change to Description
SELF-DEFERRED ADMISSION   Change to Description
SUSPENDED PATIENT   Change to Description
 
Central Return Forms
KH07 2   Change to Guidance Text
KH07 3   Change to Guidance Text
KH07 4   Change to Guidance Text
KH07 5   Change to Guidance Text
KH07 6   Change to Guidance Text
KH07 7   Change to Guidance Text
QF01 2   Change to Guidance Text
QF01 3   Change to Guidance Text
QF01 4   Change to Guidance Text
QF01 5   Change to Guidance Text
QF01 6   Change to Guidance Text
QF01 7   Change to Guidance Text
QF01 8   Change to Guidance Text
QM08 2   Change to Guidance Text
QM08 3   Change to Guidance Text
QM08 4   Change to Guidance Text
QM08R 2   Change to Guidance Text
QM08R 3   Change to Guidance Text
QM08R 4   Change to Guidance Text
 
Supporting Information
CENTRAL RETURN MIDDLE PANE   Change to Supporting Information
CENTRAL RETURNS-WAITING TIME CALCULATIONS FOR KH07+QF01   Change to Supporting Information
CENTRAL RETURNS-WAITING TIME CALCULATIONS FOR QM08+QM08R   New Supporting Information

Name:Kevin Shine
Date:7 January 2004
Sponsor:Department of Health

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


ELECTIVE ADMISSION LIST ENTRY

Change to Class: Change to Attributes

Attributes of this Class are:
KELECTIVE ADMISSION LIST ENTRY NUMBER
ADMINISTRATIVE CATEGORY
ADMISSION BOOKING SYSTEM TYPE
OELECTIVE ADMISSION LAST REVIEWED DATE
OELECTIVE ADMISSION LIST REMOVAL DATE
OELECTIVE ADMISSION LIST REMOVAL REASON
ELECTIVE ADMISSION TYPE
OGUARANTEED ADMISSION DATE
INTENDED MANAGEMENT
ORIGINAL DECIDED TO ADMIT DATE
OPREVIOUS PROVIDER OFFERED ADMISSION DATE
OWAITING PERIOD EXCLUSION
   for patient transfers only


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REFERRAL REQUEST

Change to Class: Change to Attributes

Attributes of this Class are:
OCANCER SPECIALIST REFERRAL DATE
   for suspected cancer only
OFIRST SEEN BY SPECIALIST DATE (CANCER)
   for suspected cancer only
OUT-PATIENT REFERRAL INDICATOR
ORIGINAL REFERRAL REQUEST RECEIVED DATE
   for patient transfers only
OSOURCE OF REFERRAL FOR A+E
   if request is for care by an ACCIDENT AND EMERGENCY DEPARTMENT
OSOURCE OF REFERRAL FOR CANCER
   if request is for care from specialist cancer care services
OSOURCE OF REFERRAL FOR COMMUNITY
   if request is for care by a COMMUNITY NURSE STAFF GROUP
OSOURCE OF REFERRAL FOR COMMUNITY DENTAL
   if request is for care by a Community Dental Service
OSOURCE OF REFERRAL FOR DRUG MISUSE
   if request is for care at a DRUG MISUSE FACILITY
OSOURCE OF REFERRAL FOR MENTAL HEALTH
   if request is for care from specialist mental care services
OSOURCE OF REFERRAL FOR OUT-PATIENTS
   if request is for care to be provided as an out-patient
OSOURCE OF REFERRAL FOR PROF STAFF GROUP
   if request is for care by a PROFESSIONAL STAFF GROUP SERVICE
OSUPRA SERVICE INDICATOR
OTWO WEEK WAIT EXCLUSION INDICATOR
   for suspected cancer only
URGENT CANCER REFERRAL TYPE


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ELECTIVE ADMISSION SUSPENSION INITIATOR

Change to Attribute: Change to Description

A reason for suspending an ELECTIVE ADMISSION LIST ENTRY.

Classification:
a. Initiated by CONSULTANT for medical reasons including awaiting match for tissue/organ transplants
a. Initiated by CONSULTANT for medical reasons including awaiting an organ transplant or an unrelated bone marrow transplant
b. Initiated by PATIENT



This attribute is also known by these names:
ContextAlias
pluralELECTIVE ADMISSION SUSPENSION INITIATORS


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ORIGINAL REFERRAL REQUEST RECEIVED DATE

Change to Attribute: New Attribute

ORIGINAL REFERRAL REQUEST RECEIVED DATE

This records the date on which the first REFERRAL REQUEST, for a specific health care service to be provided, was received. This date must be recorded on any subsequent REFERRAL REQUESTS for the same health care service and should never be altered or removed, even if the HEALTH CARE PROVIDER changes, until the specific health care service is provided for the PATIENT, or is no longer required.



This attribute is also known by these names:
ContextAlias
pluralORIGINAL REFERRAL REQUEST RECEIVED DATES


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WAITING PERIOD EXCLUSION

Change to Attribute: New Attribute

WAITING PERIOD EXCLUSION

It is a total of all periods that a PATIENT has been suspended, plus the effect in days if a PATIENT has self-deferred, for PATIENTS on an ELECTIVE ADMISSION LIST.

When a PATIENT has been transferred between providers, this is the total number of days that the PATIENT was excluded from the ELECTIVE ADMISSION LIST at previous provider(s) as well as with the current provider.

Please note: if a PATIENT is offered a date of admission but does not turn up and gives no advanced warning, then their waiting time is re-set from the admission date which the PATIENT failed to attend. Therefore, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations..



This attribute is also known by these names:
ContextAlias
pluralWAITING PERIOD EXCLUSIONS


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ADMISSION OFFER OUTCOME

Change to Data Element: Change to Description

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

Notes:
PATIENTS are taken off the ELECTIVE ADMISSION LIST once they are admitted into hospital. If treatment is then deferred because of lack of facilities, or for medical reasons, e.g. the PATIENT may have a cold or unacceptably high blood pressure, the PATIENT is discharged with the ADMISSION OFFER OUTCOMES recorded as 'Patient admitted  treatment deferred'. If treatment is then deferred because of lack of facilities, or for medical reasons, e.g. the PATIENT may have a cold or unacceptably high blood pressure, the PATIENT is discharged with the ADMISSION OFFER OUTCOMES recorded as 'Patient admitted - treatment deferred'. A new DECISION TO ADMIT and a new ELECTIVE ADMISSION LIST ENTRY will then be made for the PATIENT. Note that the ORIGINAL DECIDED TO ADMIT DATE will still be used for the PATIENT's waiting time calculation. However, if the PATIENT fails to arrive or if the Admission is cancelled by, or on behalf of, the PATIENT then the waiting time is re-set from the missed admission date.



This data element is also known by these names:
ContextAlias
pluralADMISSION OFFER OUTCOMES


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COUNT OF DAYS SUSPENDED

Change to Data Element: Change to Description

Format/length: n4
HES item:
National Codes:
Default Codes: 9998 - Not applicable
  9999 - Not known

Notes:
This derived data item is mandatory for the Elective Admission List Census CMDS. It gives an aggregate count of the number of days the PATIENT has been suspended since either the LAST DNA OR PATIENT CANCELLED DATE, if applicable, or from the DECIDED TO ADMIT DATE. It gives an aggregate count of the number of days the PATIENT has been suspended since either the LAST DNA OR PATIENT CANCELLED DATE, if applicable, or from the ORIGINAL DECIDED TO ADMIT DATE.



This data element is also known by these names:
ContextAlias
pluralCOUNT OF DAYS SUSPENDEDS
pluralCOUNT OF DAYS SUSPENDED


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DEFERRED ADMISSION

Change to Data Element: Change to Description

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

Notes:
DEFERRED ADMISSIONSS cover those patients with an ADMISSION OFFER OUTCOME classification of 'Patient failed to arrive' or 'Admission cancelled by, or on behalf of, the patient'. This affects the calculation of waiting times. PATIENTS should only be included in the count of deferred admissions once the offered date for admission has passed. DEFERRED ADMISSIONS cover those PATIENTS with an ADMISSION OFFER OUTCOME classification of 'Patient failed to arrive' or 'Admission cancelled by, or on behalf of, the patient'. PATIENTS should only be included in the count of DEFERRED ADMISSIONS once the offered date for admission has passed.

See also SELF-DEFERRED ADMISSION.



This data element is also known by these names:
ContextAlias
pluralDEFERRED ADMISSIONS


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DURATION OF ELECTIVE WAIT

Change to Data Element: Change to Description

Format/length: n4
HES item: ELECDUR
National Codes:
Default Codes: 9998 - Not applicable
  9999 - Not known (i.e. no date known for decision to admit): a validation error

Notes:
This derived item records the waiting time from the DECIDED TO ADMIT DATE to the provider where the treatment actually takes place, to the date of admission. This derived item records the waiting time from the ORIGINAL DECIDED TO ADMIT DATE to the admission date at the provider where the treatment actually takes place. Enter 0000-8887 in days, right justified with preceding zeros.

A waiting time of 0 (zero) days is only to be entered after careful scrutiny.

Please note that the patient's WAITING PERIOD EXCLUSIONS (their aggregate suspended and/or self-deferred periods) should be subtracted from the DURATION OF ELECTIVE WAIT.



This data element is also known by these names:
ContextAlias
pluralDURATION OF ELECTIVE WAITS


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ELECTIVE ADMISSION LIST REMOVAL REASON

Change to Data Element: Change to Description

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

Notes:
PATIENTS are taken off the ELECTIVE ADMISSION LIST once they are admitted to hospital. If treatment is then deferred because of lack of facilities or for medical reasons - the PATIENT may have a cold or unacceptably high blood pressure - the PATIENT is discharged with the ADMISSION OFFER OUTCOME recorded as: 'Patient admitted - treatment deferred'. A new DECISION TO ADMIT and a new ELECTIVE ADMISSION LIST ENTRY will then be made for the PATIENT. Note that the ORIGINAL DECIDED TO ADMIT DATE must still be used to calculate the start of the PATIENT's waiting time calculation.



This data element is also known by these names:
ContextAlias
pluralELECTIVE ADMISSION LIST REMOVAL REASONS


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SELF-DEFERRED ADMISSION

Change to Data Element: Change to Description

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

Notes:
Admissions cancelled by, or on behalf of, PATIENTS are known as self deferred admissions. Admissions cancelled by, or on behalf of, PATIENTS are known as SELF-DEFERRED ADMISSIONS. These include PATIENTS who fail to attend for admission. This affects the calculation of waiting times. Patients should only be classed as self-deferred admissions once the intended admission date has passed. PATIENTS should only be classed as SELF-DEFERRED ADMISSIONS once the intended admission date has passed. The cancellations may be made by a relative, friend or executor, if the PATIENT is unable to notify the hospital for themselves, e.g. because of handicap or extreme youth.

See DEFERRED ADMISSION and also ADMISSION OFFER OUTCOME.



This data element is also known by these names:
ContextAlias
pluralSELF-DEFERRED ADMISSIONS


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SUSPENDED PATIENT

Change to Data Element: Change to Description

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

Notes:
A PATIENT is suspended from the ELECTIVE ADMISSION LIST for medical reasons or is unavailable for admission for a specified period because of family commitments, holidays or other reasons. During this period of suspension, a PATIENT on an ELECTIVE ADMISSION LIST is unavailable for admission and therfore should not be given an OFFER OF ADMISSION for that interval. During this period of suspension, a PATIENT on an ELECTIVE ADMISSION LIST is unavailable for admission and therefore should not be given an OFFER OF ADMISSION for this interval. Note that a PATIENT cannot be suspended from the elective waiting list after an OFFER OF ADMISSION has been made.

Periods of suspension are normally deducted from the waiting time from the DECIDED TO ADMIT DATE (for this provider). Periods of suspension are normally deducted from the waiting time from the ORIGINAL DECIDED TO ADMIT DATE. However if the PATIENT has self-deferred, the period of suspension will be deducted from the date offered for admission which was refused.

In some instances, a Patient who is medically unfit for treatment could be removed from the waiting list altogether, but it should be stressed that this would need to be a clinical judgement made locally. In some instances, a PATIENT who is medically unfit for treatment could be removed from the waiting list altogether, but it should be stressed that this would need to be a clinical judgement made locally. PATIENTS on an ELECTIVE ADMISSION LIST should be those who need treatment and who are likely to be fit for surgery when offered admission. The Waiting List Action Team Handbook: Getting Patients Treated (August 1999) issued by the DH states that only PATIENTS who are clinically ready to undergo surgery should be placed on a waiting list for surgery. However, PATIENTS can become medically unfit for treatment while already on an ELECTIVE ADMISSION LIST. They may develop conditions, such as diabetes or obesity, that need to be treated before surgery can take place.

Once the period of suspension has passed, the PATIENT is restored to valid membership of an ELECTIVE ADMISSION LIST.



This data element is also known by these names:
ContextAlias
pluralSUSPENDED PATIENTS


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KH07 2

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the End of the Quarter (Provider Based)

    Part 1: Ordinary Admissions

  1. Part 1 of KH07 should be completed for intended ordinary admissions.

    Main Specialty Function and Code

  1. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  1. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

    Patients waiting for admission by months waiting

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

    Time Periods

  1. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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KH07 3

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the End of the Quarter (Provider Based)

    Part 1: Ordinary Admissions - continued

  1. Part 1 of KH07 should be completed for intended ordinary admissions.

  2. Main Specialty Function and Code

  3. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

  4. Patients waiting for admission

  5. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  6. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

  7. Patients waiting for admission by months waiting

  8. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  9. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  10. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  11. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

  12. Time Periods

  13. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

  14. Page total

  15. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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KH07 4

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the End of the Quarter (Provider Based)

    Part 1: Ordinary Admissions - continued

  1. Part 1 of KH07 should be completed for intended ordinary admissions.

    Main Specialty Function and Code

  1. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  1. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

    Patients waiting for admission by months waiting

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSIONS (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

    Time Periods

  1. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.

    FINAL TOTAL

  1. The total by column of all Ordinary Admission Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES.


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KH07 5

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the end of the Quarter (Provider Based)

    Part 2: Day Case Admissions

  1. Part 2 of KH07 should be completed for admissions intended to be treated as day case admissions.

    Main Specialty Function and Code

  1. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENT waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  1. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

    Patients waiting for admission by months waiting

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

    Time Periods

  1. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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KH07 6

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the end of the Quarter (Provider Based)

    Part 2: Day Case Admissions - continued

  1. Part 2 of KH07 should be completed for admissions intended to be treated as day case admissions.

    Main Specialty Function and Code

  1. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENT waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  1. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

    Patients waiting for admission by months waiting

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

    Time Periods

  1. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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KH07 7

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

KH07 - Demand for Elective Admission: Position at the end of the Quarter (Provider Based)

    Part 2: Day Case Admissions -continued

  1. Part 2 of KH07 should be completed for admissions intended to be treated as day case admissions.

    Main Specialty Function and Code

  1. ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of PATIENT with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENT waiting for tissue or organ transplants are classified as suspended patients and should be excluded.

  1. A count of PATIENTS with an ELECTIVE ADMISSION LIST ENTRY who have been classified as booked admissions or waiting list admissions. This count excludes planned admissions or suspended patients. In addition, note that PATIENTS waiting for an organ transplant or an unrelated bone marrow transplant are classified as SUSPENDED PATIENTS and should be excluded.

    Patients waiting for admission by months waiting

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the DECIDED TO ADMIT DATE for this provider and the date at the end of the applicable period for the return. If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time.

  1. The waiting time for each PATIENT on the ELECTIVE ADMISSION LIST is calculated as the time period between the ORIGINAL DECIDED TO ADMIT DATE and the date at the end of the applicable period for the return. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.), and please note that the waiting time is then made the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be subtracted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves, where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.

  1. Patients with an ADMISSION OFFER OUTCOME of Patient failed to arrive or Admission cancelled by, or on behalf of, patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

    Time Periods

  1. The periods listed - 3-5 months, 6-8 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.

    FINAL TOTAL

  1. The total by column of all Day Case Admission Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES.


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QF01 2

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 1: Ordinary Admissions

  1. Part 1 of QF01 refers to PATIENT intended to be treated as ordinary admissions.

    Ordinary admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient to stay in hospital for at least one night.

    Main Specialty Function and Code

  1. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.
    Patients waiting for admission

  1. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.
    Patients waiting for admission by months waiting

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.
  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
    Time periods

  1. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.
    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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QF01 3

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 1: Ordinary Admissions - continued

  1. Part 1 of QF01 refers to PATIENT intended to be treated as ordinary admissions.

    Ordinary admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient to stay in hospital for at least one night.

  2. Main Specialty Function and Code

  3. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.
  4. Patients waiting for admission

  5. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.

  6. Patients waiting for admission by months waiting

  7. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  8. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  9. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  10. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
  11. Time periods

  12. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

  13. Page total

  14. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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QF01 4

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 1: Ordinary Admissions - continued

  1. Part 1 of QF01 refers to PATIENT intended to be treated as ordinary admissions.

    Ordinary admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient to stay in hospital for at least one night.

    Main Specialty Function and Code

  1. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Patients waiting for admission

  1. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.

    Patients waiting for admission by months waiting

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
    Time periods

  1. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.

    FINAL TOTAL

  1. The total by column of all Ordinary Admission Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES.


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QF01 5

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 2: Day Case Admissions

  1. Part 2 of QF01 refers to PATIENT intended to be treated as day case admissions.

    Day case admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient not to stay in hospital overnight.

    Main Specialty Function and Code

  1. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.
    Patients waiting for admission

  1. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.

    Patients waiting for admission by months waiting

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
    Time periods

  1. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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QF01 6

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 2: Day Case Admissions - continued

  1. Part 2 of QF01 refers to PATIENT intended to be treated as day case admissions.

    Day case admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient not to stay in hospital overnight.

    Main Specialty Function and Code

  1. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.
    Patients waiting for admission

  1. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.

    Patients waiting for admission by months waiting

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.

  1. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.


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QF01 7

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 2: Day Case Admissions - continued

  1. Part 2 of QF01 refers to PATIENT intended to be treated as day case admissions.

    Day case admissions are identified by PATIENT with ELECTIVE ADMISSION LIST ENTRY where the INTENDED MANAGEMENT classification is Patient not to stay in hospital overnight.

    Main Specialty Function and Code

  1. The ELECTIVE ADMISSION LIST ENTRY should be counted by SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.
    Patients waiting for admission

  1. A count of all NHS-funded PATIENT waiting for admission to NHS or private hospitals who have an OFFER OF ADMISSION. Only PATIENT with an OFFERED FOR ADMISSION DATE at the date of the census should be counted as waiting with a date. Deferred admissions are not counted as waiting with a date until a future OFFER OF ADMISSION is made.

    Patients waiting for admission by months waiting

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.

  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep.
  1. Patients with an OFFER OF ADMISSION where the ADMISSION OFFER OUTCOME classification is Patient failed to arrive or Admission cancelled by, or on behalf of, the patient (deferred admissions) are included in the count but the waiting time is calculated differently. After the OFFERED FOR ADMISSION DATE has passed, the waiting time is calculated as the difference between the date at the end of the period and the OFFERED FOR ADMISSION DATE that the PATIENT turned down or failed to keep. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
    Time periods

  1. The periods listed - less than 3 months, 3-5 months and so on - refer to completed whole months, not partially completed ones. For example, in a case where the waiting time is between 5 and 6 months, the 3-5 months box should be used, not the 6-8 months one. Make sure that the hospital computer system does not round up time periods, as this could give misleading counts.

    Page total

  1. The total by column of all Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES appearing on the page.

    FINAL TOTAL

  1. The total by column of all Day Case Admission Patients waiting admission and Patients waiting for admission by months waiting for all the SPECIALTY FUNCTION CODES.


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QF01 8

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QF01 - Demand For Elective Admission: Position at the End of the Quarter (Responsible Population Based)

    Part 3: Coronary Revascularisation

  1. Part 3 of the form collects information on the number of PATIENT waiting for Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Angioplasty (PTCA) by months waiting at the end of the quarter in two time periods, 9 - 11 months and 12+ months.

  1. The patients are identified as ELECTIVE ADMISSION LIST ENTRY with an INTENDED PATIENT PROCEDURE, classified by OPERATIVE PROCEDURE, as being Coronary Artery Bypass Graft (CABG) (OPCS-4 code K40-46) and Percutaneous Coronary Angioplasty (PTCA) (OPCS-4 code K49-50).

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the DECIDED TO ADMIT DATE for this provider to the date at the end of the period. If the patient has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time.

  1. The waiting time for each applicable PATIENT on an ELECTIVE ADMISSION LIST is calculated from the ORIGINAL DECIDED TO ADMIT DATE to the date at the end of the period. This is still the case if the PATIENT is transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc.). Where the providers have agreed to transfer the patient the waiting time becomes the responsibility of the receiving provider.

    If the PATIENT has been suspended at all during this time, the period(s) of suspension should be deducted from the total waiting time. If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregated suspended and/or self-deferred periods) will be carried with them, except where the transfer is initiated by the PATIENT.

    If the PATIENT initiates a transfer between providers themselves (e.g. because of a house move), where there is no agreement for the transfer between the providers, the waiting time is re-set from the DECIDED TO ADMIT DATE for the new provider. Also, any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and therefore, should not be used for any further waiting time calculations.


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QM08 2

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08 - Out-Patient First Attendances Provider

    Specialty Function (column 2)

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP Written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)

  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an APPOINTMENT BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

  1. Fully booked appointments are those where a patient has been seen on the date that they were originally booked as agreed with the patient. Therefore booked appointments following GP referral should not be greater than the sum of the patients seen during the quarter i.e. column 5 should be less than or equal to columns 7 to 12.

    GP Referral Requests (written)

  1. A count of written referrals from GENERAL PRACTITIONERS, whether doctors or dentists, is required. These are GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUESTS to CONSULTANT should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE of the GP REFERRAL REQUEST should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUESTS where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:
    less than four weeks;
    four weeks and over but less than 13 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the PATIENT sees the doctor for the first time for out-patient care.



    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.

  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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QM08 3

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08 - Out-Patient First Attendances: Provider - continued

    Specialty Function (column 2)

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP Written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)

  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an APPOINTMENT BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

  1. Fully booked appointments are those where a patient has been seen on the date that they were originally booked as agreed with the patient. Therefore booked appointments following GP referral should not be greater than the sum of the patients seen during the quarter i.e. column 5 should be less than or equal to columns 7 to 12.

    GP Referral Requests (written)

  1. A count of written referrals from GENERAL PRACTITIONERS, whether doctors or dentists, is required. These are GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUESTS to CONSULTANTS should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE of the GP REFERRAL REQUEST should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUESTS where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from a Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:

    less than four weeks
    four weeks and over but less than 13 weeks;
    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.


  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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QM08 4

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08 - Out-Patient First Attendances: Provider - continued

    Specialty Function (column 2)

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP Written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)

  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an ADMISSION BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

  1. Fully booked appointments are those where a patient has been seen on the date that they were originally booked as agreed with the patient. Therefore booked appointments following GP referral should not be greater than the sum of the patients seen during the quarter i.e. column 5 should be less than or equal to columns 7 to 12.

    GP Referral Requests (written)

  1. A count of written referrals from GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUEST to CONSULTANT should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE of the GP REFERRAL REQUEST should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUEST which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUESTS where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from a Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:

    less than four weeks;
    four weeks and over but less than 13 weeks;
    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.

  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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QM08R 2

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08R - Out-patient First Attendances: Responsible Population Based

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)

  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an APPOINTMENT BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

    GP Referral Requests (written)

  1. A count of written referrals from GENERAL PRACTITIONERS, whether doctors or dentists, is required. These are GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUESTS to CONSULTANT should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUEST where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from a Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:

    less than four weeks;
    four weeks and over but less than 13 weeks;
    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.

  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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QM08R 3

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08R - Out-patient First Attendances: Responsible Population Based - continued

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)

  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an APPOINTMENT BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

    GP Referral Requests (written)

  1. A count of written referrals from GENERAL PRACTITIONERS, whether doctors or dentists, is required. These are GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUESTS to CONSULTANTS should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUESTS where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from a Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:

    less than four weeks;
    four weeks and over but less than 13 weeks;
    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.

  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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QM08R 4

Change to Central Return Form: Change to Guidance Text

Central Return Form Guidance

QM08R - Out-patient First Attendances: Responsible Population Based - continued

  1. All totals on the return are within SPECIALTY FUNCTION CODE. Note that SPECIALTY FUNCTION is based on SPECIALTY but is not identical to it.

    Shared Care clinics should use the Joint Consultant Clinic Code (990) for SPECIALTY FUNCTION CODE, rather than the individual SPECIALTY FUNCTION CODES of the CONSULTANT concerned.

    Number of referral requests for first Out-patient Appointments (columns 3 & 4)

  1. This counts all REFERRAL REQUESTS made in the quarter, which have the OUT-PATIENT REFERRAL INDICATOR set to Yes, split between GP written (column 3) and Other (column 4).

    Number of referral requests for first Out-patient Appointments (columns 5 & 6)
  1. This counts all first OUT-PATIENT APPOINTMENTS in the quarter, which have an APPOINTMENT BOOKING SYSTEM TYPE set to Full booking system, split between GP written (column 5) and Other (column 6).

    GP Referral Requests (written)

  1. A count of written referrals from GENERAL PRACTITIONER, whether doctors or dentists, is required. These are GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to Yes. All written GP REFERRAL REQUESTS to CONSULTANT should be recorded, regardless of whether they result in an OUT-PATIENT ATTENDANCE CONSULTANT. The REFERRAL REQUEST RECEIVED DATE should be used to identify referrals to be included in the return.

    Other referrals

  1. This is a count of referrals other than GP written referral requests. It includes verbal referrals from GPs - GP REFERRAL REQUESTS which have the WRITTEN REFERRAL REQUEST INDICATOR set to No. Do not include:

    • GP written referral requests;
    • REFERRAL REQUESTS with SOURCE OF REFERRAL FOR OUT-PATIENTS recorded as Initiated by the Consultant responsible for the Consultant Out-Patient Episode;
    • self referrals;
    • referrals resulting in ward attendance for nursing care, which do not result in a CONSULTANT OUT-PATIENT EPISODE;
    • referrals resulting from attendance at a drop-in clinic. These are REFERRAL REQUESTS where the OUT-PATIENT CLINIC REFERRING INDICATOR classification is Attended referring Out-Patient Clinic without prior appointment.

    All other sources of referral should be included, e.g:

    • referral from an A & E Department;
    • referral from a Consultant, other than in an A & E Department;
    • referral from Prosthetist.
    GP Written Referrals only (columns 7 to 16)

  1. Columns 7-12 of the return require the number of GP written referral first attendances seen during the quarter, broken down by the length of the wait. Waiting times are banded as:

    less than four weeks;
    four weeks and over but less than 13 weeks;
    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. Columns 13 - 16 require information on the number of GP written referral requests where the first out-patient attendance has not yet taken place at the end of the quarter, broken down by the length of wait. Waiting times are banded as:

    13 weeks and over but less than 17 weeks;
    17 weeks and over but less than 21 weeks;
    21 weeks and over but less than 26 weeks;
    26 weeks and over.

  1. The waiting time is the interval between REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the ATTENDANCE DATE of the OUT-PATIENT ATTENDANCE CONSULTANT where FIRST ATTENDANCE is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    For those not yet seen, the waiting time is the interval from the REFERRAL REQUEST RECEIVED DATE and the day the quarter ends.

  1. The waiting time is the interval between the ORIGINAL REFERRAL REQUEST RECEIVED DATE, the date the written referral request was received from the GP, or the date of the verbal request which was later confirmed, and the FIRST ATTENDANCE of the OUT-PATIENT ATTENDANCE CONSULTANT where the FIRST ATTENDANCE classification is First attendance, the date when the patient sees the doctor for the first time for out-patient care.


    The ORIGINAL REFERRAL REQUEST RECEIVED DATE should still be used to calculate the PATIENTS length of wait if they are transferred to another provider, where both providers agree to the transfer (e.g. to speed up treatment, ensure continuity of care etc..), and the waiting time is then made the responsibility of the receiving provider.

    However, if the patient initiates the transfer themselves by removing him/herself from the waiting list and subsequently are added to another provider's waiting list then the REFERRAL REQUEST RECEIVED DATE (new provider) should be used.

    For those not yet seen, the waiting time is the interval from the ORIGINAL REFERRAL REQUEST RECEIVED DATE to the day the quarter ends, unless the patient has initiated a transfer between providers themselves. In this case, the REFERRAL REQUEST RECEIVED DATE (new provider) should be used as the start date for the waiting period.

  1. For patients who refuse a reasonable appointment, the waiting time is from the first offered appointment to the date when the patient is seen, or the date of the return. For a verbal appointment offer to be deemed reasonable, the patient is to be offered a minimum of two appointments on different days, with at least three weeks notice before the first offered appointment.

    For a written appointment offer to be deemed reasonable, the patient is to be offered an appointment with a minimum of three weeks notice

    For patients who fail to attend, whether giving advance notice or not, the waiting time is from the last missed appointment to the date when the patient is seen, or the date of the return.

    Note, however, that if an appointment is rearranged to an earlier date, or to another time on the same day, then it is not a missed appointment, and the waiting time should be calculated from the date the referral is received to the new scheduled attendance date.

  1. The waiting time measures the interval between the last APPOINTMENT DATE of an OUT-PATIENT APPOINTMENT with an ATTENDED OR DID NOT ATTEND indicator of Did not attend - no advance warning given, Patient arrived late and could not be seen or Appointment cancelled by the patient, and the ATTENDANCE DATE when the patient was seen. For those not yet seen, the waiting time is the interval between the last missed appointment and the day the quarter ends.


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CENTRAL RETURN MIDDLE PANE

Change to Supporting Information: Change to Supporting Information

Central Return Forms


Introduction and Contextual Overview

Waiting Time Calculation Tables:
KH07 and QF01
QM08 and QM08R
QMCW

Central Return Forms:
Quarterly Monitoring

Hospital Aggregated Statistics

Community

Miscellaneous


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CENTRAL RETURNS-WAITING TIME CALCULATIONS FOR KH07+QF01

Change to Supporting Information: Change to Supporting Information

CENTRAL RETURNS

Central Returns

Waiting Time Calculations for KH07 and QF01

The following table provides a comparison of the waiting time calculations for Central Returns KH07 and QF01.

Please note that the Patient's charter column has been removed given that the Patient's Charter has now been replaced by "Your Guide to the NHS". However, the collection of the Patient's Original Decision To Admit continues to be an important performance management tool. Refer to "Your Guide to the NHS" for details of any new requirements. The collection of the Patient's Original Decision To Admit continues to be an important performance management tool.

Waiting List Event Calculation needed for KH07 and QF01
Original Decision To Admit (DTA)

The DTA is the DECIDED TO ADMIT DATE
Record DTA as start date
Original Decision To Admit Record ORIGINAL DECIDED TO ADMIT DATE as start date. On the first ELECTIVE ADMISSION LIST ENTRY the ORIGINAL DECIDED TO ADMIT DATE will be the same as the DECIDED TO ADMIT DATE.
Patient on waiting list  
Patient on waiting list  
Patient is transferred to another provider. Count from DTA for new provider
Two providers agree to the transfer of a PATIENT (e.g. to speed up treatment, ensure continuity of care, etc..) Count from ORIGINAL DECIDED TO ADMIT DATE. (Note: the waiting time continues at the receiving provider and becomes their responsibility).

If the PATIENT is transferred to another provider the WAITING PERIOD EXCLUSION (their aggregate suspended and/or self-deferred periods) will be carried with them. This should be carried forward as a rolling total, if the PATIENT is transferred more than once.
Patient is unavailable for treatment (suspended) and offer of admission cannot be made for that period. Omit from KH07/QF01 (but include on KH07A and KH07AR). Count from DTA for this provider and deduct period of suspension from waiting time.
PATIENT removes him/herself from the waiting list of one provider and is subsequently added to the waiting list at another provider. Count from the DECIDED TO ADMIT DATE for the new provider.

In such cases the WAITING PERIOD EXCLUSION for the previous provider (their aggregated suspended and/or self-deferred periods) will not be carried with them.
Patient offered admission  
The provider that the PATIENT is waiting to be admitted to undergoes a merger with another organisation. Count from the ORIGINAL DECIDED TO ADMIT DATE. (Note: the waiting time must continue and not be reset.)
Patient offered a reasonable date for admission but refuses this for personal reasons in advance of the date (self-deferred).

For a verbal admission date to be deemed reasonable, the patient is to be offered a minimum of two admission dates, with at least three weeks notice before the first of these admission dates.

For a written offer to be deemed reasonable, the patient is to be offered an admission date with a minimum of three weeks notice before the first of these admission dates.
Count from the first offered admission date the patient refused.
PATIENT is unavailable for treatment (suspended) and offer of admission cannot be made for that period. Omit from KH07/QF01 (but include on KH07A and KH07AR). Count from the ORIGINAL DECIDED TO ADMIT DATE and deduct period of suspension from waiting time.

PATIENTS can be 'suspended' from the active waiting list for short periods of time when they are unavailable for admission for social or medical reasons. However, the position of SUSPENDED PATIENTS must be reviewed regularly and if there is no prospect for them becoming available in the medium term consideration should be given to referring the PATIENT back to the GP.
Patient offered a date for admission but does not turn up and gives no advance warning (as for self-deferred). Count from the admission date which the patient failed to attend.
Patient offered admission  
Patient offered a date for admission but this is subsequently cancelled by the hospital. Count from DTA for this provider
PATIENT offered a reasonable date for admission but refuses this for personal reasons in advance of the date (self-deferred).

For a verbal admission date to be deemed reasonable, the PATIENT is to be offered a minimum of two admission dates, with at least three weeks notice before the first of these admission dates.

For a written offer to be deemed reasonable, the PATIENT is to be offered an admission date with a minimum of three weeks notice before the first of these admission dates.
Provided the date was a reasonable one, this is described as a 'self-deferral'.

For verbal offers, a self deferral is made if all dates offered are refused. In this case the waiting time is reset to zero from the earliest of the dates offered.

For written offers the waiting time is reset to zero from the date of the earliest admission the patient refused.

Patient admitted but treatment deferred. Patient sent home and new DTA made. Count from new DTA for this provider.
PATIENT offered a date for admission but does not turn up and gives no advance warning (self-deferred). The waiting time is reset to zero from the admission date which the PATIENT failed to attend. Therefore, the ORIGINAL DECIDED TO ADMIT DATE will no longer be used to calculate the start of the waiting time, and any WAITING PERIOD EXCLUSIONS from before the re-set waiting time date will be annulled, and should not be used for any further waiting time calculations.
Patient admitted and treatment completed. Remove from waiting list.
PATIENT offered a date for admission but this is subsequently cancelled by the hospital. Count from ORIGINAL DECIDED TO ADMIT DATE. The waiting time must continue until the PATIENT is admitted. However, any previous self-deferral(s) and periods of suspension must be taken into account.
Patient removed from waiting list (emergency admission for same condition, death, other reasons). Remove from waiting list.
PATIENT admitted but treatment deferred. PATIENT sent home and a new DECISION TO ADMIT made. Count from ORIGINAL DECIDED TO ADMIT DATE. The waiting time must continue until the PATIENT is admitted. However, any previous self-deferral(s) and periods of suspension must be taken into account. The Cancelled Operations guarantee of 28 days must be followed.
PATIENT admitted and treatment completed. Remove from waiting list on admission date.
PATIENT removed from waiting list (emergency admission for same condition, death, other reasons). Remove from waiting list.


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CENTRAL RETURNS-WAITING TIME CALCULATIONS FOR QM08+QM08R

Change to Supporting Information: New Supporting Information

CENTRAL RETURNS

<FONT CLASS="inserted">Central Returns</FONT>

Waiting Time Calculations for QM08 and QM08R

The following table provides a comparison of the waiting time calculations for Central Returns QM08 and QM08R. The coverage of the returns is for PATIENTS waiting for a first OUT-PATIENT APPOINTMENT CONSULTANT. Key parts of the central returns focus on the sub-set of these PATIENTS that were referred by GENERAL PRACTITIONERS.

Waiting Time Event Calculation needed for QM08 and QM08R
Start of waiting time. The waiting time starts from the date on which the original provider received the referral request, the ORIGINAL REFERRAL REQUEST RECEIVED DATE
PATIENT offered an APPOINTMENT DATE but refuses. As with the inpatient returns, so long as the offer was a reasonable one (sufficient amount of notice and taking into account personal circumstances) this counts as a 'self-deferral'. The out-patient waiting time is reset to zero, and starts again from the APPOINTMENT DATE the PATIENT refused.
PATIENT offered an APPOINTMENT DATE but does not attend. Once again this is a 'self-deferral'. The Out-patient waiting time is reset to zero, and starts again from the APPOINTMENT DATE the PATIENT refused.
PATIENT offered an APPOINTMENT DATE, but the provider cancels this. This has no affect on the waiting time - i.e. it should continue from the ORIGINAL REFERRAL REQUEST RECEIVED DATE.
Organisational change (e.g. Trusts merge) The waiting time is unaffected - i.e. it should continue from the date the ORIGINAL REFERRAL REQUEST RECEIVED DATE.
End of waiting time. The PATIENT is removed from out-patient Waiting list on the ATTENDANCE DATE when the PATIENT was seen.


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