NHS Information Authority
Data & Information Standards Programme
| Reference: | Change Request 363 |
| Version No: | 1.12 |
| Subject: | GMS Contract - patient registrations |
| Type of Change: | Revision of NHS Data Dictionary |
| Effective Date: | 1 April 2004 |
| Reason for Change: | Changes to NHS Data Dictionary to reflect new requirement regarding the registration of Patients with GP Practices, rather than with individual GPs. |
Background:
The new GMS contract, effective from 1st April 2004, has a significant effect on how GP practices are funded. The previous contract based its funding on Patients being registered with individual GPs. The contract changes this relationship to Patients being registered with a Practice, and it allows Practices to decide the most appropriate ways of delivering services to their Patients.
This is expected to have a profound effect on both the working methods of Practices, and on the methods employed to monitor performance against the contract, and thus the amount of funding paid to a Practice.
The impact of the new GMS Contract on the NHS Data Dictionary is likely to be significant, yet the full extent of this impact is unlikely to be known for some time. There are, however, some obvious changes that must be made to ensure that the NHS Data Dictionary reflects the requirements of the new GMS Contract.
This DSCN is concerned principally with changes to reflect the registration of Patients with Practices. Class and Attribute definitions have been amended, but diagrams have not been addressed, pending a realignment of diagrams contained in the NHS Data Dictionary, and covered by other DSCNs. Classes associated with ITEM OF SERVICE DELIVERY will continue to exist for a significant time after the new contract takes effect, even though it is not part of the contract, to cater for retrospective claims by individual GPs. This area has therefore not been addressed in this DSCN, in order that the NHS Data Dictionary reflects the current business. It is intended that the area concerning ITEM OF SERVICE DELIVERY will be addressed as and when it is deemed to be no longer needed.
This DSCN is intended for clarification only, and is not for mandating any changes to existing systems. It should be noted that it is probable that further DSCNs will be published where it is discovered that changes related to the GMS contract require the NHS Data Dictionary to be amended, and that this DSCN does not necessarily constitute a complete resolution of the changes required as a result of the GMS contract. Further work on the impact of the GMS Contract on data sets and messaging will follow as requirements become clearer.
Summary of changes:
| Class Definitions | |
| GENERAL MEDICAL PRACTITIONER PRACTICE | Change to Relationships |
| PERSON | Change to Relationships |
| REGISTRATION | Change to Description |
| REGISTRATION | Change to Attributes |
| REGISTRATION | Change to Relationships |
| Attribute Definitions | |
| ENLISTMENT DATE | Change to Description |
| HEALTH CHECK EXAMINATION DATE | Change to Description |
| REGISTRATION DISCHARGE | Change to Description |
| REGISTRATION SOURCE | Change to Description |
| REGISTRATION TYPE | Change to Description |
| RURAL PRACTICE PAYMENT | Change to Description |
| WALKING UNIT | Change to Description |
| Date: | 22 July 2004 |
| Sponsor: | Data and Information Standards Programme |
Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout. Within the Diagrams deleted classes and relationships are shown as red in colour, blue is used for changed items and green is used for created items.
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Change to Class: Change to Relationships
| may be related to one or more GENERAL MEDICAL PRACTITIONER | |
| may be the location for one or more GMP PRACTICE CONSULTATION | |
| may be the subject of one or more OTHER CLAIM BY GMP | |
| may be associated with one or more POST IN GMP PRACTICE | |
| may be responsible for one or more PREGNANCY EPISODE | |
| may be the registered practice for one or more REGISTRATION |
Change to Class: Change to Relationships
| may be located at one or more ADDRESS ASSOCIATION | |
| may be the subject of one or more CARE SPELL | |
| may be contacted by one or more COMMUNICATION CONTACT INFORMATION | |
| may be acting as one or more FINANCIAL ACCOUNT HOLDER | |
| may be the receiver of one or more GMP PRACTICE CONSULTATION | |
| may be related to one or more IMMUNISATION PROGRAMME FOR PERSON | |
| may be acting as one or more MENTAL HEALTH CARE TEAM MEMBER | |
| may be the person consenting to one or more ORGAN DONATION CONSENT | |
| may be classified as one and only one PATIENT | |
| may be the subject of one or more PERSON DEATH DETAILS | |
| may be associated with one or more PERSON GMP ASSOCIATION | |
| may be allocated an identifier of one or more PERSON IDENTIFIER | |
| may be related to one or more PERSON IN A CONTACT TRACING PROGRAMME | |
| may be related to one or more PERSON IN ADVICE AND SUPPORT PROGRAMME | |
| may be related to one or more PERSON IN A SCREENING PROGRAMME | |
| may be related to one or more PERSON IN A SURVEILLANCE STAGE | |
| may be the person in one or more PERSON IN GMP PRACTICE POST | |
| may be the user of one or more PERSON NAME | |
| may be related to one or more PERSON NATIONALITY OR RESIDENCY STATUS | |
| may be the subject of one or more PERSON OBSERVATION | |
| may be the owner of one or more PERSON PROPERTY | |
| may be related to one or more PERSON RELATIONSHIP | |
| may be from one or more PERSON RELATIONSHIP | |
| may be the holder of one or more PERSON ROLE IN ORGANISATION | |
| may be the instigator of one or more PERSON SMOKING CESSATION EPISODE | |
| may be listed on one or more PRIOR NOTIFICATION LIST ENTRY | |
| may be the owner of one or more QUALIFICATION POSSESSED | |
| may be the registered person of one or more REGISTRATION | |
| may be related to one or more SCREENING TEST | |
| may be the originator of one or more WRITTEN COMPLAINT |
Change to Class: Change to Description
A type of PERSON GMP ASSOCIATION.
An agreement between a PERSON and a GENERAL MEDICAL PRACTITIONER whereby the PERSON has been accepted onto the permanent list of a GENERAL MEDICAL PRACTITIONER for the purpose of improving or maintaining health, or has been accepted onto a restricted service list of a GENERAL MEDICAL PRACTITIONER for the purpose of providing that service only.
The restricted service list is to enable PERSONS, by choice, to receive treatment or care for the specified service from a different GENERAL MEDICAL PRACTITIONER than the GENERAL MEDICAL PRACTITIONER on whose permanent list they have been accepted for general medical services. The restricted service list is to enable PERSONS, by choice, to receive treatment or care for the specified service from a different GENERAL MEDICAL PRACTITIONER PRACTICE than the GENERAL MEDICAL PRACTITIONER PRACTICE on which permanent list they have been accepted for general medical services.
References:
Statement of Fees and Allowances Payable to General Medical Practitioners in England and Wales.
This class is also known by these names:
| Context | Alias |
|---|---|
| plural | REGISTRATIONS |
Change to Class: Change to Attributes
| K | REGISTRATION TYPE | |
| K | START DATE | |
| O | BLOCK OR SPECIAL INDICATOR | |
| DISPENSING SERVICES PROVIDED | ||
| O | DISTANCE UNITS | |
| O | DISTANCE UNITS ADDITIONAL | |
| O | END DATE | |
| O | REGISTRATION DISCHARGE | |
| O | REGISTRATION SOURCE | |
| O | RURAL PRACTICE PAYMENT | |
| O | WALKING UNIT | |
| O | WALKING UNIT ADDITIONAL |
Change to Class: Change to Relationships
| K | must be registered at one and only one GENERAL MEDICAL PRACTITIONER PRACTICE |
| K | must be the registration of one and only one PERSON |
Change to Attribute: Change to Description
The date of enlistment to the Armed Services, required if a PERSON is returning from service with the Armed Services and is applying for REGISTRATION with a GENERAL MEDICAL PRACTITIONER. The date of enlistment to the Armed Services, required if a PERSON is returning from service with the Armed Services and is applying for REGISTRATION with a GENERAL MEDICAL PRACTITIONER PRACTICE.
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | ENLISTMENT DATES |
Change to Attribute: Change to Description
The date on which a PATIENT was given a health check examination by, or on behalf of, the GENERAL MEDICAL PRACTITIONER as part of the REGISTRATION process. The date on which a PATIENT was given a health check examination by a GENERAL MEDICAL PRACTITIONER on behalf of the GENERAL MEDICAL PRACTITIONER PRACTICE, as part of the REGISTRATION process.
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | HEALTH CHECK EXAMINATION DATES |
Change to Attribute: Change to Description
Classifies the discharge reason for a PERSON moving or removing their registration from a GENERAL MEDICAL PRACTITIONER. Classifies the discharge reason for a PERSON moving or removing their registration from a GENERAL MEDICAL PRACTITIONER PRACTICE.
Classification:
| a. | Person moving from one Practice to another Practice . |
| b. | Death or emigration of Person |
| c. | Person removed from GMP Practice list because of act or threat of violence |
| d. | Person transferred at the request of the previous GMP Practice (excluding threats and acts of violence) |
| e. | Bulk transfer on closure of previous GMP Practice |
| f. | Other reason for transfer |
| g. | End of temporary or service-specific registration (e.g. maternity) |
| h. | Other |
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | REGISTRATION DISCHARGES |
Change to Attribute: Change to Description
Classifies the source of a registration of a PERSON with a GENERAL MEDICAL PRACTITIONER. Classifies the source of a registration of a PERSON with a GENERAL MEDICAL PRACTITIONER PRACTICE.
Classification:
| a. | Person moving to a Practice from another Practice |
| b. | Birth |
| c. | First acceptance. (Immigrants, ex-services, etc) |
| d. | Person transferred at the request of the previous GMP Practice |
| e. | Person transferred at their own request |
| f. | Bulk transfer on closure of previous GMP Practice |
| g. | Other reason |
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | REGISTRATION SOURCES |
Change to Attribute: Change to Description
The coded classification of REGISTRATION for a PERSON who has been accepted onto the permanent list of a GENERAL MEDICAL PRACTITIONER, or has been accepted onto a restricted service list of a GENERAL MEDICAL PRACTITIONER for the purpose of providing that service only.
Classification:
| b. | Permanent for General Medical Services and Child Health |
| a. | Permanent for General Medical Services Surveillance |
| c. | Restricted Service List: Child Health Surveillance only |
| d. | Restricted Service List: Contraceptive Services only |
| e. | Restricted Service List: Maternity Medical Services only |
| f. | Restricted Service List: Minor Surgery Services only |
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | REGISTRATION TYPES |
Change to Attribute: Change to Description
An indication of whether the GENERAL MEDICAL PRACTITIONER is claiming rural practice payment for a PERSON who has been accepted onto the permanent list of the GENERAL MEDICAL PRACTITIONER, and is resident more than 3 miles distant from the GENERAL MEDICAL PRACTITIONER PRACTICE main surgery by the normal route.
Note that these payments do not apply to those GENERAL MEDICAL PRACTITIONERS who hold a Personal Medical Services, as opposed to a General Medical Services, contract.
Classification:
| a. | Yes, claim based upon the credited Rural Practice Units |
| b. | Yes, claim based upon exceptional out-of-pocket expenses |
References:
Statement of Fees and Allowances Payable to General Medical Practitioners in England and Wales
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | RURAL PRACTICE PAYMENTS |
Change to Attribute: Change to Description
The classification of walking units claimed for rural practice payments. The classification of walking units claimed by a GENERAL MEDICAL PRACTITIONER PRACTICE for rural practice payments. These units are in addition to the distance units, and are for that part of the route which has to be walked. Walking units are credited only from the point where a GENERAL MEDICAL PRACTITIONER would have to leave an ordinary two-wheel drive car and walk to the PERSON's residence under normal winter conditions.
Classification:
| a. | For at least a quarter of a mile but less than half of a mile |
| b. | For at least half of a mile but less than three quarters of a mile |
| c. | For at least three quarters of a mile but less than one mile |
| d. | For at least one mile or over |
References:
Statement of Fees and Allowances Payable to General Medical Practitioners in England and Wales.
This attribute is also known by these names:
| Context | Alias |
|---|---|
| plural | WALKING UNITS |
For enquiries about this DSCN:-
Email: disp@nhsia.nsh.uk
Website: Internet: http://www.nhsia.nhs.uk/datastandards/pages/
NHSnet: http://nww.nhsia.nhs.uk/datastandards/pages/