IMPORTANT SECURITY ISSUES AND OTHER NOTES

1. From 1 April 1999, PATIENT NAME and PATIENT USUAL ADDRESS (not POSTCODE OF USUAL ADDRESS) must be removed from all commissioning data sets where a valid NHS NUMBER is present. This applies to all nationally defined Commissioning Data Sets Types (CDS) and Commissioning Minimum Data Sets (CMDS) and any additional locally agreed flows from service providers to commissioning bodies.

2. A valid NHS NUMBER is one that has passed the check digit calculation on entry into the source system. If an NHS NUMBER is not valid (i.e. does not conform with the check digit algorithm) then PATIENT NAMES and PATIENT USUAL ADDRESS should not be removed, as the reliability of the NHS NUMBER will not be known.

3. The NHS NUMBER STATUS INDICATOR is a mandatory part of the CMDS. PATIENT NAMES and PATIENT USUAL ADDRESS should be removed when a valid NHS NUMBER is present, even if the NHS Number Status Indicator does not have a status of 01, Number present and verified.

3. The NHS NUMBER STATUS INDICATOR is a mandatory part of the CDS. PATIENT NAMES and PATIENT USUAL ADDRESS should be removed when a valid NHS NUMBER is present, even if the NHS Number Status Indicator does not have a status of 01, Number present and verified.

B. Marital Status

4. Following the recommendations of the Data Protection Registrar, Providers should not record MARITAL STATUS in any CDS Type/CMDS, except in respect of the psychiatric specialities in the Admitted Patient Care CDS Types, where it will continue to be recorded.

4. Following the recommendations of the Data Protection Registrar, Providers should not record MARITAL STATUS in any CDS Type, except in respect of the psychiatric specialities in the Admitted Patient Care CDS Types, where it will continue to be recorded.

C. Sensitive data

5. The Human Fertilisation and Embryology Act 1990 as amended by the Human Fertilisation and Embryology (Disclosure of Information) Act 1992 imposes statutory restrictions on the disclosure of information about identifiable individuals in connection with certain infertility treatments. A list of the relevant codes is given in the table below. In these cases the NHS NUMBER, LOCAL PATIENT IDENTIFIER, PATIENT NAMES, POSTCODE OF USUAL ADDRESS and BIRTH DATE should be omitted from the CDS Types and CMDS.

5. The Human Fertilisation and Embryology Act 1990 as amended by the Human Fertilisation and Embryology (Disclosure of Information) Act 1992 imposes statutory restrictions on the disclosure of information about identifiable individuals in connection with certain infertility treatments. A list of the relevant codes is given in Table 1. In these cases the NHS NUMBER, LOCAL PATIENT IDENTIFIER, PATIENT NAMES, POSTCODE OF USUAL ADDRESS and BIRTH DATE should be omitted from the CDS Types.

6. Other statutory restrictions on the disclosure of patient information do not prohibit the disclosure to individuals involved with the treatment and prevention of certain specific diseases (HIV/AIDS and venereal diseases) in the population.

TABLE OF TREATMENTS PROVIDED UNDER THE LICENCE OF THE HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY TABLE 1: TREATMENTS PROVIDED UNDER THE LICENCE OF THE HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY

Description	OPCS-4	ICD-10
Standard In Vitro Fertilisation (IVF)	Q13.-1 Introduction of gamete into uterine cavity, or Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.2 In vitro fertilization
IVF with donor sperm	Q13.- 1 Introduction of gamete into uterine cavity, or Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.2 In vitro fertilization
IVF with donor eggs	Q13.-1 Introduction of gamete into uterine cavity, or Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.2 In vitro fertilization
Donor insemination (DI)	Q13.3 Intrauterine artificial insemination, or Q13.2 Intracervical artificial insemination	Z31.1 Artificial insemination
Gamete intrafallopian transfer (GIFT) with donor sperm	Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.3 Other assisted fertilization methods
Gamete intrafallopian transfer (GIFT) with donor eggs	Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.3 Other assisted fertilization methods
Intracytoplasmic sperm injection (ICSI)
Sub-zonal insemination (SUZI)
Zygote intrafallopian transfer (ZIFT)	Q38.3 Endoscopic intrafallopian transfer of gamete	Z31.2 In vitro fertilization
Partial Zona Dissection (PZD)
Zona drilling
Hamster- egg penetration test
Assisted hatching
Pre-implantation Genetic Diagnosis (PGD)
Storage of sperm
Storage of embryos
Use and storage of testicular tissue
Transport/satellite IVF/ICSI
Embryo donation		Z31.8 Other procreative management
Research

¹.- means all fourth characters of this rubric should be included.

7. All records containing patient identifiable information, other than those covered by the Human Fertilisation & Embryology Acts, as outlined in the Table above, should be treated as sensitive. Organisations may continue to exchange records containing NHS NUMBER, POSTCODE OF USUAL ADDRESS and BIRTH DATE in these cases, but receiving organisations must ensure that only those staff with legitimate need have access to this information, e.g. public health departments, and strictly on a need to know basis. No-one should have unrestricted access unless fully justified in accordance with the principles of the Caldicott Committee Report.

8. Where patient level data is required for other purposes within an organisation, it should be anonymised/aggregated prior to disclosure by someone with legitimate access. If this is not practicable, local protocols defining which CDS Types/CMDS are particularly sensitive (including, but not necessarily restricted to HIV/AIDS and venereal disease) agreed by the organisation Caldicott Guardian, should be put in place and identifiers stripped from these records.

8. Where patient level data is required for other purposes within an organisation, it should be anonymised/aggregated prior to disclosure by someone with legitimate access. If this is not practicable, local protocols defining which CDS Types are particularly sensitive (including, but not necessarily restricted to HIV/AIDS and venereal disease) agreed by the organisation Caldicott Guardian, should be put in place and identifiers stripped from these records.

9. Your Caldicott Guardian will be able to advise you further on all issues relating to patient confidentiality.

10. Where appropriate, further information about confidentiality is contained within the notes for individual data items.

Data Elements Introduction

Data elements are used to identify or indicate the content of:

In addition, data elements can contain text providing guidance, support, values or other information concerning the data element and its use with the above.

The data elements are listed in alphabetical order. Click on a letter in the Data Element Bookmarks to display the list of data element names for that letter. Click on a letter in the Data Element Bookmarks to display the list of data element names for that letter in the right hand screen frame. To display the content of a specific data element, click on the data element name. The content of the data element replaces the list of data element names in the rightmost screen frame.

Each attribute name, class name or data element name which appears in the data element content text is in uppercase. Where the name also appears in blue, this indicates that it is clickable and if clicked on will display the definition for that class or attribute, or the content of the data element. In the same way, if a data link is present and clicked on, the definition of the class or attribute will be displayed. Where the name also appears in blue and is underlined indicates that it is clickable and if clicked on will display the definition for that class or attribute, or the content of the data element. In the same way, if a data button is present and clicked on, the definition of the class or attribute will be displayed.

The following information may be shown within a data element:

Introduction

What are CDS View Diagrams?

The NHS data standards logical data model supports the Commissioning Data Sets (CDS). This is too large to be represented in a single diagram. Consequently the sub-set of the data model which supports the CDS has been split into a number of separate diagrams each representing a specific CDS Type. Each CDS Type view is represented by a diagram which contains the classes and their relationships which are required to support it. Not all items of information required by a CDS Type are defined classes or attributes but instead are derived by combining values of attributes or totalling attributes where particular conditions apply. The classes from which such information is derived or calculated will be shown on the CDS View diagrams. Not all items of information required by a CDS Type are defined classes or attributes but instead are derived by combining values of attributes or totalling attributes where particular conditions apply, The classes from which such information is derived or calculated will be shown on the CDS View diagrams.

What are CMDS View Diagrams

The Commissioning Minimum Data Sets (CMDS) are a set of nationally agreed data items which support the commissioning process in the NHS. The Commissioning Data Sets (CDS) have been developed to carry the CMDS data in a structured EDIFACT message format. To overcome various differences between the CMDS and CDS, it was agreed to consolidate both CMDS and CDS to reflect a single national data standard for commissioning data to be known as the Consolidated Commissioning Data Sets. This title has been shortened to Commissioning Data Sets. Wherever the term Commissioning Data Set or CDS appears in this publication it has the meaning of the single national data standard. The change to the consolidated Commissining Data Sets has therefore replaced and eliminated most usage of the original Commissioning Minimum Data Sets (CMDS). There are however, two Commissioning Minimum Data Sets (CMDS) which as yet have not been aligned to the equivalent CDS as they are still subject of review, these two CMDSs are:

• ELECTIVE ADMISSION LIST CMDS: End of Period Census
• ELECTIVE ADMISSION LIST CMDS: Event During Period

The NHS data standards logical data model supports the two remaining Commissioning Minimum Data Sets (CMDSs). Each CMDS view is represented by a diagram which contains the classes and their relationships which are required to support it. Not all items of information required by a CMDS are defined classes or attributes but instead are derived by combining values of attributes or totalling attributes where particular conditions apply. The classes from which such information is derived or calculated will be shown on the CMDS View diagrams.