The Outpatients (SMR00) dataset collects episode level data from patients on new and follow up appointments at outpatient clinics in all specialities (except A&E and Genito-Urinary Medicine).
This is a subset of data for the Brain Health Data Pilot (BHDP)

MDW Discover  > BHDP - Outpatient Appointments and Attendances - SMR00 @ 76

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The Brain Health Data Pilot (BHDP) project aims to be a shared database (like a library) of information for scientists studying brain health, especially for diseases like dementia, which affects about 900,000 people in the UK. Its main feature is a huge collection of brain images linked to routinely collected health records, both from NHS Scotland, which will help scientists learn more about dementia and other brain diseases. What is special about this database is that it will get better over time – as scientists use it and add their discoveries, it becomes more valuable. 

This is a subset of the Outpatient Appointment and Attendances (SMR00) dataset for use in the Brain Health Data Pilot (BHDP) project. 

An SMR00 is generated for outpatients receiving care in the specialties listed when:

-they attend a medical consultant outpatient clinic;
-they meet with a consultant or senior member of his/her team outwith an outpatient clinic session (including the patient"s home).
-they attend a clinic run by a nurse or an AHP identified as the Health Care Professional Responsible for Care for that clinic and who has legal and clinical responsibility for that patient.

The dataset is generally fully complete and ready for analysis three month preceding the current date.  So for example at the end of August, data is available until the end of May.

HDR UK

National Services Scotland ;,;Public Health Scotland

Field Length
6

Priority
Mandatory

Definition
Clinic date is the date on which a specific clinic session occurs.

Recording Rules
Enter the date of the clinic. All dates must be made up to 6 digits (ddmmyy) by entering preceding zeros for single digits in day or month, e.g. 2 April 1999:

0	2	0	4	9	9

This date may be assigned automatically by your computer system.
Points to Note

The record will be queried if the Clinic Date is more than 2 years after Referral Received Date (only if Referral Type = 1 or 2 - New Attendance).
Cross Checks

Date must be in correct date sequence.
Clinic Date is cross-checked against age and specialty.

Clinic Date

An outpatient attendance is the occasion of a patient attending a consultant or other medical clinic or meeting with a consultant or senior member of his team outwith a clinic session.

If the patient is a new outpatient then the attendance is a new outpatient attendance, otherwise it is a follow-up (return) outpatient attendance.

Notes

Outpatient attendances outwith clinic sessions may occur at any location including the patients home (see Home Visit). Those which take place outwith a clinic session on a ward are distinguishable from ward attendances by the fact that the meeting is with a consultant or a senior member of his team rather than with a junior doctor.
Patients attending clinics usually come from outwith the hospital but may be inpatients. If they are inpatients then usually the inpatient specialty is different from the specialty of the clinic.
Bedside consultations are not outpatient attendances. However, contacts subsequent to a bedside consultation with the same consultant are recorded as outpatient attendances (see Follow Up Outpatients - Recording Rules.
Ward attendances are not outpatient attendances.

Outpatient Attendance

Field Length
3

Priority
Mandatory

Definitions

Specialty
A Specialty is defined as a division of medicine or dentistry covering a specific area of clinical activity and identified within one of the Royal Colleges or Faculties.

Click here for a complete list of Specialties

Discipline
A Discipline is a non-medical profession related to healthcare, for which a formal training leading to a recognised professional qualification is undertaken. Examples of disciplines are physiotherapy, nursing, pharmacology.

Recording Rules
This field should be coded to the Specialty/Discipline of the consultant/GP/HCP who is in charge of the patient episode. If the consultant is formally recognised and contracted to work in more than one specialty then the patients problem or condition should dictate the specialty.

Note that this is the ONLY rule for completing this field. The designation of the beds is not used.

Specialty/Discipline comprises four characters, the first three of which are allocated by ISD for each specialty, and is mandatory for completion. For the majority of Specialty/Discipline codes, which are two characters, the 3rd character space must be left blank if the 4th character extension is used. The 4th character is an Optional extension of the code for local special interests.

The Specialty/Discipline code should be entered in the character spaces provided and left justified.

Points to Note

A separate SMR record is prepared when a patient changes Specialty, Significant Facility or Consultant on medical grounds
GPs: Patients under the care of a GP in a GP hospital must be given the Specialty code E12 (GP other than Obstetrics) regardless of whether the patients are in a short stay or long stay facility.
Staff Wards: The Specialty recorded is that of the consultant/GP in charge of the patient. Record Significant Facility as 11 (Other: including all Standard Specialty Wards, Clinical Facility 1K, Day Bed Unit 1J).
Younger Physically Disabled: Record the Specialty of the consultant in charge of the patient, which will usually be geriatric medicine. Record Significant Facility as 18 (Ward for Younger Physically Disabled) or 1E (Long Stay Unit for Care of the Elderly).
See additional notes under Significant Facility.
For SMR02 records this should reflect the speciality of the person who was responsible for the care for the mother on original admission.
Example 1- If the mother was originally admitted under the care of a midwife in an Alongside Midwifery Unit (AMU) or Freestanding Midwifery Unit (FMU), then the midwifery specialty should be recorded in this section, irrespective of whether the mother was then transferred to an Obstetric unit during labour/delivery. When a transfer has occurred Speciality should NOT be attributed to Obstetrics.

Example 2 - If the mother was originally admitted under the care of a Consultant in an Obstetric Unit then the Obstetrics specialty should be recorded here.

Cross Checks

Specialty is checked against Location Code.
Specialty is checked against Consultant.
Specialty is checked against the Patients Age (at Date of Admission).
Specialty is checked against Duration of Stay calculated between Date of Admission and Date of Discharge.
Specialty is checked against Record Type
Specialty is checked against Significant Facility.

Specialty/Discipline

Format
Characters

Field Length
6
Priority
Mandatory

Definition
This item should be seen as describing the main medical (or social) condition managed/investigated during the patients stay.

Recording Rules
The main condition is the condition, diagnosed at the end of the episode of health care, primarily responsible for the patients need for treatment or investigation. If there is more than one such condition, the one held most responsible for the greatest use of resources should be selected. If no diagnosis was made, the main symptom, abnormal finding, or problem should be selected as the main condition.

Points to Note

For patients who have died, the main condition is not necessarily the same as the condition recorded as the cause of death.
The main condition should be decided by a senior member of the medical staff and recorded in the agreed place in the case notes, on the appropriate form or computer system.
If the main condition is coded to a pair of dagger and asterisk codes, the dagger should be entered as main condition.
If the main condition is an injury or other condition due to an external cause, the injury or condition should be entered as main condition with the external cause code following the injury (or injuries).
In the case of the admission record for SMR04 the admission diagnosis would be as defined in the recording rules (but as diagnosed at the beginning of the episode of healthcare). Further guidance is given in the SMR04 section of the electronic data manual.
Cross Checks

A check is made that each Diagnosis Code is valid as defined by the ICD classification. If not, an error will be reported.
A check is made that the use of the code (although listed in the ICD Classification) is actually permitted on the record type. If a discrepancy is found, an appropriate error or query will be reported.
Main condition is cross-checked against:
Sex
Age (except SMR02)
Rarity (except SMR00, and SMR02)
Admission Type (SMR01)
Length of Stay (SMR01 and SMR04)
Waiting Time (SMR01 only)
Discharge Type (SMR01)
Condition on Discharge (SMR02 only)
SMR Validation - Main Condition

Tags:
medical  social  managed  investigated  patient  stay  diagnosed  treatment  ICD10  classification  code  SMR00  SMR01  SMR02  SMR04

Main Condition/Principal Diagnosis/Problem Managed - ICD10

General Clinical Information

Format
Characters

Field Length
6

Priority
Local

Definition
In addition to the main condition, the record should, whenever possible, also list separately other conditions or problems dealt with during the episode of health care. Other conditions are defined as those conditions that co-exist or develop during the episode of healthcare and affect the management of the patient. Conditions related to an earlier episode that have no bearing on the current episode should not be recorded.

For further information on co-morbidities and other conditions, please refer to the Scottish Clinical Coding Standards, (in particular Coding Guidelines 21 November 2007) as held on the Terminology Website

Points to Note

Up to five other significant conditions may be recorded for SMR01 returns.
Other conditions should be recorded according to the rules outlined in Coding Guidelines 21 November 2007.
From April 2020,this data item is no longer required for national collection on SMR00, though may still be collected locally.
Priority changed from Mandatory (where applicable) to Local.
Cross Checks

As for main condition.
A main condition must be recorded before the Other Condition fields can be completed.
SMR Validation - Other Conditions

Tags:
addition  main  episode  problem  management  patient  coding  guidelines  care  significant  ICD10  SMR00  SMR01  SMR02  SMR04

Other Condition/Co-morbidity and Complication ICD10 1

Other Condition/Co-morbidity and Complication ICD10 2

Other Condition/Co-morbidity and Complication ICD10 3

Other Condition/Co-morbidity and Complication ICD10 4

Other Condition/Co-morbidity and Complication ICD10 5

Format
Characters

Field Length
8

Priority
Conditional

Definition
Main Operation/Treatment/Investigative Procedure/Intervention are those aspects of clinical care carried out on patients undergoing treatment:

for the prevention, diagnosis, care or relief of disease
for the correction of deformity or deficit, including those performed for cosmetic reasons
associated with pregnancy, childbirth or contraceptive or procreative management
Typically this will be:

surgical in nature: and/or
carries a procedural risk: and/or
carries an anaesthetic risk: and/or
requires specialist training: and/or
requires special facilities or equipment only available in an acute care setting.
Points to Note

Please refer to the general rules for recording operations/procedures.
Cross Checks

A check is made that each Operation Code is valid as defined by the OPCS Classification. If not, an error will be reported.
A check is made that the use of the OPCS code is actually permitted on the record type. If a discrepancy is found, an appropriate error or query will be reported.
If Main Operation is specified, but the Date of Main Operation is not given, an error will be reported.
Each operation can have one or two codes. Checks are made to ensure that an Approach, Technique, Site or Laterality code is not supplied on its own or with another such code. If it is an error will be reported.

SMR01
If a code is recorded in the second field of a pair as well as the first field, checks are made to ensure that either:
the two codes are a recognised pair or
the code in the second field is from one of the subsidiary Y or Z chapters.
For any two consecutive single-coded operations, a check is made to see if these could be combined as one dual-coded operation. If this is possible, a query is reported.
If the patient is a Day Case, a further check will be made on each Operation code to ensure that the Operation is appropriate for such cases. If not, an error or query will be reported.
If the patient is an Outpatient, a further check will be made on each Operation code to ensure that the Operation is appropriate for such cases. If not, a query will be reported.
Each Operation code is checked to ensure that it is compatible with the stated Sex.
If a discrepancy is found an error or a query will be reported.
SMR Validation - Main and Other Operation/Treatment/Investigative Procedure

Tags:
clinical  care  patients  code  classification  undergoing  treatment  surgical  anaesthetic  acute  SMR00  SMR01  SMR02  SMR04

Main Operation/Treatment/Investigative Procedure/Intervention - OPCS4

Format
Characters

Field Length
8

Priority
Conditional

Definition
These are the additional procedures performed on an individual patient at a particular time.

Points to Note

Up to three pairs of procedures, in addition to the main procedure, may be recorded for an inpatient or day case episode on the central return. Therefore, if more than four procedures are performed during an episode of care, the clinicians opinion should be sought on which are the most significant. Local systems may allow more than four procedures to be recorded.
Cross Checks

These are detailed in Main Operation/Treatment/Investigative Procedure/Intervention.
SMR Validation - Other Operation

Tags:
additional  patient  inpatient  day  case  episode  performed  SMR00  SMR01  SMR02  SMR04

Other Operation/Treatment/Intervention/Investigative Procedures - OPCS4 1

Other Operation/Treatment/Intervention/Investigative Procedures - OPCS4 2

Other Operation/Treatment/Intervention/Investigative Procedures - OPCS4 3

Format
Date (ddmmyy)

Field Length
6

Priority
Conditional

Definition
This reflects the date the main operation was performed.

Recording Rules
The full date should be entered thus: 5 July 2004 = 05/07/04

Cross Checks

Date of Main Operation is checked to ensure it is in the correct sequence with other dates recorded.
An error will be reported if there is a Main Operation recorded but the Date of Main Operation has been omitted.
An error will be reported if an entry has been made for Date of Main Operation, but the Main Operation has been omitted.
SMR Validation - Date of Main Operation/Treatment/Investigative Procedure

Tags:
sequence  reported  performed  SMR00  SMR01  SMR02  SMR04

Date of Main Operation/Treatment/Investigative Procedure/Intervention

Format
Date (ddmmyy)

Field Length
6

Priority
Conditional

Definition
This reflects the date the other operation was performed.

Recording Rules
The full date should be entered thus: 5 July 2004 = 05/07/04

Cross Checks

Date of Other Operation is checked to ensure it is in the correct sequence with other dates recorded.
SMR Validation - Date of Other Operation

Tags:
performed  sequence  recorded  SMR00  SMR01  SMR02  SMR04

Date of Other Operation/Treatment/Intervention/Investigative Procedures 1

Date of Other Operation/Treatment/Intervention/Investigative Procedures 2

Date of Other Operation/Treatment/Intervention/Investigative Procedures 3

Format
Characters

Field Length
2

Priority
Optional

Definition
Ethnic group classifies the person according to their own perceived ethnic group and cultural background. (Scotland Census)

Points to Note

This is included as an Optional item, but may be made Mandatory at a later date in order to conform to UK-wide requirements.
This is the patients perception of his or her own ethnic group, and is intended to assist the monitoring of equality of access to NHS services..
For the A&E datamart, please ensure this data item is as complete as possible
Cross Checks
None.

Notes
The following list is the current ethnicity classification (2011 Census categories). This should be used by NHS Scotland organisations for local and SMR return purposes. Local systems may record more detailed codes as required but these must map to the categories for SMR return purposes.

The letters that appear in the group headings in the codes and value list refer to positions in the census list and are not valid SMR codes. Please only use the codes in the code list (1A, 1B etc.).

Codes and Values: Ethnic Group (Code order)

Group A - White
1A Scottish
1B Other British
1C Irish
1K Gypsy/ Traveller
1L Polish
1Z Other white ethnic group

Group B - Mixed or multiple ethnic groups
2A Any mixed or multiple ethnic groups

Group C - Asian, Asian Scottish or Asian British
3F Pakistani, Pakistani Scottish or Pakistani British
3G Indian, Indian Scottish or Indian British
3H Bangladeshi, Bangladeshi Scottish or Bangladeshi British
3J Chinese, Chinese Scottish or Chinese British
3Z Other Asian, Asian Scottish or Asian British

Group D - African
4D African, African Scottish or African British
4Y Other African

Group E - Caribbean or Black
5C Caribbean, Caribbean Scottish or Caribbean British
5D Black, Black Scottish or Black British
5Y Other Caribbean or Black

Group F - Other ethnic group
6A Arab, Arab Scottish or Arab British
6Z Other ethnic group

Group G - Refused/Not provided by patient
98 Refused/Not provided by patient

Group H - Not Known
99 Not Known

SMR Validation - Ethnic Group

Tags:
ethnicity  classification  census  person  perceived  cultural  background  categories  SMR00  SMR01  SMR02  SMR04

Ethnic Group

Patient Identification and Demographic Information

Format
Integer

Field Length
1

Priority
Local

Definition
A categorisation which divides the Scottish population into five equal categories based on the range of SIMD scores so that 20% of the population falls into each quintile (population weighted). 

Points to note

For SIMD2016 
Most Deprived Quintile = 1
Least Deprived Quintile = 5

SIMD Scotland Quintile

The index is an area based measure, calculated at data zone level and has seven domains (income, employment, education, housing, health, crime and geographical access). These have been combined into an overall index. Please note that SIMD values may appear for records prior to 1999, however ISD recommendations are to use SIMD for trend analyses from 1999 onwards. For trend analyses back to 1991, use the 2001 census based Carstairs deprivation.
For trend analyses back to before 1991, use the 1991 census based Carstairs deprivation. See the ISD website for further information.
Please indicate which SIMD version you would like for each selected variable.
 
Note on change in ordering of quintiles and deciles
Following the release of the SIMD 2009, ISD changed their ordering of quintiles and deciles to fit with the method that is used by the Scottish Government
(SG). For SIMD 2009, SIMD 2012 and future releases, the method is now: 1 = MOST deprived, 5 or 10 = LEAST deprived
 
 ISD analyses based on SIMD 2006 or SIMD 2004 will be left in their current format:  1 = LEAST deprived; 5 or 10 = MOST deprived. 
To avoid confusion, deprivation categories should always be fully labelled. For example, for SIMD 2012, 'decile 1 (most deprived)'… 'decile 10 (least deprived)'.
For time trend analyses combining SIMD 2004/2006 with SIMD 2009/2012 it is important to treat all deciles and quintiles in the same way. SIMD 2004/2006 deciles/quintiles should be reversed from 1=LEAST deprived, 5 or 10=MOST deprived to 1=MOST deprived, 5 or 10=LEAST deprived in order to keep the same convention for the deciles and quintiles throughout the analysis.

Scottish Index of Multiple Deprivation (SIMD)

The Brain Health Data Pilot (BHDP) project aims to be a shared database (like a library) of information for scientists studying brain health, especially for diseases like dementia, which affects about 900,000 people in the UK. Its main feature is a huge collection of brain images linked to routinely collected health records, both from NHS Scotland, which will help scientists learn more about dementia and other brain diseases. What is special about this database is that it will get better over time – as scientists use it and add their discoveries, it becomes more valuable. 

This is a subset of the Outpatient Appointment and Attendances (SMR00) dataset for use in the Brain Health Data Pilot (BHDP) project. 

An SMR00 is generated for outpatients receiving care in the specialties listed when:

-they attend a medical consultant outpatient clinic;
-they meet with a consultant or senior member of his/her team outwith an outpatient clinic session (including the patient's home).
-they attend a clinic run by a nurse or an AHP identified as the Health Care Professional Responsible for Care for that clinic and who has legal and clinical responsibility for that patient.

The dataset is generally fully complete and ready for analysis three month preceding the current date.  So for example at the end of August, data is available until the end of May.

BHDP - Outpatient Appointments and Attendances - SMR00

The index is an area based measure, calculated at data zone level and has seven domains (income, employment, education, housing, health, crime and geographical access). These have been combined into an overall index. Please note that SIMD values may appear for records prior to 1999, however ISD recommendations are to use SIMD for trend analyses from 1999 onwards. For trend analyses back to 1991, use the 2001 census based Carstairs deprivation.
For trend analyses back to before 1991, use the 1991 census based Carstairs deprivation. See the ISD website for further information.
Please indicate which SIMD version you would like for each selected variable.
 
Note on change in ordering of quintiles and deciles
Following the release of the SIMD 2009, ISD changed their ordering of quintiles and deciles to fit with the method that is used by the Scottish Government
(SG). For SIMD 2009, SIMD 2012 and future releases, the method is now: 1 = MOST deprived, 5 or 10 = LEAST deprived
 
 ISD analyses based on SIMD 2006 or SIMD 2004 will be left in their current format:  1 = LEAST deprived; 5 or 10 = MOST deprived. 
To avoid confusion, deprivation categories should always be fully labelled. For example, for SIMD 2012, "decile 1 (most deprived)"… "decile 10 (least deprived)".
For time trend analyses combining SIMD 2004/2006 with SIMD 2009/2012 it is important to treat all deciles and quintiles in the same way. SIMD 2004/2006 deciles/quintiles should be reversed from 1=LEAST deprived, 5 or 10=MOST deprived to 1=MOST deprived, 5 or 10=LEAST deprived in order to keep the same convention for the deciles and quintiles throughout the analysis.

BHDP - Outpatient Appointments and Attendances - SMR00

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