Health Department

St Andrew's House
EDINBURGH EH1 3DG

Dear Colleague

COLLECTION OF INFORMATION ON THE TREATMENT OF NHSSCOTLAND PATIENTS BY THE INDEPENDENT HEALTHCARE SECTOR

Summary

1 . This Circular updates the instruction issued in NHS MEL (1995)36 and requires Health Boards/NHS Trusts to stipulate in all arrangements with independent healthcare providers that appropriate Scottish Morbidity Record (SMR) data for all NHSScotland patients treated should be submitted to the Information and Statistics Division (ISD) of the Common Services Agency.

Action

2. Health Boards and NHS Trusts must take steps to ensure that all current and future arrangements with independent healthcare providers for the treatment and care of NHSScotland patients require the prompt submission of standard SMR data to ISD.

3. Health Boards are requested to pass copies of this Circular to all independent healthcare providers within their respective areas.

Yours sincerely

GERRY MARR
Director of Planning and Performance Management

6th July 2001

______________________________

Background

SMRs in respect of NHSScotland patients treated in the independent healthcare sector are currently being submitted to ISD, but there are significant omissions. As care is being purchased for these patients with NHSScotland funds, it is important to account for this activity. In addition, for epidemiological purposes and the future planning of health care by groups such as the Coronary Heart Disease Taskforce, it is necessary to have access to information on care obtained for NHSScotland patients from any source.

Data Collection

2. The Health Board or NHS Trust which initiates an agreement with an independent healthcare provider for the treatment and care of NHSScotland patients is required to ensure the submission of an appropriate and accurate SMR dataset to ISD. This requirement applies to all acute and continuing care episodes.

The Independent Sector

3. The independent healthcare sector is defined and regulated under the Nursing Homes Registration (Scotland) Act 1938 (this equates currently to 9 registered private hospitals and clinics, 14 adult voluntary hospices and 3 laser clinics).

4. Services included in this definition are:-

• Private and voluntary acute hospitals
• Private and voluntary psychiatric hospitals unless registered under Part IV of the Mental Health (Scotland) Act 1984
• Private and voluntary maternity hospitals and homes
• Hospices for the terminally ill
• Any premises (unless specifically excluded) where:

- surgical procedures are carried out under general or local anaesthesia
- pregnancies are terminated
- endoscopy is carried out
- haemodialysis or peritoneal dialysis is carried out

SMR Data Records

5. The SMR record type submitted will depend on the type of care the patient receives
and will be one of the following for each episode of care:-

• General/Acute Inpatients And Day Cases (SMR01)
• New Outpatients (SMR00)
• Maternity (SMR02)
• Neonates (SMR11)
• Mental Health (SMR04)
• Geriatric Long Stay (SMR50)
• Cardiac Surgery (SMR20)

6. Hospitals in the independent sector should continue to supply Scottish Cancer Registry data to ISD.

The Data Collection Process

7. Managing the data collection process and ensuring its timely and accurate submission to ISD is the responsibility of the NHS Trust or Health Board initiating the agreement with the independent healthcare provider.

8. It may be appropriate to send a partially complete SMR dataset to the independent healthcare provider prior to the patient attending, with the site then completing the remainder of the record on discharge, for submission either directly to ISD or via the initiator of the agreement.

9. It will be necessary for NHS Trusts/Health Boards to maintain an independent count of the number of such referrals to independent healthcare providers, for reconciliation with the number of SMR records received by ISD.

10. In common with the general strategy on data submission, the use of paper as a transmission medium should be avoided if at all possible. Options in this regard may be discussed with ISD.

Documentation and training

11. Details of the SMR datasets are set out in the SMR Data Manual, and are available in
paper or electronic format to those requiring further information.

12. Where independent hospitals require assistance with staff training to complete the
datasets and/or the implementation of SMR data recording, this will be provided on request by the Scottish Clinical Coding Centre, Information and Statistics Division (ISD), Trinity Park House, South Trinity Road, Edinburgh 0131- 551 - 8345. Please direct requests or queries to Mr Chris Jones in the first instance.