Emergency Care Data Set (ECDS) General Show and Tell No.11, 04 October 2017 Peter Sherratt, ECDS implementation lead (NHS Digital) Lizzie Poole, Information team (Nottingham University Hospitals FT) Dr. Steve Moore, Clinical champion (Countess of Chester FT) Richard Carpenter, ECDS implementation team (NHS Digital) Steve Fenner, SUS+ team (NHS Digital) Pat Carter, ECDS business analyst (NHS Digital) Iain Wallen, Director of information and analytics (NHS Improvement) Version: v1.0 The ECDS project is a collaborative project between the Department of Health, the Royal College of Emergency Medicine, NHS England, NHS Digital, NHS Improvement, NHS Providers and Public Health England. This document has been produced on behalf of the ECDS Project Board in collaboration with the organisations listed above.

New: Includes all webinars and downloads Before we start We are recording the webinar for the benefit of others Most people will be muted – please send your comments and questions via the WebEx chat function to Rozanne Addams We’ll share the slides etc. after the meeting Supporting documents are available on the ECDS web page (www.content.digital.nhs.uk/ECDS/ECDS-supporting-documentation) New: Includes all webinars and downloads Next general show and tell is 8th November @ 2pm Send your comments to : ECDS@nhs.net

On this afternoon’s call: Live site feedback Clinical champion update Case studies and early adopters ECDS extract formats Corrigendum and updated SNOMED sub-sets DQ Streaming update QA session

Quick progress update: About 15% of the NHS is now live with ECDS SUS+ is receiving data Crib sheets are being printed and sent to Trusts http://content.digital.nhs.uk/ECDS Request for help with a special project – commissioners

ECDS Go Lives The following providers have advised us they are live with ECDS: Airedale NHS Foundation Trust Bedford Hospital NHS Trust Buckinghamshire Healthcare NHS Trust Cambridge University Hospitals NHS Foundation Trust Croydon Health Services NHS Trust Manchester University NHS Foundation Trust Countess Of Chester Hospital NHS Foundation Trust (daily) Doncaster and Bassetlaw Hospitals NHS Foundation Trust Hampshire Hospitals NHS Foundation Trust North West Anglia Trust (Hinchinbrooke Hospital) Nottingham University Hospitals NHS Trust Royal Berkshire NHS Foundation Trust Salford Royal NHS Foundation Trust Shrewsbury and Telford Hospital NHS Trust Surrey and Sussex Healthcare NHS Trust The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust University Hospital Southampton NHS Foundation Trust University Hospitals Bristol NHS Foundation Trust Warrington and Halton Hospitals NHS Foundation Trust

Feedback from Nottingham Lizzie Poole – Nottingham University Hospitals NHS Trust

Clinical Champion Update Dr. Steve Moore, Countess of Chester Hospital NHS Foundation Trust

ECDS Case Studies We are working with 6 early adopters across the country to produce a series of case studies The aim is to provide ‘real-life’ examples of what it takes to implement ECDS and what the benefits are Focusing on: Project Management – Buckinghamshire Healthcare NHS Trust Nursing – Nottingham University Hospitals NHS Trust Doctors – Countess of Chester Hospital NHS Foundation Trust Administrators – Hampshire Hospitals NHS Foundation Trust Service Managers – The Hillingdon Hospitals NHS Foundation Trust Commissioners – Rotherham CCG Target completion date is November 2017

ECDS Feedback Over the last few weeks, multiple requests have been sent to the ECDS mailbox with suggested diagnoses. This has led to amendments such as ‘Viral Wheeze’ We are in the process of creating a feedback webpage to formalise these requests A flowchart to assist decision making has also been created Your suggestions have been captured for discussion by the ECDS maintenance group

No No Is this purely a symptom? i.e. Chest Pain, Abdominal Pain etc. Yes – ECDS doesn’t code symptoms No Please check the diagnosis doesn’t already exist in the ECDS data set No Yes – Please use this code. It may be worthwhile checking how the search for this term can be improved Is the diagnosis you wish to add a sub-set of a pre- existing ECDS diagnosis or closely approximate to an existing diagnosis? Yes – use this higher level code No – send code to feedback web page

SUS+ update Presented by Steve Fenner

Key points: CDS010 (A&E) extract will remain unchanged An additional extract is available – ECDS (CDS011) mapped into CDS010 (A&E) “backward compatible” A new extract in CSV format will be available A new extract in JSON format will be available Timescales for schemas IGARD process for DSCROs

Corrigendum – October 2017 Presented by Pat Carter

Corrigendum WHY do we need a corrigendum? Information Standard published in April 2017 Minor errors identified in Technical Output Specification (TOS) - Need to update to v1.01 WHAT are the changes? Truncation issue on 9 x ‘Safeguarding’ SNOMED CT codes e.g. Injury Flag set incorrectly on 1 x diagnosis: SNOMED CT code =128351009 (Infection of eye (disorder) – Inj_Flag = 1 corrected to 0 Typo’s, spelling mistakes e.g. Patient Identity tab - PATIENT PATHWAY - VERIFIED IDENTITY STRUCTURE corrected to PATIENT IDENTITY - VERIFIED IDENTITY STRUCTURE Previous Corrected SNOMED CT Description 1076841000000100 1076841000000104 At risk of radicalisation (finding)

Corrigendum WHAT are the changes (cont.)? Corrections to ECDS Unique ID’s, Sort Codes and Descriptions 1 x Comorbidity, 1 x Diagnosis, 1 x Treatment e.g. Diagnosis Inclusion of omitted Treatment code to allow differentiation of sedation and anaesthesia Added 1 x SNOMED CT code = 398239001 (Monitored anaesthesia care sedation (procedure) ) CQUIN flag set incorrectly on ‘EC Attendance Activity Characteristics’ tab Acuity and Chief complaint have ‘CQUIN data item required’ column set to N, now corrected to ‘Y’ Status ECDS UniqueID Sort1 Sort2 Sort3 SNOMED CT Description Previous 1616131000 61 31 corneal burn (disorder) Corrected 1616130000 30 Welders' keratitis (disorder)

Change outside of the Corrigendum Some ECDS SNOMED CT subsets were updated on Oct 1st Background Every April and October there is a SNOMED CT update This may / may not affect ECDS subsets Some changes are outside our control (e.g. If a SNOMED CT code is retired or replaced) Some changes we can request (e.g. A new diagnosis SNOMED CT code for an ECDS subset) Key Points for ECDS No requirement to change anything immediately – all SNOMED CT codes in the TOS are still valid Optionally you may use some / all the new SNOMED CT codes in the ECDS subsets on TRUD The TOS and the TRUD SNOMED CT subsets are now slightly out of step All SNOMED CT codes in the TOS AND the TRUD will be accepted by SUS+ and valid for CQUIN analysis If you download the subsets from TRUD some existing codes may have been replaced We plan to update the mappings document to allow for the new codes

DQ Feedback Presented by Pete Sherratt

Key points about DQ feedback: Initially we’ll focus on diagnosis and chief complaint (for CQUIN) We’ll then increase the sophistication For example: More timely feedback Presenting DQ metrics in PowerBI Additional checks and metrics

Streaming Presented by Pete Sherratt and Iain Wallen

Key points about streaming 4-hour standard Existing guidance is applicable for 4-hour wait (link) See guidance relating to “campus” Co-located GP services We need to clearly identify patients who have been streamed to co-located services Precise guidance is in progress Full guidance is under production

QA session Presented by Peter Sherratt

Investigation mapping

Next webinar is 8th November @ 2pm Future webinars…. They’re totally open – invite anyone Future topics will include: Lessons learned The maintenance of ECDS Let us know anything particular you’d like us to cover again or in more detail Next webinar is 8th November @ 2pm Send your comments to : ECDS@nhs.net