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Waiting time standard applied (WT4)
Initial analysis of national test data suggest there is considerable under recording of the mandatory field WT4. Recording of tis item is essential for reporting performance against waiting times standards. [7 April 2008] 

National waiting times standards for cataract, cardiac surgery and rapid access chest pain clinic
You may recall that the national New Ways validation on operation and procedure code was revised in December 2007, to allow 'nulls' to be valid. This change was as a result of requests from NHS Board colleagues.

This change impacts to a degree on the use of national information for reporting on waits for some procedures, however there is clearly a continued need to be able to report on waits for procedures that are covered by specific national waiting times standards, e.g. cataract and cardiac surgery which are recording and reporting requirements which pre-date New Ways. This means that recording of procedure code for patients waiting for all cataract and cardiac surgery services is mandatory on New Ways; details on required codes are set out below:

Cataract
Main Operation (OPCS4)  'C71' to 'C75' inclusive and Waiting Times Standard Applied Code (WT4) - code  '021' for whole journey target [this should be left BLANK to allow identification of waits for 'second eye' operations]

Cardiac Surgery
·         Main Operation (OPCS4)  'K25' to 'K36' inclusive (valve surgery)
·         Main Operation (OPCS4)  'K63', 'K65', 'U102' or 'U105' (angiography)
·         Main Operation (OPCS4)  'K40' to 'K46' inclusive (CABG)
·         Main Operation (OPCS4)  'K49', 'K75' or 'K501' (angioplasty)

Rapid Access Chest Pain Clinics
Rapid Access Chest Pain Clinics must be identified by using the correct code for Waiting Time Standard Applied Code (WT4)

From discussions with contacts in some NHS Boards this clarification on national requirements is not considered likely to cause additional work, as NHS Boards were already obliged to capture this information as part of monitoring of national waiting time standards. [7 April 2008] 

Date of removal from list (WT27)
Initial analysis of national test data suggests under recording of this date in some Boards. This is an issue because WT27 is included in the calculation to determine waiting time. If WT27 is not recorded, then waiting lists will be over-reported (and the associated waits), and, of course, such cases cannot be incorporated in the calculation of waiting times for completed waits.  Other information will also be impacted, e.g., numbers removed from the list. [7 April 2008]

Reason for removal from list (WT28) – Transfers to another NHS Boad area
There are a number of issues emerging regarding the coding for transfers e.g. where the management of a patient is transferred that ISD would like to give clarification on. Transfer to another NHS Board Area (code 59) should only be used where the patient, and the responsibility for their wait, is being transferred to a different Waiting List e.g. from Consultant to Consultant/ Hospital to Hospital etc. When using code 59 it is imperative that the original information on the patient's wait is recorded on the new Waiting List entry, including the original date placed on waiting list. Where the patient's wait is still under your responsibility, you will require to record, and provide, all information on the patient's wait. Recording WT28 correctly will avoid waiting times cases being inadvertently ‘lost’ to reporting and will ensure that there is no double counting. [7 April 2008]

Recording of Location Code & Provider Code
Provider Code should relate to the actual physical location where the treatment is expected to take place. This rule has implications when it is known that patients will definitely be treated out with their own Board area in that a provider code other than the default ‘home’ HB code must be recorded. This situation will invariably occur for a range of specialist services, e.g., cardiac surgery, angioplasty & neurophysiology.  Thus, for example, as elective angiographies are not carried out within Fife and Forth Valley then angiographies cannot be recorded within New Ways against any Fife or Forth Valley locations or, of course, Fife or Forth Valley as provider. Guidance on the recording of location & provider codes was issues by ISD on 20 July 2007. [7 April 2008]

Waiting times target cohort
ISD would like to give clarification on the criteria that form the waiting times target cohort under New Ways. The following information is used to determine the new ways waiting times cohort:  

·         Scotland resident
·         NHS patient
·         GMP / GDP referral (for new outpatients)
·         Clinic  Type –  Consultant or Dentist: Clinic type is derived from HCP responsible for care
·         Obstetrics and mental health specialties are excluded
·         Homeopathy is excluded for new outpatients

[7 April 2008]

New Ways Scenarios
The New Ways scenarios document contains ten scenarios which together cover the eight broad categories of New Ways patient journeys (i.e. combinations of DNA/CNA, unavailability, multiple offers).  Although these 10 scenarios won't cover every possible type of New Ways journey, they are in combination expected to encompass the vast majority of episodes (i.e. the 'no DNA/CNA, no unavailability, no multiple offer' scenario itself is expected to cover the majority of episodes). These scenarios are provided for Boards/system users to use on local systems, if they wish,  there is no national requirement to undertake this testing.  However, for those boards who do wish to test these scenarios then local results can be compared with results produced from the national warehouse (i.e. calculation of wait). It should be noted that this scenario testing is not intended to assist Board colleagues in assessing local interpretation and recording of New Ways scenarios, rather to help assess whether local systems / extracts produce the 'expected' data from these scenarios.New Ways Scenarios - 27 March 2008 [1 April 2008]

Validation - VE59a
Please note that Validation Check VE59a - Reason for removal from list must be entered when a date of removal from list has been entered. This check was originally an error, ISD then advised that it was to be removed. It has now come to our attention that this was a mistake on ISD's part. VE59a has now been reinstated in the warehouse validation as an error. It is classified as an error as it is a data item necessary for calculation of waiting times statistics. It is ISD's understanding is that this change to VE59A will not be an issue for the majority of Boards, and that the one Board for whom this change does have an impact has already been alerted by ISD staff. [26 March 2008]

Forthcoming Data Warehouse Meeting -
ISD will be hosting another Data Warehouse Meeting at St John's Hospital in the Pentland Room on Tuesday 8 April 2008, in advance of the next Chief Executive Meeting which will be held in mid April. Arrivals from 09.30, meeting start at 10.00 until 13.00. A working lunch will be served.  Topics to be covered include; Data Quality - Completeness and Accuracy;Data Fitness for Purpose; Go Live; Publications Plan. If you wish to attend this meeting or if you would prefer to join by videoconference please contact Alison Horne - e-mail alison.horne@isd.csa.scot.nhs.uk tel - 0131 275 6022 at your earliest convenience. [26 March 2008]

Data Quality
Recent New Ways Data Task Force attention has been focused on levels of data validity, however, now that most of Scotland is reaching high levels of data validity, ISD are expecting that following the New Ways Data Task Force meeting on Thursday 27 March, the focus will move towards 'completeness' i.e. does the data that is being sent to the warehouse cover all waiting times episodes for January and February 2008, and 'accuracy' i.e. do Boards recognise waiting times being reported from warehouse, especially around longer waits. Once ISD has confirmation of this change of approach we will contact New Ways leads more detail on these measures. [26 March 2008]

Milestones and Timetables
John Connaghan of Scottish Government Health Department wrote to Chief Executives on 12 March 2008 outlining the following: "In terms of milestones, we agreed at Chief Executives to aim for submissions of satisfactory data by 21 March".  ISD can now able to give some further clarity and advise of some alteration to this requirement, in light of discussions resulting from the Task Force. The Task Force have now confirmed their next meeting will be held on Thursday 27 March. As the Task Force have asked ISD to report the latest possible position at this meeting, ISD can now advise that Boards may now submit data up to midday of Tuesday 25 March. Boards are asked to ensure they submit all new outpatient, daycase and inpatient waiting times data for 1 January - 29 February 2008 by midday Tuesday 25 March. The measure for validity as defined by the Task Force is at least 95% of the 100% of submitted PAS data for the time period to be accepted into the data warehouse. Any Board or site who will be making submissions  > 100,000 records are asked to contact Nicole Allan (nicole.allan@isd.csa.scot.nhs.uk) to discuss specific timing for these. As previously outlined planned repeats and AHP data are not mandated for central submission although Boards are welcome to submit this if required for future local use. Although return outpatients for procedure are part of the waiting times cohort and mandated for central submission, ISD have been advised anecdotally that there are issues with the collection of this information. With respect to the submission of data for the 25 March deadline, ISD accept that Boards may prefer not to submit this data. ISD will be re-considering its inclusion in the first quarters reporting. ISD will analyse the data warehouse reporting back on validity of data submitted for the Thursday 27 March Task Force meeting. Boards may continue to submit data after Tuesday 25 March, please note however that these will be queued until after the snapshot for the Task Force validity measure is taken after which they will be processed as normal. [20 March 2008] 

Data Submission Numbers and File Names
Boards must ensure that they use the correct submission numbers and filename format when submitting data. Failure to do so means that manual intervention is required and staff have to spend time correcting these which in turn slows down the rate that processing can occur for all Boards so it is to everyone's benefit. If Boards can address this issue, then automatic loading can be switched on which will speed up the entire process of submitting data. [20 March 2008] 

Monitoring of Data Completeness and Quality
The most immediate focus for data submission is 'validity' which will be reported to the Task Force on Thursday 27 March, however in the days and weeks ahead in the run up to the snapshot on 7 May and the publication of first quarter data on 27 May, the focus will shift to data quality and completeness, and we are very keen to ensure that ISD supports Boards in this work.  [20 March 2008]

Firstly Boards with support from ISD staff, look at apparent anomalies in calculated wait that are being caused by error on the underlying data, i.e. periods of unavailability missing. As outlined in my e-mail last week some Boards are reporting  high levels of such anomolies in the statistics which are at odds with their local findings. There are various reasons why this might be the case and therefore Boards are strongly recommended to start looking at these figures as soon as possible. If you have access to Business Objects you will be able to run these reports from the national data warehouse locally, however if you are not in a position to do this or you experience any difficulty with running reports please contact Angela Forbes (angela.forbes@isd.csa.scot.nhs.uk) or Stephen Bush (stephen.bush@isd.csa.scot.nhs.uk).

In terms of data completeness, ISD will be comparing  data submissions for January and February 2008 against historic SMR1, SMR3 and OPWL submissions. Significant differences between historic and new data may point to issues with extraction of data and ISD will offer advice to Boards who wish to investigate any differences. Please contact Stephen Young (stephen.young@isd.csa.scot.nhs.uk) to discuss further. [20 March 2008] 

Monthly Monitoring Information (MMI)
ISD will not be producing an MMI report from  the warehouse on the 21 March. This has been agreed with colleagues in the Scottish Government Health Directorate. This will allow us to focus resources on  supporting Boards with quality and completeness work.  [20 March 2008] 

Go Live 
ISD would like to take this opportunity to reiterate the main points in relation to 'going live' (production) as we have had requests for further clarification:  The decision to go live for an individual Board is dependent on the Boards and ISD being satisfied that their data is of high enough quality, validity and completeness to be deemed appropriate for loading into the live warehouse environment. Going into production will have a number of impacts for Boards:

• Error reporting: Currently, each time an extract is submitted to the warehouse, an error report is generated and an report in Excel is e-mailed back to the submitting site. This report contains both errors and warnings. At the moment this is done manually, but once the data warehouse goes into production, Boards will instead receive an automated e-mail containing high level results. In order to obtain the detailed report you need to be able to run the BO report using the New Ways universe. Until you are in a position to access BO and do this, you will not benefit from going live.
  
• Files with incorrect filename format, submission numbers or headers will automatically be rejected so if you have not resolved these issues going live may increase resource requirement if files need to be corrected and resubmitted.
  
• Boards who wish to discuss going live should in the first instance contact Angela Forbes (angela.forbes@isd.csa.scot.nhs.uk) or Stephen Bush (stephen.bush@isd.csa.scot.nhs.uk) for further advice.

[20 March 2008]

Data Validation
As you will no doubt be well aware ISD have been working with NHS Boards requests to review and revise the validation that has been applied. A list detailing these changes is attached for your information. Angela Forbes has updated a document which compares the current data validation in comparison with the Appendix 5 data validation specification of 28 February 2007 that was last updated in December 2007. This list includes all of the current validation and is attached.  Some of you  have noticed that some validations have been tightened. The need for this has arisen from ongoing analysis of test data and is necessary to ensure calculation of wait is correct. These changes have been implemented in the warehouse over a number of weeks, but have only been picked up by some hospitals recently. I apologise for not making this explicit in earlier communication on the subject. Both the comparison document and the list of changes are available on the New Ways website data warehouse section: http://www.isdscotland.org/isd/4866.html . [14 March 2008]

Errors and Warnings
ISD have had a request for some clarification on errors and warnings: 

• A record with a warning will go into the warehouse
• A record with an error does not go into the warehouse
• Some 'errors' have been re-classified / downgraded to warnings, so where these would previously have been rejected from the warehouse, these will now be accepted. 
• A record may have multiple errors and warnings
• A record with a warning and an error will not go into the warehouse as an error 'supersedes' a warning.

[14 March 2008]

Go Live
In an e-mail of Tuesday 4 March ISD advised New Ways Leads that the national New Ways data warehouse planned to move into production (live) environment from 10 March 2008.  The development team have now built all the validation changes into the warehouse as described and the data warehouse is now ready to move into production. The decision to go live for an individual Board is dependent on the Boards and ISD being satisfied that their data is of high enough validity to be deemed appropriate for loading into the live warehouse environment. Some Boards who early on felt they were ready to submit to the live environment have now advised that do not wish to go live so that they can continue to work on cleansing their data. Boards who wish to discuss going live should in the first instance contact Angela Forbes. [14 March 2008]

Impact of going into Production
Going into production will have a number of impacts for Boards.  One of these impacts is the automation of error reporting. Currently, each time an extract is submitted to the warehouse, an error report is generated and e-mailed as an Excel file back to the submitting site. This report contains both errors and warnings. At the moment this is done manually, but once the data warehouse goes into production, you will instead receive an automated e-mail containing high level results. You will then need to be able to run a BO report which gives you the detailed information. If you require training in the use of BO in the use of the New Ways BO Universe (as opposed to general BO training') please contact Angela Forbes.  

Therefore a key requirement for going 'live' is for Boards to ensure that they have appropriate access to the national New Ways Business Objects reports e.g. for error management and data analysis purposes. Some Boards have had issues accessing BO because of local PC specification / set up which have had to be addressed and ISD staff have assisted in resolving these.

Currently if ISD staff receive a file with an incorrect filename or header they will correct this. In the production environment files will automatically be rejected if the file header or name is incorrect.  [14 March 2008]

Data Checking and Cleansing Priorities
ISD would strongly advise that the focus of your data checking and cleansing should be New Outpatients appointments, Inpatients and Daycases data a there is no requirement to submit planned repeats unless required locally. We also strongly advise any Boards whose results are showing high 'valid' data to take time to look at their figures against the waiting times guarantees. Some Boards who have been doing this have discovered high levels of data errors  that are producing corresponding errors in the tabulation of  patients' waiting times.  These errors are arising from issues in their PAS system or extract  - for example an extract which is not fully capturing unavailability which in turn means that these dates are not deducted from the wait calculation. [14 March 2008]

Data Processing
ISD have an enquiry regarding how extract submissions are managed by ISD.  At the moment, whilst we are in a 'test' environment every single file that comes in goes through a process of checking - review of sending location, whether the files are a reload or supersede previous files, originals located from the repository, correct files identified, before being added to the batch and run through the validation. Once this has happened an error report is then run manually (currently) and the 'successful' records are loaded to the test universe and the results of this are logged. This happens for every file, and each file is run sequentially in order of receipt. Staff at ISD are working on this pretty much continually to allow us to feedback results as quickly as possible to you.  [14 March 2008]   

Recording Manual
It has come to ISD attention that a few people were unaware of the existence of the Waiting Times Recording Manual which was announced in the December 2007 New Ways e-newsletter. This document defines each of the data items which comprise the waiting times 'dataset' from 1 January 2008 onwards. This manual should be used in conjunction with the 'Applying the Scottish Health Department Guidance'.  V0.1 of this document was published on the resources section of  the New Ways website on 18 December 2007. There is a link to this from the home page of the website. You can link direct to the PDF document here: http://www.isdscotland.org/isd/servlet/FileBuffer?namedFile=Waiting%20times%20recording%20manual%20v01.pdf&pContentDispositionType=inline. [14 March 2008]   

Task Force
Details of theTask Force correspondence and meetings are now published on the New Ways website. This includes a recent letter from John Connaghan on milestones and timetables which was sent to Chief Executives on 12 March 2008 and which is attached for information. [14 March 2008]   

Beardmore Event
This note is to advise that the morning session of the New Ways event on Wednesday 19 March 2008 has been postponed. The event is being postponed to allow the many staff who are currently heavily involved in meeting the 21 March timetable for new ways extraction, validation and data cleansing issues, more time for this. A new date is being arranged and will be circulated in due course. Apologies for any inconvenience this causes. [14 March 2008]