Minimum Data Set Project

Section 4SpecialistPalliativeCareHospital Support

When completing the form, please refer to the accompanying Guide.

Please answer for the period 1 April 2012 to 31 March 2013

Dataset number If you do not know your MDS dataset number please
tel 020 7697 1520 or email giving your postcode for identification
Name of organisation
Who manages your service? Answer NHS orIND(independent). Your answer should be irrespective of who funds you. / NHSIND
Is your service an integrated team where the same team members work in the hospital and at home? Tick the box if your service is integrated, otherwise leave blank
4.1 / All patients
4.1a / New patients - number of patients who received care from you for the first time ever during the year
4.1b / Continuing patients - number of patients who were first seen by you before 1 April 2012 and were still being seen by you after this date
4.1c / Re-referred patients - number of patients who had been discharged before 1 April 2012 but who were re-referred during the year (count only once).
4.1d / Total patients – found by adding the three numbers given above
4.1e / For integrated teams only – where a patient has first been seen at home
Number of patients seen in hospital
4.2 / Re-referralsin year
Number of re-referrals of patients who were discharged after 1 April 2012 but then re-referred during the year. Count each time a re-referral is made (one patient may have 1, 2 or more re-referrals)
4.3a / Patient analysis – age and gender
New Patients
Analysis of patients given in 4.1a / Total Patients
Analysis of patients given in 4.1d
Female / Male / All / Female / Male / All
Under 16 years
16 to 18 years
19 to 24 years
25 to 64 years
65 to 74 years
75 to 84 years
85 years and over
Not recorded
Totals
4.3b / Patient analysis - diagnosis
New Patients
Analysis of patients given in 4.1a / Total Patients
Analysis of patients given in 4.1d
Cancer/malignant diagnosis
Other diagnosis
Not recorded
Totals
Totals should equal numbers given in 4.1a and 4.1d
4.3c / Analysis of primary diagnosis
Cancer diagnoses - by site / New Patients
Analysis of patients given in 4.1a / Total Patients
Analysis of patients given in 4.1d
Lip, oral cavity & pharynx C00-14
Digestive organs C15-26
Respiratory & intrathoracic C30-39
Breast C50
Female genital organs C51-58
Male genital organs C60-63
Urinary tract C64-68
Eye, brain & other CNS C69-72
Lymphoid, haematopoietic C81-96
Other specified sites C40-49, 73-75
Independent multiple sites C97
Ill-defined, secondary, unspecified including carcinomatosis C76-80
Total Cancer
Non-cancer diagnoses
HIV disease/AIDS B20-24
Motor Neurone disease G12
Neurological conditions G00-G99 excluding G12 and G30
Dementia including Alzheimer’s disease G30 and other F00-03
Heart failure I50
Other heart and circulatory conditions I00-I99 excluding I50
Chronic respiratory disease J40-70
Chronic renal failure N18
All other non-cancer diagnoses
Total non-cancer
Diagnosis not recorded
4.3d / Patient analysis – ethnicity
New Patients Analysis of patients given in 4.1a / Total Patients
Analysis of patients given in 4.1d
White British
White Irish
Other white
Mixed white/black Caribbean
Mixed white/black African
Mixed white/Asian
Other mixed
Indian
Pakistani
Bangladeshi
Other Asian
Black Caribbean
Black African
Other black
Chinese
Other
Not stated
Total
Totals should equal numbers given in 4.1a and 4.1d
4.4a / Contacts with patients, carers and other professionals

Only include contacts relating to patients who have been referred
For telephone calls only include those where a significant conversation takes place
Do not include calls made by administrative staff
Joint professional contacts – count as one contact only

Face to Face / Telephone
Between team member and patient with or without carer
Between team member and carer (without patient)
Between team member and other health care professional
4.4b / Contacts without referral

Count contacts where advice is being sought but where the patient has not actually been formally referred to your service

Face to Face / Telephone
Between team member and patient with or without carer
Between team member and carer without patient
Between team member and other health care professional
4.4c / Total contacts
Face to Face / Telephone
Give the total number of contacts, with or without referral, adding up to 4.4a and 4.4b above
4.5 / Hospital Support contacts – analysis

Give the number of contacts made by each health professional.
Include contacts with patients, carers and other health care professionals as given above.
Where contacts are made jointly, made count for each professional involved.

Team member / Face to face
First / Face to face
Follow up / Telephone
Palliative care Medical Consultant
Palliative care – other doctor
Palliative Care Clinical Nurse Specialist
Other nurse
Physiotherapist
Occupational Therapist
Social worker
Pastoral/spiritual carer
Psychologist/psychotherapist
Complementary therapist
Other health care professional (not admin staff)
Totals
4.6 / Outcome
See Guide
4.6a / Deaths Total number of patients during the year who died while still under your care (not discharged)
4.6b / Discharges Total number of discharges from hospital support care during the year, i.e. periods of care which ended other than with the patient's death
4.6c / Continuing patients Total number of patients who are still registered with you at the end of the year
Total of 4.6a, b and c should be equal to or greater than 4.1d – please check
4.6d / Place of care after discharge
Patient's home (including relative’s or carer’s home)
Care home
Hospital (acute)
Hospital (community)
Hospice/specialist palliative care unit
Other (please specify)
Not recorded
4.7 / Length of care episode
4.7a /

Give the number of completed periods of care (adding up to 4.6a+b above)categorised according to the time between date of first contact and date of death or discharge.
Count a one-off contact with a patient as a care episode with a length of one day.

1 day / 29 to 42 days
2 to 7 days / 43 to 84 days
8 to 14 days / 85 days up to 180 days
15 to 28 days / Over 180 days
4.7b / Average (mean) length of period of care, defined as the average time in days from date of first contact to death or discharge (see Guide)
4.8 / Service operation

Tick the boxes to show details of your service operation.
Only give details of how your own team operates.
Do not include times when the service is operated by others who are not part of your team

9am to 5pm (or similar) / 9am to late evening / 24 hours a day
Telephone only / Actual visits / Telephone only / Actual visits / Telephone only / Actual visits
5 days a week
7 days a week
Other: give details
Any comments
Contact name
Email / Telephone

Please tell us which IT system you use for patient data

Please return by Friday 31st May 2013 to

The National Council for Palliative Care
The Fitzpatrick Building
188-194 York Way
London

N7 9AS

Tel: 020 7697 1520 Fax: 020 7697 1530

Keeping a copy of your completed forms is highly recommended

If you have any questions,please contact Adrian JonesTel: 020 7697 1520 or Email: