Data guidance

This is the Organisation Data Service (ODS) code of the trust or other service provider where the service is being delivered.

The ODS code is the unique identifying code used by the NHS for various purposes, including supporting national NHS IT systems, such as EPS.

Organisation identifier (code of provider)

All organisations must enter their organisation ODS code.

NHS specialist community mental health (SpMH): for all providers, only the organisational code of the ICB commissioner is required not the code of the individual commissioned service provider

National Digital Service: No code required in this field

The code of the national Digital Tobacco Treatment Service (DTTS)

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all admitted Patient Care inpatient admissions.

Only include “ordinary” admissions (i.e. overnight stays). Exclude day cases and regular attenders. i.e. include only category 1 from the Patient Classification list on the NHS Data Dictionary

Only to be submitted when an inpatient tobacco dependence treatment service is being delivered by the trust.

For each reporting period the count should be based on the date of admission not the date of discharge. 

Excludes all Mental Health providers, Maternity and Community and any patients known to be deceased at the time of reporting

These are aggregate counts of people (aged 16 and over at booking appointment) with a completed smoking status (any category) in the reporting month reported for all maternity bookings.

Only to be submitted when a maternity tobacco dependence treatment service is being delivered by the trust.

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all first outpatient attendances.

Only to be submitted when an outpatient tobacco dependence treatment service is being delivered by the trust.

Excludes all Mental Health providers and Maternity and any patients known to be deceased at the time of reporting

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all first community care appointments.

Only to be submitted when a community tobacco dependence treatment service is being delivered by the trust.

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all admitted Patient Care – community inpatient admissions.

Only include “ordinary” admissions (i.e. overnight stays). Exclude day cases and regular attenders. i.e. include only category 1 from the Patient Classification list on the NHS Data Dictionary

Only to be submitted when a community tobacco dependence treatment service is being delivered by the trust.

For each reporting period the count should be based on the data of admission not the date of discharge. 

Excludes Acute (physical), Maternity and all Mental Health providers and any patients known to be deceased at the time of reporting.

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all admitted Patient Care – mental health inpatient admissions.

Only include “ordinary” admissions (i.e. overnight stays). Exclude day cases and regular attenders. i.e. include only category 1 from the Patient Classification list on the NHS Data Dictionary

Exclude any patients known to be deceased at the time of reporting.

For each reporting period the count should be based on the data of admission not the date of discharge. 

Only to be submitted when an inpatient tobacco dependence treatment service is being delivered by the trust.

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all first mental health outpatient attendances.

NHS Data Dictionary

Exclude any patients known to be deceased at the time of reporting.

Only to be submitted when an outpatient tobacco dependence treatment service is being delivered by the trust.

Mental Health outpatient appointments would typically be provided by inpatient Trusts.  Do not record Community Mental Health Service appointments here.

These are aggregate counts of people (aged 16 and over) with a completed smoking status (any category) in the reporting month reported for all first community mental health service care appointments

Exclude any patients known to be deceased at the time of reporting.

Only to be submitted when a specialist community mental health tobacco dependence treatment service is being delivered by a community specialist mental health provider. 

These are aggregate counts of number of primary care patients who are on the SMI GP register and who are current smokers

A current smoker is defined as a patient with their most recent smoking status in the 12 months up to and including the reporting period end date = smoker.  This aligns to the definition in the Quality and Outcomes Framework (QOF) (SMOK002).

Only to be submitted when a  specialist community mental health tobacco dependence treatment service that accepts referrals from Primary Care is being delivered by the provider.

This is the unique number used to identify a patient within the NHS in England and Wales.

There should only be one NHS number for each patient record, and each patient should only appear once per submission window unless there is a different Activity Date and Time.

If patients are from overseas, record the string as 'NULL'. 

This refers to the type of setting within which the prevention service is being delivered.

Options are:

1. Acute (physical)

2. Mental health

3. Maternity

This is the type of activity for the current episode of care, the one which led to the patient's inclusion in this submission.

Options are:

1. Admitted patient episode Inpatient

2. Outpatient clinic attendance

3. Community Care Appointment

4. Community Mental Health Services appointment

5. Admitted Patient Episode - Community Inpatient

6. Primary Care Appointment

Maternity antenatal appointments should be recorded under the activity type outpatient clinic attendance. Admissions of pregnant women, excluding admissions for delivery, should be recorded as inpatient admissions. In the vast majority of cases it will be an appointment not an admission that leads to a referral.

ACTIVITY TYPE = “Admitted Patient Episode - Community Inpatient” only allowed when INTERVENTION SETTING = “Acute (Physical)”

For (1),, only include 'ordinary' admissions (overnight stays). Exclude day cases and regular attenders. i.e. include only category 1 from the Patient Classification list on the NHS Data Dictionary

Patient Classification list on the NHS Data Dictionary

Intended management on the NHS Data Dictionary 

Mental Health “outpatient clinic appointments” would typically be provided by inpatient Trusts.  Record all Community Mental Health Service appointments against category #4

Provide the admission/appointment date and time of the activity for the current episode of care (i.e. the one which led to the patient's inclusion in this submission).  For inpatient admissions, activity date and time should be recorded at admission (as opposed to discharge).

Note: Dates and times which are not in the specified format will be rejected. A leading apostrophe may be used to assist in inputting dates in the required format.

Note: For referrals from primary care into community specialist mental health service, the primary care appointment date (and time if available) must be reported but no primary care appointment identifier is required.  If the date isn’t available in primary care then “referral” can be regarded as the activity and hence the referral date entered in this field

This is the unique identifier for the Hospital Provider Spell which led to the patient's inclusion in this submission.

This is the same identifier that is required in the Secondary Uses Services (SUS) dataset that Trusts submit to NHS England.  It is not the unique patient id that is for internal use at Trusts only.

Required where ACTIVITY TYPE = Admitted Patient Episode (Inpatient or Community Inpatient).  This includes physical acute and mental health patients.

This is the unique identifier for the maternity episode which lead to the patient's inclusion in this submission.

This is the same identifier that is required in the Maternity Services Dataset (MSDS) that trusts submit to NHS Digital. It is not the unique patient id that is for internal use at trusts only.

[Exactly] One of Hospital Spell Number, pregnancy identifier, outpatient attendance identifier or community care contact identifier must be entered otherwise a validation warning will be shown.

This is the unique identifier for the outpatient appointment which lead to the patient's inclusion in this submission.

This is the same identifier that is required in the Secondary Uses Services (SUS) dataset that trusts submit to NHS England. It is not the unique patient id that is for internal use at trusts only.

Required where ACTIVITY TYPE = Outpatient Clinic Attendance and INTERVENTION SETTING TYPE does NOT = Maternity

This is the unique identifier for the community care contact which lead to the patient's inclusion in this submission.

This is the same identifier that is required in the Community Services Dataset (CSDS) that trusts submit to NHS England. It is not the unique patient id that is for internal use at trusts only.

Required where ACTIVITY TYPE = Outpatient Clinic Attendance

Please indicate whether the original booking and delivery (or end of pregnancy) was provided at a different trust. Options for selection are:

1. Booking and delivery (or end of pregnancy) under the care of the same trust.

2 Transfer in: original booking appointment took place at a different trust (not at this trust)

This is the date on which a person was born or is officially deemed to have been born.

The given name of the person.

The part of a person’s name which is used to describe family, clan, tribal group, or marital association.

The gender of a person as stated by them.

Options are:

1. Male

2. Female

9. Indeterminate (unable to be classified as either male or female)

X. Not known (person stated gender code not recorded)

The ethnic identity of a person as stated by them.

Ethnicities as specified by the NHS Digital data dictionary

A. White – British

B. White – Irish

C. White - Any other White background

D. Mixed – White and Black Caribbean

E. Mixed – White and Black African

F. Mixed - White and Asian

H. Mixed – Any other mixed background

G. Asian or Asian British - Indian

J. Asian or Asian British – Pakistani

K. Asian or Asian British – Bangladeshi

L. Asian or Asian British - Any other Asian background

M. Black or Black British – Caribbean

N. Black or Black British – African

P. Black or Black British - Any other Black background

R. Other Ethnic Groups – Chinese

S. Other Ethnic Groups – any other ethnic group

Z. Not stated

99. Not known

The postcode of the address nominated by the person with address association type: 'Main Permanent Residence' or 'Other Permanent Residence'. 

SMOKING STATUS - TOBACCO DEPENDENCE SERVICE

Please input the patient's smoking status at the time of admission, or booking (for maternity), or attendance (for outpatients/community/primary care). Options are:

1 Current smoker 

2  Ex-smoker

3  Non-smoker - history unknown

4  Never smoked

Z   Not Stated (patient asked but declined to provide a response)

 9.  Unknown (not recorded)
For the national Digital Tobacco Treatment Service this will be recorded by the referral hub at the point of referral into the service

Note: 

• this field is now aligned to the NHS Data Dictionary
• Validation - anything other than '1' should generate a warning that this record may not need submitting
• Current Smokers are coded as '1' in previous and current specification
• “9” is to be used for maternity transfers where smoking status is unknown

For the purpose of this data collection, smokers are defined as people who have had a cigarette regularly (at least one per week) or occasionally (less than one cigarette per week), with 2 weeks or less since their last cigarette. Where a patient is smoke-free for greater than 2 weeks and is receiving support, it would be considered that they have quit (are ex-smokers), and we would not expect data to be submitted. Women who are ex-smokers that have quit since conception, and are referred as part of good clinical practice, should not be included in this return.

People who are dual users, both smoking and using a nicotine vaping product should be classed as smokers.  Other users of nicotine vaping products should be categorised appropriately, with their vaping status include in data element #17.

Please see key definitions of these options in Appendix 1.

'Time of admission' relates to the current admission/care contact and not past admissions/care contacts where smoking status was recorded.

See definitions in Appendix 1. 

For patient-level local collections, please build upon previous 2017/19 and 2019/20 Healthy behaviours CQUINs if appropriate.

For maternity sites: Smoking statuses should be recorded at time of booking. If missed this should be collected and added at a subsequent appointment. This can also be obtained from the Maternity Services Data Set (MSDS) submissions.

According to Saving Babies Lives Care Bundle (SBLCB) guidance, CO testing should be offered, and the result and her smoking status recorded, at the booking appointment and 36 week appointment.  Even though both of these data items are required for the SBLCB, only the smoking status is required to be reported in this data collection.

Whether the patient was a user of a nicotine vaping product at the time of admission (or booking - for maternity) (or attendance for outpatients/community/primary care)

Options are:

Y; Yes 

N: No

9. : Unknown 

Whether the patient was undertaking a supported quit attempt at the time of admission (or booking - for maternity) (or attendance for outpatients/community/primary care)

Options are:

Y. Yes

N. No

9.  Unknown

Patients undertaking a supported quit attempt can be classified as smokers or ex-smokers in field SMOKING STATUS – TOBACCO DEPENDENCE SERVICE

PATIENT CURRENT  SMOKER AT DELIVERY INDICATOR

This indicates whether the patient was a smoker at the time of delivery.

Options are:

Y. Yes

N. No

9, N/A - end of pregnancy before delivery/maternity transfer

This indicates whether the patient was a smoker at 36 weeks.

Options are

Y, Yes

N. No

9.  N/A - end of pregnancy before 36 weeks gestation/maternity transfer

Carbon Monoxide (CO) monitoring at 36 weeks is a key part of the Saving Babies Lives Care Bundle, and advice from frontline service is that this provides an accurate indication of harm to the baby.

This is a Y/N indicator.

This indicates whether the patient was referred to a Tobacco Dependence Service within the same Health Care Provider (i.e. in-house).

Note: for the purpose of this collection, patients who are seen opportunistically, and do not have a formal referral to the Tobacco Dependence service, should be considered to have had a referral by the in-house service or be self-referred. As a result, they should be included in the referred patient cohort.

Services are considered as in-house when the bespoke offer of behavioural support and smoking cessation aids are not referred out to an external third party. An in-reach service could count as an in-house service as long as there is no transfer of care.  In-reach is defined as an external service commissioned by the provider to deliver services on their behalf.

Patients already on a current supported quit attempt should not be recorded as having a new referral if that attempt is continuing. However, if the attempt is unsuccessful and a new attempt is made with the support of the in‑house service, those details should be recorded under a new referral.

Note: NHS Specialist Community Mental Health (Primary Care): for this cohort an in‑house referral includes any NHS specialist community mental health service commissioned for these patients.

This refers to the date the patient was referred to a Tobacco Dependence Service within the same Health Care Provider, i.e. in-house.

Note: for patients seen opportunistically (as specified by data element 21), the date of referral to the in-house service should be the date of first contact with a Tobacco Dependence Adviser.

This is a Y/N indicator.

This specifies following referral, whether the patient was seen by a Tobacco Dependence Service within the same Health Care Provider, i.e. in-house.

Note: Patients seen opportunistically (as specified in data element 21), should be considered as having been referred and seen.

Seen is defined as a discussion between the patient and the Tobacco Dependence Adviser to give advice and be able to commence a supported quit attempt, including coaching. This can be undertaken face to face or remotely.

The default is for the Tobacco Dependence Adviser to deliver these services, unless exceptional circumstances are in place, such as during the COVID-19 crisis, where the use of hot/cold ward may preclude this. In such circumstances, it is acceptable (as a temporary arrangement) that other staff can provide adequate advice and support patients to start a quit attempt, with support from a Tobacco Dependence Adviser. 

Please provide the date, following referral, the patient was seen by the Tobacco Dependence Service within the same Health Care Provider, i.e. in-house.

Dates which are not in the specified format will be rejected.

For

This refers to the Tobacco Dependence Service care plan for the patient.

It is expected that this is populated based on the main treatment plan agreed with the Tobacco Dependence Adviser and supplements the very brief advice and any temporary nicotine replacement therapy provided at admission / booking to manage withdrawal symptoms.

10. VBA (very brief advice) only (refusal of opt-out offer of treatment)

20. Smoking reduction (a supported attempt to reduce the number of cigarettes smoked, with or without the use of nicotine)

30. Supported temporary abstinence (support to remain smoke free whilst in hospital, no follow-up care)

40. Unsupported temporary abstinence

50. Unsupported quit attempt without nicotine

60.  Unsupported quit attempt with nicotine

70.  Quit attempt with behavioural intervention and licensed medication – recommended NHS INTERVENTION

80.  Quit attempt with behavioural intervention and unlicensed nicotine containing products

90.  Quit attempt with behavioural intervention and without pharmacotherapy 

97.  No care plan (VBA or treatment) provided - unable to provide VBA due to medical or other condition

98.  No care plan (VBA or treatment) provided - other

The recommended NHS INTERVENTION is designed to highlight the recommended model from the LTP Delivery.  Care plans #20, #30, #70, #80 and #90 are considered “supported care plans.”.  Care plans #20 (smoking reduction) and #30 (temporary abstinence) are not recommended treatment plans for maternity patients.

Nicotine vaping products may be used in some settings and would currently be included under “Quit attempt with behavioural intervention and unlicensed nicotine containing products”. There is a new category for licensed nicotine vaping products, if or when they become available, in the field “TYPE OF PHARMACOTHERAPY”.  This is a change from the initial guidance for this collection which stated that “unlicensed products should include all e-cigarettes, even if any are licensed during the course of the data collection for consistency of reporting and analysis.”  Therefore, if or when these products are licensed, a quit attempt involving licensed nicotine vaping products will be recorded under option #70 (Quit attempt with behavioural intervention and licensed medication) and a quit attempt involving unlicensed nicotine vaping products will be recorded under option #80 (Quit attempt with behavioural intervention and unlicensed nicotine containing products).  Previously, all quit attempts involving nicotine vaping products would have been recorded under option #80.

It is recognised that treatment may change over the period within the in-house service, but for the purpose of this collection, the data should be based on the main management plan agreed within the NHS setting based on the discussion with the Tobacco Dependence Adviser. If this plan changes in conjunction with the Tobacco Dependence Adviser (for example with longer stay inpatients/antenatal care), then the most recent agreed plan should be submitted.

See the smoking reduction section 

The date set by a PERSON on which they intend to stop smoking.

This date is expected to be the date of discharge from hospital for inpatients with a length of stay under 28 days.

Mandatory for those undertaking a supported quit attempt (codes #70, #80, #90 from TOBACCO DEPENDENCE CARE PLAN)

Dates which are not in the specified format will be rejected

This indicates if, and where, the patient had been referred for ongoing support for tobacco dependence. Onward support is only applicable to those who started their treatment under an in-house tobacco dependence service (Tobacco Dependence Care Plans #20, #30, #70, #80 and #90). It does not apply to those who are just provided brief advice and directed/referred to an external provider.

Options are:

10. Local Authority commissioned Stop Smoking Service (this could include services provided by GPs etc.).

20. Secondary care

25 NHS Community Mental Health Service

30. NHS Community Pharmacy

40. NHS Primary Care (including GPs, but not commissioned by the local authority)

50. Third Sector (excluding LA commissioned services)

60. No onward support (patient choice).

70. No onward support (unavailable).

80. No onward support (not required)

90. Care complete in-house (no referral)

In a change to previous versions of this guidance, where it was stated to use code #20, where no onward support is required because the in-house service completed the care pathway code #90 should be used.  This option would also include where there is an internal transfer to continue treatment, for example for step down care in outpatients/community out-reach services delivered by the same provider post discharge.  The secondary care option (#20) should only be used when there is a transfer of care between secondary care organisations, for example, a patient who has care initiated in an acute hospital setting, but is then discharged with step down care being picked up by specialist community mental health provider.

Note: Services are considered as in-house when the bespoke offer of behavioural support and smoking cessation aids are not referred out to an external third party. An in-reach service could count as an in-house service as long as there is no transfer of care.

For patients that engaged with a supported Tobacco Dependence Service Care Plan (#20, #30, #70, #80 and #90), whether they had a self-reported or CO confirmed quit, at 28 days following the start of their agreed quit window, i.e. the INTENDED SMOKING QUIT DATE.  For most inpatients this should be the date of discharge from hospital.  See “Autonomous quit date” in Appendix 1 for more information.

Options are:

1. CO confirmed quit

2. Self-reported (only) quit

3. Confirmed current smoker (not quit)

4. Smoking status unknown or lost to follow-up

It is expected that the 28-day outcome will be submitted by the NHS trust as part of the pathway of care. This includes where the step-down care is provided by a different provider i.e. LA SSS for inpatients. There are a variety of pathways and levels of digital infrastructure/integration across England, so each trust will need to establish local solutions for collecting this information.

If a patient does not give consent to be followed up, they should be recorded as “4. Smoking status unknown or lost to follow up”.

See the smoking cessation section for details of how to record the outcome for patients accessing support via Specialist Community Mental Health services and choosing smoking reduction as part of their supported care plan.

For maternity patients this is a count of the number of supported attempts made during the maternity, starting from the date of the antenatal booking appointment (or first contact if a quit attempt is initiated prior to booking).

Note: Supported quit attempts defined as where the TOBACCO DEPENDENCE CARE PLAN = #70 or #80 or #90

Please specify the type of pharmacotherapy provided to the patient.

Please see below for a full list of pharmacotherapy options.

Criteria for selection are based on the same definitions as used by LA SSS:

“Bupropion only” (Option 30), “Varenicline only” (Option 40), “Cytisine only” (Option 45) and “Licensed nicotine containing products and/or Bupropion and / or Varenicline and/or Cytisine consecutively” (Option 50) are not applicable for maternity patients in line with NICE guidance

There is a new category for licensed nicotine vaping products, if or when they become available.  This is a change from the initial guidance for this collection which stated that “unlicensed products should include all e-cigarettes, even if any are licensed during the course of the data collection for consistency of reporting and analysis.”  Therefore, licensed and unlicensed nicotine vaping products should be reported in different categories.

At the time of writing Varenicline is only available off license and Cytisine is currently not available in England but they should be reported on when available.