Mental Health Services Dataset (MHSDS) guidance on changes in care provider, provider identifier, or system supplier

This guidance focuses on the effect of changing key attributes within the MHSDS that are used to identify people and referrals. This has been prioritised as changes to these attributes have the largest impact on how MHSDS information can be used. Changes to other attributes can have a lesser impact. All other attributes can be found on the Data Linkage tab of the Technical Output Specification.

Where a patient’s care pathway covers more than one reporting month, the Unique Service Request ID is used to connect elements of reported activity from one period to the next. This is crucial to accurately report patients entering treatment, waiting times and outcomes.

The Unique Service Request ID is a concatenation of the ODS code of the provider and the Service Request ID submitted by the provider, in order to produce nationally distinct identifiers. Therefore, changing a provider’s ODS code and/or system supplier can impact reported activity and outcomes.

Below we summarise the anticipated impacts on measures of the various changes that may occur as a result of changing organisation or system supplier. 

If a system supplier changes with no resulting change to Service Request IDs (and no change in ODS code), then there is no impact on published measures. If the Service Request IDs change as a result of the system change, see the section on Changes to Service Request IDs.
 

If there is a change to a provider’s ODS code, but no transfer of patients between providers or change in system supplier, then there are still impacts on reporting. The Unique Service Request ID is a concatenation of the ODS code of the provider and the Service Request ID submitted by the provider, in order to produce nationally distinct identifiers. Therefore, changing a provider’s ODS code can impact reported activity and outcomes in the same ways as defined in Changes to Service Request IDs.

Providers must start using their new ODS code on the first of a month, so that the change corresponds with reporting periods. The same data should never be submitted under more than one ODS code.

For example, if a change in ODS code was implemented on 1st April, then data for March activity should be submitted under the old code, and data for April activity should be submitted under the new code.

In order to create a new ODS code and register to submit to the MHSDS under the new code, see the Registration section of our Step-by-Step Guide to submissions. You should also inform mhsdsdq@nhsdigital.nhs.uk of the details of the change.

Changes to the Unique Service Request ID present an issue to reporting, particularly for measures based on referrals and those that include data from more than one reporting period. The period impacted will depend on the period included in the measure, i.e. the effect will continue until the months prior to the change are no longer included in the rolling reporting period.

Providers must stop flowing the old Service Request IDs. NHS Digital’s analysis will recognise that these IDs are no longer current and our analysis will account for this as accurately as possible.

Do not supply any false start or end dates of referrals

For access and waiting times, you will likely see an increase in the reported number of referrals on the treatment pathway in the period when the change is made. Because the Referral Request Received Date recorded against the new Service Request ID must be the original date the referral was received, you will likely see an increase in the number of people waiting longer than two weeks to enter treatment. Ensure that you continue to flow Care Coordinator, Care Contact and Care Activity information (as applicable for each access and waits measure) in order to stop the clock for the new Unique Service Request ID.

For measures that count a person’s second contact with a service, the patient may be counted in a later month (or in rare cases, not at all), if their first contact is counted under the old Unique Service Request ID, and the second contact under the new Unique Service Request ID.

There may be situations where some patients are being transferred between providers, but both providers are retaining their ODS codes and individual submissions, or cases where two providers are merging to become only one ODS code going forward. The same rules around data submission apply in both scenarios.

The Unique Service Request ID is a concatenation of the ODS code of the provider and the Service Request ID submitted by the provider, in order to produce nationally distinct identifiers. Therefore, changing the provider associated with a patient can impact reported activity and outcomes in the same ways as defined in Changes to Service Request IDs.

The Service Request ID may also change for the individual patients being transferred. However, this has no further impact because the Unique Service Request ID will already have changed as a result of the change in ODS code of the provider. There is therefore no benefit of attempting to retain Service Request IDs for individuals transferring between providers.

The transferred or merged data should be reported under the new ODS code from the first day that the patient(s) transferred. Ideally this would be the first of a month, so that the change corresponds with reporting periods.

The same data should never be submitted under more than one ODS code. The provider no longer caring for the transferred patients must stop flowing the old Service Request IDs. NHS Digital’s analysis will recognise that these IDs are no longer current and our analysis will account for this as accurately as possible. Do not supply any false start or end dates of referrals.

For example, if a group of patients transferred from Org A into Org B from the 1st April, then data for March activity for those patients should be submitted by Org A and data for April activity should be submitted by Org B. Org A should not submit any false end dates for referrals and should stop flowing the transferred patients for April onwards.

In order to create a new ODS code and/or register new MHSDS submitters for an existing ODS code, see the Registration section of our Step-by-Step Guide to submissions. You should also inform mhsdsdq@nhsdigital.nhs.uk of the details of the merger or transfer.

NHS Digital’s Master Person Service derives a Person ID for each patient using a number of criteria, including NHS number, date of birth and other demographic information. Person ID is used in person-based analysis on the MHSDS so that patient pathways can be mapped across organisations.

If you provide NHS numbers, changing the Local Patient ID should not have an impact on the Person ID, but you are still advised to avoid this if possible. If the demographic information of a patient changes, or if you don’t supply NHS number, changing the Local Patient ID will have an effect and should be avoided.

If a patient’s Person ID and Unique Service Request ID changes or if they have multiple referrals in the year, then they will be double counted in annually calculated statistics.

Measures that use data from outside the current reporting period, where the information is not expected to flow every month, may also be impacted. Data of this kind includes employment status, accommodation status, assessments, care plans and diagnoses, among others. Therefore, if patient demographics or Local Patient ID change, you are advised to flow this information on the patient again.

No change to ODS code of provider, Service Request IDs or any other values (due to changing system supplier, for example)

No effect on published measures.

ODS code of provider changes, but Service Request IDs and any other values stay the same (due to changing organisation information with ODS, for example)

There will be an impact on measures that are calculated over a rolling 3 or 12 month reporting period for the corresponding number of months (3 or 12, depending on the measure) following the change.

For annually calculated statistics, measures that count distinct referrals are affected for the financial year in which the change is made. Measures that count distinct patients are not affected.

Patients with open referrals are given new Service Request IDs in the same or a new organisation (due to a merger or changing system supplier, for example)

Monthly measures that are based on new referrals, admissions or discharges will increase in the first month following the change.

There will be an impact on measures that are calculated over a rolling 3 or 12 month reporting period for the corresponding number of months (3 or 12, depending on the measure) following the change.

For annually calculated statistics, measures that count distinct referrals are affected for the financial year in which the change is made. Measures that count distinct patients are not affected.

Patient information changes to the extent that derived Person ID changes (due to changes in submitted demographic data or Local Patient ID, for example)

Monthly measures should not be affected.

There is the possibility of some overcounting for measures that are calculated over a rolling 3 or 12 months and for annually calculated statistics, when specific conditions are met.

If further information is needed to support planning or decision making whilst making these changes, please contact us at mhsdsdq@nhsdigital.nhs.uk.