This document describes the processes and outpatient data captured through the Monthly Returns on Bookings process. The data is recorded by district health boards (DHBs) on MS Excel spreadsheets and forwarded to the Ministry for loading into the National Booking Reporting System (NBRS) data warehouse.
The data is critical to monitoring the objectives of the elective services project. The returns are part of the reporting requirements of DHBs to the Ministry of Health.
On this page
- Introduction
- The process for completing returns
- Standard requirements
- Reporting line descriptions
- Appendix 1 – Special notes for endoscopy and dental services
- Appendix 2 – Glossary of outpatient terms
1.0 Introduction
1.1 Purpose
This document describes the processes and outpatient data captured via Monthly Returns on Bookings. The data is recorded on Excel spreadsheets and loaded into an MS Access database. This data is then loaded into the National Booking Reporting System (NBRS) data warehouse. The data is critical to monitoring the objectives of the elective services programme. The returns are part of the reporting requirements of District Health Boards (DHBs) to the Ministry of Health.
Inpatient data is captured via the NBRS extract process. For information on requirements for NBRS extracts, refer to the NBRS Data Dictionary and File Specification.
1.2 Description
This document contains the following sections:
- The Process for Completing Returns – A description of the process for completing and submitting monthly returns is outlined.
- Standard Requirements – A list of the standard requirements for the templates returned to the Ministry is set out in this section.
- Reporting Line Descriptions – A detailed description of each reporting line and its data elements is provided in this section.
- Appendices – A set of additional key information: Special notes for Endoscopy and Dental Services; Glossary of outpatient terms.
2.0 The process for completing returns
2.1 Templates
If a spreadsheet template has changed in structure from the previous month, the Ministry of Health will advise the nominated contact at the relevant DHB.
If additional reporting information is requested on a spreadsheet template, it will be subject first to a six-month notification period before enforcement.
Returns must be completed on the template provided, and not on a previous version of the template. Template returns should be sent to Don Roberts, Data Quality Analyst, on e-mail [email protected].
DHBs need to notify Don Roberts if alterations are required to their template.
2.2 Timeframes
Completed spreadsheets are to be returned to NZHIS by the 25th of the month. If the 25th is a weekend date, then spreadsheets should be returned by the first Monday after the 25th.
NZHIS will review the completed spreadsheet, and if corrections are required it will be returned it to the relevant DHB within two working days. The DHB will correct the spreadsheet and return it to NZHIS within a further two working days.
2.3 Timeliness
The Monthly Returns data will be loaded to the NBRS data warehouse once a month so that it can be viewed through the Elective Services Patient Flow Indicator (ESPI) reports published in the NBRS Business Objects environment and Elective Services website.
The inclusion of the information in these reports is dependent on timely and complete information being supplied from all DHBs. The information may not be included if the processing of spreadsheets is delayed because:
- returns from individual DHBs are not provided by the 25th; and/or
- data is unable to be loaded by the 25th because
- templates are returned altered; and/or
- templates are returned with data that is in an incorrect format; and/or
- subsequent queries are not responded to within five working days.
The published data will be 5 weeks behind the actual month. For instance, March data provided to the Ministry in the April Monthly Return by the 25 April will be published for DHB review in the first week of May.
2.4 Contact for variations or queries
Issues regarding definitions or data requirements should be raised with the electives team ([email protected]).
Technical issues with the templates or the process for receiving and returning templates should be raised with Don Roberts, Data Quality Analyst, on e-mail [email protected].
3.0 Standard requirements
3.1 Guidelines for filling in the spreadsheet
Inconsistent completion of spreadsheets undermines the integrity of data, and consequently any analysis and reporting of that information. The following is the required standard for completing the spreadsheets for monthly reporting.
| Parameters | Details |
|---|---|
| Text (Y or N) is required in two reporting lines. | The only fields (rows) requiring text are: 1) “Were all referrals acknowledged within ten working days on whether or not a First Specialist Assessment (FSA) would be provided (Y/N)?” and 2) “Please enter Y if a specialty’s services are provided by your DHB as a visiting clinic – N if not.” |
| A date is required in one reporting line. | The only field (row) requiring a date is: Date of last review of the outpatient waiting list (please enter in DD/MM/YYYY format). |
| All other reporting lines require numeric values. Use “0” as a value, not text. | Report numbers, not text or comments. If cell(s) on a specific reporting line have a zero value, report the number as 0. For example, if the numbers waiting for FSA >18 months in Respiratory are 0 for January 04/05, then enter 0. Do not enter text alternatives such as: nil – n/a “ ” none all seen. If the cell is left blank, the Ministry will interpret that as ‘no information provided’. |
| Use “0” for missing data or where data is not applicable. | If data is missing for a particular specialty or reporting line, leave the relevant cell(s) blank. If data is missing, please notify the Elective Services contacts listed in section 2.4. Similarly, if data is not applicable to part of a column, leave the relevant cells blank. |
| Comments. | If there are any comments or explanations about data, do not put these on the reporting spreadsheet, as they may not be seen. Please e-mail these to the Elective Services contacts listed in section 2.4. |
3.2 Example of a completed spreadsheet
Below is an example of a completed return from a DHB. Only a limited range of specialties are listed for this example. Note the format of the information in terms of the use of numbers and blanks. Explanations of why Dental Services and Endoscopy should be completed differently than other specialties are listed in Appendix 1.
| Booking Systems – Monthly Return For DHB Month 6: 02–03 | Gen Surgery | Gynaecology | Orthopaedics | Paed Surgery |
|---|---|---|---|---|
| Filler | Filler | Filler | Filler | |
| OUTPATIENT DATA | ||||
| Were all referrals advised within 10 working days on whether or not an FSA would be provided? (Y/N) | N | N | N | N |
| Please enter Y if a specialty’s services are provided by your DHB as a visiting clinic – N if not. | N | N | Y | Y |
| Date of last review of the outpatient waiting list (please enter in DD/MM/YYYY format). | 30/10/2002 | 30/10/2002 | 30/10/2002 | 30/10/2002 |
| Outpatient inflows and outflows | ||||
| Number of new referrals accepted during the month | 115 | 33 | 59 | 24 |
| Number of new referrals seen during the month | 118 | 26 | 42 | 33 |
| – Number of new referrals seen during the month within 6 months of referral | 113 | 21 | 41 | 32 |
| Number seen for follow-up during the month | 117 | 59 | 130 | 48 |
| Outpatient waiting list | ||||
| Total number waiting for FSA at the end of the month | 49 | 34 | 63 | 15 |
| – Number who have been waiting for FSA for >6 months | 3 | 3 | 5 | 1 |
| – Number who have been waiting for FSA for >12 months | 0 | 1 | 1 | 0 |
| – Number who have been waiting for FSA for >18 months | 0 | 0 | 1 | 0 |
4.0 Reporting line descriptions
This section provides a detailed description of each reporting line and the expected information for the spreadsheet.
Outpatient data
Were all referrals advised within ten working days on whether or not a First Specialist Assessment (FSA) would be provided? (Y/N)
As stated – this is a check of whether a DHB service is acknowledging to both patients and their GPs their decision on the referrals it receives.
Please enter Y if a specialty’s services are provided by your DHB as a visiting clinic – N if not
A visiting outreach clinic refers to clinics provided by consultants external to your DHB. A Y or N response is required. The Ministry pre-fills the previous month’s return response, as it is unlikely to change between months.
You can change this field if either:
- clinic arrangements have changed, or
- it is incorrect.
Date of last review of outpatient waiting list (please enter in DD/MM/YYYY format)
The template sent out by the Ministry will note the date registered in the previous month’s return. It can be updated when an administrative review of the waiting lists for a specialty has been conducted. Completing the monthly return does not in itself constitute a review of a waiting list.
Outpatient inflows and outflows
Number of new referrals accepted during the month
The number of new referral letters accepted from appropriate health professionals, acute referrals, direct attendances or inter-regional transfers received during the month.
Refer to the definition of First Specialist Assessment (FSA) in Appendix 2 for further detail.
Number of new referrals seen during the month
The number of new referrals seen by the specialty during the month by the specialty. This includes acute referrals and direct attendances.
Refer to the definition of First Specialist Assessment (FSA) in Appendix 2 for further detail.
Number of new referrals seen during the month within 6 months of referral
A subset of the total number of referrals seen by the specialty during the month. Of all those seen, the number that were seen within 6 months. This includes the number seen within 2 months of referral.
Number seen for follow-up (FU) during the month
The number of follow-ups seen by each specialty during the month. Refer to the definition of Follow-up in Appendix 2 for further detail.
Outpatient waiting list
Total number waiting for FSA at the end of the month
The end-of-month position on the number of patients waiting to be seen by a specialty for their First Specialist Assessment (FSA).
Number who have been waiting for FSA for >6 months
A subset of the total number waiting for FSA at the end of the month. Of those waiting, the number that have been waiting longer than 6 calendar months since their date of referral.
Number who have been waiting for FSA for >12 months
A subset of the total number waiting at the end of the month for FSA. Of those waiting, the number that have been waiting longer than 12 calendar months since their date of referral.
Number who have been waiting for FSA for >18 months
A subset of the total number waiting for FSA at the end of the month. Of those waiting, the number that have been waiting longer than 18 calendar months since their date of referral.
Appendix 1 – Special notes for endoscopy and dental services
This section provides further information about management of endoscopies and dental treatments in the spreadsheet.
Endoscopy
If you do not purchase outpatient endoscopy procedures separately under “Endoscopy”, that section of the column should remain blank.
If outpatient endoscopy procedures are purchased as part of another specialty, these should be reported in the specialty column where they are purchased. For instance:
- Gastroenterology – ie, Gastroscopy, Colonoscopy, GRCP,
- General Medicine, or
- General Surgery – ie, Respiratory, Bronchoscopy, Urology, Cystoscopy.
Dental
Outpatient dental treatment is purchased on the basis of attendances. Typically it is not split between FSAs and Follow-ups. Therefore, unless your organisation has the capacity to track firsts and follow-ups, the only requirement is that the number of attendances be recorded in the following reporting lines:
- “Number of follow-ups seen during the month”, and
- “Number of follow-ups YTD”.
If you do track dental FSAs separately, then you need also to give waiting time information.
Appendix 2 – Glossary of outpatient terms
This section identifies the key terminology used in relation to activities associated with Elective Services.
Booking System Data
Data that focuses on elective and arranged services. Booking system data in the Monthly Returns excludes both ACC cases (ZA & ZC) and private cases.
Access Criteria For First Specialist Assessment (ACA)
Criteria that assist in prioritising referrals received from the primary sector for clinical first specialist assessment.
Clinical Priority Assessment Criteria (CPAC)
A set of national assessment tools for each specialty that assists in assessing the clinical priority of patients.
Only four specialties do not have national tools yet. They are:
- General Surgery
- Neurosurgery
- Urology
- Vascular Surgery.
For these four specialties, local or nationally recognised tools should be tracked.
First Specialist Assessment (FSA)
A first specialist assessment is the assessment undertaken by a hospital specialist following referral by a patient’s primary care practitioner, usually a general practitioner (GP).
FSAs exclude:
- Emergency Department attendances
- outpatient attendances for pre-admission assessment/screening (this is included in the price for the relevant AN-DRG based purchase unit)
- patients who have had an FSA but are waiting for diagnostics, eg, an echocardiogram or stress test.
FSAs are specialty based. When a patient is referred to a different specialty, a new FSA occurs. However, you should record only one FSA if a patient is seen by different specialists attending the same clinic.
If a patient is referred to a new specialist at a different DHB, a new FSA occurs. However, if it is the same specialist providing the service at the different DHB, eg, as part of a visiting clinic, the attendance is a follow-up.
Follow-Up (FU) Attendances
Follow-ups are further assessments by hospital specialists.
Follow-ups include:
- post-discharge follow-ups, including new clinic attendances
- services provided in a ward and/or at a designated outpatient clinic.
Follow-ups exclude:
- Emergency Department attendances
- attendances specified as separate purchase units
- pre-admission clinics.