Aggregate Contract Monitoring (ACM): Guidance for providers and commissioners - NHS England
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Aggregate Contract Monitoring (ACM): Guidance for providers and commissioners
OFFICIAL
NHS England INFORMATION READER BOX
Directorate
Medical Operations and Information Specialised Commissioning
Nursing Trans. & Corp. Ops. Commissioning Strategy
Finance
Publications Gateway Reference: 06813
Document Purpose Resources
Aggregate Contract Monitoring (ACM): Guidance for providers and
Document Name
commissioners
Author NHS England
Publication Date March 2018
Target Audience CSU Managing Directors, NHS England Directors of Commissioning
Operations, Directors of Finance, Commissioning Teams and
Information Teams
Additional Circulation #VALUE!
List
Description Aggregate Contract Monitoring (ACM) Dataset Specification - a
consistent method of SLA reporting between providers and NHS
England commissioners. This guidance provides instructions regarding
the population of the ACM data specification
Cross Reference
Aggregate Contract Monitoring (ACM)
Superseded Docs
N/A
(if applicable)
Action Required
Monthly submission of ACM
Timing / Deadlines
Monthly
(if applicable)
Contact Details for Ceri Townley, Head of Specialised Services Intelligence
further information NHS England, Commissioning Operations Directorate
c/o Wessex Area Team Office, Oakley Road
Southampton, Hampshire
SO16 4GX
07733 404969
https://www.england.nhs.uk/nhs-standard-contract/ss-reporting
Document Status
This is a controlled document. Whilst this document may be printed, the electronic version posted on
the intranet is the controlled copy. Any printed copies of this document are not controlled. As a
controlled document, this document should not be saved onto local or network drives but should
always be accessed from the intranet.OFFICIAL Aggregate Contract Monitoring Version number: 3.1 First published: March 2018 Prepared by: Martin Hart, NHS England, Ceri Townley, NHS England and Raj Bhatt, NHS England Classification: OFFICIAL
OFFICIAL Contents 1 Introduction.......................................................................................................... 5 2 Collection development ....................................................................................... 6 3 Ensuring data is fit for purpose ............................................................................ 6 4 A national format that works locally ..................................................................... 7 5 Report recipients ................................................................................................. 7 6 Submission method and timescales .................................................................... 8 7 Submissions type and resubmissions.................................................................. 9 8 Completion method ............................................................................................. 9 8.1 Individual months example .......................................................................... 10 8.2 Twelve months every month example ......................................................... 10 9 Forecasting........................................................................................................ 11 10 Generic completion guidance ......................................................................... 11 11 Specific completion guidance ......................................................................... 12 12 Frequently asked questions (FAQs) - Acute ................................................... 15 13 Frequently asked questions (FAQs) - Mental Health ...................................... 18 14 Appendix I ....................................................................................................... 23 15 Appendix II ...................................................................................................... 26 16 Reference tables............................................................................................. 26
OFFICIAL
1 Introduction
1. The intention of an Aggregate Contract Monitoring (ACM) standard file format
is to enable the interchange, in a uniform and consistent format, of monthly
aggregate contract monitoring between the purchasers and providers of
healthcare. This will ensure that monthly reporting of contracted activity and its
value is comprehensive and meets the business requirements of NHS
England as a commissioner, for the purposes of Schedule 6 of the NHS
Standard Contract.
2. For NHS England directly-commissioned services, the receipt of uniform ACM
data relating to NHS-funded activity and finance at a provider-level will allow
for the production of local NHS England reports that will then feed in to a
regional and national view. The standard format will ensure inter-provider
comparisons which is currently lacking.
3. This data collection specification is expected to be used by all providers of
NHS-funded health care including NHS healthcare providers, independent
sector providers, third sector providers and small contract providers with
whom NHS England commissions. It is hoped that, by reducing the number of
aggregate contract monitoring return formats to a single format, the ACM will
greatly reduce the administrative burden across the NHS.
4. Whilst the ACM was developed to meet the immediate need of specialised
commissioning, the specification has been adapted to accommodate activity
and cost for all NHS England directly commissioned services.
5. The programme of development work around the ACM is non-system specific
so whilst it is acknowledged that many organisations may have commonality in
the use of current software systems this template has been designed to be
independent of any one specific system.
6. Whilst historically the aggregate data specification was referred to as SLAM
(SLA Monitoring), in the interest of impartiality this should now be referred to
as Aggregate Contract Monitoring (ACM).OFFICIAL
2 Collection development
8. The initial ACM specification was issued during 2014-15 and proved useful in
subsequent developments. Appendix II provides a summary changes made to
the 2017-18 specification for the 2018-19 specification.
9. NHS England is taking this data specification through the formal information
standard development process with NHS Digital with the view to it becoming a
recognised data standard and an accompanying Information Standards Notice
(ISN) being issued. It is acknowledged that further changes and refinements
will be made as part of this process.
3 Ensuring data is fit for purpose
10. The submitted ACM should include all activity and cost details that are
included within the invoice being generated by a provider.
11. Ensuring that the data reconciles with monthly invoices from providers will
enable NHS England to deliver robust centralised reporting which is both
meaningful and usable by a number of parties. Under no circumstances
should personal confidential data (PCD), or personal information about
identifiable individuals, be submitted.
12. Whilst the primary focus in collecting and using this data is to deliver national
assurance of contract delivery many other value-added uses will be possible
to derive from a national dataset.
13. Some examples of these include:
Service-line activity reporting that can be aggregated to form a local
commissioner, regional and national view
Service-level reporting to answer questions for example: ‘How much did NHS
England spend last month on specialised cardiac services?’
Provide commissioner insight into activity levels and their cost for services not
reported in national systems such as Secondary Uses Service (SUS)
Provide an insight into the equity of access of services not reported in national
systems such as SUS
Supporting national benchmarking of local non-tariff prices for services that
are not under tariff Providing assurance that NHS England is undertaking its
statutory duties in terms of the Armed Forces Covenant
Allow root-cause analysis of key system drivers
Provide support for service change planning and hospital capacity planning
analysis
Improved year-end forecasting and forecasting against plan for all services
Support for scenario planning when services are moved to either differing
providers or when commissioning responsibility changes e.g. from NHS
England to Clinical Commissioning Groups (CCGs), giving providers more
accurate activity benchmarking and local tariff comparisons.OFFICIAL
4 A national format that works locally
14. The national standardised ACM specification has been designed to allow
nationally consistent reporting. In the interests of streamlining the flow of data
within the NHS the specification has been expanded slightly from previous
versions to accommodate information at a detail which could be required
locally. This should allow the flexibility of reporting from the ACM to serve
multiple audiences whilst avoiding the need for multiple flows of similar data.
5 Report recipients
15. Most providers will provide health care for a number of different
commissioning organisations. In addition to each of the CCGs with whom it
commissions, a provider may have to create ACM data where NHS England is
the responsible commissioner for:
Specialised services
Secondary dental care
Armed forces care
Health and justice care
16. Each NHS England Region will be serviced by a specific Commissioning
Support Unit(s) (CSU), who will utilise the services of a specific Data Services
for Commissioners Regional Office (DSCRO). This will include the service
provided by the three specific CSUs who collate data relating to armed forces,
highly-specialised services and specialised mental health services
respectively.
17. Providers need send their ACM reports to the correct CSU/DSCRO by splitting
the total provider ACM into commissioner-specific elements, making use of the
NHS England Commissioned Service Category code for NHS England
directly commissioned activity and sending this to the respective CSU/DSCRO
responsible for that particular commissioner.OFFICIAL
6 Submission method and timescales
18. The Reporting Requirements Schedule of the NHS Standard Contract that is
drafted locally and agreed with providers should specify the explicit delivery
mechanism used to send ACM data to the right recipient (Data Landing Portal
(DLP), NHS Mail, secure FTP etc.).
19. Commissioners will need to agree file naming conventions as part of the wider
data interchange mechanism so it is easy to identify which provider has
submitted which file and the activity period covered by each submission.
20. The ACM file specification has the following guidance regarding submission
timescales:
21. “This ACM is required to be submitted on a monthly basis to the
DSCRO/CSU/other organisation as nominated by each commissioning
function in line with the dates documented in the data submission
timetable within Schedule 6 of the NHS Standard Contract. The total
financial value contained within the ACM for any particular month MUST
tie-back to the invoices raised in reference to the same period. Any
monthly resubmission of data must be accompanied by a reissued
monthly ACM dataset to be used on a bulk-replacement basis.”
22. The ACM file specification includes a File Date field in order to manage the
above requirement.
23. The production of an ACM by year end may result in a file of a relatively large
size. Providers and commissioners need to ensure, by local agreement that
they employ suitable measures to allow for the production and transfer of such
files.
24. The submission of ACM is tied in to that of the timetable within Schedule 6 of
the NHS Standard Contract to ensure that ACM submissions can be
reconciled with both SUS Commissioning Data Set (CDS) submissions and
any other patient-level datasets that support the aggregate figures in the ACM.
These include:
National patient-level drug contract monitoring template
National patient-level device contract monitoring template
Other clinical datasets used in the Identification Rules (IR) for prescribed
specialised services e.g. The Trauma Audit & Research Network (TARN), UK
Rehabilitation Outcomes Collaborative (UKROC), spinal surgery database etc.
Mental Health Services Data Set (MHSDS)
25. For consistency, providers and commissioners may wish to provide their 2018-
19 plans in the same format as the ACM. Should this be the case, fields
relating to actual activity and price should be blank, with the month field set to
zero and year field to ‘18/19’. For Specialised Mental Health Providers all
commissioning plans should be documented within the Mental Health Price
and Activity Matrix (MH PAM).OFFICIAL
26. A General Medical Practice Code (Patient Registration) field has been
included for organisations to use should they require. If plans are not held at
this level of granularity, this field can be left blank.
7 Submissions type and resubmissions
27. All data must be submitted in line with the agreed submission dates within
Schedule 6 of the NHS Standard Contract. Providers may submit multiple
versions of an ACM for a specific period up to these agreed dates.
28. All submissions or resubmissions must be on a bulk replacement basis, up to
the agreed submission dates within Schedule 6 of the NHS Standard
Contract.
29. Any data submitted by providers before these dates for a reporting period or
periods overwrites and replaces in full any previous submissions for the
same reporting period or periods. Providers must not submit data for part
months.
30. Amendments after these agreed submission dates can only be submitted
where this has been agreed by the relevant commissioner and the provider.
8 Completion method
31. The scope of the ACM is inclusive. In order to support the validation process,
providers must ensure that it includes all that which is included in the monthly
invoice. The total financial value contained within the ACM for any particular
month must tieback to the invoices raised in reference to the same period.
32. In order to maintain the ACM format, even when a specific field e.g. Further
Detail Description is not used, this should be left blank. Under no
circumstances should any field be omitted.
33. All submissions up to the agreed submission date will be on a bulk
replacement / update basis i.e. each submission / resubmission will overwrite
and replace in full any previous submissions for the same reporting period or
periods.
34. The inclusion of separate Month, Year and File Date fields will assist in the
data submission / resubmission and bulk replacement process. It is
appreciated that some of these fields may not be present in some contract
monitoring systems and may have to be added following export from these
systems.OFFICIAL
35. Providers must use a consistent method of completion to populate the ACM
with data for each ACM submission. This will be one of two formats:
Individual months
Twelve months every month
36. No other completion method (e.g. current month only or cumulative year
to date) is permitted. A minimum requirement for all providers in 2018-19
is a submission of individual months (see example below).
8.1 Individual months example
37. This must contain data relating to the current reporting month and all previous
months, with all previous months shown individually. Each submission
must contain data for each of the submission periods prior to the current
submission period - the June 2018 submission will contain plan and actual
data for activity and finance for April 2018, May 2018 and June 2018 all shown
separately.
38. Table 1 below shows a simplified (i.e. not all fields shown for sake of clarity)
ACM report against two separate contract lines for ACM reporting relating to
activity and associated value up to and including month 2.
Table 1 (data shown for illustrative purposes only)
Plan Actual Plan Actual
Month Year POD HRG
Activity Activity Finance Finance
1 18/19 EL EA20Z 50 30 £487,750 £292,650
2 18/19 EL EA20Z 50 54 £487,750 £526,770
1 18/19 NEL EA52Z 10 12 £148,270 £177,924
2 18/19 NEL EA52Z 10 14 £148,270 £207,578
39. As a development, where possible or where it is already taking place,
submissions will show twelve months every month. Some contract monitoring
systems currently in use have this feature incorporated as an export option.
8.2 Twelve months every month example
40. Table 2 shows a simplified ACM report (i.e. not all fields shown for sake of
clarity) against 2 separate contract lines for ACM reporting relating to activity
and associated value up to and including month 2. The black text shows
planned and actual activity and finance separately for month 1 and 2. Blue text
shows the future month plan (adjusted) with dark pink text showing the
forecast actual (forecast based on a simple full-year projection)OFFICIAL
Table 2 (data shown for illustrative purposes only)
Plan Actual Plan Actual
Month Year POD HRG
Activity Activity Finance Finance
1 18/19 EL EB06A 50 30 £220,050.00 £132,030.00
2 18/19 EL EB06A 50 54 £220,050.00 £237,654.00
3 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
4 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
5 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
6 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
7 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
8 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
9 18/19 EL EB06A 40 42 £176,040.00 £184,842.00
10 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
11 18/19 EL EB06A 35 42 £154,035.00 £184,842.00
12 18/19 EL EB06A 50 42 £220,050.00 £184,842.00
1 18/19 NEL EB07A 10 12 £43,310.00 £51,972.00
2 18/19 NEL EB07A 10 14 £44,010.00 £61,614.00
3 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
4 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
5 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
6 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
7 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
8 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
9 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
10 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
11 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
12 18/19 NEL EB07A 10 13 £44,010.00 £57,213.00
9 Forecasting
41. Providers, in collaboration with commissioners, will need to use whatever
forecasting methodology they consider appropriate for their local health
economy.
10 Generic completion guidance
42. In the template specification, those fields shown in UPPER CASE are
standard NHS data items whose format and valid codes can be found in the
NHS Data Model & Dictionary v3. These fields must be populated using
nothing other than a valid code (including those used for missing or
unknown values).
43. All text contained within the submission must be in UPPER CASE.
44. All organisation and GP practice codes (where used) must be populated using
valid codes as issued by the NHS Digital - Organisation Data Service (ODS).OFFICIAL
All healthcare resource group codes must be the current version for the
reporting year in question.
45. Specialty codes included within the ACM must be activity treatment function
codes (previously known as treatment function codes or TFCs) and not
consultant main specialty codes.
46. Points of delivery (PODs) by themselves will not necessarily define a specific
service. In order to achieve sufficient levels of granularity, PODs should be
used in conjunction with other fields within the data specification e.g. an
activity treatment function code, service code or healthcare resource group
code. In the case of non-activity based PODs it is not expected for the
Organisation Code (Responsible CCG), Healthcare Resource Group or
General Medical Practice Code (Patient Registration) fields to be populated.
47. The use of local codes is supported by the inclusion of some fields e.g. Local
Point of Delivery or Further Detail. It is expected that the need for local
codes will allow the capture of greater levels of granularity and detail regarding
the service(s) being commissioned.
11 Specific completion guidance
48. Organisation Code (Code of Provider) field
This field is a five character alphanumeric field, the first three characters
denoting the Trust or national provider with the final two denoting the specific
site within that same provider. It is not mandatory to have site-specific data but
where this is required for specific monitoring purposes, providers will be
expected to complete this field with a valid five character value.
49. Local Sub-Specialty Code field
This field has been included following feedback from users where it is used to
support local commissioning processes. It is unlikely to be used for the
purposes of aggregated reporting by NHS England. In line with the NHS Data
Model & Dictionary v3, this field is alpha-numeric eight character field.
Where further detail is required, it is anticipated that any local mapping
schemes will be supported by lookup files outside the ACM process.
50. NHS England Commissioned Service Category field
This field must be completed for all activity that is directly commissioned by
NHS England, irrespective of whether it relates to armed forces, health in
justice, public health, secondary dentistry or specialised services, since this
allows the ACM to be split by the responsible NHS England team. Activity
relating to all other commissioners should be coded to 99.OFFICIAL
51. Healthcare Resource Group (HRG) field
This field should be populated using a national HRG code. Top-up suffixes
should be made explicit e.g. AA18Z/8 showing a specialised service top-up or
QZ15B/BP25 for that of a best practice tariff.
Where appropriate, providers and commissioners by local agreement may
wish this field to be populated using a locally-defined HRG - albeit in the same
format as that of a national code.
52. National Point Of Delivery field / Local Point Of Delivery field
It is accepted that providers and their commissioners may require points of
delivery (PODs) that are not listed in the national list of PODs (see Appendix
I). For this reason there is a Local Point of Delivery and Local Point of
Delivery Description field within the ACM. Should these be utilised, providers
and commissioners must ensure that there is a robust mapping of these local
codes to their national equivalents, making sure that the measure (unit of
volume) for any specific local POD matches that nationally.
It will be the responsibility of the both the provider and DSCRO/CSU/other
organisation to ensure that the National Point of Delivery field is consistently
populated where non-standard local PODs are used.
Local activity that cannot be mapped to a National Point of Delivery field
should be coded to other in the National Point of Delivery field and a
narrative put in the Further Detail field. NHS England intends to work with
commissioners and providers nationally over the coming year to refine these
data line descriptions by agreeing logical groupings to support aggregation
and reporting consistency.
53. Commissioning for Quality and Innovation (CQUIN) point of delivery
(POD)
Monies relating to all CQUIN payments should be recorded with a National
Point of Delivery of CQUIN.
54. Further Detail Code and Further Detail Description fields
Free text code and description fields have been included in the ACM
specification. This is similar to the Ad Hoc fields in the Civica SLAM and other
equivalent contracting software products.
The Further Detail Description field must to be used in instances where the
National Point of Delivery has been identified as requiring more information
(those identified by an asterisk in the list of National Point of Delivery
codes).OFFICIAL
Where the National Point of Delivery is indicated as requiring the completion
of the Further Detail Description field the text should be descriptive. It is
suggested that providers show: the local code used for this service in the
Further Detail Code field and some textual description / measure in the
Further Detail Description field. It is advised that where providers and
commissioners need to capture structured data in the Further Detail
Description field, a delimiter e.g. the ‘pipe’ character (‘|’) should be used by
local agreement in the format DESCRIPTION|MEASURE, assuming that this
does not interfere with any delimiter used as an export field separator.
e.g. ADDITIONAL ACTIVITY FOR NEW SERVICE|OBD
Where a local (i.e. non-standard) HRG has been used in the Healthcare
Resource Group field, this should be described in the Further Detail
Description field.
Where a service is commissioned using a standard National Point of
Delivery but counted using a different measure this differing measure must be
shown in the Further Detail Description field.
Where it may add value e.g. where the National Point of Delivery is CQUIN,
the Further Detail Description field may also be used to provide further
information.
55. General Medical Practice Code (Patient Registration)
The General Medical Practice Code (Patient Registration) field has been
included for validation purposes and / or where organisations have a
requirement for data at this level of granularity. For consistency in reporting, if
planned activity has not been agreed at this level, monthly monitoring will not
be at this level and the field can be left blank.
56. Drugs and devices
The National Point of Delivery relating to the POD with the code DRUG
should be on twelve separate lines if the ‘twelve months every month’
completion method is adopted or a single line per month if the ‘individual
months’ completion method is adopted.
The National Point of Delivery relating to the POD with the code DEVICE
should be on twelve separate lines if the ‘twelve months every month’
completion method is adopted or a single line per month if the ‘individual
months’ completion method is adopted.
Patient-level details relating to these lines will be included in two separate data
submissions (the Drugs Patient Level Contract Monitoring and Devices PatientOFFICIAL
Level Contract Monitoring) whose total value for each month must match that
contained within the ACM.
The activity fields for both drugs and devices PODs (where POD is ‘DRUG’ or
‘DEVICE’) should be set to zero and financial values completed with the
relevant aggregate financial information.
12 Frequently asked questions (FAQs) - Acute
Q1. Should the Healthcare Resource Group field include best practice tariff
and specialised top-up flags?
A1.Yes. The template has been designed to accept HRG code containing
respective top-up suffix where applicable.
Q2. Should the ACM be used to capture patient-level data?
A2. The ACM specification been designed to support NHS England’s
requirement for contract monitoring and invoice validation. The contract
monitoring process must be supported by aggregate contract data for which the
template was primarily designed however it is possible to use the template for
patient-level data capture where this is required locally. If patient-level data is
being captured and submitted please ensure that personal confidential data
(PCD), personal information about identified or identifiable individuals, are never
recorded in the template.
Q3. Other than the ACM data, are other supporting datasets required to be
submitted by providers as part of the centralised contract monitoring
process?
A3. A patient level drugs and devices dataset must be submitted in parallel to the
ACM dataset. It is expected that the aggregate total of the Total Cost field in the
patient level drugs and patient level devices datasets will match that in the ACM).
Q4. The points of delivery (PODs) in use locally are different from those
released with the ACM specification and guidance. How should providers
map local PODs to the nationally recognised list?
A4. It is clearly understood that local commissioning processes will require a
wide range of PODs to be recorded and reported on locally. As NHS England is
looking to consolidate these local data sets, a level of consistency must be
achieved. To ensure that aggregation to regional and national levels is possible a
list of national PODs has been distributed with the ACM.
It is expected that the majority of activity and finance will fit within these
categories. Where a local POD does not appear in the national list the nearest
match should be found. Where a local POD offers a greater level of granularityOFFICIAL than is required nationally a more generic POD could be selected in the template e.g. a local POD describing an outpatient clinic being carried out for a specific disease or taking place in a specific location could be mapped to a national POD of OPFA for a new attendance or OPFUP for a follow-up attendance. Q5. Plans are not available at a GP practice level. Can plans be submitted without populating this field? A5. Yes. The General Medical Practice Code (Patient Registration) field has been included following feedback from some providers and commissioners who set and monitor activity at this level. If, locally, plans and actuals are not recorded at this level of granularity the field may be left blank with data aggregated to commissioner level only i.e. NHS England or CCG. Q6. Why do providers need to submit the financial value for Market Forces Factor (MFF) as this could be derived from national reference tables? A6. In the vast majority of cases NHS England could assume that where the tariff is nationally agreed i.e. the value in the National Tariff field is ‘Y’, then MFF is to be calculated in accordance with the reference tables supplied within the Payments by Results (PbR) Guidance. However, during the consultation process it has become apparent that there are some instances where providers and commissioners have agreed a local tariff that is still subject to MFF uplift outside of the agreed tariff. For the avoidance of any doubt it is felt to be a more robust dataset if the MFF financial value is captured separately. Q7. Local reporting requirements require the capture of a number of additional fields beyond those documented in the template. Can providers add additional fields to the template to support local reporting requirements? A7. Yes. A number of very general purpose fields are included in the specification to support this requirement following the consultation process. Q8. Could provider site code be included as a field in the ACM template? A8. The template layout requests a five digit provider code, the last 2 digits of which refer to the site within the provider. Q9. Why are descriptions not included where only a coded field value is included? A9. The data set specification has been created with the minimum number of data items and to contain no fields which could otherwise be derived in order to minimise file sizes.
OFFICIAL Q10. Why have plan versus actual variances not been included? A10. The data set specification has been created with the minimum number of data items and to contain no fields which could otherwise be derived in order to minimise file sizes. Q11. Why has CQUIN been included as a POD rather than a field to be populated for each data row? Would it not have made more sense to split CQUIN across contract lines rather than as a separate POD? A11. The POD of CQUIN was added as a direct result of the consultation process. Consultation indicated that the majority of providers and commissioners would prefer to capture CQUIN as an individual POD rather than profiled across all other activity lines. Q12. Can the template accommodate multiple adjustment lines? A12. Yes. The further detail code and further detail description fields can be used to store the description of any financial adjustments. Q13. Is the inclusion of ‘forecast’ values mandatory? A13. No. It is hoped that during the year providers and commissioners will develop methods for calculating forecasts. NHS England will work with stakeholders during the year to discuss how forecasting could best be delivered. Q14. Why can we not send the current month and a year to date (YTD) position every month? A14. The submission of a YTD data set will not support the invoice reconciliation process as resubmissions will be lost in year meaning that individual activities and financial values will no longer be attributable to an individual month. Q15. Can a timetable be supplied showing the dates by which each month’s file needs to be submitted? A15. The submission timetable for the ACM dataset is dependent on the formal PbR timetable which is yet to be officially published. Q16. Why are there no data items within the ACM that show the annual plan? A16. The data set specification has been created with the minimum number of data items. The annual plan figures will be the same as those in the agreed contract within the price activity matrix.
OFFICIAL 13 Frequently asked questions (FAQs) - Mental Health Q1. Is the ACM a reporting requirement for Specialised Mental Health providers? A1. Yes the ACM is a reporting requirement for Specialised Mental Health providers. The ACM dataset should include all activity and cost details that are included within the invoice being generated by a provider. Q2. How does the ACM differ to the national SMH Provider Template and the MHSDS? A2. The ACM is primarily an aggregate reporting requirement for Specialised Mental Health providers. The MHSDS and SMH provider datasets are both patient level datasets. The MHSDS is a patient level, output based, secondary uses data set for children, young people and adults who are in contact with Mental Health Services (excluding gender services). Version 3.0 of the MHSDS now includes the required dataset fields to identify activity for Specialised Mental Health services for referrals, ward stays and care contacts however there is not national coverage against the MHSDS version 2.0 with valid Specialised Commissioning records flowing. It is expected that a more detailed reconciliation will take place against the SMH provider dataset and the MHSDS v3.0 output to determine the comparability between these datasets and continued aim to remove the reporting requirement for the SMH provider dataset in due course. Q3. Should the ACM be used to capture patient-level data? A3. The 2017-18 ACM specification has been designed to support NHS England’s requirement for contract monitoring and invoice validation. The contract monitoring process must be supported by aggregate contract data for which the template was primarily designed. However it is possible to use the template for patient-level data capture where this is required locally. If patient- level data is being captured and submitted please ensure that personal confidential data (PCD), personal information about identified or identifiable individuals, are never recorded in the template. The use of the Very General Purpose fields (VGP) can be used to submit a local / pseudonymised patient identifier if required and has been marked as an ‘Optional’ dataset field within the ACM dataset specification accordingly. Q4. Other than the ACM data, are other supporting datasets required to be submitted by providers as part of the centralised contract monitoring process? A4. Yes. The SMH provider template (and MHSDS) must be submitted in parallel to the ACM dataset. It is expected that the aggregate total within these patient level datasets match that in the ACM.
OFFICIAL
Q5. Should the ACM be used to capture contractual plans for Specialised
Mental Health Services?
A5. No. All contractual plans relating to Specialised Mental Health services
should be recorded against the Mental Health Price and Activity Matrix (MH
PAM) as described in Schedule 2b of the NHS Standard Contract. Where
providers have contractual arrangements for non-specialised mental health
services this level of planned information should be submitted within an ACM
format.
Q6. What information is required to be submitted in the Activity Treatment
Function Code field for Specialised Mental Health Services?
A6. The NHS Data Dictionary Treatment Function Codes (TFC) listed below
should be used to complete this field in the dataset and should be read in
conjunction with the Specialised Mental Health Service Category Codes.
Table 3
Activity Treatment
Activity Treatment Function Code Description
Function Code
100 GENERAL SURGERY
710 ADULT MENTAL ILLNESS
711 CHILD AND ADOLESCENT PSYCHIATRY
712 FORENSIC PSYCHIATRY
720 EATING DISORDERS
724 PERINATAL PSYCHIATRY
Q7. Should the Healthcare Resource Group field be included as part of the
submission for Specialised Mental Health providers?
A7.Yes. The template has been designed for all healthcare organisations and is
a mandatory dataset item. Since specialised mental health services do not utilise
Health Care Resource Groupings for identification please record this dataset item
with the value ‘ZZ00Z’.OFFICIAL
Q8. What information is required to be submitted under the ‘National Point
of Delivery’ dataset field for Specialised Mental Health services?
A8. The following National Point of Delivery (POD) codes should be used to
complete this dataset field and should be read in conjunction with the Specialised
Mental Health Service Category Codes.
Table 4
National Point of
National Point of Delivery Description
Delivery Code
DCRE DAY CARE
IPOBD OCCUPIED BED DAY
COMM CONTACT
OPFA OUTPATIENT FIRST ATTENDANCE
OPFUP OUTPATIENT FOLLOW-UP ATTENDANCE
EL ELECTIVE SPELL
BLOCK BLOCK
CQUIN CQUIN
ADJUSTMENT ADJUSTMENT
OTHER OTHER
Q9. What information is required to be submitted in the National Tariff
dataset field for Specialised Mental Health services?
A9. This dataset field should be completed with the value ‘N’ to denote that the
activity is outside of PbR National Tariff arrangements.
Q10. What information is required to be submitted under the MFF dataset
fields for Specialised Mental Health services?
A10. This dataset field should be completed with the value ‘0.00’ as MFF is not
applicable to non-PbR activity.OFFICIAL
Q11. Where should healthcare organisations record service category
codes, unit, ward and local patient identifiers for Specialised Mental Health
Services?
A11. The dataset specification has been designed to allow for the recording of
this information within the Very General Purpose (VGP) dataset fields (excluding
unit code). Outlined below is the dataset location to record this information where
required.
Field Field Completion Status - Mandatory
Number Field Name Data Format (M) / Required (R) / Optional (O)
M - For acute providers
M - For all mental health providers to
record the National ODS Unit Code
4 ORGANISATION CODE (CODE OF PROVIDER) an5 (Where applicable)
M for all mental health providers to
record Service Category Code, O for
25 VGP1 an50 acute providers
M for all mental health providers to
record Service Category Description, O
26 VGP1 Description an100 for acute providers
R for all mental health providers to
record the Local Ward Code for
Inpatient Services, O for acute
27 VGP2 an50 providers
R for all mental health providers to
record the Local Ward Description for
Inpatient Services, O for acute
28 VGP2 Description an100 providers
O for all mental health providers to
record a Local Patient Identifer, O for
29 VGP3 an50 acute providers
O for all mental health providers to
record a Local Patient Identifer, O for
30 VGP3 Description an100 acute providers
Q12. Can I use the VGP dataset fields to record additional information for
Specialised Mental Health services?
A12. Yes. The VGP dataset field can be used to record additional information
which allows further transparency of data of SMH services and has been labelled
as an Optional dataset field. The VGP dataset items should not contain any
personal confidential data (PCD), personal information about identified or
identifiable individuals.OFFICIAL Q13. Why have plan versus actual variances not been included? A13. The data set specification has been created with the minimum number of data items and to contain no fields which could otherwise be derived in order to minimise file sizes. Q14. Why has CQUIN been included as a POD rather than a field to be populated for each data row? Would it not have made more sense to split CQUIN across contract lines rather than as a separate POD? A14. The POD of CQUIN was added as a direct result of the consultation process. Consultation indicated that the majority of providers and commissioners would prefer to capture CQUIN as an individual POD rather than profiled across all other activity lines. Q15. Can the template accommodate multiple adjustment lines? A15. Yes. The further detail code and further detail description fields can be used to store the description of any financial adjustments. Q16. Is the inclusion of ‘forecast’ values mandatory? A16. No. It is hoped that during the year providers and commissioners will develop methods for calculating forecasts. NHS England will work with stakeholders during the year to discuss how forecasting could best be delivered. Q17. Can I submit multiple ACM files against individual Mental Health units? A17. No. All data must be submitted within a singular file which should include all activity and cost details that are included within the invoice being generated by a provider (not a singular MH unit). Providers must not submit data for part months or individual units (only a singular file with all units will be accepted).
14 Appendix I
The following matrix is list of valid National Point of Delivery codes, their associated measures and how these map to differing
patient types. Only those codes shown below should be used as a National Point of Delivery.
National Point Measure
Level 1 Level 2 Level 3 Level 4 Level 5 Measure
of Delivery Description
Emergency NEL SPELL Finished spell
Emergency NELXBD OBD Bed day
Excess bed days
(admission method
21-25,28, 2A-2D) Short stay NELST SPELL Finished spell
Non-elective Occupied bed days NELOBD OBD Bed day
Non-emergency Non-emergency NELNE SPELL Finished spell
(admission method Excess bed days NELNEXBD OBD Bed day
31-32, 81-83) Occupied bed days NELNEOBD OBD Bed day
Daycase (patient class 2 & LoS 0) DC SPELL Finished spell
Ordinary elective (patient class 1) EL SPELL Finished spell
Elective Regular day (patient class 3 & LoS 0) RADAY SPELL Finished spell
Admitted Patient (admission method 11-13) RANIGHT SPELL Finished spell
Regular night (patient class 4 & LoS 0)
Care (APC)
Excess bed days ELXBD OBD Bed day
Occupied bed days ELOBD OBD Bed day
Occupied bed days IPOBD OBD Bed day
Generic Finished consultant episodes IPFCE FCE Finished episode
Specialling (enhanced observation) IPSPECIAL HOUR Hour
Adult (HRG beginning XC) ACC OBD Bed day
Critical Care Paediatric (HRG beginning XB) PIC OBD Bed day
Neonatal (HRG beginning XA) NIC OCD Cot day
Chemotherapy (HRG beginning SB) CHEMOIP Number of HRGs
Unbundled
Other* IPUNB Narrative in Further Detail Description fieldOFFICIAL
National Point Measure
Level 1 Level 2 Level 3 Level 4 Level 5 of Delivery Measure Description
Consultant led OPFASPCL ATT Attendance
Single professional
Non-consultant led OPFASPNCL ATT Attendance
Consultant led OPFAMPCL ATT Attendance
Multi-professional
Non-consultant led OPFAMPNCL ATT Attendance
First Non-face to face NF2FFA ATT Attendance
Domiciliary visit OPFAHOME ATT Attendance
Pre-operative assessment OPFAPREOP ATT Attendance
Ward attender WAFA ATT Attendance
Other OPFA ATT Attendance
Attendance
Consultant led OPFUPSPCL ATT Attendance
Single professional
Non-consultant led OPFUPSPNCL ATT Attendance
Consultant led OPFUPMPCL ATT Attendance
Multi-professional
Outpatient (NAC) Non-consultant led OPFUPMPNCL ATT Attendance
Follow-up Non-face to face NF2FFUP ATT Attendance
Domiciliary visit OPFUPHOME ATT Attendance
Pre-operative assessment OPFUPPREOP ATT Attendance
Ward attender WAFUP ATT Attendance
Other OPFUP ATT Attendance
First OPPROCFA ATT Attendance
Procedure Follow-up OPPROCFUP ATT Attendance
Non-specific attendance type OPPROC ATT Attendance
Radiology (HRG beginning RA) OPUNBRAD TEST Test
Chemotherapy (HRG beginning SB) CHEMOOP Number of HRGs
Unbundled
Pathology OPUNBPAT TEST Test
Other* OPUNB Narrative in Further Detail Description field
Direct Access (DA) DA ATT Attendance
A&E (AE) AE ATT Attendance
High Cost Drugs Financial value
DRUG
(HCDRUG) only
High Cost Devices Financial value
DEVICE
(HCDEVICE) onlyOFFICIAL
National Point Measure
Level 1 Level 2 Level 3 Level 4 Level 5 of Delivery Measure Description
Radiotherapy (HRG beginning SC) RAD FRACTION Delivery of fraction
Year of Care* YOC YOC Year of care
Package of Care* POC POC Package of care
Ante-natal MATPATHAN MPATH Pathway
Maternity Pathway
Post-natal MATPATHPN MPATH Pathway
IVF Treatment IVF CYCLE Cycle
Tests* TEST TEST Test
ARD Hospital / Satellite =
Dialysis Adult SESSION; APD / Measure implied
(HRG beginning
CAPD = DAY; by HRG coded
LD) CRD Home = WEEK
Child
Rehabilitation (HRG beginning VC) REHAB WOBD Weighted bed day
Other (OTHER) Critical Care Transport (HRG XA06Z, XB08Z) CCTRANS JOURNEY Journey
Urgent and emergency care AMBUE CALL Call
Hear and treat/refer AMBHTR PATIENT Patient
Ambulance See and treat/refer AMBSTR INCIDENT Incident
Services AMBSTC INCIDENT Incident
See, treat and convey
Requires narrative in the Further Detail
AMBOTHER
Other* field
Device Maintenance* MAINT ATT Attendance
Day Care DCRE ATT Day care
Community COMM CONTACT Contact
Public Health Screening SCREEN PATIENT Patient
MDT Review* MDT Narrative in Further Detail Description field
Looked After Children Health Assessments* LAC Narrative in Further Detail Description field
Other* OTHER Narrative in Further Detail Description field
CQUIN CQUIN Financial value only
Non-Activity Adjustment* ADJUSTMENT Financial value only
(NONACT) Block* BLOCK Financial value only
Other* NAOTHER Financial value only
Notes:
* Denotes mandatory population of the 'Further Detail Description' field. The Further Detail Description field MUST be completed.
The 'BLOCK' National Point of Delivery should only ever be used where this relates to monies, with the activity measure set to
ZERO.15 Appendix II The following fields have been removed The following fields have been added to from the 2017-18 specification: the 2017-18 specification: No changes No changes The following fields have been renamed or their format changed from the 2017-18 specification: No changes No changes Data fields shown in UPPER CASE have the same definition and format as those same data elements in the NHS Data Model & Dictionary v3 16 Reference tables Aggregate Contract Monitoring (ACM) specification Service Category codes Specialised Service Line codes ACM example dataset Specialised Mental Health Service Category Codes
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