Section 3: Data guidance

The Organisation Data Service (ODS) code of the trust 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 the Electronic Prescription Service. Most NHS providers have an ODS code.

Read more about codes in the data dictionary. 

All organisations must enter their organisation ODS code.

These are aggregate counts of patients assessed for alcohol when attending emergency care in the reporting month.

Data should be reported for each trust site separately. The following categories should be reported:

• Yes - positive alcohol dependence (pre-existing or new clinical diagnosis)
• Yes - possible alcohol dependence (identified through alcohol health-risk assessment, for example a score of 11 or 12 for Audit C, or 20+ on full AUDIT)
• Yes - negative alcohol dependence
• No - Not assessed (for alcohol health-risk or clinically assessed for alcohol dependence)

These are aggregate counts of patients assessed for alcohol when admitted as an inpatient in the reporting month. Include ordinary admissions only and exclude day cases and regular attenders - for example, include only option 1 from the patient classification: 

Read more about patient classification in the data dictionary (this exclusion applies to the aggregate section only)

This should include assessments that took place before the patient was admitted (in emergency care).

Data should be reported for each trust site separately. The following categories should be reported:

• Yes - positive alcohol dependence (pre-existing or new clinical diagnosis)
• Yes - possible alcohol dependence (identified through alcohol health-risk assessment, such as AUDIT or similar)
• Yes - negative alcohol dependence
• No - Not assessed (for alcohol health-risk or clinically assessed for alcohol dependence)

These are aggregate counts of patients assessed for alcohol when attending an outpatient appointment in the reporting month. Aggregate information is only required from first appointments. Patient level records are required for any patients referred from an outpatient setting.

Data should be reported for each trust site separately. The following categories should be reported:

• Yes - positive alcohol dependence (pre-existing or new clinical diagnosis)
• Yes - possible alcohol dependence (identified through alcohol health-risk assessment, such as AUDIT or similar)
• Yes - negative alcohol dependence
• No - Not assessed (for alcohol health-risk or clinically assessed for alcohol dependence)

The ODS code of the hospital site 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. Most NHS providers have an ODS code.

All organisations must enter their organisation ODS code (5 characters).

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

Read more about NHS Number in the data dictionary.

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/Timestamp. Validation breaches will result in an error and rejection.

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

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

Read more about birth dates in the data dictionary.

The given name of the person.

The surname or family name of the person.

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 sex code not recorded)

Read more about gender in the data dictionary.

The ethnic identity of a person as stated by them.

Ethnicities as specified by the NHSD 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
G - Mixed – Any other mixed background 
H - 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 patient with address association type: 'Main Permanent Residence' or 'Other Permanent Residence'.

Whether the patient’s risk of alcohol dependence has been indicated using a validated tool (such as AUDIT/AUDIT-C, FAST) or confirmed by clinical assessment. Although alcohol risk assessment tools can provide an indication of possible dependence, they are in no way diagnostic. Positive diagnosis of dependence should be determined by clinical assessment and diagnosis.

Options are: 

1. Yes - positive alcohol dependence
2. Yes - possible alcohol dependence

AUDIT-C is intended as a pre-screen to identify those who should receive full AUDIT. However, there has been some work that correlates AUDIT-C with full AUDIT scores in order to use AUDIT-C alone to assess alcohol risk. The most reliable comparator study of this is that of Coulten et al 2018.

This correlates an AUDIT-C score of 11 or 12 with a full AUDIT score of 20 and above, signifying potential dependence. 

In previous initiatives undertaken with NHSE&I and in the alcohol and tobacco CQUIN, guidance has been to use AUDIT-C 11 and 12 as the range for potential dependence. Therefore, for consistency it is recommended that the same threshold is used here. 

We advise that a positive AUDIT-C score (5+) should trigger a full AUDIT, in line with WHO guidance on the use of AUDIT short forms.

Please provide the date and time of the activity for the current episode of care (that is, the one which led to the patient's inclusion in this submission). This will often be the date and time that the person arrived at the hospital - for example, admission date and time or emergency care attendance arrival data and time

Note: Dates and times which are not in the specified format will be rejected.

This is the unique identifier for the Emergency Care Attendance which led to the patient being referred to the ACT.   The referral to the ACT may occur in EC or in a subsequent (linked) inpatient admission spell.

Read more about the emergency care attendance identifier in the data dictionary.

Note: this is NOT the local patient hospital number

This is the unique identifier for the Hospital Provider Spell which either led to the patient being referred to the ACT or succeeded an emergency attendance where the patient was referred to the ACT.

Read more about the Hospital Provider Spell in the data dictionary.

Note: this is NOT the local patient hospital number

This is the unique identifier for the outpatient appointment which lead to the patient being referred by the ACT. 

Note: this is NOT the local patient hospital number

This is the unique identifier for the outpatient appointment which led to the patient being referred to the ACT.

This indicates the source of the referral to the ACT.

Options are:

1. Emergency Care
2. Inpatient
3. Outpatient

This is a Y/N Indicator.

This indicates if the patient is new to the ACT (that is, either completely new or beginning a new episode of support after a gap). For the data collection this is defined as: not having been seen already during the current month and not having been seen in the previous month either.

This indicates the number of interactions that the patient has had with the ACT.   Only interactions pre-discharge from hospital should be reported in all cases apart from where referred as an outpatient.

An ACT episode starts from the time that a patient has agreed to treatment by the ACT, and has had their first consultation with the service, to the time that they are either discharged from hospital or discharged from the ACT (if remaining in hospital or if referred as an outpatient). In this period a patient may have multiple consultations (interactions) with members of the ACT.  A patient may be followed-up by the ACT after discharge from hospital and whilst this is good practice, these interactions are out of scope of this measure and the national collection.

This is a Y/N indicator.

Whether the patient was referred to continue treatment in community alcohol services. This includes referrals to any community alcohol service (for example, the AA or other voluntary and charity sector services). Referrals are defined as any contact with a community alcohol service and not just a formal referral.

This specifies whether the patient was formally referred to continue treatment in community alcohol services.

Options are:

1. First referral/not on caseload
2. Not first referral/already on caseload
3. Not first referral/previously open and discharged

Note: This field is mandatory where COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

ACT PREVENTED INPATIENT EMERGENCY ADMISSION INDICATOR

Emergency Care Referrals only.

This indicates whether the ACT intervention has prevented an inpatient emergency admission and the patient was seen and managed in emergency care.

Instances where ACT intervention has prevented an admission. Admission avoidance can be defined as an occurrence in which a patient had a contact with ACT, and as a result, no longer needed to be admitted into hospital. Avoidance of an admission of >= 4 days that would have been necessary if the ACT were not in place.

An averted inpatient emergency admission can be declared if the Emergency Department made an initial decision to refer the patient to medics for admission but intervention by the ACT has changed this plan. It is acknowledged that this figure will be subjective as it depends on the experience and confidence of the Emergency Department doctors, as one may plan to admit where another would discharge the same patient. We would ask that a level of professional judgement is taken in capturing this data.

This specifies whether the patient completed Medically Assisted Withdrawal (MAW), in which setting and whether it was under the supervision of the ACT.

Options are:

1. Patient completed MAW in HOSPITAL, under the supervision of the ACT.
2. Patient completed MAW, outside of hospital, under the supervision of the ACT (for example, the patient completed MAW as ambulatory care or an outpatient)
3. Patient was discharged and referred to a community alcohol service to complete MAW. Note: this option refers to the initial intention for the patient to start and complete MAW in the community, irrespective of their final status following the onwards referral or whether the patient is advised to resume drinking at a reduced level (where appropriate) until services have the capacity to support a MAW.
4. Patient was discharged without completing MAW and without ongoing support.

Completion of MAW should be regarded as completion of a course of pharmacotherapy that enables the patient to be in a stable condition whilst free of alcohol indefinitely if this is the patient’s desired outcome. It is part of the role of ACTs to inform patients of the value of remaining abstinent on discharge, to encourage and support them in having abstinence as a goal and to refer them to ongoing treatment and support post-discharge from the hospital. Where a patient wishes to resume drinking on discharge and this is recorded in their care plan/notes, the MAW should be considered complete for the ACT.

Note: If not applicable (i.e. the patient did not require MAW), this data element should be left blank and N (No) should be input in the 'MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR' (Data element 22).

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 1, 2 or 3
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 1 or 2
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = N

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 1, 2 or 3
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 2

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 3
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 3
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = Y
• MEDICALLY ASSISTED WITHDRAWAL (MAW) CARE SETTING AND STATUS = 4

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = N
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = N
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = N

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = N
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = N

• MEDICALLY ASSISTED WITHDRAWAL (MAW) REQUIRED INDICATOR = N
• COMMUNITY ALCOHOL SERVICES - REFERRAL INDICATOR = Y