Provider code mapping within HES

Invalid provider codes

Some of the data provided in the HES extract has provider codes which are either out of date, missing, or that have never been a valid provider code. Where this occurs, it is not possible to assign this work to any provider, leading to gaps in information on care.

HES is a cumulative extract covering the year to date; as such it is possible for a code to be valid when submitted but invalid when the data is extracted. HES works on the principle that all data should be mapped to a code that is valid at the time that the extract was taken.

For example, if the annual refresh dataset contained an organisation that had changed its organisation code mid year, all of the activity it performed should be mapped to the code in existence at the end of the year.

Simple maps versus complicated maps

A simple map is where one organisation has changed code into another single organisation code (a one-to-one change). A complicated map is where activity for a single organisation code has changed to include more than one organisation codes (a one-to-many change).

Simple map process (one-to-one)

HES uses a multi-stage automatic process to determine any mapping required. Mapping is done at a three-character level for NHS organisations, but at a five-character level for independent sector organisations.

The three passes are as follows:

• First pass: The code is checked against the 'successor list' maintained by Connecting for Health. if a match to a valid code can be found then the provider code is updated to that code.
• Second pass (inpatient and outpatient only): The site of treatment is checked. If a match to a valid code can be found then the provider code is updated to that code.
• Third pass: The sender code is checked. If a match to a valid code can be found then the provider code is updated to that code.

If no valid code has been determined by the end of the third pass then the episode is deleted from HES.

For example, a record in the inpatient extract has a null provider code, a site of treatment of 5AN01 and a sender code of 5AN00.

The first pass attempts to see if any valid successor can be found for the null provider code. A null value has never been a valid value, therefore it has no successor; no mapping occurs and it moves onto the second pass.

The second pass attempts to map 5AN to site of treatment. 5AN is no longer a valid code; no mapping occurs and it moves onto the third pass.

The third pass attempts to map 5AN to sender code. 5AN is still not a valid code; no mapping occurs and it moves onto final stage and marks the records for deletion.

Complicated mapping process (one-to-many)

Complicated mapping occurs where a single organisation has changed to multiple codes. These are removed from the automatic mapping process to avoid incorrect mappings. Each complicated mapping has to be judged individually since no two are alike.

All data needs to be mapped to a valid provider code. In event of no map being possible the data will be deleted. The HES team will undertake to consult with the trust(s) in question to ensure that the mapping is correct. However, this is not required to proceed.

Any mapping provided by a trust will be used in preference to any mapping generated by the HES team.

The successor file will be checked against provider code at five-character level to determine if a mapping can be undertaken, although the results will only be mapped to three-character level (or five-character level for independent sector treatment centres).

If no valid map can be found using the provider code, the site of treatment (for inpatient and A&E;) will then also be checked against the successor file. If a valid mapping can be undertaken it will be applied at three-character level (five-character level for independent sector treatment centres).

Duplicates

In certain cases, data for a single episode has been submitted under both an obsolete and active code. In such cases mapping the data under the old code creates duplicates within the new code. The standard HES duplicate removal process is designed to catch and remove these duplicates. For information on duplicate detection and removal within HES please see our 'Quick links' section.

This process may not be 100 per cent effective in all cases. However, the increase in accuracy and usability created by provider code mapping outweighs the small number of duplicates that are infrequently created.

Feedback

In order that the quality of data within SUS improves when an invalid provider code is detected, the sender of that code is contacted to ensure that the data is deleted or resubmitted using the correct provider code.

Further information

If you have any further information please contact the HES Data Quality team via e-mail ([email protected]).