Reporting Data Item

Business Justification

Definition

Note: Where ‘NHS Wales Data Dictionary’ the definition is as per the Data Dictionary.

Permissible Values

6. SURGERY

6.0

ENCDv4.5b (7.4)

Surgical intent

To enable analysis by surgical intent.

The purpose of the surgical procedure(s) being carried out.

Permissible values are agreed by the clinical steering groups and conform to the requirements of the reporting output specifications. Currently there is no explicit requirement to map to terminologies or classifications. This will be kept under review.

•     Diagnostic

•     Staging

•     Curative

•     Palliative

6.1

ENCDv4.5b (7.9)

Date on which surgical procedure(s) started

Diagnostic and staging procedures

To estimate the level of accuracy of the diagnosis and staging when accounting for casemix and outcome analysis.

Curative and palliative procedures

To identify the date diagnostic and staging procedures were performed. To determine the time interval between referral and diagnosis by the specialist team and the start of treatment. Required to be able to measure survival time from the start of treatment. To enable the date of first definitive treatment to be recorded.

The date on which the surgical procedure was performed.

6.2

ENCDv4.5b (7.10 & 7.11)

Surgical procedure(s) carried out

To determine type of surgery performed to enable analysis of surgically related data. To measure the effectiveness of surgical procedures performed and to be used as a measure for survival.

The type of procedure performed.

See the current version of the Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures (OPCS) of interventions and procedures.

*Permissible grouped values and labels will be dependent upon the output specifications.

6.3

NBOCAP

WBCA

Site code (of surgery)

To enable surgical analysis by organisation / surgical centre. Required for submission to the national clinical cancer audits.

The organisation code for the site where the patient is treated.

NHS Wales Data Dictionary

6.4

NBOCAP

WBCA

CCI

Surgical urgency

Required for casemix and outcome and for submission to the Welsh and National Bowel Cancer Clinical Audits.

NCEPOD (National Confidential Enquiry into Patient Outcome and Death) classification of Interventions contains the relevant definitions and permissible values.

NCEPOD (National Confidential Enquiry into Patient Outcome and Death) classification of Interventions.

6.5

NBOCAP

WBCA

ASA (American Association of Anaesthesiologists) grade

To allow co-morbidity to be taken into account in the analysis of treatment and outcome. Also required for submission to the Welsh and National Bowel Cancer Clinical Audits.

The American Society of Anaesthesiologists grading contains the relevant definitions and permissible values.

The American Society of Anaesthesiologists grade classification.

6.6

NBOCAP

WBCA

Surgical access

To determine the use of new surgical methods and for submission to the Welsh and National Bowel Cancer Clinical Audits.

The approach used to perform the abdominal part of the main procedure.

Permissible values are agreed by the clinical steering groups and conform to the requirements of the reporting output specifications. Currently there is no explicit requirement to map to terminologies or classifications. This will be kept under review.

•     Open operation

•     Laparoscopic then open

•     Laparoscopic converted to open

•     Laparoscopic completed

•     Laparoscopic and endoscopic

•     Endoscopic

6.7

NBOCAP

WBCA

Stoma

Required for casemix and outcome analysis and for submission to the Welsh and National Bowel Cancer Clinical Audits.

The type of stoma created.

Permissible values are agreed by the clinical steering groups and conform to the requirements of the reporting output specifications. Currently there is no explicit requirement to map to terminologies or classifications. This will be kept under review.

•     Ileostomy temporary

•     Ileostomy permanent

•     Colostomy temporary

•     Colostomy permanent

6.8

NBOCAP

WBCA

Surgical complications

To determine patterns of adverse events associated with a treatment. Also required for submission to the Welsh and National Bowel Cancer Clinical Audits.

Any complications relevant to the surgical treatments that the patient has received (during the primary treatment period).

Permissible values are agreed by the clinical steering groups and conform to the requirements of the reporting output specifications. Currently there is no explicit requirement to map to terminologies or classifications. This will be kept under review.

•     Leak: unequivocal clinical evidence of anastomotic breakdown with or without radiology

•     Abscess: any wound (wound infection = pus in wound = abscess), intra abdominal or pelvic pus

•     Bleed: any gastrointestinal, intra abdominal or wound bleed

•     Obstruction: any postoperative bowel obstruction

•     Stoma malfunction

•     Other (resulting in readmission within 14 days of surgical procedure)

6.9

NBOCAP

WBCA

Reason for no surgical treatment

The only curative treatment for bowel cancer is surgery. Required for analysis of why up to 40% of patients do not have surgery and therefore have no prospect of cure. Required for submission to the Welsh and National Bowel Cancer Clinical Audits.

The reason why surgical treatment was not carried out.

Permissible values are agreed by the clinical steering groups and conform to the requirements of the reporting output specifications. Currently there is no explicit requirement to map to terminologies or classifications. This will be kept under review.

•     Patient unfit due to a pre-diagnosed medical condition

•     Patient refused treatment

•     Advanced disease

•     Other

6.10

NBOCAP

WBCA

Discharge date (of surgery)

Enables analysis to be performed on the length of (surgical) in-patient stays, from the date the surgical procedure was carried out. Required for submission to the Welsh and National Bowel Cancer Clinical Audits.

Date of discharge from the (surgical) Hospital Provider Spell. The date on which a patient dies or is discharged from a continuous spell of (surgical) care using the hospital bed(s) within a single hospital provider. Identical to the end date of the last consultant episode of care and ward stay within a (surgical) hospital provider spell.

NHS Data Dictionary