Title

Referrals (April 2012 onwards)

Last update

24/10/2024 24/10/2024

Next update

21/11/2024

Publishing organisation

Welsh Government

Source 1

Outpatient Referral Dataset, Digital Health and Care Wales (DHCW)

Contact email

stats.healthinfo@gov.wales

Designation

None

Lowest level of geographical disaggregation

Local health boards

Geographical coverage

Wales

Languages covered

English and Welsh

Data licensing

You may use and re-use this data free of charge in any format or medium, under the terms of the Open Government License - see http://www.nationalarchives.gov.uk/doc/open-government-licence

Keywords

gp referrals; nhs; NHS referrals

General description

Resubmissions of the Referrals data in the Outpatient Referrals Dataset (OPR DS) occur each month. As a result, data in the release and Stats Wales is revised to reflect this. Please see the latest release for the impact of the revisions.

GP referrals cover both referrals from General Medical Practitioners and General Dental Practitioners.

Change of data source for GP referrals data for April 2012 data onwards:
The data source for GP referrals for first outpatient appointments has changed from the aggregate GP referrals data collection to the OPR DS.

The monthly aggregate GP Referrals data collection was historically used to assess trends at LHB and specialty level of GP referrals to first outpatient appointments. This data source was published by the Welsh Government as the definitive source of GP referrals data from June 2006 until July 2012.The Outpatient Referrals Dataset (OPR DS) was approved in May 2007 by the Welsh Information Standards Board (WISB), full implementation was completed by December 2007 and formal collection and reporting began mid 2008. This is a patient-level data set that allows more detailed analysis.
Following detailed data quality assessments and reviews of the data, the Welsh Government moved to using the OPR DS as the source of the official statistics for April 2012 data onwards and has ceased the monthly aggregate GP Referrals data collection.

The reasons for this were to:
- Have just one definitive source of data for GP referrals;
- Remove the burden on data providers of supplying data for two similar data sets;
- Remove the confusion for analysts and users which exists by having two similar data sets for GP referrals information, containing different data in some cases; and
- Allow more granularity for research and data mining (the OPR DS provides patient level data, whereas the aggregate GP referrals data collection provides high level, summary data).

For April 2012 data onwards, “treatment function code” has been used to determine into which specialty the referral is made, changing from "main specialty (of consultant)". Treatment function code is the specialty under which a patient is currently being treated or is waiting to be treated, irrespective of the specialty of the consultant, whereas main specialty (of consultant) is the specialty of the consultant under which the patient will be/is currently being treated.

The reasons for using treatment function code are as follows:
It provides an improved measure of demand on the service. Referral figures have been reported historically using ‘Main Specialty (of Consultant)’ to identify the consultant care for which the patient is awaiting treatment. Using treatment function code enables reporting of referrals by the specialty to which the patients have been referred rather than by the specialty to which the consultant is registered.

Due to the changing management of referrals in secondary care (for example, the use of pooled specialty waiting lists and referrals now often being referred directly to a specialty or service rather than a named individual) using main specialty is no longer appropriate, as the data should be more standardised. Using treatment function code will bring this data set in line with national standards, and it should introduce more coherence between data sets (i.e. specialty figures for referral to treatment times are also reported using treatment function code).

From April 2016, there has been a change in the treatment function codes submitted by the local health boards; this includes the cessation of the nursing treatment function. Whilst the other changes are likely to result in movements between different codes, the nursing treatment function affects Cwm Taf University LHB in particular as it was the only health board to submit a large number of referrals for that code (around 2,000 in March 2016, the last month when data was submitted).

Information on non-GP referrals are included in this table. For information on the non-GP referrals please see this statistical article:
http://gov.wales/docs/statistics/2015/150224-analysis-outpatient-referrals-en.pdf

Data collection and calculation

Please find this information in the related statistical release, as per the given weblink.

From 1st April 2019 health service provision for residents of Bridgend local authority moved from Abertawe Bro Morgannwg to Cwm Taf. For more information see the joint statement from Cwm Taf and Abertawe Bro Morgannwg University Health Boards (see weblinks). The health board names have changed with Cwm Taf University Health Board becoming Cwm Taf Morgannwg University Health Board and Abertawe Bro Morgannwg University Health Board becoming Swansea Bay University Health Board. A link to the statement from the minister for health and social service can be found in the weblinks section.

More detailed treatment functions have been introduced recently but have not been used consistently across all Local Health Boards; for example, patients receiving vascular surgery may have been recorded in either “General Surgery” or “Vascular Surgery” treatment functions.
To reduce uncertainty and make counts more reliable, the new functions will be removed temporarily and treatment functions will be recorded under the more general headings; for example, all patients receiving vascular surgery will now be published under “General Surgery” until consistent recording of treatment functions is confirmed across all Local Health Boards. This has now been fully actioned back to April 2016 when the new codes were introduced and will remain] under general headings until the more detailed treatment functions are used consistently across Wales.

The new treatment function codes which were announced in April 2016 have not been used consistently by health boards, so to date, any data submitted for a new code has been recoded to the pre-April 2016 codes. However, from June 2019 some health boards have submitted data for the new Respiratory Physiology treatment function code, which will be published to reflect the current pilot period for reporting sleep disordered breathing service. Note that while this data is being published to support this pilot, the data is still not being consistently reported by health boards so caution is advised when using this data.

Frequency of publication

Monthly

Data reference periods

April 2012 onwards

Users, uses and context

Please find this information in the related statistical release, as per the given weblink.

Revisions information

In the March 2019 release, Abertawe Bro Morgannwg health board resubmitted data back to April 2014 to include data for the Source of Referral: Other source of referral (not initiated). This data was previously not included when it should have been.

Data was excluded for referrals to Betsi Cadwaladr University Health Board from November 2016 to December 2017 due to initial problems with the new Welsh Patient Administration System (WPAS). This has been resolved as of the March 2018 update and data has been backdated to cover the period affected.

From December 2015 our revisions policy is that each month we revise data for the previous 12 months (i.e. each month we publish 13 months of data). At the end of every financial year, when the largest historical revisions are received, we revise figures back to April 2012 (i.e. when we publish March figures each year we revise figures back to April 2012). Prior to December 2015, we revised data back to April 2012 every month.

Statistical quality

Please find this information in the related statistical release, as per the given weblink.

Hywel Dda did not submit any data for mental health treatment codes in from August 2020 due to the Mental Health Migration project, in the months after the pandemic this accounted for between 90 to 180 referrals, but prior to the pandemic this would have accounted for around 240 referrals a month.

Note that data included in this statistical release covers a time period during the coronavirus (COVID-19) pandemic, which has affected both how some NHS services have been offered and people's choices regarding health services. See the latest release for more information.

Weblinks

The most recent statistical release can be found on the following weblink:
https://gov.wales/nhs-referrals-first-outpatient-appointments

On the 24th February 2015 we published a statistical article, which detailed the impact on the data of including other sources of referrals, and identified patterns and trends of non-GP sources of referral.
http://gov.wales/docs/statistics/2015/150224-analysis-outpatient-referrals-en.pdf

https://cwmtaf.wales/welsh-government-announce-decision-on-bridgend-boundary-change/
https://gov.wales/written-statement-health-board-boundary-bridgend-associated-planning

Name

Hlth0051

Dataset

OData (JSON) https://statswales.gov.wales/Download/File?fileName=HLTH0051.zip

Metadata

OData (JSON) https://statswales.gov.wales/Download/File?fileName=HLTH0051.xml

Dimensions

OData (JSON) https://statswales.gov.wales/Download/File?fileName=HLTH0051_dimensions.csv

Items

OData (JSON) https://statswales.gov.wales/Download/File?fileName=HLTH0051_dimensionitems.csv