Q1

2

Some private hospitals do not use hospital or patient identity numbers, so what should be recorded for the patient identifier?
Use any alphanumeric code that will enable you to identify the patient whilst you are gathering all the census information. As long as it is different for each patient that is all that matters.

Q2

4

Where can I find lists of codes for commissioning organisations (PCTs and other commissioners)?
Please use our Com Body Lookup page to help you locate codes for Commissioning Organisations.

Q3

5

Some long stay patients no longer have a home postcode. What postcode should be recorded?
Please DO NOT use the hospital postcode. For patients in hospital for one year or more at census, if postcode is unknown, enter XX1 1XX. Please use the following pseudo postcodes where the patient's postcode is not known (and they have been in hospital for less than a year):
ZZ99 3VZ = No fixed abode
ZZ99 3WZ = Not known
ZZ99 2WZ = Northern Ireland
ZZ99 1WZ = Scotland
ZZ99 3GZ = Wales

Q4

8, 13

What is the correct combination of codes for ethnicity and the way ethnicity is assessed in situations where a) the patient refuses to self assign their ethnic group and b) staff don’t ask?
It is very important that staff do check ask the patient to say which ethnic group they belong to and you should allow plenty of time so that if a patient is unable or unwilling to answer they can be asked again at a later date. However, if a patient refuses that is a valid response and the record should be Ethnicity (Line 8) code Z for Not Stated and Way assessed (Line 13) code 1, Self assessment. Where there is no ethnic category because staff have not asked the patient, then the record should be Ethnicity code Z, Not stated and Way Assessed, code 4, Not assessed.

Q5

Should patients on leave be counted in the Census?
The census population includes detained patients on Section 17 leave, and detained patients who are AWOL (but not informal patients on leave).

Q6

19

Please clarify what is meant by the consent status.
For informal patients, the question is about their capacity to consent to their overall plan of care and treatment. (Broadly speaking, we are looking to identify patients who fall within the 'Bournewood' description incapacitated compliant patients against truly 'voluntary' patients). For formal / detained patients we want to know whether they are capable or incapable of consenting to their overall plan of treatment and, if they are capable, whether they are consenting. It is important from the point of view of any plan of treatment that the patient's wishes and views are taken into account and, regardless of whether a patient is on Form 38 or Form 39, we would expect staff to be taking a patient's views into account and to know whether or not they are consenting. If a patient's consent is fluctuating (ie they agree to treatment one day and not the next) it is their consent on the day of the census that is required

Q7

25

Some of are staff are not comfortable asking patients about sexual orientation. Why is it necessary?
Last year some providers reported that some staff felt uncomfortable asking this question with some patients. The Q & A leaflet expleains why it it is important that they do. In order to help with staff training there are two items on the 2007 DVD which are relevant: a training item showing a scenario with staff and patient and also a discussion item that explains why sexual orientation is included in the Census. You might find it helpful to prepare your own advice about this issue - these simple leaflets prepared by South London and Maudsley Mental Health NHS Trust for staff and for service users offer good examples of how you might do this. Staff might also consider using a prompt card with the answer codes so that patients do not have to put their answer into words. Please note that there is an additional answer code for this item this year.

Q8

26

Some of our patients communicate using gestures only. What language should be recorded?
Free text responses in the 2006 Census return showed that many patients in learning disability services had no verbal speach and did not use BSL or Makaton. This year we have added a code for Non Verbal Communication. Please also bear in mind that these patients may need specialist assistance in communicating and if this is the case you should also record that they require an interpreter ( in the broadest sense).

Q9

31-35

What period does the question about recorded incidents cover?
For each of the 5 given types of incident you need to show the number of incidents recorded for each patient during this hospital spell, or within the last three months - ie since 1 January 2008 - if they have been in hospital for more than 3 months. This year, rather than recording a number you select from a numbered range (10+ is the highest band, so there is no need to count more than 10 of each type of incident).

Q10

Should learning disability respite units and tenanted houses run by the NHS be included in the census?
In terms of Learning Disability Services provided by NHS there is a continuum from inpatients to registered and supported homes, all of which can have some NHS links either directly or through seconded staff.  Following the publication of Valuing People , many NHS services are in the process of re-providing the learning disability services that provide long term accommodation and are now considered outdated. These may be on campuses or in large residential care homes. Where such NHS facilities are BOTH registered as care homes under the Care Standards Act 2000 AND regulated by the Commission for Social Care Inspection ( CSC I), they should be excluded from the census. In such cases one would  expect that nursing and mental health services provided to these facilities would be provided in the same way as they would be to people in their own homes ( for example, by community teams ).