A brief note if you are wondering what the ‘heads’ report is all about.

First of all, congratulations!

If you are receiving your ‘heads’ report then this means you have almost completed the entire matching process. We only send out the heads report when the vast majority of the matching has been completed.

This means that working from the Case Mix Programme data you now have told us about all eligible admissions from the ward to critical care during the study. In other words, all the tails are matched.

All that remains are the heads that didn’t match or that somehow don’t quite appear as expected. In other words these are cases reported on the (SPOT)light web portal that, on the basis of the information you have provided, should have matched.

Possibilities are

• Match pending – contemporary CMP data not available. We are waiting for CMP data from this period to be submitted before we can run the match.
• CMP number is invalid – this might be a typographical error
• Confirm –  a new episode of illness: this means that a patient has more than one visit on the web portal. We need to be sure that the reported (SPOT)light visit is the first for that episode of illness
• Unable to match (CMP number won’t match or not reported): here you have indicated the patient was admitted to a Case Mix Programme monitored unit but despite the tails matching we have been unable to find a match.
• Record incomplete –  please check your DVR. This record appears to fall below the minimum dataset standard
• Possible match – confirm via tails report. A match has been found but remains unconfirmed. Please confirm using the tails report.

As before, please complete columns Q and R (new response code and notes and return the sheet to us). Most corrections will be via the web portal or the tails matching sheets.

Codes for the ‘Heads’ matching have been appended to the list in current use for ‘tails’.

We have introduced two new categories for responses to the tails matching process.

• 9 … where we have matched the correct patient but the incorrect visit
• 10 … where we have matched the incorrect patient
• 11 … where you wish to propose a match that our system has not identified.

Each of these response codes requires some extra detail in the notes column.

If you are telling us that we have the right patient but the wrong visit (code 9) then please enter the correct visit date (in the DD/MM/20YY format e.g. 30/01/2012). Enter just the date and nothing else as we will import the date and use this to correct the match.

if you are telling us that we have the wrong patient (code 10) then please enter the correct hospital number as it appears on the (SPOT)light web portal. Enter just the date and nothing else, and again we will import and rematch using the new information.

Code 11 won’t make any sense until you are doing your heads (not tails) matching which we will provide once the tails are complete. This should be quick as the majority of the work will have been done during the tails matching. However there will be the odd patient who we deemed ineligible and therefore never chased. You will however have reported their admission to critical care, and when we do our final check they will appear as unmatched on the heads report. At this point please propose the correct match.

This issue of missing the ‘non-admitted’ patients has been a massive source of anxiety for us. It is only relevant if you are following the ‘all referrals’ or ‘prospective data flow’ approach. In which case, then we have to completely depend on the quality of the initial data capture.

If a month’s data can only be completed by ‘backfilling’ (i.e. pulling notes) then we will flag that as a time period where it is likely that the patients not admitted are a biased sample. Where there is little ‘backfilling’ then we can be more sure that we have not missed patients seen but not admitted.

We will not discard any data but this will permit us to run a sensitivity analysis and makes sure that our conclusions are not affected by months with different levels of data completeness.