Update to Industry Standard Code list for VitalityHealth

From Monday 11th July, VitalityHealth will be reducing the list of Industry Standard Codes they accept from non-GMC practitioners.
This will help make your billing data more accurate and reduce the number of rejected claims.



The PPR Data Standards

Each registered practitioner has a specialist profile on The PPR which provides a “one-stop-shop” online portal for them to record their details which can then support them in managing and marketing their practice.

Data standards are the rules by which data are recorded and described to be shared, integrated and exchanged with other parties across differing programs. The PPR uses a set of data standards so every practitioner's profile includes essential information in a format that can be shared with other organisations. These currently include UK private medical insurance companies (PMIs) and hospitals who use the data to support practitioner recognition and the granting of practising privileges. However, our ambition is for these standards to be adopted within the healthcare sector to facilitate easy integration across the NHS and private practice without the potential time constraints and development costs to third parties.

Our data standards, making up the profile, currently cover the following twelve areas:

  • The demographic and contact details of the practitioner including:
    • correspondence address to be used by insurers or hospitals for general communication purposes
    • billing address, used by the practitioner for invoices and receiving insurer payments
  • The professional details of the practitioner including:
    • registration details to a suitable regulatory/primary professional body
  • NHS practice details, required for certain professions
  • Private practice details including:
    • hospitals where the practitioner currently has practising privileges
    • the patients treated by demographic groups
    • the type of care given
  • Scope of Practice including:
    • plain language procedure grouping for CCSD-coded procedures
    • the number of times a CCSD-coded procedure has been performed at a qualifying site over a 12-month rolling period
    • colour-coded breakdown of activity by age group
  • Fitness to Practise including:
    • affirmation regarding historical withdrawal of practising privileges
    • affirmation of prior or current investigations and proceedings by the police and any professional body, both in the UK and elsewhere
    • confirmation of a Licence to Practise
    • dates of the last and next appraisal
    • certifications, including the name of the certification body (uploads required)
    • confirmation of the issuance of a Disclosure and Barring Service (DBS) check (upload required)
    • registration details to the Information Commissioner’s Office, with renewal details
  • The practitioner's qualifications, specialty(-ies) and sub-specialty(-ies) including:
    • details of where the practitioner gained their primary medical qualification(s)
    • a list of procedure and treatments undertaken
    • details of the practitioner's particular clinical interests
  • Medical secretary details, including linking them to specific hospitals/practices
  • Details of any publications the practitioner has written
  • Payment details, for receipt of payments into a bank account from insurers
  • Medical indemnity/insurance details (upload required)
  • Details of the practitioner's status with the private medical insurance companies including:
    • the practitioner's recognition status with each insurer
    • the practitioner's provider numbers with those insurers
    • confirmation as to whether the practitioner adheres to each insurer's fee schedule

Some information The PPR records is mandatory and this is indicated throughout this document as those fields shown in red. Fields that are conditional are shown in blue. Further fields will be automatically populated from other sources and these are shown in green.

Practitioners can edit and update their profile.

All private hospitals and all private medical insurers who offer policies to the public in the UK can view a basic profile for practitioners linked to their organisations. Only a few elements of the profile can be edited by these organisations. A fuller profile is viewable by those hospitals and insurers with an enhanced subscription package. The profile cannot be viewed by anyone unauthorised to do so.

Future plans include the development and enhancement of the standards to capture additional data:

  • Professional details
    • registration details of additional professional bodies, such as BMA, Royal Colleges etc, with renewal dates and potential for auto-update
  • Fitness to Practise
    • registration to UK wide registries e.g. National Joint Registry, Breast and Cosmetic Implant Registry etc
    • DBS regular auto-update for those on the Update Service to validate current status
  • Medical Indemnity/Insurance
    • renewal and auto-update
  • Appraisal/Revalidation 
    • Responsible Officer details
    • whole scope of practice, private and NHS (if applicable), which may also include procedure credentialing
    • mandatory/statutory training, including details of when this is due to be repeated
    • details of continual professional development, including reflection notes

As the healthcare industry evolves, so must The PPR. We will continue to work in consultation with stakeholders to develop and maintain data standards which meet the needs of the industry.