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{
  "resourceType": "StructureDefinition",
  "id": "England-Immunization",
  "url": "https://fhir.nhs.uk/StructureDefinition/England-Immunization",
  "version": "1.0.0",
  "name": "EnglandImmunization",
  "title": "England Immunization",
  "status": "draft",
  "date": "2023-08-18",
  "publisher": "NHS England",
  "contact": [
    {
      "name": "NHS England",
      "telecom": [
        {
          "system": "email",
          "value": "interoperabilityteam@nhs.net",
          "use": "work",
          "rank": 1
        }
      ]
    }
  ],
  "description": "This profile defines the NHS England constraints and extensions on the FHIR UK Core resource [UK Core Immunization](https://simplifier.net/hl7fhirukcorer4/ukcore-immunization)",
  "purpose": "This profile is intended to cover the recording of current and historical administration of vaccines to individuals across all healthcare disciplines in all care settings and all regions in England. \\n\\nThis profile does not support the administration of non-vaccine agents, even those that may have or claim to have immunological effects. While the terms \\\"immunisation\\\" and \\\"vaccination\\\" are not clinically identical, for the purposes of the FHIR profile, the terms are used synonymously.",
  "copyright": "Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Immunization",
  "baseDefinition": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Immunization",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Immunization.extension",
        "path": "Immunization.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Immunization.extension:parentPresent",
        "path": "Immunization.extension",
        "sliceName": "parentPresent",
        "min": 0,
        "mustSupport": false
      },
      {
        "id": "Immunization.extension:vaccinationProcedure",
        "path": "Immunization.extension",
        "sliceName": "vaccinationProcedure",
        "min": 0,
        "mustSupport": true
      },
      {
        "id": "Immunization.identifier",
        "path": "Immunization.identifier",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Immunization.identifier.system",
        "path": "Immunization.identifier.system",
        "min": 1
      },
      {
        "id": "Immunization.identifier.value",
        "path": "Immunization.identifier.value",
        "min": 1
      },
      {
        "id": "Immunization.status",
        "path": "Immunization.status",
        "mustSupport": true
      },
      {
        "id": "Immunization.statusReason",
        "path": "Immunization.statusReason",
        "binding": {
          "strength": "required",
          "valueSet": "https://fhir.nhs.uk/ValueSet/England-ReasonImmunizationNotAdministered"
        }
      },
      {
        "id": "Immunization.statusReason.coding",
        "path": "Immunization.statusReason.coding",
        "min": 1
      },
      {
        "id": "Immunization.statusReason.coding.system",
        "path": "Immunization.statusReason.coding.system",
        "min": 1
      },
      {
        "id": "Immunization.statusReason.coding.code",
        "path": "Immunization.statusReason.coding.code",
        "min": 1
      },
      {
        "id": "Immunization.statusReason.coding.display",
        "path": "Immunization.statusReason.coding.display",
        "min": 1
      },
      {
        "id": "Immunization.vaccineCode",
        "path": "Immunization.vaccineCode",
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.nhs.uk/ValueSet/England-VaccineCode"
        }
      },
      {
        "id": "Immunization.vaccineCode.coding",
        "path": "Immunization.vaccineCode.coding",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Immunization.vaccineCode.coding.system",
        "path": "Immunization.vaccineCode.coding.system",
        "min": 1
      },
      {
        "id": "Immunization.vaccineCode.coding.code",
        "path": "Immunization.vaccineCode.coding.code",
        "min": 1
      },
      {
        "id": "Immunization.vaccineCode.coding.display",
        "path": "Immunization.vaccineCode.coding.display",
        "min": 1
      },
      {
        "id": "Immunization.patient",
        "path": "Immunization.patient",
        "constraint": [
          {
            "key": "nhse-imm-001",
            "severity": "warning",
            "human": "subject - An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or (identifier.exists()))"
          },
          {
            "key": "nhse-imm-002",
            "severity": "error",
            "human": "Length of the supplied NHS Number is wrong.",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([0-9]{10})$'))"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Immunization.patient.identifier",
        "path": "Immunization.patient.identifier",
        "min": 1
      },
      {
        "id": "Immunization.patient.identifier.system",
        "path": "Immunization.patient.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/nhs-number"
      },
      {
        "id": "Immunization.patient.identifier.value",
        "path": "Immunization.patient.identifier.value",
        "min": 1
      },
      {
        "id": "Immunization.occurrence[x]",
        "path": "Immunization.occurrence[x]",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Immunization.recorded",
        "path": "Immunization.recorded",
        "mustSupport": true
      },
      {
        "id": "Immunization.primarySource",
        "path": "Immunization.primarySource",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Immunization.reportOrigin",
        "path": "Immunization.reportOrigin",
        "mustSupport": true
      },
      {
        "id": "Immunization.location",
        "path": "Immunization.location",
        "mustSupport": true
      },
      {
        "id": "Immunization.manufacturer",
        "path": "Immunization.manufacturer",
        "mustSupport": true
      },
      {
        "id": "Immunization.manufacturer.display",
        "path": "Immunization.manufacturer.display",
        "min": 1
      },
      {
        "id": "Immunization.lotNumber",
        "path": "Immunization.lotNumber",
        "mustSupport": true
      },
      {
        "id": "Immunization.expirationDate",
        "path": "Immunization.expirationDate",
        "mustSupport": true
      },
      {
        "id": "Immunization.site",
        "path": "Immunization.site",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite"
        }
      },
      {
        "id": "Immunization.site.coding",
        "path": "Immunization.site.coding",
        "min": 1
      },
      {
        "id": "Immunization.site.coding.system",
        "path": "Immunization.site.coding.system",
        "min": 1
      },
      {
        "id": "Immunization.site.coding.code",
        "path": "Immunization.site.coding.code",
        "min": 1
      },
      {
        "id": "Immunization.site.coding.display",
        "path": "Immunization.site.coding.display",
        "min": 1
      },
      {
        "id": "Immunization.route",
        "path": "Immunization.route",
        "mustSupport": true
      },
      {
        "id": "Immunization.doseQuantity",
        "path": "Immunization.doseQuantity",
        "mustSupport": true
      },
      {
        "id": "Immunization.performer",
        "path": "Immunization.performer",
        "mustSupport": true
      },
      {
        "id": "Immunization.performer.actor",
        "path": "Immunization.performer.actor",
        "constraint": [
          {
            "key": "nhse-imm-003",
            "severity": "error",
            "human": "An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or identifier.exists())"
          },
          {
            "key": "nhse-imm-004",
            "severity": "error",
            "human": "NMC must be of the format NNANNNNA",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/nmc-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/nmc-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/nmc-number').value.matches('^[0-9]{2}[A-Z]{1}[0-9]{4}[A-Z]{1}$'))"
          },
          {
            "key": "nhse-imm-005",
            "severity": "error",
            "human": "GMP must be of the format GNNNNNNN and not be a spurious code (starts with G6 or G7)",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/gmp-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/gmp-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/gmp-number').value.matches('^[G]{1}[01234589]{1}[0-9]{6}$'))"
          },
          {
            "key": "nhse-imm-006",
            "severity": "error",
            "human": "GMC must be of the format CNNNNNNN",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/gmc-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/gmc-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/gmc-number').value.matches('^[C]{1}[0-9]{7}$'))"
          },
          {
            "key": "nhse-imm-007",
            "severity": "error",
            "human": "GPHC must be of the format NNNNNNN",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/gphc-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/gphc-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/gphc-number').value.matches('^[0-9]{7}$'))"
          },
          {
            "key": "nhse-imm-008",
            "severity": "error",
            "human": "HCPC must be of the format AANNNNNN",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/hcpc-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/hcpc-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/hcpc-number').value.matches('^[A-Z]{2}[0-9]{6}$'))"
          },
          {
            "key": "nhse-imm-009",
            "severity": "error",
            "human": "DIN format must be NNNNNN",
            "expression": "identifier.exists().not() or identifier.where(system='https://fhir.hl7.org.uk/Id/din-number').exists().not() or (identifier.where(system='https://fhir.hl7.org.uk/Id/din-number').exists()  and identifier.where(system='https://fhir.hl7.org.uk/Id/din-number').value.matches('^[0-9]{6}$'))"
          },
          {
            "key": "nhse-imm-010",
            "severity": "error",
            "human": "SDS Role Profile Id must be 12 digits",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/sds-role-profile-id').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/sds-role-profile-id').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/sds-role-profile-id').value.matches('^[0-9]{12}$'))"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Immunization.reasonCode",
        "path": "Immunization.reasonCode",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.nhs.uk/ValueSet/England-ImmunizationExplanationReason"
        }
      },
      {
        "id": "Immunization.reasonCode.coding",
        "path": "Immunization.reasonCode.coding",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Immunization.reasonCode.coding.system",
        "path": "Immunization.reasonCode.coding.system",
        "min": 1
      },
      {
        "id": "Immunization.reasonCode.coding.code",
        "path": "Immunization.reasonCode.coding.code",
        "min": 1
      },
      {
        "id": "Immunization.reasonCode.coding.display",
        "path": "Immunization.reasonCode.coding.display",
        "min": 1
      },
      {
        "id": "Immunization.protocolApplied",
        "path": "Immunization.protocolApplied",
        "mustSupport": true
      },
      {
        "id": "Immunization.protocolApplied.targetDisease",
        "path": "Immunization.protocolApplied.targetDisease",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "(Work in progress) The vaccine preventable disease the dose is being administered for.",
          "valueSet": "http://hl7.eu/fhir/ig/dgc/ValueSet/covid-19-diseases"
        }
      }
    ]
  }
}

name : EnglandImmunization

{

}