NHS Digital FHIR Medicines (Retired - 2.1.14)

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

Prescription Order Outpatient Subsequent Response

Response to an update message. In this example this is the subsequent repsonse to the cancellation of a outpatient prescription Prescription Order Outpatient Cancel

This response is sent after the prescription is returned to EPS by the dispenser.

{
    "resourceType": "Bundle",
    "id": "42b94e14-8240-40fd-b32a-359be0dd3c57",
    "identifier": {
        "system": "https://tools.ietf.org/html/rfc4122",
        "value": "42b94e14-8240-40fd-b32a-359be0dd3c57"
    },
    "type": "message",
    "entry":  [
        {
            "fullUrl": "urn:uuid:3599c0e9-9292-413e-9270-9a1ef1ead99c",
            "resource": {
                "resourceType": "MessageHeader",
                "eventCoding": {
                    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
                    "code": "prescription-order-response",
                    "display": "Prescription Order Response"
                },
                "source": {
                    "endpoint": "https://sandbox.api.service.nhs.uk/electronic-prescriptions/$process-message"
                },
                "focus":  [
                    {
                        "reference": "urn:uuid:a7b86f8d-1d7c-fc28-e050-d20ae3a215f4"
                    },
                    {
                        "reference": "urn:uuid:51793ac0-112f-46c7-a891-9af8cefb206e"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:a7b86f8d-1d7c-fc28-e050-d20ae3a215f4",
            "resource": {
                "resourceType": "MedicationRequest",
                "extension":  [
                    {
                        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionStatusHistory",
                        "extension":  [
                            {
                                "url": "status",
                                "valueCoding": {
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationrequest-status-history",
                                    "code": "R-0001",
                                    "display": "Prescription/item was cancelled"
                                }
                            }
                        ]
                    },
                    {
                        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-ResponsiblePractitioner",
                        "valueReference": {
                            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca645"
                        }
                    },
                    {
                        "extension":  [
                            {
                                "url": "quantityWords",
                                "valueString": "twenty eight"
                            },
                            {
                                "url": "schedule",
                                "valueCoding": {
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationrequest-controlled-drug",
                                    "code": "CD2",
                                    "display": "Schedule 2"
                                }
                            }
                        ],
                        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-ControlledDrug"
                    }
                ],
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                        "value": "A7B86F8D-1D7C-FC28-E050-D20AE3A215F0"
                    }
                ],
                "status": "cancelled",
                "intent": "order",
                "medicationCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "36126511000001106",
                            "display": "Morphine 10mg modified-release tablets"
                        }
                    ]
                },
                "subject": {
                    "reference": "urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23"
                },
                "authoredOn": "2019-12-30T12:00:00+00:00",
                "requester": {
                    "reference": "urn:uuid:63aa76ee-4b0d-41d8-97d5-fe86a134736b"
                },
                "groupIdentifier": {
                    "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                    "value": "3C2366-B81001-0A409U"
                },
                "dispenseRequest": {
                    "extension":  [
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PerformerSiteType",
                            "valueCoding": {
                                "system": "https://fhir.nhs.uk/CodeSystem/dispensing-site-preference",
                                "code": "0004"
                            }
                        }
                    ],
                    "quantity": {
                        "value": 28,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    },
                    "performer": {
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "FX748"
                        }
                    }
                },
                "substitution": {
                    "allowedBoolean": false
                }
            }
        },
        {
            "fullUrl": "urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23",
            "resource": {
                "resourceType": "Patient",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9453740519"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "family": "CORY",
                        "given":  [
                            "ETTA"
                        ],
                        "prefix":  [
                            "MISS"
                        ]
                    }
                ],
                "gender": "female",
                "birthDate": "1999-01-04",
                "address":  [
                    {
                        "use": "home",
                        "postalCode": "DE21 4QH"
                    }
                ],
                "generalPractitioner":  [
                    {
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "B81001"
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca645",
            "resource": {
                "resourceType": "PractitionerRole",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                        "value": "100102238986"
                    },
                    {
                        "system": "https://fhir.hl7.org.uk/Id/nhsbsa-spurious-code",
                        "value": "G7345213"
                    }
                ],
                "practitioner": {
                    "identifier": {
                        "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                        "value": "C1234567"
                    },
                    "display": "DR RAZIA ALI"
                },
                "organization": {
                    "identifier": {
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "RBA"
                    },
                    "display": "TAUNTON AND SOMERSET NHS FOUNDATION TRUST"
                },
                "specialty":  [
                    {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode",
                                "code": "100",
                                "display": "GENERAL MEDICINE"
                            }
                        ]
                    }
                ],
                "code":  [
                    {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-SDSJobRoleName",
                                "code": "R8000"
                            }
                        ]
                    }
                ],
                "location":  [
                    {
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "RBA11"
                        },
                        "display": "MUSGROVE PARK HOSPITAL"
                    }
                ],
                "healthcareService":  [
                    {
                        "identifier": {
                            "use": "official",
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "A99968"
                        },
                        "display": "SOMERSET BOWEL CANCER SCREENING CENTRE"
                    }
                ],
                "telecom":  [
                    {
                        "system": "phone",
                        "value": "01234567890",
                        "use": "work"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:51793ac0-112f-46c7-a891-9af8cefb206e",
            "resource": {
                "resourceType": "CommunicationRequest",
                "status": "unknown",
                "subject": {
                    "reference": "urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23"
                },
                "payload":  [
                    {
                        "contentString": "Please make an appointment to see your GP. Review date due"
                    },
                    {
                        "contentReference": {
                            "reference": "urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9",
                            "display": "List of Repeat Medications for re-ordering"
                        }
                    }
                ],
                "requester": {
                    "type": "Organization",
                    "identifier": {
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "RBA"
                    },
                    "display": "TAUNTON AND SOMERSET NHS FOUNDATION TRUST"
                },
                "recipient":  [
                    {
                        "type": "Patient",
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/nhs-number",
                            "value": "9453740519"
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9",
            "resource": {
                "resourceType": "List",
                "status": "current",
                "mode": "snapshot",
                "subject": {
                    "reference": "urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23"
                },
                "entry":  [
                    {
                        "item": {
                            "display": "Bendroflumethiazide 2.5 mg Tablets (3/6)"
                        }
                    },
                    {
                        "item": {
                            "display": "Salbutamol 100micrograms/dose inhaler CFC free 200 dose (2/6)"
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:63aa76ee-4b0d-41d8-97d5-fe86a134736b",
            "resource": {
                "resourceType": "PractitionerRole",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                        "value": "223891001086"
                    }
                ],
                "practitioner": {
                    "identifier": {
                        "system": "https://fhir.nhs.uk/Id/sds-user-id",
                        "value": "8703415201"
                    },
                    "display": "Dr Liz Scott"
                },
                "organization": {
                    "identifier": {
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "RBA"
                    },
                    "display": "TAUNTON AND SOMERSET NHS FOUNDATION TRUST"
                },
                "code":  [
                    {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-SDSJobRoleName",
                                "code": "R1720",
                                "display": "Clerical Worker"
                            }
                        ]
                    }
                ],
                "healthcareService":  [
                    {
                        "identifier": {
                            "use": "official",
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "A99968"
                        },
                        "display": "SOMERSET BOWEL CANCER SCREENING CENTRE"
                    }
                ],
                "telecom":  [
                    {
                        "system": "phone",
                        "value": "01234567890",
                        "use": "work"
                    }
                ]
            }
        }
    ]
}
<Bundle xmlns="http://hl7.org/fhir">
    <id value="42b94e14-8240-40fd-b32a-359be0dd3c57" />
    <identifier>
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="42b94e14-8240-40fd-b32a-359be0dd3c57" />
    </identifier>
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:3599c0e9-9292-413e-9270-9a1ef1ead99c" />
        <resource>
            <MessageHeader>
                <eventCoding>
                    <system value="https://fhir.nhs.uk/CodeSystem/message-event" />
                    <code value="prescription-order-response" />
                    <display value="Prescription Order Response" />
                </eventCoding>
                <source>
                    <endpoint value="https://sandbox.api.service.nhs.uk/electronic-prescriptions/$process-message" />
                </source>
                <focus>
                    <reference value="urn:uuid:a7b86f8d-1d7c-fc28-e050-d20ae3a215f4" />
                </focus>
                <focus>
                    <reference value="urn:uuid:51793ac0-112f-46c7-a891-9af8cefb206e" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:a7b86f8d-1d7c-fc28-e050-d20ae3a215f4" />
        <resource>
            <MedicationRequest>
                <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionStatusHistory">
                    <extension url="status">
                        <valueCoding>
                            <system value="https://fhir.nhs.uk/CodeSystem/medicationrequest-status-history" />
                            <code value="R-0001" />
                            <display value="Prescription/item was cancelled" />
                        </valueCoding>
                    </extension>
                </extension>
                <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-ResponsiblePractitioner">
                    <valueReference>
                        <reference value="urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca645" />
                    </valueReference>
                </extension>
                <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-ControlledDrug">
                    <extension url="quantityWords">
                        <valueString value="twenty eight" />
                    </extension>
                    <extension url="schedule">
                        <valueCoding>
                            <system value="https://fhir.nhs.uk/CodeSystem/medicationrequest-controlled-drug" />
                            <code value="CD2" />
                            <display value="Schedule 2" />
                        </valueCoding>
                    </extension>
                </extension>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
                    <value value="A7B86F8D-1D7C-FC28-E050-D20AE3A215F0" />
                </identifier>
                <status value="cancelled" />
                <intent value="order" />
                <medicationCodeableConcept>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="36126511000001106" />
                        <display value="Morphine 10mg modified-release tablets" />
                    </coding>
                </medicationCodeableConcept>
                <subject>
                    <reference value="urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23" />
                </subject>
                <authoredOn value="2019-12-30T12:00:00+00:00" />
                <requester>
                    <reference value="urn:uuid:63aa76ee-4b0d-41d8-97d5-fe86a134736b" />
                </requester>
                <groupIdentifier>
                    <system value="https://fhir.nhs.uk/Id/prescription-order-number" />
                    <value value="3C2366-B81001-0A409U" />
                </groupIdentifier>
                <dispenseRequest>
                    <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-PerformerSiteType">
                        <valueCoding>
                            <system value="https://fhir.nhs.uk/CodeSystem/dispensing-site-preference" />
                            <code value="0004" />
                        </valueCoding>
                    </extension>
                    <quantity>
                        <value value="28" />
                        <unit value="tablet" />
                        <system value="http://snomed.info/sct" />
                        <code value="428673006" />
                    </quantity>
                    <performer>
                        <identifier>
                            <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                            <value value="FX748" />
                        </identifier>
                    </performer>
                </dispenseRequest>
                <substitution>
                    <allowedBoolean value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23" />
        <resource>
            <Patient>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="9453740519" />
                </identifier>
                <name>
                    <use value="official" />
                    <family value="CORY" />
                    <given value="ETTA" />
                    <prefix value="MISS" />
                </name>
                <gender value="female" />
                <birthDate value="1999-01-04" />
                <address>
                    <use value="home" />
                    <postalCode value="DE21 4QH" />
                </address>
                <generalPractitioner>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="B81001" />
                    </identifier>
                </generalPractitioner>
            </Patient>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca645" />
        <resource>
            <PractitionerRole>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
                    <value value="100102238986" />
                </identifier>
                <identifier>
                    <system value="https://fhir.hl7.org.uk/Id/nhsbsa-spurious-code" />
                    <value value="G7345213" />
                </identifier>
                <practitioner>
                    <identifier>
                        <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                        <value value="C1234567" />
                    </identifier>
                    <display value="DR RAZIA ALI" />
                </practitioner>
                <organization>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="RBA" />
                    </identifier>
                    <display value="TAUNTON AND SOMERSET NHS FOUNDATION TRUST" />
                </organization>
                <code>
                    <coding>
                        <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-SDSJobRoleName" />
                        <code value="R8000" />
                    </coding>
                </code>
                <specialty>
                    <coding>
                        <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode" />
                        <code value="100" />
                        <display value="GENERAL MEDICINE" />
                    </coding>
                </specialty>
                <location>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="RBA11" />
                    </identifier>
                    <display value="MUSGROVE PARK HOSPITAL" />
                </location>
                <healthcareService>
                    <identifier>
                        <use value="official" />
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="A99968" />
                    </identifier>
                    <display value="SOMERSET BOWEL CANCER SCREENING CENTRE" />
                </healthcareService>
                <telecom>
                    <system value="phone" />
                    <value value="01234567890" />
                    <use value="work" />
                </telecom>
            </PractitionerRole>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:51793ac0-112f-46c7-a891-9af8cefb206e" />
        <resource>
            <CommunicationRequest>
                <status value="unknown" />
                <subject>
                    <reference value="urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23" />
                </subject>
                <payload>
                    <contentString value="Please make an appointment to see your GP. Review date due" />
                </payload>
                <payload>
                    <contentReference>
                        <reference value="urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9" />
                        <display value="List of Repeat Medications for re-ordering" />
                    </contentReference>
                </payload>
                <requester>
                    <type value="Organization" />
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="RBA" />
                    </identifier>
                    <display value="TAUNTON AND SOMERSET NHS FOUNDATION TRUST" />
                </requester>
                <recipient>
                    <type value="Patient" />
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/nhs-number" />
                        <value value="9453740519" />
                    </identifier>
                </recipient>
            </CommunicationRequest>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:d0f003a0-8763-43d5-a264-ce52a38901c9" />
        <resource>
            <List>
                <status value="current" />
                <mode value="snapshot" />
                <subject>
                    <reference value="urn:uuid:848d8470-bd51-494e-9347-8142ea75cb23" />
                </subject>
                <entry>
                    <item>
                        <display value="Bendroflumethiazide 2.5 mg Tablets (3/6)" />
                    </item>
                </entry>
                <entry>
                    <item>
                        <display value="Salbutamol 100micrograms/dose inhaler CFC free 200 dose (2/6)" />
                    </item>
                </entry>
            </List>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:63aa76ee-4b0d-41d8-97d5-fe86a134736b" />
        <resource>
            <PractitionerRole>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
                    <value value="223891001086" />
                </identifier>
                <practitioner>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/sds-user-id" />
                        <value value="8703415201" />
                    </identifier>
                    <display value="Dr Liz Scott" />
                </practitioner>
                <organization>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="RBA" />
                    </identifier>
                    <display value="TAUNTON AND SOMERSET NHS FOUNDATION TRUST" />
                </organization>
                <code>
                    <coding>
                        <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-SDSJobRoleName" />
                        <code value="R1720" />
                        <display value="Clerical Worker" />
                    </coding>
                </code>
                <healthcareService>
                    <identifier>
                        <use value="official" />
                        <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                        <value value="A99968" />
                    </identifier>
                    <display value="SOMERSET BOWEL CANCER SCREENING CENTRE" />
                </healthcareService>
                <telecom>
                    <system value="phone" />
                    <value value="01234567890" />
                    <use value="work" />
                </telecom>
            </PractitionerRole>
        </resource>
    </entry>
</Bundle>
Bundle
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