NHSDigital-Patient
Profile uri | FHIR Module | Maturity Level |
---|---|---|
https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient | Administration | normative |
Patient | I | Patient | |
extension | 0.. | ||
medicalApplianceSupplier | S | 0..1 | Extension |
nominatedPharmacy | S | 0.. | Extension |
preferredDispenserOrganization | S | 0..1 | Extension |
identifier | S | ||
nhsNumber | S | ||
system | S | ||
name | S | ||
use | |||
family | S | ||
given | S | ..5 | |
telecom | S | ||
gender | S | ||
birthDate | S | ||
deceased[x] | S | ||
address | S | ||
extension | 0.. | ||
addressKey | S | 0..1 | |
use | |||
line | |||
multipleBirth[x] | |||
contact | S | ||
communication | S | ||
generalPractitioner | S | Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) | |
(All Slices) | |||
identifier | 1.. | ||
system | 1.. | ||
value | 1.. | ||
registeredGPPractice | ..1 | ||
identifier | |||
system | Fixed Value | ||
registeredGeneralMedicalPractitioner | |||
identifier | |||
system | Fixed Value | ||
managingOrganization | |||
identifier | 1.. | ||
system | Fixed Value |
from
Patient | I | Patient | |
extension | 0.. | ||
medicalApplianceSupplier | S | 0..1 | Extension |
nominatedPharmacy | S | 0.. | Extension |
preferredDispenserOrganization | S | 0..1 | Extension |
identifier | S | ||
nhsNumber | S | ||
system | S | ||
name | S | ||
use | |||
family | S | ||
given | S | ..5 | |
telecom | S | ||
gender | S | ||
birthDate | S | ||
deceased[x] | S | ||
address | S | ||
extension | 0.. | ||
addressKey | S | 0..1 | |
use | |||
line | |||
multipleBirth[x] | |||
contact | S | ||
communication | S | ||
generalPractitioner | S | Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) | |
(All Slices) | |||
identifier | 1.. | ||
system | 1.. | ||
value | 1.. | ||
registeredGPPractice | ..1 | ||
identifier | |||
system | Fixed Value | ||
registeredGeneralMedicalPractitioner | |||
identifier | |||
system | Fixed Value | ||
managingOrganization | |||
identifier | 1.. | ||
system | Fixed Value |
- Command 'pagelink' could not render: Page not found.- PDS Example - Jane Smith
- Command 'pagelink' could not render: Page not found.
- Command 'pagelink' could not render: Page not found.
Constraint Profiles
This profile is designed around Patient Demographics Services and PDS may be used as the source of this data. Use of PDS is not mandatory for Patient resources, Patient Administration Systems (PAS) and Master Patient Index (MPI) may be used instead. Only traced NHS Number SHOULD be used with this resource unless explicitly stated. Within NHS Trusts the inclusion of MRN (Medical Record Numbers) identifiers is highly recommended.
Definition
Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Constraints
- patient-nhs (ERROR) Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.
- extension:birthPlace.url
- extension:cadavericDonor.url
- extension:patientReligion.url
- extension:patientInterpreterRequired.url
- extension:medicalApplianceSupplier
- extension:nominatedPharmacy
- extension:preferredDispenserOrganization
- identifier
- identifier:nhsNumber
- identifier:nhsNumber.system
- name
- name.family
- name.given
- telecom
- gender
- birthDate
- birthDate.extension:birthTime.url
- deceased
- address
- address.extension:addressKey
- contact
- communication
- communication.extension:proficiency.extension:level.url
- communication.extension:proficiency.extension:type.url
- communication.extension:proficiency.url
- generalPractitioner
- generalPractitioner:registeredGPPractice
- generalPractitioner:registeredGPPractice.identifier.system
- generalPractitioner:registeredGeneralMedicalPractitioner
- generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system
- managingOrganization.identifier.system
extension:birthPlace.url
Element Id | Patient.extension:birthPlace.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthPlace |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
extension:cadavericDonor.url
Element Id | Patient.extension:cadavericDonor.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
extension:patientReligion.url
Element Id | Patient.extension:patientReligion.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-religion |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
extension:patientInterpreterRequired.url
Element Id | Patient.extension:patientInterpreterRequired.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
extension:medicalApplianceSupplier
Element Id | Patient.extension:medicalApplianceSupplier |
Cardinality | 0..1 |
Slice Name | medicalApplianceSupplier |
type | Extension(ExtensionUKCoreMedicalApplianceSupplier) |
Definition
{ "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PreferredDispenserOrganization", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y23456" } } }
extension:nominatedPharmacy
Element Id | Patient.extension:nominatedPharmacy |
Cardinality | 0..* |
Slice Name | nominatedPharmacy |
type | Extension(ExtensionUKCoreNominatedPharmacy) |
Definition
A patient can choose up to three nominated dispensers to cover different contractor types:
- Community Pharmacy
- Appliance Contractor
- Dispensing Doctor
Each of those nominations is held in an Extension.
All require a ODS/ANANA code from Organisation Data Services. This contains download CSV files for these organisations, for API access please see Organisation Data Service - FHIR API
nominatedPharmacy (extension nominatedPharmacy)
"extension": [ { "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NominatedPharmacy", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y12345" } } },
extension:preferredDispenserOrganization
Element Id | Patient.extension:preferredDispenserOrganization |
Cardinality | 0..1 |
Slice Name | preferredDispenserOrganization |
type | Extension(ExtensionUKCorePreferredDispenserOrganization) |
Definition
{ "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicalApplianceSupplier", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y34567" } } }
identifier
Element Id | Patient.identifier |
Cardinality | 0..* |
Slicing | OPEN discriminator - VALUE system |
type | Identifier |
Definition
At least one patient identifier, MUST be provided.
Where a traced NHS number is available for a patient this MUST be included. In general an untraced NHS Number MUST not be used, if an untracted NHS Number is used the extension https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus MUST be used.
Name | FHIR identifier | OID/HL7v3 | HL7v2 ITK | Format | Description |
---|---|---|---|---|---|
NHS Number | https://fhir.nhs.uk/Id/nhs-number | 2.16.840.1.113883.2.1.4.1 | NHS | NNNNNNNNNN | NHS Number allocated to the patient in England and Wales |
CHI Number | 2.16.840.1.113883.2.1.3.2.4.16.53 | NNNNNNNNNN | CHI Number allocated to the patient in Scotland | ||
NHS Logon ID | https://fhir.nhs.uk/Id/nhs-login-sub | uuid | NHS Login unique identifer which is referred to as sub in NHS Login (OpenID) |
Local identifiers such as MRN MUST include a system which identifies NHS provider/assigning authority.
"identifier": [ { "system": "https://fhir.nhs.uk/Id/nhs-number", "value": "9000000009" }, { "system": "https://fhir.elmet.nhs.uk/Id/MRN", "value": "X54321" } ],
Requirements
Patients are almost always assigned specific numerical identifiers.
identifier:nhsNumber
Element Id | Patient.identifier:nhsNumber |
Cardinality | 0..1 |
Slice Name | nhsNumber |
type | Identifier |
Definition
An identifier for this patient.
Requirements
Patients are almost always assigned specific numerical identifiers.
identifier:nhsNumber.system
Element Id | Patient.identifier:nhsNumber.system |
Cardinality | 1..1 |
Fixed Value | https://fhir.nhs.uk/Id/nhs-number |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
name
Element Id | Patient.name |
Cardinality | 0..* |
type | HumanName |
Definition
At least one patient name must be provided. It is recommended a use is provided.
"name": [ { "family": "Smith", "given": [ "Jane" ], "prefix": [ "Mrs" ], "suffix": [ "MBE" ], "use": "usual" } ]
Requirements
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Comment
A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
name.family
Element Id | Patient.name.family |
Cardinality | 0..1 |
type | string |
Definition
The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Comment
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
name.given
Element Id | Patient.name.given |
Cardinality | 0..5 |
type | string |
Definition
Given names, including any middle names.
Comment
If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
telecom
Element Id | Patient.telecom |
Cardinality | 0..* |
type | ContactPoint |
Definition
List of contact points for the patient; for example, phone numbers or email addresses. When a patient tagged as restricted
or very restricted
is retrieved, all contact points are removed from the response.
"telecom": [ { "system": "phone", "use": "work", "value": "01632960587" } ]
Requirements
People have (primary) ways to contact them in some way such as phone, email.
Comment
A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
gender
Element Id | Patient.gender |
Cardinality | 0..1 |
Terminology Binding | AdministrativeGender (Required) The gender of a person used for administrative purposes. |
type | code |
Definition
Classification of the gender of a patient. The classification is phenotypical rather than genotypical, i.e. it does not provide codes for medical or scientific purposes. It is the administrative gender that the patient wishes to be known as. In some cases, this may not be the same as the patient’s registered birth gender, or their current clinical gender.
Requirements
Needed for identification of the individual, in combination with (at least) name and birth date.
Comment
The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.
birthDate
Element Id | Patient.birthDate |
Cardinality | 0..1 |
type | date |
Definition
The date on which the patient was born or is officially deemed to have been born.
It is a date in the format yyyy-mm-dd
. Due to data quality issues on a small number of patients yyyy-mm
and yyyy
format may also be returned.
When a patient tagged as very restricted
is retrieved, birth date is removed from the response.
Requirements
Age of the individual drives many clinical processes.
Comment
At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
birthDate.extension:birthTime.url
Element Id | Patient.birthDate.extension:birthTime.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthTime |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
deceased[x]
Element Id | Patient.deceased[x] |
Cardinality | 0..1 |
type | booleandateTime |
Definition
The date and time on which a person died or is officially deemed to have died, if applicable and known.
It is a datetime in the format yyyy-mm-ddTHH:MM:SS+HH:MM
or yyyy-mm-dd
. Due to data quality issues on a small number of patients yyyy-mm
and yyyy
format may also be returned.
When a patient tagged as very restricted
is retrieved, death date is removed from the response.
Requirements
The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Comment
If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
address
Element Id | Patient.address |
Cardinality | 0..* |
type | Address |
Definition
List of addresses associated with the patient.
These are fully populated on a retrieval or a successful update, only the home address is returned on a search. When a patient tagged as restricted
or very restricted
is retrieved, all addresses are removed from the response.
"address": [ { "line": [ "1 Trevelyan Square", "Boar Lane", "City Centre", "Leeds", "West Yorkshire" ], "postalCode": "LS1 6AE", "use": "home" } ],
Requirements
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Comment
Patient may have multiple addresses with different uses or applicable periods.
address.extension:addressKey
Element Id | Patient.address.extension:addressKey |
Cardinality | 0..1 |
Slice Name | addressKey |
type | Extension(ExtensionUKCoreAddressKey) |
Definition
Postal Address File (PAF) key associated with this address formatted as a FHIR extension. Empty if no PAF key for the address is known, or an object specifying the code system of the address key and the value of the address key.
contact
Element Id | Patient.contact |
Cardinality | 0..* |
type | BackboneElement |
Definition
A list of patient contacts. Only emergency contacts are returned and only emergency contacts should be added. Any other contacts should be added to the patients Related Person. Patients designate here any contact number they desire to be used in case of an emergency. Note, while a patient may also desire to record various related persons telecom details, these do not separately allow for a concept of emergency contact; only ranking. See RelatedPerson endpoint. When a patient tagged as restricted or very restricted is retrieved, all contacts are removed from the response.
Requirements
Need to track people you can contact about the patient.
Comment
Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Constraints
- pat-1 (ERROR) SHALL at least contain a contact's details or a reference to an organization
communication
Element Id | Patient.communication |
Cardinality | 0..* |
type | BackboneElement |
Definition
A language which may be used to communicate with the patient about his or her health.
Requirements
If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
Comment
If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
communication.extension:proficiency.extension:level.url
Element Id | Patient.communication.extension:proficiency.extension:level.url |
Cardinality | 1..1 |
Fixed Value | level |
type | uri |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
communication.extension:proficiency.extension:type.url
Element Id | Patient.communication.extension:proficiency.extension:type.url |
Cardinality | 1..1 |
Fixed Value | type |
type | uri |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
communication.extension:proficiency.url
Element Id | Patient.communication.extension:proficiency.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-proficiency |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
Comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
generalPractitioner
Element Id | Patient.generalPractitioner |
Cardinality | 0..* |
Slicing | OPENATEND discriminator - VALUE identifier.system |
type | Reference(NHSDigitalPractitioner NHSDigitalPractitionerRole NHSDigitalOrganization) |
Definition
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
"generalPractitioner": [ { "type": "Organization" "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y12345" }, "display": "Kirkgate Practice" } ]
Requirements
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Constraints
- nhsd-5 (WARNING) generalPractitioner - a display name should be provided
generalPractitioner:registeredGPPractice
Element Id | Patient.generalPractitioner:registeredGPPractice |
Cardinality | 0..1 |
Slice Name | registeredGPPractice |
type | Reference(UKCorePractitioner UKCoreOrganization UKCorePractitionerRole) |
Definition
Patient's registered GP Practice. Use V81998 for no registered practice and V81999 for not known as per NHS Data Dictionary guidelines.
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
generalPractitioner:registeredGPPractice.identifier.system
Element Id | Patient.generalPractitioner:registeredGPPractice.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/ods-organization-code |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
generalPractitioner:registeredGeneralMedicalPractitioner
Element Id | Patient.generalPractitioner:registeredGeneralMedicalPractitioner |
Cardinality | 0..* |
Slice Name | registeredGeneralMedicalPractitioner |
type | Reference(UKCorePractitioner UKCoreOrganization UKCorePractitionerRole) |
Definition
This is to support legacy use cases where the patients GP is present
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system
Element Id | Patient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/gmp-number |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
managingOrganization.identifier.system
Element Id | Patient.managingOrganization.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/ods-organization-code |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.