Implementation Guidance

The following implementation gives context to the paylaod.

The following resources are populated:

The Regsiter with a GP Surgery use case is available on the NHS FHIR Server FHIR Development and Testing Tools (Skunkworks) (nhsdigital.github.io), here you can create examples and interact with the data.

There are further service details on NHS England Demographics Implementation Guide (simplifier.net)

Who is Registering?

FHIR Resouce

QuestionniareResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Myself
  • Parent or Guardian

Guidance

Indicates the person submitting the form.

NHS Login

FHIR Resouce

Patient

Format

valueCodeableConcept

Allowed values

Codes:

  • Unverified
  • P0
  • P5
  • P9

Guidance

Indicates whether a person has used NHs login and the status of their idenity verification. More on NHS login levels of ID verification can be found here.

Enter details of where you go for your education

FHIR Resouce

QuestionniareResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • School
  • Nursery
  • Home Schooled
  • None of the above

Guidance

Used only for school aged patients.

Name of School

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'school' is selected as the type of education.

School Postcode

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'school' is selected as the type of education.

School Telephone

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'school' is selected as the type of education.

Name of Nursary

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'nursary' is selected as the type of education.

Nursary Postcode

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'nursary' is selected as the type of education.

Nursary Telephone

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'nursary' is selected as the type of education.

Home School Postcode

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'home school' is selected as the type of education.

Home School Telephone

FHIR Resouce

QuestionniareResponse

Format

valueString

Guidance

Only populated if 'homes school' is selected as the type of education.

Is anyone else involved in your care?

FHIR Resouce

QuestionniareResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Hosptial specialist/consultant,
  • Health visitor,
  • Social worker,
  • Other health professional,
  • None of the above

Guidance

Indicates if ptofessional care is provided.

Which language do you need an interpreter for?

FHIR Resouce

Observation

Format

valueCodeableConcept

Allowed values

Codes:

  • British Sign Language interpreter needed (finding) SCTID: 204331000000107
  • Arabic language interpreter needed (finding) SCTID: 203311000000101
  • Bengali language interpreter needed (finding) SCTID: 203321000000107
  • Chinese interpreter needed (finding) SCTID: 972591000000100
  • Persian language interpreter needed (finding) SCTID: 203421000000104
  • French language interpreter needed (finding) SCTID: 203441000000106
  • Gaelic language interpreter needed (finding) SCTID: 343721000000107
  • German language interpreter needed (finding) SCTID: 203581000000102
  • Gujarati language interpreter needed (finding) SCTID: 203601000000106
  • Italian language interpreter needed (finding) SCTID: 203371000000106
  • Lithuanian language interpreter needed (finding) SCTID: 203721000000108
  • Polish language interpreter needed (finding) SCTID: 203901000000102
  • Portuguese language interpreter needed (finding) SCTID: 203911000000100
  • Panjabi language interpreter needed (finding) SCTID: 203961000000103
  • Somali language interpreter needed (finding) SCTID: 204021000000108
  • Spanish language interpreter needed (finding) SCTID: 204031000000105
  • Tamil language interpreter needed (finding) SCTID: 204131000000109
  • Turkish language interpreter needed (finding) SCTID: 204191000000105
  • Urdu language interpreter needed (finding) SCTID: 204211000000109

Guidance

This field is populated using SNOMED codes and will only be filled if the patient has specified a need for a language interpreter in the patient resource.

Do you want to get your prescription items direct from NAME OF SURGERY?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

A value of True indicates that the patient is requesting a dispensing doctor.

Do you live more than 1 mile from your nearest pharmacy?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

A value of True indicates that the patient has met the requirements to be eligible for a dispensing doctor.

Would you have serious difficulty travelling to your nearest pharmacy to get medicines or medical appliances?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

A value of True indicates that the patient has met the requirements to be eligible for a dispensing doctor.

Have you ever been a member of the UK Armed Forces or are a family member registered with the Defence Medical Services?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

This infomration is required for onward processing of GPLinks messages.

Are you returning from overseas?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

This infomration is required for onward processing of GPLinks messages.

What was the date you left the UK?

FHIR Resouce

QuestionniareResponse

Format

valueDate

Guidance

This infomration is required for onward processing of GPLinks messages.

What was the date you returned to the UK?

FHIR Resouce

QuestionniareResponse

Format

valueDate

Guidance

This infomration is required for onward processing of GPLinks messages.

Have you recently moved to the UK from abroad?

FHIR Resouce

QuestionniareResponse

Format

valueBoolean

Guidance

This infomration is required for onward processing of GPLinks messages.

Where were you born?

FHIR Resouce

Observation

Format

valueCodeableConcept

Allowed values

Codes:

  • England,
  • Wales,
  • Isle of Man,
  • Scotland,
  • Northern Ireland,
  • None of These

Guidance

The country of birth is SNOMED code SCTID: 315354004, the value sent in this field is a response to this code. If the patient selects none of these, they are directed to the following question 'Country of birth (not Home Nations)' to enter a value.

Country of birth (not Home Nations)

FHIR Resouce

Observation

Format

valueString

Guidance

The country of birth is SNOMED code SCTID: 315354004. This will only be populated if the patient has selected 'None of These' in the previous question 'Where were you born?'.

Have you moved to the UK from EU, EEA or Switzerland?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

True indicates a patient has moved to the UK from EU, EEA or Switzerland.

Do you know your chargeable status?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

True indicates a patient does know their chargeable status.

Do you have any of these documents?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • EHIC,
  • S1 form,
  • I don't have any of these documents

Guidance

The question is presented if the patient has provided answers that indicate they will need the documents listed in the answer.

European health insurance card details - Full Name

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients full name as per EHIC details.

European health insurance card details - DOB

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients date of birth as per EHIC details.

European health insurance card details - Country Code

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients country code as per EHIC details.

European health insurance card details - PIN

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients Personal ID Number as per EHIC details.

European health insurance card details - Identification Number of the Institution

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients identification number of the institution as per EHIC details.

European health insurance card details - Expiry Date

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The patients expiry date as per EHIC details.

Have you got all your immunisations?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Unknown

Guidance

This reflects the patient's view of their immunisations and may not accurately represent their official health record.

Did you get your routine vaccinations in the UK?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

This reflects the patient's view of their immunisations and may not accurately represent their official health record.

Do you have any existing or pre-existing medical conditions?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This reflects the patient's view of their medical conditions and may not accurately represent their official health record. This question is asked but they patient may decline to provide an answer.

List of any existing or pre-existing medical conditions?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Alzheimers disease or dementia
  • Asthma
  • Cancer
  • Diabetes
  • Epilepsy
  • Heart disease
  • High blood pressure
  • Stroke
  • Thyroid disease
  • Other

Guidance

This reflects the patient's view of their medical conditions and may not accurately represent their official health record. This is a list of common medical conditions, the patient may enter more information in the following question 'About your current and pre-existing medical conditions'

About your current and pre-existing medical conditions

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This reflects the patient's view of their medical conditions and may not accurately represent their official health record. This is a free text field for patients to enter any relevant details.

Do you have any allergies?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

This reflects the patient's view of their allergues and may not accurately represent their official health record.

About your allergies

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This reflects the patient's view of their allergues and may not accurately represent their official health record. This is a free text field for patients to enter any relevant details.

Do you have any mental health conditions?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

This reflects the patient's view of their mental health conditions and may not accurately represent their official health record.

About your mental health conditions

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This reflects the patient's view of their mental health conditions and may not accurately represent their official health record. This is a free text field for patients to enter any relevant details.

Do you have any disabilities?

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

This reflects the patient's view of their disabilities and may not accurately represent their official health record.

About your disabilities

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This reflects the patient's view of their disabilities and may not accurately represent their official health record. This is a free text field for patients to enter any relevant details.

Do you have a carer?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

What type of carer do you have?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Young carer under 18
  • Paid as a job
  • Unpaid but may get benefits
  • Foster carer
  • None of the above

Guidance

The answer indicates the type of profesional care.

Carer's details - first name

FHIR Resouce

Patient

Format

ValueString

Guidance

Only populated if the patient has a Carer.

Carer's details - last name

FHIR Resouce

Patient

Format

ValueString

Guidance

Only populated if the patient has a Carer.

Carer's details - relationship to user

FHIR Resouce

Patient

Format

ValueString

Guidance

Only populated if the patient has a Carer.

Carer's details - phone number

FHIR Resouce

Patient

Format

ValueString

Guidance

Only populated if the patient has a Carer.

Additional Carer's details - first name

FHIR Resouce

QuestionnaireResponse

Format

ValueString

Guidance

Only populated if the patient has an additional Carer.

Additional Carer's details - last name

FHIR Resouce

QuestionnaireResponse

Format

ValueString

Guidance

Only populated if the patient has an additional Carer.

Additional Carer's details - relationship to user

FHIR Resouce

QuestionnaireResponse

Format

ValueString

Guidance

Only populated if the patient has an additional Carer.

Additional Carer's details - phone number

FHIR Resouce

QuestionnaireResponse

Format

ValueString

Guidance

Only populated if the patient has an additional Carer.

Are you a carer?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

Are you a carer?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Young carer under 18,
  • Paid as a job,
  • Unpaid but may get benefits,
  • Foster carer,
  • None of the above

Guidance

Only populated if the patient is a Carer.

Do you or your carer need to be communicated with in an accessible form?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

About you or your carer's communication needs

FHIR Resouce

QuestionnaireResponse

Format

valueString

Guidance

This is free text to allow the patient to communicate needs.

Do you or your carer need any reasonable adjustments to make your visit to the GP surgery accessible?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

About you or your carer's access needs

FHIR Resouce

QuestionnaireResponse

Format

valueString

Guidance

This is free text to allow the patient to communicate needs.

Do you currently take any prescription medication?

FHIR Resouce

QuestionnaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

*Can you provide more details about your prescription medication?

FHIR Resouce

QuestionnaireResponse

Format

valueString

Guidance

This is free text. This question is conditional if the answer is 'True' to the question 'Do you currently take any prescription medication?'.

Are any of these repeat prescriptions?

FHIR Resouce

QuestionnaireResponse

Format

valueBoolean

Guidance

This question is conditional if the answer is 'True' to the question 'Do you currently take any prescription medication?'.

What is your height?

FHIR Resouce

Observation

Format

valueString

Guidance

The answer will be encoded against SCTID: 1162419008.

What is your weight?

FHIR Resouce

Observation

Format

valueString

Guidance

The answer will be encoded against SCTID: 784399000.

How often do you drink alcohol or have a drink containing alcohol?

FHIR Resouce

Observation

Format

valueCodeableConcept

Allowed values

Codes:

  • xxxxxxx
  • 228277002
  • 228276006
  • 43783005
  • 86933000

Guidance

The codes correspond to the following:

  • xxxxxxx - Never
  • 228277002 - Light drinker
  • 228276006 - Occasional drinker
  • 43783005 - Moderate drinker
  • 86933000 - Heavy drinker If the patient selects 'Prefer Not to Say' the answer is populated as the following:

FHIR Resouce

QuestionnaireResponse

Format

valueString

Guidance

The 'Prefer Not to Say' response will be given in a QuestionnaireResponse resource as a string.

How many units of alcohol do you drink on a typical day when you are drinking?

FHIR Resouce

Observation

Format

valueString

Guidance

The answer will be encoded against SCTID: 1082631000000102 - Alcohol units consumed per day (observable entity)

How often have you had six or more units of alcohol on a single occasion in the last year?

FHIR Resouce

Observation

Format

valueCodeableConcept

Allowed values

Codes:

  • Never
  • Less than monthly
  • Monthly
  • Weekly
  • Daily or almost daily
  • Prefer not to say

Guidance

This question will be populated if patient has answered to indicate they drink alcohol.

Have you ever smoked?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes
  • No
  • Asked - Declined

Guidance

This question is asked but they patient may decline to provide an answer.

What best describes you?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • I smoke
  • I used to smoke, Prefer not to say
  • Asked - Declined

Guidance

This question will be populated if the patient has indicated they have smoked. This question is asked but they patient may decline to provide an answer.

When did you stop smoking?

FHIR Resouce

QuestionaireResponse

Format

valueDate

Guidance

This questions will be populated if the patient hasindicated they used to smoke.

Do you want important information from your GP record to be available to other health and care professionals?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Yes, share a Summary Care Record with additional information
  • Yes, share a Summary Care Record without additional information
  • No, do not share a Summary Care Record

Guidance

This question is around sharing health information.

What is your relationship to the person being registered?

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • Parent or Guardian
  • Carer
  • Other

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child.

Dependant journey - What are your details? - First Name

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Dependant - What are your details? - Last Name

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Dependant - What are your details? - Relationship to person being registered

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Dependant - What are your details? - DOB

FHIR Resouce

QuestionaireResponse

Format

valueDate

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Dependant - What are your details? - NHS Number

FHIR Resouce

QuestionaireResponse

Format

valueInteger

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Dependant - What are your details? - Telephone

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child. The question is asking information relating to the person completing the form.

Enter the postcode where the mother of [dependant] was living when their baby was born

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

This question is relevant to the dependant journey e.g. a parent entering information on behalf of their child.

Application submitted Time

FHIR Resouce

QuestionaireResponse

Format

valueDate

Guidance

The time and date that the pateint submitted the registration application.

Application Reference

FHIR Resouce

QuestionaireResponse

Format

valueString

Guidance

The registration application reference number.

Child Application

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

The True flag indicates a child registration application.

PDS Match

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

The True flag indicates the patient has been matched to a PDS record.

Send details to NBO

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

The True flag indicates the patient details have been sent to NBO in the event they have EHIC data.

Registration Type

FHIR Resouce

QuestionaireResponse

Format

valueCodeableConcept

Allowed values

Codes:

  • 01
  • 02
  • 03
  • 04
  • 05
  • 06

Guidance

The codes relate to the registration type:

  • 01 - Type 1 - Birth
  • 02 - Type 2 - 1st Accetptance
  • 03 - Type 3 - Transfer In
  • 04 - Type 4 - Immigrant
  • 05 - Type 5 - Ex Services
  • 06 - Type 6 - Internal Transfer

Out of Catchment Area

FHIR Resouce

QuestionaireResponse

Format

valueBoolean

Guidance

True indicates that the patient is out of catchment area.