Refer Patient
A referral to Social Care for a Supported Hospital Discharge can take many forms. It could be accompanied by a formal Assessment Notice (as per Care Act 2014), however it is not uncommon for the Social Care Practitioners to get involved early in the discharge process, e.g. to help triage pathway and/or have visibility that one of their service users has been admitted to hospital and may need an early review. By enabling the referral to be sent separately to the Assessment Notice allows Social Care Teams to undertake any Primary care duties, before the patient has formally consented to an assessment.
HTTPS Request
Method:
POST
Request URL:
The request URL will consist of 'https
Host Environments:
The Host URLs will determined by the service provider, for example the host URLs for the Nottinghamshire County Council Social Care Data Service are:
Environment | Host |
---|---|
Test | health-interoperability-test.nottscc.gov.uk |
Live | health-interoperability.nottscc.gov.uk |
Base URL:
/ReferralService/v3/ReferralRequest
Note: the Healthcare Locator Service API can be used to identify the Host and Base URL (excluding the FHIR Resource element).
Query String /Parameters:
None
Example Request Url:
https
Request Body:
The Request body should be in either json or xml format
The primary base FHIR resource is a CareConnect-SHD-ReferralRequest-1, with references to other resources as per the Entity Relationship Model below:
See Examples for an illustration of the Request body of a typical Referral to Social Care for a Supported Hospital Discharge.
Response
Success
SHALL return a HTTP status code 201
Created on successful execution of the request
SHALL return an HTTP Location
response header containing the full resolvable URL to the newly created ReferralRequest.
- The URL will contain the ‘server’ assigned logical Id of the new ReferralRequest resource.
- The URL format MUST be:
https
.://[host]/[path]/[id] - An example Location response header:
https
.://health-interoperability-test.nottscc.gov.uk/ReferralService/v3/ReferralRequest/11284224
Note: Implementors MUST be be able to capture and log the ReferralRequest Id in order to send subsequent updates for the referral / reosources that reference it.
Error
An Error SHALL return one of the following HTTP Status Codes and an OperationOutcome with details of the issue:
HTTP Code | Display | Description |
---|---|---|
400 |
Bad Request | Poor Syntax or breaks a core FHIR constraint |
401 |
Unauthorized | User is not authorised to perform the request. |
403 |
Forbidden | The request is forbidden, authorization will not help. |
409 |
Conflict | User has requested to create a resource that already exists. |
422 |
Unprocessable Entity | The syntax is valid, but cannot be processed, e.g. breaks a business rule. |
500 |
Internal Error | The server encountered an unexpected condition which prevented it from fulfilling the request. |
JSON example of an OperationOutcome for a 409
Conflict Error
XML example of an OperationOutcome for a 409
Conflict Error
Profiles
The Refer Patient (to Social Care for Supported Hospital Discharge) Use Care is supported by the following profiles
StructureDefinition | Version |
---|---|
CareConnect-SHD-ReferralRequest-1 | 0.0.1 |
CareConnect-SHD-Patient-1 | 0.0.1 |
CareConnect-SHD-Encounter-1 | 0.0.1 |
CareConnect-SHD-Location-1 | 0.0.1 |
CareConnect-SHD-Organization-1 | 0.0.1 |
CareConnect-SHD-Practitioner-1 | 0.0.1 |
SHD-QuestionnaireResponse-PreliminaryNeedsAssessment | 0.0.1 |
SHD-QuestionnaireResponse-COVID19 | 0.0.1 |
SHD-QuestionnaireResponse-AssessmentNotice | 0.0.1 |
SHD-QuestionnaireResponse-CHCChecklist | 0.0.1 |
Extensions | Version |
---|---|
Extension-SHD-MedicallyFitDetails | 0.0.1 |
Rules and Mappings
The generic business context data mappings for the 'Madatory' and 'Must Support' elements are detailed in the Profiles section, however the section below deatils any specific rules or contrains that apply to this use case.
Pre-requisites
The patient MUST :
- be over 18 years old
- not be deceased
- have an active Encounter with a NHS Trust
- not already have an active Supported Hospital Discharge Referral to Social Care
Data Mappings
CareConnect-SHD-ReferralRequest-1
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.status | 1..1 | code | Binding RequestStatus At the point of referral the ReferralRequest.status SHALL be "active" |
ReferralRequest.intent | 1..1 | code | Binding RequestIntentAt the point of referral the ReferralRequest.intent SHALL be "plan" at the point of initial referral |
CareConnect-SHD-Encounter-1
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.context.status | 1..1 | code | At the point of referral the Encounter.status SHALL be "in-progress" |
ReferralRequest.context.statusHistory | 0..0 | BackboneElement | Status History is Not Allowed at the point of referral |
ReferralRequest.context.period.end | 0..1 | dateTime | At the point of referral as the Encounter will be in-progress, the Encounter.period.end will relate to the Target Discharge Date i.e. the Predicted Date that the Patient is expectided to no longer meet any of the criteria to reside in hospital (see Hospital Discharge Service: Policy and Operating Model (Annex A)).Note: The FHIR dateTime data type supports date and partial date, as well as a full date-time value. Hence the time element is not required if the source system only captures a date. |
CareConnect-SHD-Practitioner-1
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.requester.agent.telecom | 1..* | ContactPoint | As a minimum , either a telephone number or email address SHALL be provided for the Hospital Liaison [Care Act Regulations para 6 (2)(b)] |
SHD-QuestionnaireResponse-PreliminaryNeedsAssessment
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.supportingInfo[preliminaryNeedsAssessment].basedOn | 0..0 | Reference (CareConnect-SHD-ReferralRequest-1) | Reference to the ReferralRequest the Preliminary Needs Assessment relates to is Not Allowed if sent with the ReferralRequest |
SHD-QuestionnaireResponse-COVID19
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.supportingInfo[covid19Assessment].basedOn | 0..0 | Reference (CareConnect-SHD-ReferralRequest-1) | Reference to the ReferralRequest the COVID-19 Assessment relates to is Not Allowed if sent with the ReferralRequest |
SHD-QuestionnaireResponse-CHCChecklist
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.supportingInfo[chcChecklist].basedOn | 0..0 | Reference (CareConnect-SHD-ReferralRequest-1) | Reference to the ReferralRequest the CHC Checklist relates to is Not Allowed if sent with the ReferralRequest |
SHD-QuestionnaireResponse-AssessmentNotice
FHIR Element | Card. | Type | Description/Business Context |
---|---|---|---|
ReferralRequest.supportingInfo[assessmentNotice].basedOn | 0..0 | Reference (CareConnect-SHD-ReferralRequest-1) | Reference to the ReferralRequest the Assessment Notice relates to is Not Allowed if sent with the ReferralRequest |
Examples
Request Body
JSON example of a CareConnect-SHD-ReferralRequest-1
XML example of a CareConnect-SHD-ReferralRequest-1