Share Needs Assessment(s) / CHC Checklist

To support the referral for a supported discharge, health may send through additional documentation to provide third parties more information about the patient's competencies, needs, risks etc.

The API currently enables the sharing of structured content of the following

  • Preliminary Needs Assessment
  • COVID-19 Assessment
  • CHC Checklist

Note: Sharing of content of each of the above types would need to be shared as seperate requests. For example if both the 'Preliminary Needs Assessment' and the 'COVID-19 Assessment' details changed, then two HTTPS requests would be required.


HTTPS Request

Method:

PUT (conditional update).

Alternatively, the first time the QuestionnaireResponse is shared a conditional create can be used using the POST Method

Request URL:

The request URL will consist of 'https://'+'{Host}'+'{BaseURL}'+'?'+'{QueryString}'

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/QuestionnaireResponse

Query String /Parameters:

Name Value
based-on ReferralRequest/{Referral ID}

Note: Absolute or Relative referencing is supported, however Parameter Value MUST be the same as the QuestionnaireResponse.basedOn.reference value in the request body

Example Request Url:

https://health-interoperability-test.nottscc.gov.uk/ReferralService/v3/QuestionnaireResponse?based-on=ReferralRequest/11284224



Request Body:

The Request body should be in either json or xml format

The primary base FHIR resource will depend on the data that is being sahred/updated, i.e.:

See Examples for an illustration of the Request body of a typical QuestionnaireResponse for Sharing a Needs Assessment / CHC Checklist


Response

Success

PUT SHALL return a HTTP status code 200 OK on successful execution of the request

Where a POST method used, SHALL return a HTTP status code 201 Created on successful execution of the request

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 400 Bad Request

{
    "resourceType": "OperationOutcome",
    "issue":  [
        {
            "severity": "error",
            "code": "processing",
            "diagnostics": "Can not update resource, request URL must contain an ID element for update (PUT) operation (it must be of the form [base]/[resource type]/[id])"
        }
    ]
}


XML example of an OperationOutcome for a 400 Bad Request

<OperationOutcome xmlns="http://hl7.org/fhir">
    <issue>
        <severity value="error" />
        <code value="processing" />
        <diagnostics value="Can not update resource, request URL must contain an ID element for update (PUT) operation (it must be of the form [base]/[resource type]/[id])" />
    </issue>
</OperationOutcome>



Profiles

The Share Needs Assessment(s) / CHC Checklist Use Care is supported by the following profiles

StructureDefinition Version
SHD-QuestionnaireResponse-PreliminaryNeedsAssessment 0.0.1
SHD-QuestionnaireResponse-COVID19 0.0.1
SHD-QuestionnaireResponse-CHCChecklist 0.0.1
Extensions Version
None
ValueSets Version
NHS Continuing Healthcare Checklist Domain Level Score 0.0.1
NHS Continuing Healthcare Checklist Outcome 0.0.1
CodeSystems Version
NHS Continuing Healthcare Checklist Domain Level Score 0.0.1
NHS Continuing Healthcare Checklist Outcome 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 have an Active Referral Request:

Data Mappings

SHD-QuestionnaireResponse-PreliminaryNeedsAssessment

FHIR Element Card. Type Description/Business Context
QuestionnaireResponse.basedOn 1..1 Reference (CareConnect-SHD-ReferralRequest-1) Reference to the ReferralRequest the Preliminary Needs Assessment relates to SHALL be provided when sent after the ReferralRequest.

Note: Absolute or Relative referencing is supported, however QuestionnaireResponse.basedOn.reference value MUST be the same as the based-on Parameter Value in the request url.
QuestionnaireResponse.status 1..1 code Create a Preliminary Needs Assessment: status=completed

Update a Preliminary Needs Assessment: status=amended

SHD-QuestionnaireResponse-COVID19

FHIR Element Card. Type Description/Business Context
QuestionnaireResponse.basedOn 1..1 Reference (CareConnect-SHD-ReferralRequest-1) Reference to the ReferralRequest the COVID-19 Assessment relates to SHALL be provided when sent after the ReferralRequest.

Note: Absolute or Relative referencing is supported, however QuestionnaireResponse.basedOn.reference value MUST be the same as the based-on Parameter Value in the request url.
QuestionnaireResponse.status 1..1 code Create a COVID-19 Assessment: status=completed

Update a COVID-19 Assessment: status=amended

SHD-QuestionnaireResponse-CHCChecklist

FHIR Element Card. Type Description/Business Context
QuestionnaireResponse.basedOn 1..1 Reference (CareConnect-SHD-ReferralRequest-1) Reference to the ReferralRequest the CHC Checklist relates to SHALL be provided when sent after the ReferralRequest.

Note: Absolute or Relative referencing is supported, however QuestionnaireResponse.basedOn.reference value MUST be the same as the based-on Parameter Value in the request url.
QuestionnaireResponse.status 1..1 code Create a CHC Checklist: status=completed

Update a CHC Checklist: status=amended

Examples

Request Body

JSON example of a SHD-QuestionnaireResponse-PreliminaryNeedsAssessment

{
    "resourceType": "QuestionnaireResponse",
    "meta": {
        "profile":  [
            "https://fhir.nottinghamshire.gov.uk/STU3/StructureDefinition/SHD-QuestionnaireResponse-PreliminaryNeedsAssessment"
        ]
    },
    "basedOn":  [
        {
            "reference": "ReferralRequest/123456"
        }
    ],
    "questionnaire": {
        "reference": "https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-PreliminaryNeedsAssessment"
    },
    "status": "completed",
    "authored": "2020-04-29T14:31:00.896Z",
    "item":  [
        {
            "linkId": "1",
            "text": "Capacity",
            "item":  [
                {
                    "linkId": "1.1",
                    "text": "Is the person able to give informed consent to their discharge arrangements?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "unable",
                                "display": "Unable"
                            }
                        }
                    ]
                },
                {
                    "linkId": "1.1.1",
                    "text": "If not, give details and a mental capacity assessment is needed",
                    "answer":  [
                        {
                            "valueString": "If not, give details and a mental capacity assessment is needed"
                        }
                    ]
                },
                {
                    "linkId": "1.2",
                    "text": "Deprivation of Liberty Safeguards: Will the person be deprived of their liberty? – i.e. under continuous supervision and control and not free to leave and not able to give informed consent to these arrangements.",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "1.2.1",
                    "text": "If Yes- give details",
                    "answer":  [
                        {
                            "valueString": "DOLs"
                        }
                    ]
                },
                {
                    "linkId": "1.3",
                    "text": "Are there any cognition or other risks? Any risks being left alone or with others",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "1.3.1",
                    "text": "If Yes- give details",
                    "answer":  [
                        {
                            "valueString": "Cognition Risks"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "2",
            "text": "Current Medical Needs to support discharge arrangements",
            "item":  [
                {
                    "linkId": "2.1",
                    "text": "Details of currently prescribed medications",
                    "answer":  [
                        {
                            "valueString": "Details of currently prescribed medications"
                        }
                    ]
                },
                {
                    "linkId": "2.2",
                    "text": "Medical Equipment e.g. oxygen",
                    "answer":  [
                        {
                            "valueString": "Medical Equipment e.g. oxygen"
                        }
                    ]
                },
                {
                    "linkId": "2.3",
                    "text": "Is support with medication required?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "2.3.1",
                    "text": "If Yes- give details, e.g Mediwallet",
                    "answer":  [
                        {
                            "valueString": "Mediwallet"
                        }
                    ]
                },
                {
                    "linkId": "2.4",
                    "text": "Known Allergies",
                    "answer":  [
                        {
                            "valueString": "Allergies"
                        }
                    ]
                },
                {
                    "linkId": "2.5",
                    "text": "Other medical needs which impact discharge arrangements. Past Medical history e.g. COPD, Diabetes",
                    "answer":  [
                        {
                            "valueString": "Other medical needs which impact discharge arrangements. Past Medical history e.g. COPD, Diabetes"
                        }
                    ]
                },
                {
                    "linkId": "2.6",
                    "text": "Details of any tests or awaiting results for after discharge",
                    "answer":  [
                        {
                            "valueString": "Details of any tests or awaiting results for after discharge"
                        }
                    ]
                },
                {
                    "linkId": "2.7",
                    "text": "Has a respect form been completed?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "2.7.1",
                    "text": "If Yes- details of Respect form",
                    "answer":  [
                        {
                            "valueString": "Do not resuscitate"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "3",
            "text": "Living arrangements",
            "item":  [
                {
                    "linkId": "3.1",
                    "text": "Does the patient live alone?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "3.2",
                    "text": "Accommodation type and living arrangements. E.g. bungalow, who lives with, etc",
                    "answer":  [
                        {
                            "valueString": "Flat, floor 6"
                        }
                    ]
                },
                {
                    "linkId": "3.3",
                    "text": "Keysafe including number?",
                    "answer":  [
                        {
                            "valueString": "Yes 123456KS"
                        }
                    ]
                },
                {
                    "linkId": "3.4",
                    "text": "Lifeline or similar monitoring equipment?",
                    "answer":  [
                        {
                            "valueString": "Lifeline Alarm"
                        }
                    ]
                },
                {
                    "linkId": "3.5",
                    "text": "Urgent accommodation risks and issues if known – only if this will prevent the discharge going ahead. E.g. EMAS concerns raised, family refusing discharge",
                    "answer":  [
                        {
                            "valueString": "Urgent accommodation risks and issues if known – only if this will prevent the discharge going ahead. E.g. EMAS concerns raised, family refusing discharge"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "4",
            "text": "Input from the person’s discharge care needs",
            "item":  [
                {
                    "linkId": "4.1",
                    "text": "Mobility Status - Can the person mobilise?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "with-aid",
                                "display": "With aid"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.1.1",
                    "text": "If with aid please state the level of assistance required?",
                    "answer":  [
                        {
                            "valueString": "A frame"
                        }
                    ]
                },
                {
                    "linkId": "4.2",
                    "text": "Is the patient able to safely /independently manage stairs?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.3",
                    "text": "Are there any steps at the person’s property?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.4",
                    "text": "Is the patient able to transfer off the bed?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "with-equipment",
                                "display": "With Equipment"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.5",
                    "text": "Is the patient able to transfer off the chair?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "with-equipment",
                                "display": "With Equipment"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.6",
                    "text": "Is the patient able to transfer off the toilet?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "with-equipment",
                                "display": "With Equipment"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.7",
                    "text": "If equipment selected on any of the above, has this equipment been ordered to ensure a safe discharge?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.8",
                    "text": "How does the person feel they will transfer between areas of their home?  (between bed and chair and toilet or bathroom, any steps at their property, between rooms etc)?",
                    "answer":  [
                        {
                            "valueString": "How does the person feel they will transfer between areas of their home? (between bed and chair and toilet or bathroom, any steps at their property, between rooms etc)?"
                        }
                    ]
                },
                {
                    "linkId": "4.9",
                    "text": "Can the person bear their own weight fully?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.9.1",
                    "text": "Details if No or Partially",
                    "answer":  [
                        {
                            "valueString": "Needs an A Frame"
                        }
                    ]
                },
                {
                    "linkId": "4.10",
                    "text": "Can the person prepare drinks or a meal for themselves at home?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.10.1",
                    "text": "Please give details of alternative (e.g. meals delivery/ family support)",
                    "answer":  [
                        {
                            "valueString": "Needs help cooking and feeding"
                        }
                    ]
                },
                {
                    "linkId": "4.11",
                    "text": "Does the person have any difficulty swallowing?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.11.1",
                    "text": "If Yes- give details",
                    "answer":  [
                        {
                            "valueString": "Needs pureed food"
                        }
                    ]
                },
                {
                    "linkId": "4.12",
                    "text": "Is the person able to wash and dress themselves on discharge?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "4.12.1",
                    "text": "If No- give details",
                    "answer":  [
                        {
                            "valueString": "Will need help washing"
                        }
                    ]
                },
                {
                    "linkId": "4.13",
                    "text": "What does the person want to ideally achieve? e.g. return to independence, support at home etc",
                    "answer":  [
                        {
                            "valueString": "What does the person want to ideally achieve? e.g. return to independence, support at home etc"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "5",
            "text": "Specialist Input needed after discharge",
            "item":  [
                {
                    "linkId": "5.1",
                    "text": "Does the person have any wounds or sores that need to be dressed or managed? (awareness for providers on bed sores etc)",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "5.1.1",
                    "text": "If Yes give details",
                    "answer":  [
                        {
                            "valueString": "Dressing will need changing daily"
                        }
                    ]
                },
                {
                    "linkId": "5.2",
                    "text": "Does the person have any Continence needs?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "5.2.1",
                    "text": "If Yes give details",
                    "answer":  [
                        {
                            "valueString": "Pads required at night"
                        }
                    ]
                },
                {
                    "linkId": "5.3",
                    "text": "How will the person support themselves overnight between visits? (e.g. if needs toilet in the night)",
                    "answer":  [
                        {
                            "valueString": "How will the person support themselves overnight between visits? (e.g. if needs toilet in the night)"
                        }
                    ]
                },
                {
                    "linkId": "5.4",
                    "text": "Can the person fully communicate their needs?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "no",
                                "display": "No"
                            }
                        }
                    ]
                },
                {
                    "linkId": "5.4.1",
                    "text": "If No please give communication needs. e.g. translator, carer support",
                    "answer":  [
                        {
                            "valueString": "Translator for French"
                        }
                    ]
                },
                {
                    "linkId": "5.5",
                    "text": "Are you planning to organise hospital transport for this person?",
                    "answer":  [
                        {
                            "valueCoding": {
                                "code": "yes",
                                "display": "Yes"
                            }
                        }
                    ]
                },
                {
                    "linkId": "5.5.1",
                    "text": "If Yes date and time booked for",
                    "answer":  [
                        {
                            "valueDateTime": "2020-05-01T12:10:00.000Z"
                        }
                    ]
                }
            ]
        },
        {
            "linkId": "6",
            "text": "Additional Information",
            "item":  [
                {
                    "linkId": "6.1",
                    "text": "Please use this section to provide any other additional information that is relevant to the discharge",
                    "answer":  [
                        {
                            "valueString": "Please use this section to provide any other additional information that is relevant to the discharge"
                        }
                    ]
                }
            ]
        }
    ]
}


XML example of a SHD-QuestionnaireResponse-PreliminaryNeedsAssessment

<QuestionnaireResponse xmlns="http://hl7.org/fhir">
    <meta>
        <profile value="https://fhir.nottinghamshire.gov.uk/STU3/StructureDefinition/SHD-QuestionnaireResponse-PreliminaryNeedsAssessment" />
    </meta>
    <basedOn>
        <reference value="ReferralRequest/123456" />
    </basedOn>
    <questionnaire>
        <reference value="https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-PreliminaryNeedsAssessment" />
    </questionnaire>
    <status value="completed" />
    <authored value="2020-04-29T14:31:00.896Z" />
    <item>
        <linkId value="1" />
        <text value="Capacity" />
        <item>
            <linkId value="1.1" />
            <text value="Is the person able to give informed consent to their discharge arrangements?" />
            <answer>
                <valueCoding>
                    <code value="unable" />
                    <display value="Unable" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="1.1.1" />
            <text value="If not, give details and a mental capacity assessment is needed" />
            <answer>
                <valueString value="If not, give details and a mental capacity assessment is needed" />
            </answer>
        </item>
        <item>
            <linkId value="1.2" />
            <text value="Deprivation of Liberty Safeguards: Will the person be deprived of their liberty? – i.e. under continuous supervision and control and not free to leave and not able to give informed consent to these arrangements." />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="1.2.1" />
            <text value="If Yes- give details" />
            <answer>
                <valueString value="DOLs" />
            </answer>
        </item>
        <item>
            <linkId value="1.3" />
            <text value="Are there any cognition or other risks? Any risks being left alone or with others" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="1.3.1" />
            <text value="If Yes- give details" />
            <answer>
                <valueString value="Cognition Risks" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="2" />
        <text value="Current Medical Needs to support discharge arrangements" />
        <item>
            <linkId value="2.1" />
            <text value="Details of currently prescribed medications" />
            <answer>
                <valueString value="Details of currently prescribed medications" />
            </answer>
        </item>
        <item>
            <linkId value="2.2" />
            <text value="Medical Equipment e.g. oxygen" />
            <answer>
                <valueString value="Medical Equipment e.g. oxygen" />
            </answer>
        </item>
        <item>
            <linkId value="2.3" />
            <text value="Is support with medication required?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="2.3.1" />
            <text value="If Yes- give details, e.g Mediwallet" />
            <answer>
                <valueString value="Mediwallet" />
            </answer>
        </item>
        <item>
            <linkId value="2.4" />
            <text value="Known Allergies" />
            <answer>
                <valueString value="Allergies" />
            </answer>
        </item>
        <item>
            <linkId value="2.5" />
            <text value="Other medical needs which impact discharge arrangements. Past Medical history e.g. COPD, Diabetes" />
            <answer>
                <valueString value="Other medical needs which impact discharge arrangements. Past Medical history e.g. COPD, Diabetes" />
            </answer>
        </item>
        <item>
            <linkId value="2.6" />
            <text value="Details of any tests or awaiting results for after discharge" />
            <answer>
                <valueString value="Details of any tests or awaiting results for after discharge" />
            </answer>
        </item>
        <item>
            <linkId value="2.7" />
            <text value="Has a respect form been completed?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="2.7.1" />
            <text value="If Yes- details of Respect form" />
            <answer>
                <valueString value="Do not resuscitate" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="3" />
        <text value="Living arrangements" />
        <item>
            <linkId value="3.1" />
            <text value="Does the patient live alone?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="3.2" />
            <text value="Accommodation type and living arrangements. E.g. bungalow, who lives with, etc" />
            <answer>
                <valueString value="Flat, floor 6" />
            </answer>
        </item>
        <item>
            <linkId value="3.3" />
            <text value="Keysafe including number?" />
            <answer>
                <valueString value="Yes 123456KS" />
            </answer>
        </item>
        <item>
            <linkId value="3.4" />
            <text value="Lifeline or similar monitoring equipment?" />
            <answer>
                <valueString value="Lifeline Alarm" />
            </answer>
        </item>
        <item>
            <linkId value="3.5" />
            <text value="Urgent accommodation risks and issues if known – only if this will prevent the discharge going ahead. E.g. EMAS concerns raised, family refusing discharge" />
            <answer>
                <valueString value="Urgent accommodation risks and issues if known – only if this will prevent the discharge going ahead. E.g. EMAS concerns raised, family refusing discharge" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="4" />
        <text value="Input from the person’s discharge care needs" />
        <item>
            <linkId value="4.1" />
            <text value="Mobility Status - Can the person mobilise?" />
            <answer>
                <valueCoding>
                    <code value="with-aid" />
                    <display value="With aid" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.1.1" />
            <text value="If with aid please state the level of assistance required?" />
            <answer>
                <valueString value="A frame" />
            </answer>
        </item>
        <item>
            <linkId value="4.2" />
            <text value="Is the patient able to safely /independently manage stairs?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.3" />
            <text value="Are there any steps at the person’s property?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.4" />
            <text value="Is the patient able to transfer off the bed?" />
            <answer>
                <valueCoding>
                    <code value="with-equipment" />
                    <display value="With Equipment" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.5" />
            <text value="Is the patient able to transfer off the chair?" />
            <answer>
                <valueCoding>
                    <code value="with-equipment" />
                    <display value="With Equipment" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.6" />
            <text value="Is the patient able to transfer off the toilet?" />
            <answer>
                <valueCoding>
                    <code value="with-equipment" />
                    <display value="With Equipment" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.7" />
            <text value="If equipment selected on any of the above, has this equipment been ordered to ensure a safe discharge?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.8" />
            <text value="How does the person feel they will transfer between areas of their home?  (between bed and chair and toilet or bathroom, any steps at their property, between rooms etc)?" />
            <answer>
                <valueString value="How does the person feel they will transfer between areas of their home? (between bed and chair and toilet or bathroom, any steps at their property, between rooms etc)?" />
            </answer>
        </item>
        <item>
            <linkId value="4.9" />
            <text value="Can the person bear their own weight fully?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.9.1" />
            <text value="Details if No or Partially" />
            <answer>
                <valueString value="Needs an A Frame" />
            </answer>
        </item>
        <item>
            <linkId value="4.10" />
            <text value="Can the person prepare drinks or a meal for themselves at home?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.10.1" />
            <text value="Please give details of alternative (e.g. meals delivery/ family support)" />
            <answer>
                <valueString value="Needs help cooking and feeding" />
            </answer>
        </item>
        <item>
            <linkId value="4.11" />
            <text value="Does the person have any difficulty swallowing?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.11.1" />
            <text value="If Yes- give details" />
            <answer>
                <valueString value="Needs pureed food" />
            </answer>
        </item>
        <item>
            <linkId value="4.12" />
            <text value="Is the person able to wash and dress themselves on discharge?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="4.12.1" />
            <text value="If No- give details" />
            <answer>
                <valueString value="Will need help washing" />
            </answer>
        </item>
        <item>
            <linkId value="4.13" />
            <text value="What does the person want to ideally achieve? e.g. return to independence, support at home etc" />
            <answer>
                <valueString value="What does the person want to ideally achieve? e.g. return to independence, support at home etc" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="5" />
        <text value="Specialist Input needed after discharge" />
        <item>
            <linkId value="5.1" />
            <text value="Does the person have any wounds or sores that need to be dressed or managed? (awareness for providers on bed sores etc)" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="5.1.1" />
            <text value="If Yes give details" />
            <answer>
                <valueString value="Dressing will need changing daily" />
            </answer>
        </item>
        <item>
            <linkId value="5.2" />
            <text value="Does the person have any Continence needs?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="5.2.1" />
            <text value="If Yes give details" />
            <answer>
                <valueString value="Pads required at night" />
            </answer>
        </item>
        <item>
            <linkId value="5.3" />
            <text value="How will the person support themselves overnight between visits? (e.g. if needs toilet in the night)" />
            <answer>
                <valueString value="How will the person support themselves overnight between visits? (e.g. if needs toilet in the night)" />
            </answer>
        </item>
        <item>
            <linkId value="5.4" />
            <text value="Can the person fully communicate their needs?" />
            <answer>
                <valueCoding>
                    <code value="no" />
                    <display value="No" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="5.4.1" />
            <text value="If No please give communication needs. e.g. translator, carer support" />
            <answer>
                <valueString value="Translator for French" />
            </answer>
        </item>
        <item>
            <linkId value="5.5" />
            <text value="Are you planning to organise hospital transport for this person?" />
            <answer>
                <valueCoding>
                    <code value="yes" />
                    <display value="Yes" />
                </valueCoding>
            </answer>
        </item>
        <item>
            <linkId value="5.5.1" />
            <text value="If Yes date and time booked for" />
            <answer>
                <valueDateTime value="2020-05-01T12:10:00.000Z" />
            </answer>
        </item>
    </item>
    <item>
        <linkId value="6" />
        <text value="Additional Information" />
        <item>
            <linkId value="6.1" />
            <text value="Please use this section to provide any other additional information that is relevant to the discharge" />
            <answer>
                <valueString value="Please use this section to provide any other additional information that is relevant to the discharge" />
            </answer>
        </item>
    </item>
</QuestionnaireResponse>