SHD-QuestionnaireResponse-PreliminaryNeedsAssessment
This is the StructureDefinition overview for the SHD-QuestionnaireResponse-PreliminaryNeedsAssessment. This QuestionnaireResponse contains a Preliminary Needs Assessment completed by Hospital Staff and shared as part of a Supported Hospital Discharge with third partied (e.g. Social Care, Community Health).
The Preliminary Needs Assessment QuestionnaireResponse can be contained/referenced in the initial ReferralRequest, or can shared as a seperaet update subsequently with reference to the relevant ReferralRequest.id
The official URL for this profile is: https
Differential
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Hybrid
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Snapshot (default)
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PreliminaryNeedsAssessment Data Mapping
The table below provides the generic business context data mappings for the 'Mandatory' and 'Must Support' elements in the SHD-QuestionnaireResponse-PreliminaryNeedsAssessment profile. However, please see the individual use case guidance for specifc constraints and context.
| FHIR Element | Card. | Type | Description/Business Context |
|---|---|---|---|
| QuestionnaireResponse.basedOn | 0..1 | Reference (CareConnect-SHD-ReferralRequest-1) | Reference to the ReferralRequest the Preliminary Needs Assessment resposnses relates to SHALL be provided if sent after the ReferralRequest |
| QuestionnaireResponse.questionnaire.reference | 1..1 | string | Fixed Value: 'http |
| QuestionnaireResponse.status | 1..1 | code | Fixed Value: 'completed' |
| QuestionnaireResponse.authored | 1..1 | DateTime | The date/time the Preliminary Needs Assessment was completed / last updated by the health worker |
| QuestionnaireResponse.item | 1..* | BackboneElement | MUST SUPPORT the items in the table below |
SHD-Questionnaire-PreliminaryNeedsAssessment Table
| Questionnaire.url[0] | https://fhir.nottinghamshire.gov.uk/STU3/Questionnaire/SHD-Questionnaire-PreliminaryNeedsAssessment |
| Questionnaire.version[0] | 0.0.1 |
| Questionnaire.name[0] | SHD-Questionnaire-PreliminaryNeedsAssessment |
| Questionnaire.title[0] | SHD-Questionnaire-PreliminaryNeedsAssessment |
| Questionnaire.status[0] | draft |
| Questionnaire.date[0] | 2020-04-21T17:59:11.362Z |
| Questionnaire.publisher[0] | NottsCC |
| Questionnaire.description[0] | Preliminary Needs Assessment completed by Hospital Staff and shared as part of a Supported Hospital Discharge with third partied (e.g. Social Care, Community Health) |
| Questionnaire.purpose[0] | Preliminary Needs Assessment completed by Hospital Staff and shared as part of a Supported Hospital Discharge with third partied (e.g. Social Care, Community Health) |
| Questionnaire.subjectType[0] | Patient |
| Questionnaire.item[0].linkId[0] | 1 |
| Questionnaire.item[0].text[0] | Capacity |
| Questionnaire.item[0].type[0] | group |
| Questionnaire.item[0].required[0] | False |
| Questionnaire.item[0].item[0].linkId[0] | 1.1 |
| Questionnaire.item[0].item[0].text[0] | Is the person able to give informed consent to their discharge arrangements? |
| Questionnaire.item[0].item[0].type[0] | choice |
| Questionnaire.item[0].item[0].required[0] | False |
| Questionnaire.item[0].item[0].option[0].value[0].code[0] | yes |
| Questionnaire.item[0].item[0].option[0].value[0].display[0] | Yes |
| Questionnaire.item[0].item[0].option[1].value[0].code[0] | no |
| Questionnaire.item[0].item[0].option[1].value[0].display[0] | No |
| Questionnaire.item[0].item[0].option[2].value[0].code[0] | unable |
| Questionnaire.item[0].item[0].option[2].value[0].display[0] | Unable |
| Questionnaire.item[0].item[1].linkId[0] | 1.1.1 |
| Questionnaire.item[0].item[1].text[0] | If not, give details and a mental capacity assessment is needed |
| Questionnaire.item[0].item[1].type[0] | text |
| Questionnaire.item[0].item[1].enableWhen[0].question[0] | 1.1 |
| Questionnaire.item[0].item[1].enableWhen[0].answer[0].code[0] | no |
| Questionnaire.item[0].item[1].enableWhen[1].question[0] | 1.1 |
| Questionnaire.item[0].item[1].enableWhen[1].answer[0].code[0] | unable |
| Questionnaire.item[0].item[1].required[0] | True |
| Questionnaire.item[0].item[2].linkId[0] | 1.2 |
| Questionnaire.item[0].item[2].text[0] | 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. |
| Questionnaire.item[0].item[2].type[0] | choice |
| Questionnaire.item[0].item[2].required[0] | False |
| Questionnaire.item[0].item[2].option[0].value[0].code[0] | yes |
| Questionnaire.item[0].item[2].option[0].value[0].display[0] | Yes |
| Questionnaire.item[0].item[2].option[1].value[0].code[0] | no |
| Questionnaire.item[0].item[2].option[1].value[0].display[0] | No |
| Questionnaire.item[0].item[3].linkId[0] | 1.2.1 |
| Questionnaire.item[0].item[3].text[0] | If Yes- give details |
| Questionnaire.item[0].item[3].type[0] | text |
| Questionnaire.item[0].item[3].enableWhen[0].question[0] | 1.2 |
| Questionnaire.item[0].item[3].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[0].item[3].required[0] | True |
| Questionnaire.item[0].item[4].linkId[0] | 1.3 |
| Questionnaire.item[0].item[4].text[0] | Are there any cognition or other risks? Any risks being left alone or with others |
| Questionnaire.item[0].item[4].type[0] | choice |
| Questionnaire.item[0].item[4].required[0] | False |
| Questionnaire.item[0].item[4].option[0].value[0].code[0] | yes |
| Questionnaire.item[0].item[4].option[0].value[0].display[0] | Yes |
| Questionnaire.item[0].item[4].option[1].value[0].code[0] | no |
| Questionnaire.item[0].item[4].option[1].value[0].display[0] | No |
| Questionnaire.item[0].item[5].linkId[0] | 1.3.1 |
| Questionnaire.item[0].item[5].text[0] | If Yes- give details |
| Questionnaire.item[0].item[5].type[0] | text |
| Questionnaire.item[0].item[5].enableWhen[0].question[0] | 1.3 |
| Questionnaire.item[0].item[5].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[0].item[5].required[0] | True |
| Questionnaire.item[1].linkId[0] | 2 |
| Questionnaire.item[1].text[0] | Current Medical Needs to support discharge arrangements |
| Questionnaire.item[1].type[0] | group |
| Questionnaire.item[1].required[0] | False |
| Questionnaire.item[1].item[0].linkId[0] | 2.1 |
| Questionnaire.item[1].item[0].text[0] | Record any amendments or changes to medication not reflected on the GP record |
| Questionnaire.item[1].item[0].type[0] | text |
| Questionnaire.item[1].item[0].required[0] | False |
| Questionnaire.item[1].item[1].linkId[0] | 2.2 |
| Questionnaire.item[1].item[1].text[0] | Medical Equipment e.g. oxygen |
| Questionnaire.item[1].item[1].type[0] | text |
| Questionnaire.item[1].item[1].required[0] | False |
| Questionnaire.item[1].item[2].linkId[0] | 2.3 |
| Questionnaire.item[1].item[2].text[0] | Is support with medication required? |
| Questionnaire.item[1].item[2].type[0] | choice |
| Questionnaire.item[1].item[2].required[0] | False |
| Questionnaire.item[1].item[2].option[0].value[0].code[0] | yes |
| Questionnaire.item[1].item[2].option[0].value[0].display[0] | Yes |
| Questionnaire.item[1].item[2].option[1].value[0].code[0] | no |
| Questionnaire.item[1].item[2].option[1].value[0].display[0] | No |
| Questionnaire.item[1].item[3].linkId[0] | 2.3.1 |
| Questionnaire.item[1].item[3].text[0] | If Yes- give details, e.g Mediwallet |
| Questionnaire.item[1].item[3].type[0] | text |
| Questionnaire.item[1].item[3].enableWhen[0].question[0] | 2.3 |
| Questionnaire.item[1].item[3].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[1].item[3].required[0] | True |
| Questionnaire.item[1].item[4].linkId[0] | 2.4 |
| Questionnaire.item[1].item[4].text[0] | Known Allergies |
| Questionnaire.item[1].item[4].type[0] | text |
| Questionnaire.item[1].item[4].required[0] | False |
| Questionnaire.item[1].item[5].linkId[0] | 2.5 |
| Questionnaire.item[1].item[5].text[0] | Other medical needs which impact discharge arrangements. Past Medical history e.g. COPD, Diabetes |
| Questionnaire.item[1].item[5].type[0] | text |
| Questionnaire.item[1].item[5].required[0] | False |
| Questionnaire.item[1].item[6].linkId[0] | 2.6 |
| Questionnaire.item[1].item[6].text[0] | Details of any tests or awaiting results for after discharge |
| Questionnaire.item[1].item[6].type[0] | text |
| Questionnaire.item[1].item[6].required[0] | False |
| Questionnaire.item[1].item[7].linkId[0] | 2.7 |
| Questionnaire.item[1].item[7].text[0] | Has a ReSPECT form been completed? |
| Questionnaire.item[1].item[7].type[0] | choice |
| Questionnaire.item[1].item[7].required[0] | False |
| Questionnaire.item[1].item[7].option[0].value[0].code[0] | yes |
| Questionnaire.item[1].item[7].option[0].value[0].display[0] | Yes |
| Questionnaire.item[1].item[7].option[1].value[0].code[0] | no |
| Questionnaire.item[1].item[7].option[1].value[0].display[0] | No |
| Questionnaire.item[1].item[8].linkId[0] | 2.7.1 |
| Questionnaire.item[1].item[8].text[0] | If Yes- details of ReSPECT form |
| Questionnaire.item[1].item[8].type[0] | text |
| Questionnaire.item[1].item[8].enableWhen[0].question[0] | 2.7 |
| Questionnaire.item[1].item[8].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[1].item[8].required[0] | True |
| Questionnaire.item[2].linkId[0] | 3 |
| Questionnaire.item[2].text[0] | Living arrangements |
| Questionnaire.item[2].type[0] | group |
| Questionnaire.item[2].required[0] | False |
| Questionnaire.item[2].item[0].linkId[0] | 3.1 |
| Questionnaire.item[2].item[0].text[0] | Does the patient live alone? |
| Questionnaire.item[2].item[0].type[0] | choice |
| Questionnaire.item[2].item[0].required[0] | False |
| Questionnaire.item[2].item[0].option[0].value[0].code[0] | yes |
| Questionnaire.item[2].item[0].option[0].value[0].display[0] | Yes |
| Questionnaire.item[2].item[0].option[1].value[0].code[0] | no |
| Questionnaire.item[2].item[0].option[1].value[0].display[0] | No |
| Questionnaire.item[2].item[1].linkId[0] | 3.2 |
| Questionnaire.item[2].item[1].text[0] | Accommodation type and living arrangements. E.g. bungalow, who lives with, etc |
| Questionnaire.item[2].item[1].type[0] | text |
| Questionnaire.item[2].item[1].required[0] | False |
| Questionnaire.item[2].item[2].linkId[0] | 3.3 |
| Questionnaire.item[2].item[2].text[0] | Keysafe including number? |
| Questionnaire.item[2].item[2].type[0] | text |
| Questionnaire.item[2].item[2].required[0] | False |
| Questionnaire.item[2].item[3].linkId[0] | 3.4 |
| Questionnaire.item[2].item[3].text[0] | Lifeline or similar monitoring equipment? |
| Questionnaire.item[2].item[3].type[0] | text |
| Questionnaire.item[2].item[3].required[0] | False |
| Questionnaire.item[2].item[4].linkId[0] | 3.5 |
| Questionnaire.item[2].item[4].text[0] | Urgent accommodation risks and issues if known – only if this will prevent the discharge going ahead. E.g. EMAS concerns raised, family refusing discharge |
| Questionnaire.item[2].item[4].type[0] | text |
| Questionnaire.item[2].item[4].required[0] | False |
| Questionnaire.item[3].linkId[0] | 4 |
| Questionnaire.item[3].text[0] | Input from the person’s discharge care needs |
| Questionnaire.item[3].type[0] | group |
| Questionnaire.item[3].required[0] | False |
| Questionnaire.item[3].item[0].linkId[0] | 4.1 |
| Questionnaire.item[3].item[0].text[0] | Mobility Status - Can the person mobilise? |
| Questionnaire.item[3].item[0].type[0] | choice |
| Questionnaire.item[3].item[0].required[0] | False |
| Questionnaire.item[3].item[0].option[0].value[0].code[0] | independently |
| Questionnaire.item[3].item[0].option[0].value[0].display[0] | Independently |
| Questionnaire.item[3].item[0].option[1].value[0].code[0] | with-aid |
| Questionnaire.item[3].item[0].option[1].value[0].display[0] | With aid |
| Questionnaire.item[3].item[1].linkId[0] | 4.1.1 |
| Questionnaire.item[3].item[1].text[0] | If with aid please state the level of assistance required? |
| Questionnaire.item[3].item[1].type[0] | text |
| Questionnaire.item[3].item[1].enableWhen[0].question[0] | 4.1 |
| Questionnaire.item[3].item[1].enableWhen[0].answer[0].code[0] | with-aid |
| Questionnaire.item[3].item[1].required[0] | True |
| Questionnaire.item[3].item[2].linkId[0] | 4.2 |
| Questionnaire.item[3].item[2].text[0] | Is the patient able to safely /independently manage stairs? |
| Questionnaire.item[3].item[2].type[0] | choice |
| Questionnaire.item[3].item[2].required[0] | False |
| Questionnaire.item[3].item[2].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[2].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[2].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[2].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[2].option[2].value[0].code[0] | NA |
| Questionnaire.item[3].item[2].option[2].value[0].display[0] | Not Applicable |
| Questionnaire.item[3].item[3].linkId[0] | 4.3 |
| Questionnaire.item[3].item[3].text[0] | Are there any steps at the person’s property? |
| Questionnaire.item[3].item[3].type[0] | choice |
| Questionnaire.item[3].item[3].required[0] | False |
| Questionnaire.item[3].item[3].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[3].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[3].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[3].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[3].option[2].value[0].code[0] | dont-know |
| Questionnaire.item[3].item[3].option[2].value[0].display[0] | Don't Know |
| Questionnaire.item[3].item[4].linkId[0] | 4.4 |
| Questionnaire.item[3].item[4].text[0] | Is the patient able to transfer off the bed? |
| Questionnaire.item[3].item[4].type[0] | choice |
| Questionnaire.item[3].item[4].required[0] | False |
| Questionnaire.item[3].item[4].option[0].value[0].code[0] | independently |
| Questionnaire.item[3].item[4].option[0].value[0].display[0] | Independently |
| Questionnaire.item[3].item[4].option[1].value[0].code[0] | with-equipment |
| Questionnaire.item[3].item[4].option[1].value[0].display[0] | With Equipment |
| Questionnaire.item[3].item[5].linkId[0] | 4.5 |
| Questionnaire.item[3].item[5].text[0] | Is the patient able to transfer off the chair? |
| Questionnaire.item[3].item[5].type[0] | choice |
| Questionnaire.item[3].item[5].required[0] | False |
| Questionnaire.item[3].item[5].option[0].value[0].code[0] | independently |
| Questionnaire.item[3].item[5].option[0].value[0].display[0] | Independently |
| Questionnaire.item[3].item[5].option[1].value[0].code[0] | with-equipment |
| Questionnaire.item[3].item[5].option[1].value[0].display[0] | With Equipment |
| Questionnaire.item[3].item[6].linkId[0] | 4.6 |
| Questionnaire.item[3].item[6].text[0] | Is the patient able to transfer off the toilet? |
| Questionnaire.item[3].item[6].type[0] | choice |
| Questionnaire.item[3].item[6].required[0] | False |
| Questionnaire.item[3].item[6].option[0].value[0].code[0] | independently |
| Questionnaire.item[3].item[6].option[0].value[0].display[0] | Independently |
| Questionnaire.item[3].item[6].option[1].value[0].code[0] | with-equipment |
| Questionnaire.item[3].item[6].option[1].value[0].display[0] | With Equipment |
| Questionnaire.item[3].item[7].linkId[0] | 4.7 |
| Questionnaire.item[3].item[7].text[0] | If equipment selected on any of the above, has this equipment been ordered to ensure a safe discharge? |
| Questionnaire.item[3].item[7].type[0] | choice |
| Questionnaire.item[3].item[7].enableWhen[0].question[0] | 4.4 |
| Questionnaire.item[3].item[7].enableWhen[0].answer[0].code[0] | with-equipment |
| Questionnaire.item[3].item[7].enableWhen[1].question[0] | 4.5 |
| Questionnaire.item[3].item[7].enableWhen[1].answer[0].code[0] | with-equipment |
| Questionnaire.item[3].item[7].enableWhen[2].question[0] | 4.6 |
| Questionnaire.item[3].item[7].enableWhen[2].answer[0].code[0] | with-equipment |
| Questionnaire.item[3].item[7].required[0] | False |
| Questionnaire.item[3].item[7].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[7].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[7].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[7].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[8].linkId[0] | 4.8 |
| Questionnaire.item[3].item[8].text[0] | 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)? |
| Questionnaire.item[3].item[8].type[0] | text |
| Questionnaire.item[3].item[8].required[0] | False |
| Questionnaire.item[3].item[9].linkId[0] | 4.9 |
| Questionnaire.item[3].item[9].text[0] | Can the person bear their own weight fully? |
| Questionnaire.item[3].item[9].type[0] | choice |
| Questionnaire.item[3].item[9].required[0] | False |
| Questionnaire.item[3].item[9].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[9].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[9].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[9].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[9].option[2].value[0].code[0] | partially |
| Questionnaire.item[3].item[9].option[2].value[0].display[0] | Partially |
| Questionnaire.item[3].item[10].linkId[0] | 4.9.1 |
| Questionnaire.item[3].item[10].text[0] | Details if No or Partially |
| Questionnaire.item[3].item[10].type[0] | text |
| Questionnaire.item[3].item[10].enableWhen[0].question[0] | 4.9 |
| Questionnaire.item[3].item[10].enableWhen[0].answer[0].code[0] | no |
| Questionnaire.item[3].item[10].enableWhen[1].question[0] | 4.9 |
| Questionnaire.item[3].item[10].enableWhen[1].answer[0].code[0] | partially |
| Questionnaire.item[3].item[10].required[0] | True |
| Questionnaire.item[3].item[11].linkId[0] | 4.10 |
| Questionnaire.item[3].item[11].text[0] | Can the person prepare drinks or a meal for themselves at home? |
| Questionnaire.item[3].item[11].type[0] | choice |
| Questionnaire.item[3].item[11].required[0] | False |
| Questionnaire.item[3].item[11].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[11].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[11].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[11].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[12].linkId[0] | 4.10.1 |
| Questionnaire.item[3].item[12].text[0] | Please give details of alternative (e.g. meals delivery/ family support) |
| Questionnaire.item[3].item[12].type[0] | text |
| Questionnaire.item[3].item[12].enableWhen[0].question[0] | 4.10 |
| Questionnaire.item[3].item[12].enableWhen[0].answer[0].code[0] | no |
| Questionnaire.item[3].item[12].required[0] | True |
| Questionnaire.item[3].item[13].linkId[0] | 4.11 |
| Questionnaire.item[3].item[13].text[0] | Does the person have any difficulty swallowing? |
| Questionnaire.item[3].item[13].type[0] | choice |
| Questionnaire.item[3].item[13].required[0] | False |
| Questionnaire.item[3].item[13].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[13].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[13].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[13].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[14].linkId[0] | 4.11.1 |
| Questionnaire.item[3].item[14].text[0] | If Yes- give details |
| Questionnaire.item[3].item[14].type[0] | text |
| Questionnaire.item[3].item[14].enableWhen[0].question[0] | 4.11 |
| Questionnaire.item[3].item[14].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[3].item[14].required[0] | True |
| Questionnaire.item[3].item[15].linkId[0] | 4.12 |
| Questionnaire.item[3].item[15].text[0] | Is the person able to wash and dress themselves on discharge? |
| Questionnaire.item[3].item[15].type[0] | choice |
| Questionnaire.item[3].item[15].required[0] | False |
| Questionnaire.item[3].item[15].option[0].value[0].code[0] | yes |
| Questionnaire.item[3].item[15].option[0].value[0].display[0] | Yes |
| Questionnaire.item[3].item[15].option[1].value[0].code[0] | no |
| Questionnaire.item[3].item[15].option[1].value[0].display[0] | No |
| Questionnaire.item[3].item[16].linkId[0] | 4.12.1 |
| Questionnaire.item[3].item[16].text[0] | If No- give details |
| Questionnaire.item[3].item[16].type[0] | text |
| Questionnaire.item[3].item[16].enableWhen[0].question[0] | 4.12 |
| Questionnaire.item[3].item[16].enableWhen[0].answer[0].code[0] | no |
| Questionnaire.item[3].item[16].required[0] | True |
| Questionnaire.item[3].item[17].linkId[0] | 4.13 |
| Questionnaire.item[3].item[17].text[0] | What does the person want to ideally achieve? e.g. return to independence, support at home etc |
| Questionnaire.item[3].item[17].type[0] | text |
| Questionnaire.item[3].item[17].required[0] | False |
| Questionnaire.item[4].linkId[0] | 5 |
| Questionnaire.item[4].text[0] | Specialist Input needed after discharge |
| Questionnaire.item[4].type[0] | group |
| Questionnaire.item[4].required[0] | False |
| Questionnaire.item[4].item[0].linkId[0] | 5.1 |
| Questionnaire.item[4].item[0].text[0] | Does the person have any wounds or sores that need to be dressed or managed? (awareness for providers on bed sores etc) |
| Questionnaire.item[4].item[0].type[0] | choice |
| Questionnaire.item[4].item[0].required[0] | False |
| Questionnaire.item[4].item[0].option[0].value[0].code[0] | yes |
| Questionnaire.item[4].item[0].option[0].value[0].display[0] | Yes |
| Questionnaire.item[4].item[0].option[1].value[0].code[0] | no |
| Questionnaire.item[4].item[0].option[1].value[0].display[0] | No |
| Questionnaire.item[4].item[1].linkId[0] | 5.1.1 |
| Questionnaire.item[4].item[1].text[0] | If Yes give details |
| Questionnaire.item[4].item[1].type[0] | text |
| Questionnaire.item[4].item[1].enableWhen[0].question[0] | 5.1 |
| Questionnaire.item[4].item[1].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[4].item[1].required[0] | True |
| Questionnaire.item[4].item[2].linkId[0] | 5.2 |
| Questionnaire.item[4].item[2].text[0] | Does the person have any Continence needs? |
| Questionnaire.item[4].item[2].type[0] | choice |
| Questionnaire.item[4].item[2].required[0] | False |
| Questionnaire.item[4].item[2].option[0].value[0].code[0] | yes |
| Questionnaire.item[4].item[2].option[0].value[0].display[0] | Yes |
| Questionnaire.item[4].item[2].option[1].value[0].code[0] | no |
| Questionnaire.item[4].item[2].option[1].value[0].display[0] | No |
| Questionnaire.item[4].item[3].linkId[0] | 5.2.1 |
| Questionnaire.item[4].item[3].text[0] | If Yes give details |
| Questionnaire.item[4].item[3].type[0] | text |
| Questionnaire.item[4].item[3].enableWhen[0].question[0] | 5.2 |
| Questionnaire.item[4].item[3].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[4].item[3].required[0] | True |
| Questionnaire.item[4].item[4].linkId[0] | 5.3 |
| Questionnaire.item[4].item[4].text[0] | How will the person support themselves overnight between visits? (e.g. if needs toilet in the night) |
| Questionnaire.item[4].item[4].type[0] | text |
| Questionnaire.item[4].item[4].required[0] | False |
| Questionnaire.item[4].item[5].linkId[0] | 5.4 |
| Questionnaire.item[4].item[5].text[0] | Can the person fully communicate their needs? |
| Questionnaire.item[4].item[5].type[0] | choice |
| Questionnaire.item[4].item[5].required[0] | False |
| Questionnaire.item[4].item[5].option[0].value[0].code[0] | yes |
| Questionnaire.item[4].item[5].option[0].value[0].display[0] | Yes |
| Questionnaire.item[4].item[5].option[1].value[0].code[0] | no |
| Questionnaire.item[4].item[5].option[1].value[0].display[0] | No |
| Questionnaire.item[4].item[6].linkId[0] | 5.4.1 |
| Questionnaire.item[4].item[6].text[0] | If No please give communication needs. e.g. translator, carer support |
| Questionnaire.item[4].item[6].type[0] | text |
| Questionnaire.item[4].item[6].enableWhen[0].question[0] | 5.4 |
| Questionnaire.item[4].item[6].enableWhen[0].answer[0].code[0] | no |
| Questionnaire.item[4].item[6].required[0] | True |
| Questionnaire.item[4].item[7].linkId[0] | 5.5 |
| Questionnaire.item[4].item[7].text[0] | Has transport been arranged for this person? |
| Questionnaire.item[4].item[7].type[0] | choice |
| Questionnaire.item[4].item[7].required[0] | False |
| Questionnaire.item[4].item[7].option[0].value[0].code[0] | yes |
| Questionnaire.item[4].item[7].option[0].value[0].display[0] | Yes |
| Questionnaire.item[4].item[7].option[1].value[0].code[0] | no |
| Questionnaire.item[4].item[7].option[1].value[0].display[0] | No |
| Questionnaire.item[4].item[8].linkId[0] | 5.5.1 |
| Questionnaire.item[4].item[8].text[0] | If Yes date and time booked for |
| Questionnaire.item[4].item[8].type[0] | dateTime |
| Questionnaire.item[4].item[8].enableWhen[0].question[0] | 5.5 |
| Questionnaire.item[4].item[8].enableWhen[0].answer[0].code[0] | yes |
| Questionnaire.item[4].item[8].required[0] | True |
| Questionnaire.item[5].linkId[0] | 6 |
| Questionnaire.item[5].text[0] | Additional Information |
| Questionnaire.item[5].type[0] | group |
| Questionnaire.item[5].required[0] | False |
| Questionnaire.item[5].item[0].linkId[0] | 6.1 |
| Questionnaire.item[5].item[0].text[0] | Please use this section to provide any other additional information that is relevant to the discharge |
| Questionnaire.item[5].item[0].type[0] | text |
| Questionnaire.item[5].item[0].required[0] | False |