Transfer of Care R4 Hackathon Implementation Guide

This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Patient demographics

The Patient demographics section contains information about the patient. PRSB Elements should be formatted as subheadings in any HTML sent.

Section Description Card. MRO* FHIR Target and Guidance
Patient demographics Patient details and contact information. 1 only M Carried in the CodeableConcept of Composition.section.code FHIR element. ValueSet UKCoreCompositionSectionCode
PRSB Element Description Card. MRO* FHIR Target and Guidance
Patient name The full name of the patient 1 only M The legal name of the patient from the Patient Demographics Service (PDS), or the name volunteered by the patient in text and carried in the FHIR element Patient.name with the Patient.name.use containing the value "official".
Patient preferred name The name by which a patient wishes to be addressed. 0 to 1 R The preferred name volunteered by the patient and recorded on the Patient Administration System (PAS), or a preferred name given by PDS that the patient has asked to be called by in text and carried in Patient.name with the Patient.name.use containing the value "usual".
Date of birth The date of birth of the patient. 1 only M The date of birth of the patient taken from PDS, or the date of birth volunteered by the patient (as recorded on the PAS (Patient Administration System). The date of birth will be as precise as possible but should at least contain a year. This will be in text and carried in the FHIR element Patient.birthDate.
Gender The patient's gender. As the patient wishes to portray themselves. 0 to 1 R Text using the values of "Not known", "Male", "Female" or "Not specified" and mapped to the value carried in the FHIR element Patient.gender.code using the required FHIR ValueSet administrative-gender
NHS number The unique identifier for a patient within the NHS in England and Wales. 0 to 1 R Sent as text as per the NHS Data Dictionary NHS number. Traced NHS Numbers only should be used and the NHS number SHOULD be carried in the FHIR element Patient.identifier.
Other identifier Country specific or local identifier, e.g., Community Health Index (CHI) in Scotland. Two data items: type of identifier and identifier. 0 to many R Recorded as per: NHS Data Dictionary - local identifier. The assigning authority should also be supplied along with the country or local identifier. This is carried as text and also carried in the FHIR element Patient.identifier.
Patient address Patient's usual place of residence. 1 only M Sent in accordance with the NHS Data Dictionary: patient usual address. May be auto generated from PDS, GP referral record, or from the local PAS. Text and also carried in the FHIR element Patient.address
Patient email address Email address of the patient 0 to 1 O Set in accordance with the NHS Data Dictionary: contact email address (patient or lead contact). May be auto generated from PDS, GP referral record, or from the local PAS. Text and also carried in the FHIR element Patient.telecom with Patient.telecom.code containing the value "email".
Patient telephone number Telephone contact details of the patient. To include, e.g., mobile, work and home number if available. 0 to many O Contact details may come from PDS, or those recorded on the local PAS.Both the actual contact number and its use (work number, home number, mobile number etc.) should be sent. Text and also carried in the FHIR element Patient.telecom with Patient.telecom.code containing the value "phone".
Relevant contacts Include the most important contacts including:*Personal contacts e.g., next of kin, in case of emergency contact, lasting power of attorney, dependents, informal carers etc.*Health/care professional contacts e.g., social worker, hospital clinician, care coordinator, Independent Mental Capacity Advocate (IMCA) etc. Name, relationship, role (if formal role), contact details and availability, e.g. out of hours. 0 to 1 R Details of relevant contacts, such as carers or family members, as recorded on the local system, or volunteered by the patient. This will be a free text list of relevant contacts.
* M=Mandatory R=Required O=Optional

Example Patient Demographics Section

{
    "resourceType": "Composition",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Composition"
        ]
    },
    "status": "final",
    "type": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "373942005",
                "display": "Discharge summary"
            }
        ]
    },
    "subject": {
        "reference": "urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9"
    },
    "encounter": {
        "reference": "urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd"
    },
    "date": "2023-01-28T10:00:00+00:00",
    "author":  [
        {
            "reference": "urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f"
        }
    ],
    "title": "Cardiology Service Discharge Summary",
    "section":  [
        {
            "title": "Patient demographics",
            "code": {
                "coding":  [
                    {
                        "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings",
                        "code": "patient-demographics",
                        "display": "Patient demographics"
                    }
                ]
            },
            "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Patient name</th><td><p>Prefix: Mr</p><p>Given Name: Andy</p><p>Family Name: Andrews</p></td></tr><tr><th>Date of birth</th><td>1 January 1967</td></tr><tr><th>Gender</th><td>Male</td></tr><tr><th>NHS number</th><td>9449305072</td></tr><tr><th>Patient address</th><td><p>Address Line: 21, Grove Street, Overtown</p><p>City: Leeds</p><p>Post Code: LS21 1PF</p></td></tr></tbody></table></div>"
            },
            "entry":  [
                {
                    "reference": "urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9"
                }
            ]
        }
    ]
}
<Composition xmlns="http://hl7.org/fhir">
    <!--   optional elements removed for readability   -->
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Composition" />
    </meta>
    <status value="final" />
    <type>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="373942005" />
            <display value="Discharge summary" />
        </coding>
    </type>
    <subject>
        <reference value="urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9" />
    </subject>
    <encounter>
        <reference value="urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd" />
    </encounter>
    <date value="2023-01-28T10:00:00+00:00" />
    <author>
        <reference value="urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f" />
    </author>
    <title value="Cardiology Service Discharge Summary" />
    <section>
        <title value="Patient demographics" />
        <code>
            <coding>
                <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings" />
                <code value="patient-demographics" />
                <display value="Patient demographics" />
            </coding>
        </code>
        <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml"><table width="100%"><tbody><tr><th>Patient name</th><td><p>Prefix: Mr</p><p>Given Name: Andy</p><p>Family Name: Andrews</p></td></tr><tr><th>Date of birth</th><td>1 January 1967</td></tr><tr><th>Gender</th><td>Male</td></tr><tr><th>NHS number</th><td>9449305072</td></tr><tr><th>Patient address</th><td><p>Address Line: 21, Grove Street, Overtown</p><p>City: Leeds</p><p>Post Code: LS21 1PF</p></td></tr></tbody></table></div>
        </text>
        <entry>
            <reference value="urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9" />
        </entry>
    </section>
    <!--   other sections removed for readability   -->
</Composition>

This text section should be linked to a UKCore-Patient profiled resource.

{
    "resourceType": "Patient",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
        ]
    },
    "identifier":  [
        {
            "extension":  [
                {
                    "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
                    "valueCodeableConcept": {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland",
                                "code": "01",
                                "display": "Number present and verified"
                            }
                        ]
                    }
                }
            ],
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449305072"
        }
    ],
    "name":  [
        {
            "use": "official",
            "family": "Andrews",
            "given":  [
                "Andy"
            ],
            "prefix":  [
                "Mr"
            ]
        }
    ],
    "gender": "male",
    "birthDate": "1966-11-12",
    "address":  [
        {
            "line":  [
                "41 Livingstone Road, Overtown"
            ],
            "city": "Leeds",
            "postalCode": "LS21 1PQ"
        }
    ]
}
<Patient xmlns="http://hl7.org/fhir">
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
    </meta>
    <identifier>
        <extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus">
            <valueCodeableConcept>
                <coding>
                    <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland" />
                    <code value="01" />
                    <display value="Number present and verified" />
                </coding>
            </valueCodeableConcept>
        </extension>
        <system value="https://fhir.nhs.uk/Id/nhs-number" />
        <value value="9449305072" />
    </identifier>
    <name>
        <use value="official" />
        <family value="Andrews" />
        <given value="Andy" />
        <prefix value="Mr" />
    </name>
    <gender value="male" />
    <birthDate value="1966-11-12" />
    <address>
        <line value="41 Livingstone Road, Overtown" />
        <city value="Leeds" />
        <postalCode value="LS21 1PQ" />
    </address>
</Patient>
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