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 and carer concerns, expectations and wishes

The Patient and carer concerns, expectations and wishes section carries information about the concerns of the patient or their representative. PRSB Elements should be formatted as subheadings in any HTML sent.

Section Description Card. MRO* FHIR Target and Guidance
Patient and carer concerns, expectations and wishes A description of the concerns, expectations or wishes of the patient. 0 to 1 O Carried in the CodeableConcept of Composition.section.code FHIR element. ValueSet UKCoreCompositionSectionCode
PRSB Element Description Card. MRO* FHIR Target and Guidance
Patient and carer concerns, expectations and wishes Description of the concerns, wishes or goals of the person in relation to their care, as expressed by the person, their representative or carer. Record who has expressed these (patient or carer/ representative on behalf of the patient). Where the person lacks capacity this may include their representative's concerns, expectations or wishes. 0 to 1 R A record of statements expressed by the person or their carer or representative. Text only.
Advance statement Written requests and preferences made by a person with capacity conveying their wishes, beliefs and values for their future care should they lose capacity. Include the location of the document if known. 0 to 1 R A record of the presence of an advance statement in text. The content of the advance statement should also be included as text or attached as a document where available see section on FHIR Attachments.
* M=Mandatory R=Required O=Optional

Example Patient and Carer Concerns 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:31686b67-9f20-4644-9a54-193d2f91de57"
    },
    "encounter": {
        "reference": "urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a"
    },
    "date": "2015-02-17T10:00:00+00:00",
    "author":  [
        {
            "reference": "urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc"
        }
    ],
    "title": "Cardiology Service Discharge Summary",
    "section":  [
        {
            "title": "Patient and carer concerns, expectations and wishes",
            "code": {
                "coding":  [
                    {
                        "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings",
                        "code": "patient-and-carer-concerns",
                        "display": "Patient and carer concerns, expectations and wishes"
                    }
                ]
            },
            "text": {
                "status": "additional",
                "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Patient and carer concerns, expectations and wishes</th><td>The carer is concerned about the possibility of the patient suffering from a heart attack, \n bearing a similarity to the illness of the mother of the patient.  The patient is worried about the impact of their illness on their ability to work and drive.</td></tr></tbody></table></div>"
            }
        }
    ]
}
<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:31686b67-9f20-4644-9a54-193d2f91de57" />
    </subject>
    <encounter>
        <reference value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" />
    </encounter>
    <date value="2015-02-17T10:00:00+00:00" />
    <author>
        <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" />
    </author>
    <title value="Cardiology Service Discharge Summary" />
    <section>
        <title value="Patient and carer concerns, expectations and wishes" />
        <code>
            <coding>
                <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings" />
                <code value="patient-and-carer-concerns" />
                <display value="Patient and carer concerns, expectations and wishes" />
            </coding>
        </code>
        <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml"><table width="100%"><tbody><tr><th>Patient and carer concerns, expectations and wishes</th><td>The carer is concerned about the possibility of the patient suffering from a heart attack, 
 bearing a similarity to the illness of the mother of the patient.  The patient is worried about the impact of their illness on their ability to work and drive.</td></tr></tbody></table></div>
        </text>
    </section>
</Composition>

Example Coded Resources

TBC - potentially a UKCore-List of UKCore-Observation, UKCore-Communication

back to top