This is a fixed value of

  "type": {
      "coding": [
          {
              "system": "http://terminology.hl7.org/CodeSystem/claim-type",
              "code": "pharmacy",
              "display": "Pharmacy"
          }
      ]
  },

The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

Example:

 "patient": {
      "reference": "Patient/6d4e737a-b119-4a26-84af-ef6b84c7a7dd"
  },

This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.

This should point to the Virtually FHIR Organization resource

This is a fixed value of

 "priority": {
      "coding": [
          {
              "system": "http://terminology.hl7.org/CodeSystem/processpriority",
              "code": "normal"
          }
      ]
  },

Fixed value of

   "category": {
              "coding": [
                  {
                      "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
                      "code": "attachment"
                  }
              ]
          },

This is a fixed value of

"insurance": [
      {
          "sequence": 1,
          "focal": true,
          "coverage": {
              "identifier": {
                  "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                  "value": "T1450"
              },
              "display": "NHS BUSINESS SERVICES AUTHORITY"
          }
      }
  ],

For conformance use

 "class": {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "AMB",
        "display": "ambulatory"
    }

{
            "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicalApplianceSupplier",
            "valueReference": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "Y34567"
                }
            }
        }

A patient can choose up to three nominated dispensers to cover different contractor types:

• Community Pharmacy
• Appliance Contractor
• Dispensing Doctor

Each of those nominations is held in an Extension.

All require a ODS/ANANA code from Organisation Data Services. This contains download CSV files for these organisations, for API access please see Organisation Data Service - FHIR API

nominatedPharmacy (extension nominatedPharmacy)

"extension":  [
        {
            "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NominatedPharmacy",
            "valueReference": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "Y12345"
                }
            }
        },

A patient's preferred dispensing organisation.

{
            "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PreferredDispenserOrganization",
            "valueReference": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "Y23456"
                }
            }
        }

At least one patient identifier, MUST be provided.

Where a traced NHS number is available for a patient this MUST be included. In general an untraced NHS Number MUST not be used, if an untracted NHS Number is used the extension https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus MUST be used.

Local identifiers such as MRN MUST include a system which identifies NHS provider/assigning authority.

"identifier":  [
        {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9000000009"
        },
        {
            "system": "https://fhir.elmet.nhs.uk/Id/MRN",
            "value": "X54321"
        }
    ],

How this name should be used.

• usual - Known as, conventional or the one patient normally uses. A patient always has a usual name.
• temp - An alias or temporary name. This may also be used for temporary names assigned at birth or in emergency situations.
• nickname - A name that the patient prefers to be addressed by, but is not part of their usual name.
• old - This name is no longer in use (or was never correct, but retained for records).
• maiden - Name changed for Marriage. A name used prior to changing name because of marriage. This term is not gender specific. The use of this term does not imply any particular history for a person's name.

The following use codes are included in the name-use value set, but should not be used and is not be returned as part of a retrieval.

• official - The formal name as registered in an official (government) registry, but which name might not be commonly used. May be called "legal name".
• anonymous - Anonymous assigned name, alias, or pseudonym (used to protect a person's identity for privacy reasons).

Given names, including any middle names.

List of contact points for the patient; for example, phone numbers or email addresses. When a patient tagged as restricted or very restricted is retrieved, all contact points are removed from the response.

"telecom":  [
        {
            "system": "phone",
            "use": "work",
            "value": "01632960587"
        }
    ]

Classification of the gender of a patient. The classification is phenotypical rather than genotypical, i.e. it does not provide codes for medical or scientific purposes. It is the administrative gender that the patient wishes to be known as. In some cases, this may not be the same as the patient’s registered birth gender, or their current clinical gender.

The date on which the patient was born or is officially deemed to have been born.

It is a date in the format yyyy-mm-dd. Due to data quality issues on a small number of patients yyyy-mm and yyyy format may also be returned.

When a patient tagged as very restricted is retrieved, birth date is removed from the response.

The date and time on which a person died or is officially deemed to have died, if applicable and known.

It is a datetime in the format yyyy-mm-ddTHH:MM:SS+HH:MM or yyyy-mm-dd. Due to data quality issues on a small number of patients yyyy-mm and yyyy format may also be returned.

When a patient tagged as very restricted is retrieved, death date is removed from the response.

Postal Address File (PAF) key associated with this address formatted as a FHIR extension. Empty if no PAF key for the address is known, or an object specifying the code system of the address key and the value of the address key.

Purpose of this address:

• home - the home address is the patient's normal residence. Home address is also known as usual, main, registered, current or permanent address
• temp - a temporary address is an address used for a set period of time, but where the patient's home, permanent address remains unchanged
• billing - an address used for correspondence purposes only
• work - an office address. This can be returned due to legacy data but cannot be added or replaced on update

A patient should have no more than one current temp and/or billing address. However, historically this was constrained only by the integration requirements and was not enforced so theoretically more than one can exist for a patient when retrieving. Where multiple instances already exist for the patient it is not expected that local systems should manage those, but should choose the most appropriate one to maintain (e.g. by examining period dates).

A home address is the patient's main residential address and should normally be used for all clinical and demographic purposes, including clinical and appointment correspondence. However additionally, temp and billing addresses may be provided by a patient when there is a requirement to record an alternative location for the purposes of unbroken care. When sending correspondence to a patient:

• a present and valid billing address may take precedence over home and temp addresses. A patient should have only a single current billing address. An address is considered 'valid' according to its period start and end dates.
• if no current billing address is provided, a temp address may take precedence over the home address, again if it is valid according to its period start and end dates.
• if there is no valid, current billing and/or temp address, the home address must be used.

All lines of the address except the postal code.

Systems must apply the following formatting convention when adding or replacing addresses lines:

• line 1 - premises ID and/or house name, e.g. Flat 1 or The Old Schoolhouse
• line 2 - house number, dependent thoroughfare name and descriptor (if present), thoroughfare name and descriptor, e.g. 23 Mill Lane
• line 3 - dependent locality/village, locality (if present), e.g. Boxgrove
• line 4 - post town, e.g. Leeds
• line 5 - county (if present), e.g. West Yorkshire

If any of the lines are blank, they are not returned due to FHIR conformance constraints.

must contain at most 5 items

The order in which the patient was born, with 1 indicating the first or only birth in the sequence, 2 indicating the second birth in the sequence, 3 indicating the third, and so on up to 7.

There are two other valid values; 8 meaning Not applicable and 9 meaning Not known.

1 ≤ value ≤ 9

A list of patient contacts. Only emergency contacts are returned and only emergency contacts should be added. Any other contacts should be added to the patients Related Person. Patients designate here any contact number they desire to be used in case of an emergency. Note, while a patient may also desire to record various related persons telecom details, these do not separately allow for a concept of emergency contact; only ranking. See RelatedPerson endpoint. When a patient tagged as restricted or very restricted is retrieved, all contacts are removed from the response.

MUST contain an ANANA/ODS code.

 "identifier":  [
        {
            "use": "official",
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "RR805"
        }
    ],

MUST contain an ANANA/ODS code.

The ODS/SDS name of the Organisation

    "name": "NHS NIGHTINGALE HOSPITAL YORKSHIRE AND THE HUMBER"

Contact phone numbers and address of the organisation.

    "telecom":  [
        {
            "system": "fax",
            "value": "0113 242 6496",
            "use": "work"
        },
        {
            "system": "phone",
            "value": "0113 243 3144",
            "use": "work"
        }
    ],
    "address":  [
        {
            "line":  [
                "KINGS ROAD"
            ],
            "city": "HARROGATE",
            "postalCode": "HG1 5LA",
            "country": "ENGLAND"
        }
    ],
    "partOf": {
        "reference": "https://directory.spineservices.nhs.uk/R4/Organization/RR805",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "RR8"
        }
    }

The Questionnaire that defines and organizes the questions for which answers are being provided.

"questionnaire": "https://fhir.nhs.uk/Questionnaire/COVIDVaccinationMedicalExemption",

The date and/or time that this set of answers were last changed.

"authored": "2021-09-09T08:32:00+00:00",

A group or question item from the original questionnaire for which answers are provided.

 "item": [
        {
            "linkId": "exemptionStatus",
            "answer": [
                {
                    "valueCoding": {
                        "system": "https://fhir.nhs.uk/CodeSystem/covid-vaccination-medical-exemption",
                        "code": "4",
                        "display": "Rejected: Exemption from COVID vaccination and testing"
                    }
                }
            ]
        }
   ]

Is used as the author on request resources.

"extension":  [
        {
            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-Prescription",
            "extension":  [
                {
                    "url": "courseOfTherapyType",
                    "valueCoding": {
                        "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy",
                        "code": "acute",
                        "display": "Acute"
                    }
                }
            ]
        }
    ],

"extension": [
        {
            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation",
            "extension": [
                {
                    "url": "numberOfRepeatsAllowed",
                    "valueUnsignedInt": 6
                },
                {
                    "url": "numberOfRepeatsIssued",
                    "valueUnsignedInt": 2
                }
            ]
        },

For EPS

A single identifier MUST be present and the value must be a UUID.

"identifier":  [
        {
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "5AC84C11-DB8B-44DA-8FCF-8980B3D13596"
        }
    ],

EPS Only

An identifier to the original prescription-order MUST be present. Only the short form identifier needs to be supplied.

"groupIdentifier": {
        "system": "https://fhir.nhs.uk/Id/prescription-order-number",
        "value": "88AF6C-C81007-00001C"
    },

These workflow tasks have status which indicates the Task status.

The following diagram reflects the "typical" state machine for Task. Note that not all states will be supported by all workflows and that some workflows may support additional transitions, including transitions from terminal states (e.g. back to "in-progress" from "failed" or "completed").

<img src="https://www.hl7.org/fhir/task-state-machine.svg"></img>

For example:

A patient requesting a repeat prescription would ask for task with code fulfil used with 103742009 | Renewal of prescription and a status of requested.
Once reviewed (by a clinician), the task status would be changed to accepted. When the task is then picked up (in-progress) and the related MedicationRequest is sent, the status would change to completed.

For EPS

Only in-progress is currently supported for reasonCode = 373784005 (Dispensing medication) and focus is a dispense-notification.

rejected / cancelled / failed are supported for reasonCode = 33633005 (Prescription of drug) and focus is a prescription-order.

For EPS only

"statusReason": [{
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason",
                "code": "DA",
                "display": "Dosage Amendments"
            }
        ]
    }]

Is not processed by EPS and is included for FHIR compliance reasons. The value should always be order.

e-RS

Reference to the resource which is the focus of the action

 "focus": {
        "reference": "https://server.fire.ly/ServiceRequest/eb13327f-e990-4667-b37a-89eb93a94c47"
    },

** EPS Only**

This will be the Bundle.identifier of the message this Task is acting on. For Tasks with a reasonCode of 373784005 - Dispensing medication this will be a dispense-notification message. For Tasks with a reasonCode of 33633005 - Prescription of drug this will be the prescription-order message from the Task/$release operation.

"focus": {
        "type": "Bundle",
        "identifier": {
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "334a3195-1f6c-497a-8efe-d272ca9c4e38"
        }
    },

Tasks are often generated as a consequence of other workflows or relate to FHIR Workflow resources. For example a repeat medication request will be related to a previous MedicationRequest or a medication reconciliation may relate to a hospital admissions Encounter/EpisodeOfCare. This is carried in the focus element.

focus can be omitted. For example if an ED generated a Medication Review as a result of COPD Emergency encounter they may chose to include a reference to the Encounter but they may decide instead to use a more specific reasonCode such as 394720003 | Asthma medication review.

Date and time the task was created.

"authoredOn": "2020-12-21T17:03:20-00:00",

EPS Only

This may contain cancellation reason.

e-RS

Used to add notes to the worklist items

"note": [
    {
      "text": "Optional comments"
    }
  ]

In e-RS this is also known as the review date due.

e-RS

• If deferred to provider (because there were no appointments available for a directly bookable service) then this is the date by which the provide should resolve the appointment slot issue; or
• If the referral was sent to a triage service then this is the date by which the provider should have reviewed the referral