Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.
Element: substitution
Within UK healthcare, substitution is not the norm so the international FHIR definition where "If nothing is specified substitution may be done." does not align with UK healthcare prescribing best practice.
It could be unwise to assume all UK implementations will prevent substitution if not explicitly stated, especially if the same clinical system has been previously implemented outside the UK.
It is therefore recommended that this element is business required with a default boolean value of
false to denote substitution is not allowed.
Allowing substitution
Where substitution to be be allowed, set to true. The inclusion of the coded reason is optional as the valueset defined in FHIR is of limited benefit to UK healthcare.