GP Connect - Emergency Supply of Medications (ITK3)

Note: This specification was originally titled "Digital Medicines (DigiMeds)" and maintained by the PODAC Programme.

Release notes

Historical versions and their release notes can be found below, including links to the respective version of the specification.

1.3.0-private-beta

Released on 24th December 2024 THIS VERSION CURRENT VERSION

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Important

The retirement status of the emergency supply of medicines use-case has been removed.
This version of the specification has been migrated from the NHS developer network. It does not change the guidance in the previous specification; however, it has been designed to make it clearer as to what data items are supported, and how they currently flow between community pharmacy and GP IT systems.

Changes

Profiles	A complete list of FHIR profiles highlighting what is used in this specification.
Example 1	The example in the previous specification was malformed and not valid FHIR. The updated example has been generated using Firely and is valid.
Guidance added in the Build setion	The previous specfication did not clearly articulate which items would be sent from a Community Pharmacy in the FHIR payload. The "Build" section contains guidance from each section along with a example HTML, a render, and FHIR snippets.
Migrated the Digital Medicines specification to Simplifier and rebranded to GP Connect	The PODAC DigiMeds team was disbanded in 2023, and the Digital Medicines specification was deprecated in favour of GP Connect: Update Record. With the exception of Vaccinations, all former use-cases that the Digital Medicines specification supported either have been, or will be migrated to Update Record. NHS England have a national vaccination team who are at the time of writing, defining a strategic solution to flow vaccination events through the NHS ecosystem; however, in the interim, the Vaccinations part of Digital Medicines will be used to flow Seasonal Influenza, COVID-19, Respiratory Syncytial Virus (RSV), and Pertussis vaccination events from Community Pharmacy, or NHS England's Data Processing Service (DPS). Emergency supply of medicine events from Community Pharmacy will still flow using this mechanism using 1.1.3-alpha of the specification

1.2.9-private-beta

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Changes

IMPORTANT NOTICE: The Minor Illness specification has been RETIRED
IMPORTANT NOTICE: The Vaccination and Emergency Supply specifications are in PRODUCTION, but have been DEPRECATED
MedicationDispense.daysSupply mandated for MinorIllness (if medication is provided)
Remove batch number from medication
Updated Digital Medicines Headings page to align with PRSB headings for Minor Illness
Dose directions description (dosage instruction) mandated
Contact with professionals heading page updated to include reference to CareConnect-ITK-Encounter-1
Minor Illness Consultation Composition.type changed to 1577041000000109, Community Pharmacist Consultation Service for minor illness
Further details given for Medication Dispense List and Medications and Medical Devices Section
Medications - guidance amended that only AMP / AMPP dm+d codes shall be sent
AllergyIntolerance - guidance amended to correct ECL statements for causative agent.
AllergyIntolerance - Remove Evidence data item (not required).
AllergyIntolerance - clarification on reaction.severity
Condition - remove Evidence data item (not required)
Procedure - remove Category data item (not required)
Procedure - remove anesthetic Issues data item (not required)
Added page “Build Minor Illness Referral Consultation Document Coded Data” from Design and Constructing Clinical Coded Structures Overview

1.2.8-private-beta

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Changes

Minor Illness example changed to take out sub headings of Clinical Summary
New MIRC MESH Id added
Corrections for section heading names and associated codes
Attendance details (1077881000000105) -> Contacts with professionals (https://fhir.nhs.uk/CodeSystem/SectionCode|contacts-with-professionals)
Clinical narrative (1077901000000108) -> Clinical Summary (887181000000106)
Consent (61861000000100) -> Legal information (886961000000102)

1.2.7-private-beta

Link to specification

Changes

Minor illness specification: added Safeguarding; Examination findings and Signpost details sections
Updated Minor illness example
Change Minor Illness medication and medical devices section to be same as Emergency Supply
Minor Illness presenting complaint or issues section, changed to use a SNOMED code & removed Symptom Duration
Minor Illness - remove Referrer details section

1.2.6-private-beta

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Changes

Referral details - Clarification that Referral Details are details on onward referral(s). Change to intro text; change to "Referral to" sub heading description; change to example from self-referral to a GP referral.
Attendance details - Change to example to include a Service example for Emergancy Supply. Removal of prefixes (e.g. "Name:") from example. Tidy up example - for example changed some <p> tags for <br/>. - Added Emergecy Supply to "Consultation method". Added Consultation method to example. Change Location to Community pharmacy.
GP Practice - Removed label ("ODS Organization Code:") from Practice identifier in example. Added GP Practice name and address in example.
Patient demographics - removed prefixes (Name: etc.) from the example. Improved formatting of Address by changing <p> to <br/>. Name now appears in one line.
Change to menu structure - Moved Observations from Common Headings to Minor Illness Referral Consultation

1.2.5-private-beta

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Changes

The Pharmacy Digital Minor Illness Referral Service care communication has been renamed to Minor Illness Referral Consultation (MIRC).
New heading Referrer Details has been added to the Minor Illness Referral Consultation section.
Existing headings for Minor Illness Referral Consultation have been updated - these are:
Minor Illness Referral Consultation (MIRC) guidance has been added to Common Headings pages for
New Common Heading page added for Observations, which includes details on how to form coded entry data for the Minor Illness Referral Consultation document.
New Example Scenario added: Jack Smith Minor Illness Referral Consultation (MIRC).

Note: At the time of publication, FHIR profile development to support the Minor Illness Referral Consultation (MIRC) care communication has not been completed. This development is planned for the future and will include:

A new MessageDefinition FHIR profile for the Minor Illness Referral Consultation (MIRC) care communication, with StructureDefinition: ITK-DM-MIRC-MessageDefinition-1.
A new code and display "ITK013D - ITK Digital Medicine Minor Illness Referral Consultation" to be added to the CodeSystem ITK-MessageEvent-2.
Changes to CareConnect-ITK-DM-DMIRS-Composition:
- Add new Composition.section for "Referrer Details" with SNOMED CT representation: 1052891000000108 | Referrer details (record artifact) |
- Add new Composition.section for "Observations" with SNOMED CT representation: [1102421000000108 | Observations (record artifact) |](1102421000000108 | Observations (record artifact) |)
- Correction to Composition.section.title for "presentingComplaintOrIssues", from "Presentin complaint or issues" to "Presenting complaint or issues".
Corrections to existing example scenarios - SNOMED CT representations in the following examples have been updated:
- Jack Dawkins Vaccinations COVID Vaccination Given
- Hettie Winters Vaccinations COVID Vaccination Not Given

1.2.4-private-beta

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Changes

Vaccinations: "Vaccine procedure" updated to align with the Version 1.2 update to the ValueSet: CareConnect-VaccinationProcedure-1
New example scenarios: The example scenarios are:
- for a COVID vaccination that is given
- for a COVID vaccination that is not given

1.2.3-private-beta

Link to specification

Changes

Added DaysSupply as required and changed Indication to optional within Medications and Medical devices headings
Added DaysSupply as required to Medication Dispense List
Updated examples on Medication Dispense List
Added MedicationDispense.quantity coded data requirements
Clarification on use of Medication.form
Amendments to the Emergency Supply example scenario, including supply of both insulin and needles, and amendements to the ITK Header example
Added requirement to reference an CareConnect-ITK-Header-Organization-1 resource within the <sender> element of the ITK Header
Added relevant MESH WorkflowIDs

1.2.2-private-beta

Link to specification

Changes

Examples updated

Banners added clarifying that examples are illustrative, and have not been formally clinically assured Examples aligned with specification to correctly show
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Composition.section.text content
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Location of event - FHIR Target changed to additional freetext added to
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Composition.section.text
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Serialisation code - optional field. Removed from examples.
Vaccine procedure - examples changed to 955691000000108 | Seasonal influenza vaccination given by pharmacist (situation) |
Vaccine product - examples changed to 35727111000001109 | Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Viatris UK Healthcare Ltd) (product) |
Difference between 1.2.1-private-beta

1.2.1-private-beta

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Changes

SNOMED code replacement

Replaced 820261000000101 | Controlled drug dispensing record (record artifact) | with 1218611000000102 | Urgent supply of prescription items by community pharmacy (record artifact) |

1.2.0-private-beta

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Changes

Added four new areas to the Specification:

New medicine service
Medication review
Digital minor illness referral service (DMIRS)
Appliance review service

This produces four new compositions profiles, Messaging Architecture and Message Headings

Message Definitions section has been removed
All examples have the
tag which was shown at the beginning and the end, now put into a comments wrapper
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Text

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Added new section Design & Build > Document Replacement
Added new section Messaging Architecture>Document Profiles>Digital Medicines Document Profiles has been created and now encapsulates all information
Added new section Message Headings > Overview of Headings has been created and now encapsulates all information
A "FHIR Target" column has been added to every Message Heading page showing the FHIR mapping
An in-correct SNOMED code was used in the previous release: 886721000000107 Referral details replaces 1052891000000108 Referrer details
All Optional elements have been highlighted in red within the Message Headings to avoid confusion when implementing

1.1.3-alpha

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Changes

The two scenario examples contained errors which have now been fixed and run against the Test Harness. They should now correctly validate and help suppliers with more guidance.

1.1.2-alpha

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Changes

A patch release to correct SNOMED codes for Consent and Eligibility Criteria from temp codes to actual provided values:
- New codes added:
  - 61871000000107 | Eligibility for treatment
  - 61861000000100 | Consent
- Profiles changed:
  - Consent and Eligibility Criteria Section CareConnect-ITK-DM-Immunization-Composition-1
  - Consent Section CareConnect-ITK-DM-EmergencySupply-Composition-1

1.1.1-alpha

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Changes

All gist linked examples have now been embedded into the spec as inline coding
All gist linked Message Definition examples embedded into the spec as inline coding
"Assure" menu section has been removed
"Deploy" menu section has been removed
New section "Distribution list" added to the specification
Immunizations references renamed to Vaccinations to match PRSB headings
Referrer details renamed to Referral Details in all sections to match PRSB headings
Following sections updated and checked to match the PRSB headings following review (Click on the links to see a change comparison)
- Allergies and Adverse Reactions Section
- Appliances
- Distribution list (NEW SECTION)
- GP Practice
- Medications
- Patient demographics
- Plan and requested actions
- Referral details
- Vaccinations

1.1.0-alpha

Alpha release supporting the following for Immunizations and Emergency Medication Supply:

FHIR profiles developed using the FHIR Release STU3 specification
SNOMED CT coding support where applicable

1.0.0-experimental

This draft version includes implementation guidance to support the development of the Digital Medicines specification in preparation for an Alpha release, supporting the following for Immunizations and Emergency Medication Supply:

FHIR profiles developed using the FHIR Release STU3 specification
SNOMED CT coding support where applicable