Supplementary Remote Monitoring Data from a Virtual Ward Stay - Draft Implementation Guidance v1.0

This draft implementation guidance was developed between February and March 2023 as part of the NHS England Virtual Wards Interoperability Discovery. It is provided for information only and is not currently being updated.

If you are not participating in the Discovery, you are advised not to develop against this guidance until a formal announcement has been made. The team can be contacted by emailing


  1. Background & Use Case
  2. Architecture
  3. Data Model
  4. Data Transfer Mechanisms
  5. Assurance
  6. Help & Support

Overview & Purpose

This draft implementation guidance is being developed to improve interoperability between clinical systems and remote monitoring platforms in virtual wards models of care. The guidance is specific to the transfer of the Supplementary Remote Monitoring Data from a virtual ward stay in PDF format use-case. This standard should not be implemented instead of a current solution but built alongside and used to support any current integrations.

Our intention is to develop a draft interoperability standard and iterate this standard over time with our stakeholders, through weekly touchpoints and agile ways of working. Our key stakeholder groups are:

  • Remote Monitoring Suppliers
  • Integrated Care Systems (ICS)/Integrated Care Boards (ICBs)
  • NHS Healthcare Providers
  • Destination System Suppliers

Please only develop against the standard if you are working with us directly.

Version History

Version Date Release Notes
v1.0 04 April 2023 Release version for end of Discovery phase. Updated banner text to past tense.
v0.7 03 April 2023
  • Updated guidance for Observation SNOMED CT Code for Oxygen Saturation to use the code “SCTID: 447755005 Finding of Oxygen Saturation (Finding)”
  • Corrected duplicate Observation SNOMED CT Code for oxygen saturation on FHIR Observation guidance page
  • Updated the FHIR example for Observation
  • Minor updates and clarifications to wording on the FHIR population guidance pages
v0.6 27 March 2023
  • Addition of full bundle example
  • Addition of guidance on NHS number verification alongside the FHIR Patient profile population guidance
  • Detail added on Observation SNOMED CT codes and references between profiles representing NEWS2 total scores, subscores and raw Observation values
Changes following review from the programme clinical lead and the NHS England Interoperability Standards Team:
  • Clinical safety guidance has been expanded
  • Minor updates and clarifications to wording across all pages
  • Corrections to examples on the FHIR Encounter profile population guidance (status and serviceProvider)
  • Changes to the FHIR Organization profile population guidance (name is now required, and telecom has been added as optional)
0.5 10 March 2023
  • Added further guidance in Section 1.2 around possible content of data transfer
  • Added new section 4.3 to clarify scope regarding Receipt of data transfer
  • Expanded Section 4.4 on Error handling, to clarify scope
  • Expanded Section 5.1 on Clinical Safety
  • Updated definition of "Required" across FHIR guidance to provide clarity and align with wider project collateral
  • Changed SNOMED CT example for DocumentReference.type code
  • Added guidance on using DocumentReference.docStatus field
  • Added guidance on referencing the Encounter resource from the DocumentReference resource
  • Added clarity on the use of the Encounter resource
  • Minor corrections to wording and cardinality discrepancies
0.4 24 Feb 2023
  • Added optionality guidance key for resource population guidance - clarified definitions of mandatory, required and optional
  • Added Encounter as mandatory resource in the FHIR Bundle
  • Added Observation resource guidance
  • Updates to optionality and cardinality of data items across FHIR resources
  • Added further examples to FHIR resource pages
  • Updates to formatting across resource guidance
0.3 10 Feb 2023
  • Added data source organisation details as a mandatory resource within the FHIR Bundle
  • Updated the optionality of data items within the FHIR Patient resource
  • Updated the optionality of data items within the FHIR DocumentReference resource
  • Added guidance on the use of identifiers (UUIDs) for referencing within the FHIR Bundle (including updates to the mandatory data items included in the FHIR Bundle
  • Minor updates to the use case diagram
0.2 30 Jan 2023 Added FHIR Bundle guidance page
0.1 27 Jan 2023 Initial draft