Notice

This version of the NHS England Implementation Guide is currently under development.
This is a 'pre-release' version and exists for the purpose ofinternal review of the Clinical and Technical Assurance Sprint 1, and is not suitable for development purposes.

Female Genital Mutilation (FGM)

Add FGM Risk Indicator

As a Healthcare Worker:

I can add the patient’s FGM risk indicator

So that:

Other healthcare workers know if the patient has any family history of FGM

Use Case Flows

Actors

Healthcare worker

Frequency of Use

Real-time

Triggers

Healthcare worker decides that the patient is at risk of FGM. Decision made to add FGM risk indicator.

Pre-conditions

Patient has a verified NHS number

Post-conditions

FGM risk indicator added to FGM-IS for the patient

Main Course

The healthcare worker decides the patient is at risk of FGM
The healthcare worker adds the risk indicator to FGM-IS

Alternative Course

Patient already as an FGM risk indicator on FGM-IS and addition is rejected
Patient is over 18 and addition of FGM risk indicator is rejected by FGM-IS

Exception

System exception e.g. network access, RBAC failure, API error

View FGM Risk Indicator

As a Healthcare Worker:

I can view the patient’s FGM Indicator

So that:

I know if the patient has any Family history of FGM

Use Case Flows

Actors

Healthcare worker

Frequency of Use

Real-time

Triggers

Patient attends health setting and meets criteria for system to trigger FGM status query i.e. under 18 with female genitalia

Pre-conditions

Patient has a verified NHS number

Post-conditions

Healthcare worker is made aware of any risk of FGM

Main Course

The patient presents at the care setting
The healthcare worker is made aware of the patient being at risk of FGM

Alternative Course

Patient’s NHS number is not on FGM-IS. Nothing is presented to the health or social care

Exception

System exception e.g. network access, RBAC failure, API error

Delete FGM Risk Indicator

As a Healthcare Worker:

I can delete the patient’s FGM risk indicator if it is no longer required

So that:

The patient's FGM risk indicator is correct

Use Case Flows

Actors

Healthcare worker

Frequency of Use

Real-time

Triggers

Healthcare worker decides that the patient is no longer at risk of FGM. Decision made to deleted FGM risk indicator

Pre-conditions

Patient has a verified NHS number

Post-conditions

FGM risk indicator removed from FGM-IS for the patient

Main Course

The healthcare worker decides the patient should not have an FGM risk indicator recorded
The healthcare worker removes the risk indicator from FGM-IS

Alternative Course

N/A

Exception

System exception e.g. network access, RBAC failure, API error

FHIR Assets for Sprint 1

StructureDefinition Extension-England-FlagRemovalReason

Canonical_URL	Description	Profile_Purpose
https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason	An extension used to allow the removal of a Flag and to indicate the reason why the Flag needs removal or has been removed.	The extension extends the Flag resource to support the NHS England requirements for removal of Flags with a stated reason.

Context of Use:

Flag

Tree View

Extension	I		Extension	There are no (further) constraints on this element Element Id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	Element Id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason Mappings rim:N/A
value[x]		1..1	Binding	Element Id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding EnglandFlagRemovalReason (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueCoding			Coding	Data Type Coding
system	Σ	1..1	uri	There are no (further) constraints on this element Element Id Extension.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.3 rim:./codeSystem orim:*fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element Id Extension.value[x].version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.7 rim:./codeSystemVersion orim:*fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element Id Extension.value[x].code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.1 rim:./code orim:*fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element Id Extension.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.2 - but note this is not well followed rim:CV.displayName orim:*fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element Id Extension.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Sometimes implied by being first rim:CD.codingRationale orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Table View

Extension		..
Extension.url		..
Extension.value[x]	Coding	1..
Extension.value[x].system		1..
Extension.value[x].code		1..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="Extension-England-FlagRemovalReason" />
    <url value="https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason" />
    <version value="1.0.0" />
    <name value="ExtensionEnglandFlagRemovalReason" />
    <title value="Extension England Flag Removal Reason" />
    <status value="draft" />
    <date value="2023-08-18" />
    <publisher value="NHS England" />
    <contact>
        <name value="NHS England" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="An extension used to allow the removal of a Flag and to indicate the reason why the Flag needs removal or has been removed." />
    <purpose value="The extension extends the Flag resource to support the NHS England requirements for removal of Flags with a stated reason." />
    <copyright value="Copyright &#169; 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \&quot;License\&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \&quot;AS IS\&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Flag" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Coding" />
            </type>
            <binding>
                <strength value="required" />
                <valueSet value="https://fhir.nhs.uk/England/ValueSet/England-FlagRemovalReason" />
            </binding>
        </element>
        <element id="Extension.value[x].system">
            <path value="Extension.value[x].system" />
            <min value="1" />
        </element>
        <element id="Extension.value[x].code">
            <path value="Extension.value[x].code" />
            <min value="1" />
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "Extension-England-FlagRemovalReason",
    "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason",
    "version": "1.0.0",
    "name": "ExtensionEnglandFlagRemovalReason",
    "title": "Extension England Flag Removal Reason",
    "status": "draft",
    "date": "2023-08-18",
    "publisher": "NHS England",
    "contact":  [
        {
            "name": "NHS England",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "An extension used to allow the removal of a Flag and to indicate the reason why the Flag needs removal or has been removed.",
    "purpose": "The extension extends the Flag resource to support the NHS England requirements for removal of Flags with a stated reason.",
    "copyright": "Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        }
    ],
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Flag"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://fhir.nhs.uk/England/StructureDefinition/Extension-England-FlagRemovalReason"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "binding": {
                    "strength": "required",
                    "valueSet": "https://fhir.nhs.uk/England/ValueSet/England-FlagRemovalReason"
                }
            },
            {
                "id": "Extension.value[x].system",
                "path": "Extension.value[x].system",
                "min": 1
            },
            {
                "id": "Extension.value[x].code",
                "path": "Extension.value[x].code",
                "min": 1
            }
        ]
    }
}

Examples

Note:There is currently no example that uses this extension. An example will be added in a future release.

Extension Specific Guidance

There is a binding within this extension to ValueSet-England-FlagRemovalReason.

England FGM Removal Reason

Description
A set of codes that define the reason a FGM Flag was removed.

HTML View

This code system https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason defines the following codes:

Code	Display
0	Added in error - this child does not have a family history of FGM
2	No longer required - this child has had FGM

Table View

CodeSystem.id[0]	England-FGMRemovalReason
CodeSystem.url[0]	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason
CodeSystem.version[0]	1.0.0
CodeSystem.name[0]	EnglandFGMRemovalReason
CodeSystem.title[0]	England FGM Removal Reason
CodeSystem.status[0]	draft
CodeSystem.date[0]	2023-08-18
CodeSystem.publisher[0]	NHS England
CodeSystem.contact[0].name[0]	NHS England
CodeSystem.contact[0].telecom[0].system[0]	email
CodeSystem.contact[0].telecom[0].value[0]	interoperabilityteam@nhs.net
CodeSystem.contact[0].telecom[0].use[0]	work
CodeSystem.contact[0].telecom[0].rank[0]	1
CodeSystem.description[0]	A set of codes that define the reason a FGM Flag was removed.
CodeSystem.copyright[0]	Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.
CodeSystem.caseSensitive[0]	True
CodeSystem.content[0]	complete
CodeSystem.concept[0].code[0]	0
CodeSystem.concept[0].display[0]	Added in error - this child does not have a family history of FGM
CodeSystem.concept[1].code[0]	2
CodeSystem.concept[1].display[0]	No longer required - this child has had FGM

XML View

<CodeSystem xmlns="http://hl7.org/fhir">
    <id value="England-FGMRemovalReason" />
    <url value="https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason" />
    <version value="1.0.0" />
    <name value="EnglandFGMRemovalReason" />
    <title value="England FGM Removal Reason" />
    <status value="draft" />
    <date value="2023-08-18" />
    <publisher value="NHS England" />
    <contact>
        <name value="NHS England" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="A set of codes that define the reason a FGM Flag was removed." />
    <copyright value="Copyright &#169; 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \&quot;License\&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \&quot;AS IS\&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <caseSensitive value="true" />
    <content value="complete" />
    <concept>
        <code value="0" />
        <display value="Added in error - this child does not have a family history of FGM" />
    </concept>
    <concept>
        <code value="2" />
        <display value="No longer required - this child has had FGM" />
    </concept>
</CodeSystem>

JSON View

{
    "resourceType": "CodeSystem",
    "id": "England-FGMRemovalReason",
    "url": "https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason",
    "version": "1.0.0",
    "name": "EnglandFGMRemovalReason",
    "title": "England FGM Removal Reason",
    "status": "draft",
    "date": "2023-08-18",
    "publisher": "NHS England",
    "contact":  [
        {
            "name": "NHS England",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "A set of codes that define the reason a FGM Flag was removed.",
    "copyright": "Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "caseSensitive": true,
    "content": "complete",
    "concept":  [
        {
            "code": "0",
            "display": "Added in error - this child does not have a family history of FGM"
        },
        {
            "code": "2",
            "display": "No longer required - this child has had FGM"
        }
    ]
}

England Flag Removal Reason

HTML View

ValueSet 'EnglandFlagRemovalReason'

Version	1.0.0
Published by	NHS England
Status	Draft (since 2023-08-18)

This ValueSet defines the set of codes that can be used to indicate the reason a Flag was removed.

Contact Information

NHS England

Email: interoperabilityteam@nhs.net

This value set includes codes from the following code systems:

Import all codes from CodeSystem EnglandFGMRemovalReason

Expansion

This expansion was generated on 2023-08-02T12:00:00+00:00

Code	System	Display
0	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason	Added in error - this child does not have a family history of FGM
2	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason	No longer required - this child has had FGM

Table View

ValueSet.id[0]	England-FlagRemovalReason
ValueSet.url[0]	https://fhir.nhs.uk/England/ValueSet/England-FlagRemovalReason
ValueSet.version[0]	1.0.0
ValueSet.name[0]	EnglandFlagRemovalReason
ValueSet.title[0]	England Flag Removal Reason
ValueSet.status[0]	draft
ValueSet.date[0]	2023-08-18
ValueSet.publisher[0]	NHS England
ValueSet.contact[0].name[0]	NHS England
ValueSet.contact[0].telecom[0].system[0]	email
ValueSet.contact[0].telecom[0].value[0]	interoperabilityteam@nhs.net
ValueSet.contact[0].telecom[0].use[0]	work
ValueSet.contact[0].telecom[0].rank[0]	1
ValueSet.description[0]	This ValueSet defines the set of codes that can be used to indicate the reason a Flag was removed.
ValueSet.copyright[0]	Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.
ValueSet.compose[0].include[0].system[0]	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason
ValueSet.compose[0].include[0].version[0]	1.0.0
ValueSet.expansion[0].timestamp[0]	2023-08-02T12:00:00+00:00
ValueSet.expansion[0].contains[0].system[0]	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason
ValueSet.expansion[0].contains[0].code[0]	0
ValueSet.expansion[0].contains[0].display[0]	Added in error - this child does not have a family history of FGM
ValueSet.expansion[0].contains[1].system[0]	https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason
ValueSet.expansion[0].contains[1].code[0]	2
ValueSet.expansion[0].contains[1].display[0]	No longer required - this child has had FGM

XML View

<ValueSet xmlns="http://hl7.org/fhir">
    <id value="England-FlagRemovalReason" />
    <url value="https://fhir.nhs.uk/England/ValueSet/England-FlagRemovalReason" />
    <version value="1.0.0" />
    <name value="EnglandFlagRemovalReason" />
    <title value="England Flag Removal Reason" />
    <status value="draft" />
    <date value="2023-08-18" />
    <publisher value="NHS England" />
    <contact>
        <name value="NHS England" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This ValueSet defines the set of codes that can be used to indicate the reason a Flag was removed." />
    <copyright value="Copyright &#169; 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \&quot;License\&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \&quot;AS IS\&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <compose>
        <include>
            <system value="https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason" />
            <version value="1.0.0" />
        </include>
    </compose>
    <expansion>
        <timestamp value="2023-08-02T12:00:00+00:00" />
        <contains>
            <system value="https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason" />
            <code value="0" />
            <display value="Added in error - this child does not have a family history of FGM" />
        </contains>
        <contains>
            <system value="https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason" />
            <code value="2" />
            <display value="No longer required - this child has had FGM" />
        </contains>
    </expansion>
</ValueSet>

JSON View

{
    "resourceType": "ValueSet",
    "id": "England-FlagRemovalReason",
    "url": "https://fhir.nhs.uk/England/ValueSet/England-FlagRemovalReason",
    "version": "1.0.0",
    "name": "EnglandFlagRemovalReason",
    "title": "England Flag Removal Reason",
    "status": "draft",
    "date": "2023-08-18",
    "publisher": "NHS England",
    "contact":  [
        {
            "name": "NHS England",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This ValueSet defines the set of codes that can be used to indicate the reason a Flag was removed.",
    "copyright": "Copyright © 2023+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "compose": {
        "include":  [
            {
                "system": "https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason",
                "version": "1.0.0"
            }
        ]
    },
    "expansion": {
        "timestamp": "2023-08-02T12:00:00+00:00",
        "contains":  [
            {
                "system": "https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason",
                "code": "0",
                "display": "Added in error - this child does not have a family history of FGM"
            },
            {
                "system": "https://fhir.nhs.uk/England/CodeSystem/England-FGMRemovalReason",
                "code": "2",
                "display": "No longer required - this child has had FGM"
            }
        ]
    }
}