NHS Booking and Referral Standard

Referrals into Pharmacy (Application 5) Change Log

This page will list all updates to the BaRS Application 5

- Indicates a change inspired by provider or supplier feedback.

Key	Description
non-breaking	Non-breaking changed introduced to the standard since the last release
breaking	Breaking changed introduced to the standard since the last release
correction	Correction to the standard since the last release

1.0.0-beta.4

This is a minor "patch" addressing a small revision of the requirements for 1.0.0-beta.4 release in the implementation guide.

Application Change Log

Change	Description	Impact
Updated Use-Case Category codes	Updated Use-Cases Category codes added for use in Application 5.	correction
Updates to Application 5 Examples	Updates to all Application 5 Examples to include the latest Use-Case Category codes.	non-breaking

### Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
Patient.extension.valueCodeableConcept	Patient.extension.url.valueCodeableConcept	Patient.extension.valueCodeableConcept	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding	Patient.extension.url.valueCodeableConcept.coding	Patient.extension.url.valueCodeableConcept.coding	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding	1..1	0..*	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.system	Patient.extension.url.valueCodeableConcept.coding.system	Patient.extension.valueCodeableConcept.coding.system	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.code	Patient.extension.url.valueCodeableConcept.coding.code	Patient.extension.valueCodeableConcept.coding.code	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.display	Patient.extension.url.valueCodeableConcept.coding.display	Patient.extension.valueCodeableConcept.coding.display	Update	Referral Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept	Patient.extension.url.valueCodeableConcept	Patient.extension.valueCodeableConcept	Update	Booking Request	FHIR path incorrect	correction

Previous Releases

1.0.0-beta.3

This is a minor "patch" addressing a small revision of the requirements for 1.0.0-beta.3 release in the implementation guide.

Application Change Log

Change	Description	Impact
Removed requirement to support Safeguarding	The requirement to record and send Safegaurding concerns has been removed, at the request of Policy team. There is a concern around the usage and interpretation of the flag and, until there are consistent prinicples of use in place, this cannot be supported.	Suppliers must not send Safegurding concerns via a flag. End users may still add any concerns under notes.
Removed requirement to support Additional Information Sources	The requirement to record and send Additional Information Sources (external sources looked up by the Sender during assessment) has been removed, at the request of Policy team. The Pharmacy systems have access to GP Record and Local Shared Care Records already.	Suppliers must not send references to Additional Information Sources looked up during their assessment.
Replaced references to CPCS (Community Pharmacist Consultation Service)	Removed references to CPCS and replaced with 'Pharmacy First'. Correction to align with latest naming conventions. NB: task.code still references CPCS because this is a SNOMED code value.	No impact on supplier's technical solutions
Expanded Payload>Task guidance	Expanded guidance to make clear task.restriction is a guide on timeframe, for the pharmacist, and not a directive. The patient is required to contact the pharmacy, as per policy guidelines.	Limited impact on supplier's technical solutions. The latest policy guidance has already been made available.

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact

1.0.0-beta.2

This is a minor "patch" addressing a small issue with the 1.0.0-beta.1 release of the implementation guide.

Application Change Log

Change	Description	Impact
Payload description for Condition amended	The description of the Condition resource reference two Careplan elements rather than Condition ones.		Correction. No change for suppliers.

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact

1.0.0-beta.1

This application moved from alpha to beta with a few minor updates.

Application Change Log

Change	Description	Impact
Workflow diagram updated	Workflow amended to support new policy workflow narrative, putting the onus on the patient to contact the Pharmacist. The Pharmacist would only contact the patient first if they have concerns upon receipt of the referral.
Scope change Constraint added	Added Constraint regarding reduced scope to meet delivery timeline.
Additional NHS Verification Status permissable	A patient's NHS number can now be sent if it is known to be present but not traced.
Safeguarding Concern no longer mandated	The inclusion of Safeguarding Concerns is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision.
Individual Requirements no longer mandated	The inclusion of Individual Requirements is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
Urgency no longer mandated	Sending an urgency timeframe is not part of the scope for beta and, therefore, not being mandated in this release. Policy currently dictates the patient is responsible for contacting the Pharmacist, however, this requirement may be reinstated in the stable revision, following public beta.
Cancellation no longer mandated	Cancelling a referral is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
Re-refer no longer mandated	Re-referring is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
Novel Medications no longer mandated	Including novel medications is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
Novel Allergies no longer mandated	Including novel allergies is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
SPNs no longer mandated	Sending SPNs is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.
Additional Information Sources no longer mandated	Sending reference to Additional Information Sources is not part of the scope for beta and, therefore, not being mandated in this release. This is a temporary state for beta phase only and the requirement will be reinstated in the stable revision, following public beta.

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
Careplan.activity	SHOULD	MUST	Updated	Ref	Business logic 'Necessity' was incorrect. This value MUST always be present	correction
Task.description			Updated	Ref	Amended description to align with updated policy workflow narrative	non-breaking
ServiceRequest.occurencePeriod.end			Updated	Ref	Amended end time to reflect current 24hrs policy response in CPCS MI	non-breaking
ServiceRequest.requester	SHOULD	MUST	Updated	Ref	ServiceRequest.requester Necessity is SHOULD when should be a MUST. Most suppliers already conform to this	breaking
ServiceRequest.occurencePeriod.start	MUST	SHOULD	Updated	Ref	Amended to reflect policy change. The Sender cannot indicate urgency because the patient must make contact with the pharmacist	non-breaking
ServiceRequest.occurencePeriod.end	MUST	SHOULD	Updated	Ref	Amended to reflect policy change. The Sender cannot indicate urgency because the patient must make contact with the pharmacist	non-breaking
Bundle.meta.versionId			Updated	Ref	Updated example value to reflect use of version	non-breaking

1.0.0-beta

This application moved from alpha to beta with a few minor updates.

Application Change Log

Change	Description	Impact

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
Bundle.meta.lastUpdated			Updated	Ref	Profile cardinality was incorrect. Updated from 1..1 to 0..1	correction
Bundle.meta.versionId		MUST	Added	Ref	The version of bundles is key to workflow and existed in examples	breaking
CarePlan.status			Updated	Ref	Incorrect status published. Updated from 'complete' to 'completed'	correction
Patient.contact.telecom.rank		MUST	Added	Ref	The rank of a contact's contact number is essential to processing of a request but was omitted from the guidance. The rank existed in examples	breaking
Organization.identifier	MUST	SHOULD	Updated	Ref	Removed the necessity to include an identifier because these are not always available and not required to drive workflow	non-breaking
Organization.identifier.system	MUST	SHOULD	Updated	Ref	as above	non-breaking
Organization.identifier.value	MUST	SHOULD	Updated	Ref	as above	non-breaking
Practitioner.identifier	MUST	SHOULD	Updated	Ref	Removed the necesity to include an identifier because these are not always available and not required to drive workflow	non-breaking
Practitioner.identifier.system	MUST	SHOULD	Updated	Ref	as above	non-breaking
Practitioner.identifier.value	MUST	SHOULD	Updated	Ref	as above	non-breaking
PractitionerRole.practitioner	MUST	SHOULD	Updated	Ref	Removed the necesity to reference a Practitioner (in some circumstances) because the PractitionerRole may be sufficient when linked to an Organisation. Additionally,this not required to drive workflow	non-breaking
PractitionerRole.practitioner.reference	MUST	SHOULD	Updated	Ref	as above	non-breaking
PractitionerRole.organization	MUST	SHOULD	Updated	Ref	Removed the necesity to reference an Organization because the PractitionerRole may be sufficient when linked to a Practitioner. Additionally,this not required to drive workflow	non-breaking
PractitionerRole.organization.reference	MUST	SHOULD	Updated	Ref	as above	non-breaking
PractitionerRole.healthcareService	MUST	SHOULD	Updated	Ref	Removed the necessity to reference an Organization because the PractitionerRole may be sufficient when linked to a Practitioner. Additionally,this not required to drive workflow	non-breaking
PractitionerRole.healthcareService.reference	MUST	SHOULD	Updated	Ref	as above	non-breaking
Observation.encounter	MUST	SHOULD	Updated	Ref	Removed the necessity to strictly tie an Observation to an Encounter, there will be instances where relating to the patient is sufficient	non-breaking
Observation.encounter.reference	MUST	SHOULD	Updated	Ref	as above	non-breaking
HealthcareService.Id		MUST	Added	Ref	The Id was omitted from guidance but is required to be included in the HTTP response from the Receiver. This follows the standard pattern of response by Receiver so should have already been included.	breaking
HealthcareService.providedBy	MUST	SHOULD	Updated	Ref	Removed the necessity to relate an Organisation to a HealthcareService. Although, it should be included if known, it is not always known and is not required to drive workflow	non-breaking
HealthcareService.providedBy.reference	MUST	SHOULD	Updated	Ref	as above	non-breaking
Condition.Id		MUST	Added	Ref	The Id was omitted from guidance but is required to be included in the HTTP response from the Receiver. This follows the standard pattern of response by Receiver so should have already been included.	breaking
Task.Id		MUST	Added	Ref	The Id was omitted from guidance but is required to be included in the HTTP response from the Receiver. This follows the standard pattern of response by Receiver so should have already been included.	breaking
Task.restriction.period	MUST	SHOULD	Updated	Ref	Incorrect necessity published. Updated from 'MUST' to 'SHOULD'	correction

1.0.0-alpha

This is a pre-release of v1.0.0-alpha - Referral into Pharmacy(application 5) which supports the use case "GP to Pharmacy CPCS Minor Illness".
Releasing of v1.0.0 following the sucessful Private Beta of BaRS-UEC2. There are a number of updates that have been applied since v1.0.0-alpha that have informed by the Private Beta. These are all detailed the in the change logs.

Application Change Log

Change	Description	Impact
Application 5 released	The first version of application 5 was released

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact