Referrals into Pharmacy (Application 5) Change Log
This page will list all updates to the BaRS Application 5
| 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 |
1.1.0
This stable release (v1.1.0) of Application 5 expands functionality to additional use cases, Oral Contraception, Blood Pressure and Online Consultations.
Application Change Log
| Change | Description | Impact |
|---|---|---|
| Added new use cases | Support for Pharmacy services Oral Contraception and Blood Pressure and Online Consultation tools sending to Pharmacy. | non-breaking |
| Rationalised use case betwen Overview and Scope | Updated supported use cases under the Scope section to align with Overview, as with all other Applications. | non-breaking |
| Must include sending Organisation Type | New requirement to include the organization.type FHIR element from a SNOMED coded list. | breaking |
| Should include Body Mass Index (BMI) | New requirement to optionally include BMI in referrals. | non-breaking |
| Must include Blood Pressure (BP) reading when referring to BP services | Blood Pressure (BP) service requirement to include latest BP reading (in a FHIR Observation resource) in referrals. | non-breaking |
| Should include Oral Contraception (OC) medication when referring to OC services | Oral Contraception (OC) service requirement to include current OC medication (in a FHIR MedicationStatement resource) in referrals. | non-breaking |
| Added Constraint for Online Consultation use case | Online Consultation referrals must be reviewed by a representative of the sending organisation before referring, rather than automating based on patient information only. | non-breaking |
| Added Constraint for Oral Contraception and Blood Pressure services | Referrals must be sent in line with published policy specifications. | non-breaking |
| Fixed typo in Referral requirement | Added 'ed' to 'registered' in requirement 'The referral Receiver must display the Sender organisation name and identifier (Note - This organisation may not be the patient's registered GP Surgery.)' | non-breaking |
Payload Change Log
| FHIR Element | Previous | Current | Other | Referral/Booking | Rationale | Impact |
|---|---|---|---|---|---|---|
| ServiceRequest.occurencePeriod | Update | Referral Request | Necessity changed from SHOULD to MAY to more accurately reflect policy of patient making contact | non-breaking | ||
| ServiceRequest.occurencePeriod.start | Update | Referral Request | Necessity changed from SHOULD to MAY to more accurately reflect policy of patient making contact | non-breaking | ||
| ServiceRequest.occurencePeriod.end | Update | Referral Request | Necessity changed from SHOULD to MAY to more accurately reflect policy of patient making contact | non-breaking | ||
| Organization.type | new | Referral Request | Element added to reflect new requirement to indicate the kind of organisations involved in the referral | non-breaking | ||
| Organization.coding.system | new | Referral Request | Element added to reflect new requirement to indicate the system value for the kind of organisations involved in the referral | non-breaking | ||
| Organization.coding.value | new | Referral Request | Element added to reflect new requirement to indicate the value of the kind of organisations involved in the referral | non-breaking | ||
| Organization.coding.display | new | Referral Request | Element added to reflect new requirement to indicate the display value for the kind of organisations involved in the referral | non-breaking | ||
| Observation.code.coding | Observation.code.text | Observation.code.coding | Update | Referral Request | Changed from text to coded value in the example provided. Text is still permissible but a coded value is recommended | non-breaking |
| Observation.category | New | Referral Request | Observation.category SHOULD be included in blood pressure and BMI referral requests | non-breaking | ||
| Observation.valueQuantity | New | Referral Request | Observation.valueQuanity SHOULD be used to include BMI in referral requests | non-breaking | ||
| Observation.component | New | Referral Request | Observation.component SHOULD be used to include Blood Pressure in referral requests | non-breaking | ||
| AllergyIntolerance | New | Referral Request | Allergies can now be included in referral requests | non-breaking |
1.0.0
This is the first stable release (v1.0.0) of Application 5 and reinstates key functionality removed in 1.0.0-beta.1 release.
Application Change Log
| Change | Description | Impact |
|---|---|---|
| Cancellation now mandated | Cancelling a referral has been reinstated in this stable release. | breaking |
| Re-refer now mandated | Re-referring has been reinstated in this stable release. | breaking |
| Novel Medications now mandated | Including novel medications has been reinstated in this stable release. | breaking |
| Novel Allergies now mandated | Including novel allergies has been reinstated in this stable release. | breaking |
| SPNs now mandated | Sending SPNs has been reinstated in this stable release. | breaking |
| Individual Requirements | Sending Individual Requirements e.g. 'wheelchair access' has been updated to avoid ambiguity. | non-breaking |
| Display the Sender organisation information | During public beta, it was identified Receivers were not displaying Sender details to end users. Therefore, when a patient was unregistered, the receiving user had no recourse to contact any clinical bodies (Sending GP surgery or patient's registered GP surgery) about the referral. It was deemed clinically and administratively necessary for the end-user to be provided with details (name, ODS code) of the Sending organisation. | breaking |
| Removed beta Constraints | Removed Constraints relating to beta: Reduced requirements scope and use of UEC DoS. | non-breaking |
Payload Change Log
| FHIR Element | Previous | Current | Other | Referral/Booking | Rationale | Impact |
|---|---|---|---|---|---|---|
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 |
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 |
|---|---|---|---|---|---|---|