NHS Booking and Referral Standard

Booking and Referrals into UEC (Application 1) Change Log

This page will list all updates to the BaRS Application 1

- 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

2.0.0

This is a major release with a significant change to the Implementation Guidance and examples for v2.0.0. The changes are detailed in the change log.

Application Change Log

Change	Description	Impact
Updated requirements to support additional NHS No. Status	Extended requirement to support NHS No. status of 'Number present but not traced'	breaking

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
Patient.identifier.extension.valueCodeableConcept.coding.code	This SHOULD be populated. Where used this MUST either be number-present-and-verified or no NHS number MUST be sent, no other status is valid	This SHOULD be populated. Where used this MUST be 'number-present-and-verified' or 'number-present-but-not-traced', else no NHS number MUST be sent. No other statuses are permitted.	Update	Referral Request	Accommodate NHS No. Requirement	breaking
Patient.identifier.extension.valueCodeableConcept.coding.display	This SHOULD be populated. Where used this MUST either be populated with 'Number present and-verified' no other status is valid	This SHOULD be populated. Where used this MUST be populated with 'Number present and verified' or 'Number present but not traced'. No other statuses are permitted.	Update	Referral Request	Accommodate NHS No. Requirement	breaking
Patient.identifier.extension.valueCodeableConcept.coding.code	This SHOULD be populated. Where used this MUST either be number-present-and-verified or no NHS number MUST be sent, no other status is valid	This SHOULD be populated. Where used this MUST be 'number-present-and-verified' or 'number-present-but-not-traced', else no NHS number MUST be sent. No other statuses are permitted.	Update	Booking Request	Accommodate NHS No. Requirement	breaking
Patient.identifier.extension.valueCodeableConcept.coding.display	This SHOULD be populated. Where used this MUST either be populated with 'Number present and-verified' no other status is valid	This SHOULD be populated. Where used this MUST be populated with 'Number present and verified' or 'Number present but not traced'. No other statuses are permitted.	Update	Booking Request	Accommodate NHS No. Requirement	breaking

Previous Releases

1.0.8

This is a minor "patch" with clarifications to limited areas of the Implementation Guidance and examples for v1.0.8.

Application Change Log

Change	Description	Impact
MedicationStatement	Link path updated in Referral request	correction
Booking Request	Typos in word Appointment fixed	correction
Booking Request	bundle.meta.versionID added to payload for consistency across BaRS documentation	correction
Referral Response	bundle.meta.versionID added to payload for consistency across BaRS documentation	correction
Consent	link text updated to navigate to CONS01 - Consent - Direct Care	correction

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
MedicationStatement	https://simplifier.net/hl7fhirukcorer4/ukcoremedicationstatement	https://simplifier.net/hl7fhirukcorer4/ukcore-medicationstatement	Update	Referral Request	FHIR link updated	correction
Appointment.serviceCategory	Appointent	Appointment	Update	Referral Request	Typos resolved	correction
bundle.meta.versionID		This MUST be populated with the version of the Application the bundle complies with. The Receiver will read this to know whether they are capable of processing.	Update	Booking Request	Implementation guidance added	correction
bundle.meta.versionID		This MUST be populated with the version of the Application the bundle complies with. The Receiver will read this to know whether they are capable of processing.	Update	Referral Response	Implementation guidance added	correction

1.0.7

This is a minor "patch" with clarifications to limited areas of the Implementation Guidance and examples for v1.0.7.

Application Change Log

Change	Description	Impact
Implementation Guidance updated	encounter.class.display value corrected from "Emergency" to "emergency"	correction
NHSD-Requesting-Practioner Examples updated	FHIRPractioner corrected to FHIRPractionerRole	correction

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
encounter.class.display			Update	Referral Request	encounter.class.display value corrected from "Emergency" to "emergency" in Implementation Guidance	correction

1.0.6

This is a minor "patch" adding use case categories to the Application for v1.0.6.

Application Change Log

Change	Description	Impact
use case codes added	use case codes defined for each use case	addition

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
ServiceRequest.category.coding			Update	Booking/Referral Request	Updated guidance to reflect this additional value for use case categories	Addition
Appointment.serviceCategory.coding			Update	Booking/Referral Request	Updated guidance to reflect this additional value for use case categories	Addition

1.0.5

This is a minor "patch" addressing one small revision of the payload guidance for v1.0.4.

Application Change Log

Change	Description	Impact

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
HealthcareService.identifier.value			Update	Booking/Referral Request	Updated guidance to reflect this value relates to the 'receiving' HealthcareService rather than the 'sending'	correction

1.0.4

This is a minor "patch" addressing a small revision of the requirements for v1.0.3 which includes the new Use-Case Category codes that will now be used across all Applications of BaRS.

Application Change Log

Change	Description	Impact
New Use-Case Category codes	New Use-Cases Category codes added for use in Application 1.	correction
Updates to Application 1 Examples	Updates to all Application 1 Examples to include the latest Use-Case Category codes.	non-breaking

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
ServiceRequest.category.code			New	Referral Request	The new Use-Case Codes have been made generic	correction
Patient.extension.valueCodeableConcept	Patient.extension.url.valueCodeableConcept	Patient.extension.valueCodeableConcept	Update	Referral / Booking Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding	Patient.extension.url.valueCodeableConcept.coding	Patient.extension.url.valueCodeableConcept.coding	Update	Referral / Booking Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding	1..1	0..*	Update	Referral / Booking Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.system	Patient.extension.url.valueCodeableConcept.coding.system	Patient.extension.valueCodeableConcept.coding.system	Update	Referral / Booking Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.code	Patient.extension.url.valueCodeableConcept.coding.code	Patient.extension.valueCodeableConcept.coding.code	Update	Referral / Booking Request	FHIR path incorrect	correction
Patient.extension.valueCodeableConcept.coding.display	Patient.extension.url.valueCodeableConcept.coding.display	Patient.extension.valueCodeableConcept.coding.display	Update	Referral / Booking Request	FHIR path incorrect	correction

1.0.3

This is a minor "patch" addressing a small issue with the previous release of the implementation guide.

Application Change Log

Change	Description	Impact

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
QuestionnaireResponse.source.reference			Updated	Ref	The guidance indicated that a FHIR resource (RelatedPerson) not included in the MessageDefinition could be used and this has been removed. Updated guidance to cover use of third parties completing QuestionnaireResponse.	correction

1.0.2

This is a minor "patch" addressing small issues with the previous release of the implementation guide.

Application Change Log

Change	Description	Impact
Flag Rejected services Code updated	Flag Rejected services Code updated to SNOMED value and 111 to ED example amended	non-breaking

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
ServiceRequest.requester	SHOULD	MUST	Updated	Ref	ServiceRequest.requester Necessity is SHOULD when should be a MUST. Most suppliers already conform to this	breaking
HealthcareService			Updated	Book	Guidance around how to build and populate this resource corretced. It is linked to and based upon the response from GET /Slot, similar to Slot and Schedule	correction
HealthcareService.Id			Updated	Book	This Id value must correlate with what is received via the GET /Slot request, and included in the request bundle	correction

1.0.1

This is a minor "patch" addressing a few small issues with the 1.0.0 release of the implementation guide.

Application Change Log

Change	Description	Impact
Updated items to Change Log v1.0.0	Several corrections and updates have been made to the Change Log for BaRS-UEC1 v1.0.0 and 3 elements added to the change log.	correction
Additional items added to Change Log v1.0.0	3 additional lines have been added that were missing from the original Change Log for BaRS-UEC1 v1.0.0 : MessageHeader.destination.endpoint, MessageHeader.source.endpoint, ServiceRequest.category.coding.display	correction
Added additional cancellation guidance	Additional guidance in the "how does it work?" section for the two cancellation flows was added to provide more clarification on payload composition	non-breaking
Updated workflow diagram on How it works page	Update the workflow image on how it works to remove referrence to ITK	correction

1.0.0

Releasing of v1.0.0 following the sucessful Private Beta of BaRS-UEC1. 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
Referral response - e.g DNA/WNB	The requirment to have the ability to send or receive referral responses like DNA/WNA(Safeguarding) resposnes has been removed from this version. There is no policy supporting this functionality currently. The responsability of the safeguarding will lie with the receiver.	breaking
Use of BaRS-UEC1 to UTC	The use of BaRS-UEC1 has been approved for use in 111-UTC, CAS-UTC	non-breaking
Flexible workflows are now optional	As long as an Application supports a combined booking and referral or a standalone referral this meets the flexibility requirements.	non-breaking
Book-Rebook-Cancel	The previous requirement to mandate a sender to make a new booking prior to cancelling their original booking has been clinically reviewed and relaxed to allow the original booking to be cancelled first.	non-breaking

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking	Rationale	Impact
MessageHeader.extension.CDSSExtension Software and Version	Should	Must		Ref, Book	Increased necessity for the current Application.	breaking
MessageHeader.destination.endpoint			Updated	Ref, Book	Updated endpoint guidance to use the HTTPS instead of HTTP as this is more consistent with the current format.	correction
MessageHeader.source.endpoint			Updated	Ref, Book	Updated endpoint guidance to use the HTTPS instead of HTTP as this is more consistent with the current format.	correction
MessageHeader.source.contact.system	Must	Should		Ref, Book	Relaxed necessity for the current Application.	non-breaking
MessageHeader.source.contact.value	Must	Should		Ref, Book	Relaxed necessity for the current Application.	non-breaking
MesssageHeader.definition	Could	Must		Ref, Book	Increased necessity for the current Application to enable validation of the payload.	breaking
MessageHeader.eventCoding.coding.display	Should	Must		Ref, Book	Increased necessity for the current Application. This human readable value is being used for display to users.	breaking
MessageHeader.reason.coding.display	Should	Must		Ref, Book	Increased necessity for the current Application. This human readable value is being used for display to users.	breaking
ServiceRequest.occurancePeriod.start	Must	Should		Ref	Relaxed necessity for the current Application.	correction
ServiceRequest.occurancePeriod.end	Must	Should		Ref	Relaxed necessity for the current Application.	correction
ServiceRequest.requester	-	Should		Ref	Updated necessity for the current Application	non-breaking
ServiceRequest.category.coding.display	Should	Must		Ref	Increased necessity for the current Application.	breaking
ServiceRequest.location	Must	May		Ref	Relaxed necessity for the current Application.	correction
ServiceRequest.supportingInfo	-	Should		Ref	Updated necessity for the current Application.	non-breaking
ServiceRequest.patientInstruction			Removed	Ref	Removed, information is now contained within the careplan.	non-breaking
Patient.extension.coding.display(NHS Number)	Could	Should		Ref, Book	Increased necessity for the current Application. The human readable value is being used for display to users.	correction
Patient.address	-	Should		Ref, Book	Updated necessity for the current applApplicationication.	correction
Patient.contact.extension(contactPreferrence)	Must	-	Removed	Ref, Book	Removed, contact ext has been removed this is now communicated in through rank only.	breaking correction
Patient.contact.telecom	Should	Must		Ref, Book	Increased necessity for the current Application. There must always be a contact.	breaking correction
Patient.extension(Birthsex)			Removed	Ref, Book	Removed, this is to be recorded as an Observation	correction
Patient.extension(Religion)			Removed	Ref, Book	Removed, there are no values for this in UK Core. No additional guidance over core FHIR guidance.	correction
Practitioner.identifier	-	Must		Ref, Book	Updated necessity for the current Application.	breaking
PractitionerRole.practioner.reference	-	Must		Ref, Book	Updated necessity for the current Application.	breaking
PractitionerRole.organization.reference	-	Must		Ref, Book	Updated necessity for the current Application.	breaking
MedicationStatement			Updated	Ref	Updated the overall guidance for the resource. All necessity is based on UK Core.	correction
MedicationStatement.subject.reference	Should	Must		Ref	Increased necessity for the current Application. If there is a medication resource there MUST be a reference to the patient	breaking
AllergyIntolerance			Updated	Ref	Update the overall guidance for the resource. All necessity is based on UK Core.	correction
Flag.category	-	Must		Ref	Updated necessity for the current Application. To ensure the business process can be successfully executed.	breaking
Flag.code	-	Must		Ref	Updated necessity for the current Application. To ensure the business process can be successfully executed.	breaking
QuestionnaireResponse.extension(Reason)	-	Must		Ref	Updated necessity for the current Application. Without the extension you do not know what you are processing.	breaking correction
QuestionnaireResponse.subject	-	Must		Ref	Updated necessity for the current Application.	breaking correction
QuestionaireResponse.item		Must	Updated	Ref	Updated necessity for the current Application. See guidance on the way to use nested items for QuestionaireResponse.	breaking correction
Observation.performer	Must	Should		Ref	Relaxed necessity for the current Application. When using 111 Online the performer is the patient and therefore not always required. e.g BirthSex	non-breaking
Observation.note	Could	Should Not		Ref	Updated necessity for the current Application. Notes in an observation SHOULD be in the CarePlan.	non-breaking
HealthcareService	-	Must	Added	Ref, Book	Added resource to the guidance. The whole resource is included in the examples	breaking correction
Consent.scope	-	Must		Ref	Updated necessity for the current Application.	breaking correction
Consent.category	-	Must		Ref	Updated necessity for the current Application.	breaking correction
Consent.patient.referrence	-	Must		Ref	Updated necessity for the current Application.	breaking correction
Consent.policyRule	-	Must		Ref	Updated necessity for the current Application.	breaking correction
Consent.dateTime	-	Must		Ref	Updated necessity for the current Application.	breaking correction
Booking Only
Appointment	-		Updated	Book	Updated the overall guidance for the resource.	non-breaking
Appointment.status	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.start	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.end	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.slot.referrence	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.created	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction

V1.0.0 before we decided to remove the response workflow.

Application Change Log

Change	Link	Description	Impact
Referral response - e.g Safeguarding response	link-to-section	It is no longer mandatory to receive referral responses for BaRS-UEC1. The requirement for BaRS-UEC1 has always been for a receiving system to advertise what workflows/Application they support. Provided receivers can describe their capability in the capability statement they do not need to consume a referral response	breaking
Use of BaRS-UEC1 to UTC	link-to-section	The use of BaRS-UEC1 has been approved for use in 111-UTC, CAS-UTC	non-breaking
Could not find subject. File not found for 'subject=handshake:' Flexible workflows are now optional	link-to-section	As long as an Application supports a combined booking and referral or a standalone referral this meets the flexibility requirements.	non-breaking
Could not find subject. File not found for 'subject=handshake:' Book-Rebook-Cancel	link-to-section	The previous requirement to mandate a sender to make a new booking prior to cancelling their original booking has been clinically reviewed and relaxed to allow the original booking to be cancelled first.	non-breaking
Could not find subject. File not found for 'subject=handshake:' Removed Birth Sex from Patient resource	link-to-section	Recording Birth Sex as structured data is optional. The sending of Birth Sex is now captured in an Observation resource and NOT the Patient resource.	breaking

Payload Change Log

FHIR Element	Previous	Current	Other	Referral/Booking/Response	Rationale	Impact
MessageHeader.extension.extCDSS Software and Version	Should	Must		Ref, Book, Resp	Increased necessity for the current Application.	non-breaking
MessageHeader.endpoint			Updated	Ref, Book, Resp	Updated endpoint guidance to use the HTTPS instead of HTTP as this is more consistent with the current format.	correction
MessageHeader.source.contact.system	Must	Should		Ref, Book, Resp	Relaxed necessity for the current Application.	non-breaking
MessageHeader.source.contact.value	Must	Should		Ref, Book, Resp	Relaxed necessity for the current Application.	non-breaking
MesssageHeader.definition	Could	Must		Ref, Book, Resp	Increased necessity for the current Application to enable validation of the payload.	breaking
MessageHeader.category.coding.display	Should	Must		Ref, Book, Resp	Increased necessity for the current Application. This human readable value is being used for display to users.	non-breaking
ServiceRequest.occurancePeriod.start	Must	Should		Ref, Resp	Relaxed necessity for the current Application.	correction
ServiceRequest.occurancePeriod.end	Must	Should		Ref, Resp	Relaxed necessity for the current Application.	correction
ServiceRequest.requester	-	Should		Ref, Resp	Updated necessity for the current Application	non-breaking
ServiceRequest.location	Must	May		Ref, Resp	Relaxed necessity for the current Application.	correction
ServiceRequest.supportingInfo	-	Should		Ref, Resp	Updated necessity for the current Application.	non-breaking
ServiceRequest.Patient.instruction			Removed	Ref, Resp	Removed, information is now contained within the careplan.	non-breaking
Patient.ext.coding.display(NHS Number)	Could	Should		Ref, Book, Resp	Increased necessity for the current Application. The human readable value is being used for display to users.	correction
Patient.address	-	Should		Ref, Book, Resp	Updated necessity for the current Application.	correction
Patient.contact.ext(contactPreferrence)	Must	-	Removed	Ref, Book, Resp	Removed, contact ext has been removed this is now communicated in through rank only.	breaking correction
Patient.contact.telecom	Should	Must		Ref, Book, Resp	Increased necessity for the current Application. There must always be a contact.	breaking correction
Patient.ext(Birthsex)			Removed	Ref, Book, Resp	Removed, this is to be recorded as an Observation	correction
Patient.ext(Religion)			Removed	Ref, Book, Resp	Removed, there are no values for this in UK Core. No additional guidance over core FHIR guidance.	correction
Practitioner.identifier	-	Must		Ref, Book, Resp	Updated necessity for the current Application.	breaking
PractitionerRole.practioner.reference	-	Must		Ref, Book, Resp	Updated necessity for the current Application.	breaking
PractitionerRole.organisation.reference	-	Must		Ref, Book, Resp	Updated necessity for the current Application.	breaking
MedicationStatement			Updated	Ref, Resp	Updated the overall guidance for the resource. All necessity is based on UK Core.	correction
MedicationStatement.reference	Should	Must		Ref, Resp	Increased necessity for the current Application. If there is a medication resource there MUST be a reference to the patient	breaking
AllergyIntolerance			Updated	Ref, Resp	Update the overall guidance for the resource. All necessity is based on UK Core.	correction
Flag.category	-	Must		Ref, Resp	Updated necessity for the current Application. To ensure the business process can be successfully executed.	breaking
Flag.code	-	Must		Ref, Resp	Updated necessity for the current Application. To ensure the business process can be successfully executed.	breaking
QuestionaireResponse.extension(Reason)	-	Must		Ref, Resp	Updated necessity for the current Application. Without the extension you do not know what you are processing.	breaking correction
QuestionaireResponse.subject	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
QuestionaireResponse.item		Must	Updated	Ref, Resp	Updated necessity for the current Application. See guidance on the way to use nested items for QuestionaireResponse.	breaking correction
Observation.performer	Must	Should		Ref, Resp	Relaxed necessity for the current Application. When using 111 Online the performer is the patient and therefore not always required. e.g BirthSex	non-breaking
Observation.note	Could	Should Not		Ref, Resp	Updated necessity for the current Application. Notes in an observation SHOULD be in the CarePlan.	non-breaking
HealthcareService	-	Must	Added	Ref, Book, Resp	Added resource to the guidance. The whole resource is included in the examples	breaking correction
Consent.scope	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
Consent.category	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
Consent.referrence	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
Consent.policyRule	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
Consent.dateTime	-	Must		Ref, Resp	Updated necessity for the current Application.	breaking correction
Booking Only
Appointment	-		Updated	Book	Updated the overall guidance for the resource.	non-breaking
Appointment.status	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.start	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.end	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.slotReferrence	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Appointment.created	-	Must		Book	Updated necessity and guidance for the current Application.	breaking correction
Response Only
MessageHeader.response	-	Must		Resp	Updated necessity for the current Application.	breaking correction
Appointment.status	-	Must		Resp	Updated necessity for the current Application. Guidance updated to reflect the fixed value to be used	breaking correction
Appointment.baseOn	-	Must		Resp	Updated necessity for the current Application.	breaking correction