NHS Booking and Referral Standard

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Referrals into Pharmacy (Application 5)

Use Cases Supported

This application supports the use of the following use cases:

  • Primary Care to Community Pharmacy (Pharmacy First)

Introduction

Overview

This page provides guidance for implementing the Referral Standard (BaRS) specifically for the use cases listed above. It should be used alongside the BaRS Core implementation guide and Payload Definitions when developing to the standard.

Data model endorsements

The GP to Pharmacy (Pharmacy First) Minor Illness referral information data model is informed by user research with pharmacy service providers. We have engaged with NHS England (NHSE) Policy teams to establish the service information requirements. The data model is based on the Community Pharmacy Standard v3.0 as defined and endorsed by the Professional Records Standards Body (PRSB). The referral information has been validated by the NHSE Pharmacy Clinical Reference Group. This provides the necessary confidence that solutions built to the standard will be both fit for purpose and safe.

Scope and Requirements

Scope Overview

This BaRS Application (Referrals into Pharmacy Application 5) supports the following use case ONLY:

  • GP to Pharmacy - Pharmacy First (for Minor Illness Service)

The payload and workflow have been designed to support this service. Other BaRS Applications offer scope for alternative use cases.

Functional Scope

Service Discovery

  • Establishing a service to direct requests to is a mandatory step in the workflow
  • There is no restriction on the service discovery tools used. Any are capable of being supported whether national or proprietary. However, the NHS England Directory of Services supports this application and futher details are provided in the 'Find a Service' section
  • The service must be configured within the BaRS infrastructure (Endpoint Catalogue) before requests can be made

Referral

  • A referral is a request for care, on behalf of an individual, from one service to another
  • The referral can be sent without having to establish the capacity of the receiving service
  • The referral will contain primarily clinical information, indicating the need of the individual and must state the anticipated action required by the receiving service (see Task FHIR resource)

API-M

  • All requests and responses associated with BaRS must occur through the BaRS API Proxy

Constraints

  • All Service IDs in First of Type (FoT) will be those from the Urgent and Emergency Care (UEC) Directory of Services (DoS)
  • No guidance is provided on the display of referral information beyond the Principles for rendering BaRS Payload
  • Consent within BaRS will be for Direct-Care only
  • Certificates for Receiving messages to use nhs.uk domains only
  • Receiving endpoints are to be internet facing
  • Clincial Constraints exist - See Hazard Log
  • No element level 'updates' to requests are supported. A new request must be generated to change information in the referral request
  • Reduce Scope and Requirements for beta phase to support delivery timeline

Requirements

Service Discovery

  • The service must support a unique identifier which the Sender extracts to engage in the BaRS referral workflow

Referral

  • Clinical and non-clinical users must be capable of making referrals
  • The referral Receiver must accept the referral request regardless of whether the patient is known to the service provider
  • The referral Receiver must accept potential patients who do not have a national validated identifier e.g. NHS Number.
  • Where a national identifier is included, it must have a verification status of 'Number present and verified' or 'Number present but not traced', otherwise, the referral Sender must not include it in the request
  • Any new or existing individual requirements, e.g. need for interpreter, recorded as part of the assessment, should be included in the referral Sender's request
  • The referral Receiver must clearly identify any included individual requirements to the end user
  • The referral Receiver must accurately represent information made by the Sender to the end user
  • The referral Sender must include the Pharmacy Service that the request is intended for (from the defined list)
  • The referral Sender must indicate consent to share (for Direct Care) to the Receiver
  • The referral Sender should indicate the urgency (providing timeframe within which included actions are expected to take place) of the request to the Receiver
  • The referral Sender should indicate novel medications, established during the latest assessment and not available on existing records, to the Receiver
  • The referral Sender should indicate novel allergies, established during the latest assessment and not available on existing records, to the Receiver
  • The referral Sender should indicate localised Special Patient Notes (SPNs) to the Receiver
  • The referral Sender must make available the human readable identifier for the referral, included in the HTTP synchronous response, to the end user so they can share with the patient/third party
  • Where the referral was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
  • Where the referral was not successful, the Sender must present an appropriate message to the end user. See failure scenarios for more detail.
  • Update to amend a referral request is not supported. If a referral Sender wishes to change information in a request they must follow the re-refer workflow

Cancel referral

  • The referral Sender should be capable of cancelling any referral made by them, within the current consultation or after the consultation event
  • The referral Sender must perform a read of the referral to be cancelled, from the referral Receiver, prior to cancellation to ensure they are working with the most up-to date information and it has not already been actioned
  • Where the cancellation was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
  • Where the cancellation was not successful, the Sender must present an appropriate message to the end user. See failure scenarios for more detail.
  • The referral Receiver must store all previous versions of the referral
  • The referral Receiver must not be required to inform the patient of the cancellation of the referral.  Business/clinical responsibility for informing the patient remains with the referral Sender

Re-refer

  • The referral Sender should be capable of re-referring within the current consultation or after the consultation event
  • If the patient recontacts the sending service after the sender's consultation has been completed, the patient should be reassessed prior to attempting to re-refer
  • The referral Sender should revoke the original referral prior to making a re-referral, whether within the current consultation or after the consultation event
  • Where the re-referral was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
  • Where the re-referral was not successful, the Sender must present an appropriate message to the end user. See failure scenarios for more detail.
  • The referral Receiver must not be required to inform the patient of the cancellation, incurred as part of the re-refer process.  Business/clinical responsibility for informing the patient remains with the referral Sender

Contacts

  • A minimum of one contact (patient or third party) with a contact method (phone, email, etc.) of phone must be provided in referral requests
  • All contacts must have a rank associated with them
  • There must be only one contact with a rank of 1
  • All contacts must have at least one contact method (phone, email, etc.)
  • All contact methods must have a rank
  • There must be only one contact method with a rank of 1
  • The contact ranked 1 and the contact method ranked 1 must be the primary callback for the request

Audit

  • Sufficient information around any activity through the API and subsequent BaRS workflow must be persisted to aid support incidents and audit requirements

Error Handling

Non Functional

How does it work?

This section describes how the primary operations used in this application work. This diagram illustrates the workflow and interactions of a referral request:

To support the workflows for this application of the standard the operations that need to be supported are:

Find a Service

The BaRS referral process as shown above does not include guidance on how a user should determine if a referral to Pharmacy is appropriate for the patient. It is the responsibility of the referring organisaton to ensure patients are pre-screened by GP Practice staff (care navigators or clinicians) prior to beginning the referral process, using their own judgement or an appropriate triage tool.

Directory of Services API

Pharmacy services are profiled on the Directory of Services (DoS).

For this application, systems should use the Directory of Services - Urgent and Emergency Care - REST API.

Details on how to develop to use this API and onboard to use it in production, are provided in the links above.

For this application the Service Type search will be used: Search by Service Type | docs-dos-api (developer.nhs.uk).

Guidance on how to call the DoS API

This API supports a search by location (e.g. the patient's current location). Note that the DoS API used does not support the concept of searching for services that are open within a given timeframe, however the results from DOS include all opening times. The service search results should be filtered to those that are open in the timeframe required for the referral. The filtered results should be displayed back to the user, in order to allow them to choose with the patient where they want to go.

The search parameters to be used are as follows:
caseID String No Do not populate
postcode String Yes Populate with where the GP Practice is or the Patient’s home address – dependent on where the patient is now
searchDistance Integer No Do not populate – the default value is 37.5 miles which is more than adequate search radius
gpPracticeID Integer No Do not populate
age Integer No Do not populate
gender String No Do not populate
disposition String No Do not populate
serviceTypeIds Array Yes Use the relevant service type for the need required in the referral – as detailed further in next section
numberPerType Integer No Do not populate

Guidance on service search and which services to display
Community Pharmacy Consultation Service and Common Conditions Service Use Service Type ID 131- Pharmacy Urgent Meds Supply
Note this is labelled 'Pharmacy Urgent Meds Supply', but it is deemed appropriate to return one profile per Pharmacy that will do Pharmacy Urgent Meds Supply, CPCS and CCS.
 These services are time critical and the patient must be seen within 24 hours, and so any pharmacies closed now (or closing in the next 30 mins) AND not open in the next 24 hours should not be displayed to the user.
Discretion is permitted if the nearest pharmacy is open now but due to close soon.

If no pharmacies in the local area are open in the next 24 hours then a message needs to be clearly displayed to the user so they can consider other alternatives. (Note this is a very unlikely scenario – but may happen in rural areas with only a few nearby Pharmacies or around bank holiday weekends).

Ensure the display clearly shows:
  • The opening times, to allow the user to provide opening times to the patient so that they can go to the pharmacy when it is open.
  • The phone number for the pharmacy; the user can give this to the patient so they can call and pre-arrange when to come in.
    		•
    Blood Pressure Check Service Use Service Type ID 149 - Pharmacy Blood Pressure Check This service is not time critical and so all nearest services can be displayed to the user.
    Ensure the display clearly shows:
  • The opening times, to allow the user to provide opening times to the patient so that they can go to the pharmacy when it is open.
  • The phone number for the pharmacy, so the user can give this to the patient in case they want to call and pre-arrange when to come in.
    		•
    Pharmacy Contraception Service Use Service Type ID 149 - Pharmacy Contraception This service is not time critical and so all nearest services can be displayed to the user.
    Ensure the display clearly shows:
  • The opening times, to allow the user to provide opening times to the patient so that they can go to the pharmacy when it is open.
  • The phone number for the pharmacy, so the user can give this to the patient in case they want to call and pre-arrange when to come in.
    		•

    When a service is chosen, the "Service ID" field in the DOS data will be used as the Receiver Service Identifier to then initiate the referral as per the following sections.

    Make a Referral

    Making a referral for this application follows the standard pattern for BaRS operations.

    The message definition that defines this payload for this application is: BARS Message Definition ServiceRequest - Request Referral

    In addition to that the specific workflow parameters that are required are as follows:
    Referral Request (New) POST /$process-message{servicerequest-request} ServiceRequest (active) MessageHeader (EventCoding) = servicerequest-request
    MessageHeader (ReasonCode) = new
    ServiceRequest (Status) = active
    ServiceRequest (Category) = referral
    ServiceRequest (Category) = referraltopharmacy
    Encounter (Status) = triaged/finished
    All resources to include 'lastUpdated' value, under meta section

    Additionally the HTTP request header would be:

    NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_000001>
X-Correlation-Id = <GUID_000002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR Practitioner (Base64 Encoded)} 
NHSD-Requesting-Software =  {FHIR Device (Base64 Encoded)}

    The HTTP response header would be:

    X-Request-Id = <GUID_000001>
X-Correlation-Id = <GUID_000002>

    Cancel a Referral

    To cancel a referral this application follows the standard pattern for BaRS operations with an additional step. Before beginning the standard pattern as descbribed on the linked section, the referral sender must perform a read of the referral to be cancelled, from the referral receiver, prior to cancellation to ensure they are working with the most up-to date information and it has not already been actioned. This is done by performing a "GET ServiceRequest by ID" call to the receiving system's corresponding API endpoint (via the BaRS proxy).

    The response to this request will be the requested ServiceRequest resource which should be checked for its current status to ensure it does not already have a status of "revoked" or "completed". If not, this version of the ServiceRequest should be used when re-submitting the modified resource in the POST bundle as described in the standard pattern.

    The message definition that defines this payload for this application is: BARS Message Definition ServiceRequest - Request - Cancelled

    As a general principle, when performing an update type of operation (of which cancellation is a special case), only the focus resource, any resources that are mandated due to contextual, linking or referential integrity reasons and any resources that include elements that are being changed, should be include. This is always defined within the relevent message definition.

    If the update-to-cancel is taking place as part of a re-referral routine, once the cancellation is complete, the new referral message can be sent. This step in the workflow would follow the same process as 'Make a referral' detailed above.

    In addition the specific workflow parameters that are required are as follows:
    Get Referral GET /ServiceRequest{id} n/a n/a
    Referral Request (Cancel) POST /$process-message{servicerequest-request} ServiceRequest (revoked) MessageHeader (EventCoding) = servicerequest-request
    MessageHeader (ReasonCode) = update
    ServiceRequest (Status) = revoked
    ServiceRequest (Category) = referral
    ServiceRequest (Category) = referraltopharmacy
    Encounter (Status) = triaged/finished
    All resources to include 'lastUpdated' value, under the meta section, which must be a later timestamp, on updates, if the content of a particular resource contains updated info. Otherwise, maintain the timestamp originally sent.

    Additionally the HTTP request header for the GET ServiceRequest would be:

    NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_107>
X-Correlation-Id = <GUID_108>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR Practitioner (Base64 Encoded)} 
NHSD-Requesting-Software =  {FHIR Device (Base64 Encoded)}

    The HTTP response header for the GET ServiceRequest would be:

    X-Request-Id = <GUID_107>
X-Correlation-Id = <GUID_108>

    the HTTP request header for the POST $process-message would be:

    NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_000003>
X-Correlation-Id = <GUID_000002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR Practitioner (Base64 Encoded)} 
NHSD-Requesting-Software =  {FHIR Device (Base64 Encoded)}

    The HTTP response header for the POST $process-message would be:

    X-Request-Id = <GUID_000003>
X-Correlation-Id = <GUID_000002>

    Bundle Processing - detailed

    Below is a pseudo code example of how a bundle could be processed based on the above workflow variables:

    > Logical - Based on a logical step through in a code format 
    Receive_Request
{
	initialise_variable "messageType" 
	initialise_variable "MessageReason" 
	initialise_variable "RequestType"
	
	//HTTP_Headers
	{
		if (HttpHeaders is null || HttpHeaders not Guid )
			OperationOutcome.issue.code = "invalid"
			throw exception with "REC_BAD_REQUEST"
			then return with HTTP.ResponseCode 400
		else if (HttpHeaders.RequestId == RequestId.AlreadyReceived)
			OperationOutcome.issue.code = "duplicate"
			throw exception with "REC_CONFLICT"
			then return with HTTP.ResponseCode 409
	}
	//Bundle
	{
		if(Bundle.meta.versionID is null)
			OperationOutcome.issue.code = "invariant"
			throw exception with "REC_BAD_REQUEST"
			then return with HTTP.ResponseCode 422
		else if!(Bundle.meta.versionID in versionID.supported)
			OperationOutcome.issue.code = "not-supported"
			throw exception with "REC_UNPROCESSABLE_ENTITY"
			then return with HTTP.ResponseCode 422
	}
	//Contents;
	{
		switch(MessageHeader.eventCoding)
		{
			case "servicerequest-request":
				if (MessageHeader.reason.code == "new" && ServiceRequest.status == "active")
					{
						switch(ServiceRequest.Category)
						{
							case "Referral":
								if (Careplan.status != "completed")
								{
									RequestType = "unknown"
									OperationOutcome.issue.code = "invariant"//A content validation rule failed
									throw exception with "REC_BAD_REQUEST"
									then return  HTTP.ResponseCode 400
								}
								else if(Encounter.Status.In("triaged","finished"))
									RequestType = "Im Receiving a new Referral"
								else
									RequestType = "unknown"
									OperationOutcome.issue.code = "invariant"//A content validation rule failed
									throw exception with "REC_BAD_REQUEST"
									then return  HTTP.ResponseCode 400
								break;
							default:
								RequestType = "unknown"
								OperationOutcome.issue.code = "invariant"//A content validation rule failed
								throw exception with "REC_BAD_REQUEST"
								then return  HTTP.ResponseCode 400;
						}
					}
				else if (MessageHeader.reason.code == "update")
					{
						switch(ServiceRequest.category)
						{
							case "Referral":
								if(ServiceRequest.status.In("entered-in-error","revoked"))
								{RequestType = "im receiving a cancelled referral"}
								else
								{
									RequestType = "unknown"
									OperationOutcome.issue.code = "invariant"//A content validation rule failed
									throw exception with "REC_BAD_REQUEST"
									then return  HTTP.ResponseCode 400								
								}
								break;
							default:
								RequestType = "unknown"
								OperationOutcome.issue.code = "invariant"//A content validation rule failed
								throw exception with "REC_BAD_REQUEST"
								then return  HTTP.ResponseCode 400;
						}
					}
				else
				{
					RequestType = "unknown"
					OperationOutcome.issue.code = "invariant"//A content validation rule failed
					throw exception with "REC_BAD_REQUEST"
					then return  HTTP.ResponseCode 400}
				break;
			case "servicerequest-response":
				if (MessageHeader.Response is null )
				{
						RequestType = "Invalid servicerequest-response"
						OperationOutcome.issue.code = "invariant"//A content validation rule failed
						throw exception with "REC_BAD_REQUEST"
						then return  HTTP.ResponseCode 400;
				}
				else if ( !Message.Response.identifier.existsLocally())
				{
						RequestType = "none or invalid response ID"
						OperationOutcome.issue.code = "not-found"//A content validation rule failed
						throw exception with "REC_NOT_FOUND"
						then return  HTTP.ResponseCode 404;
				}
				switch (ServiceRequest.Category)
					{
						case "Referral":
							if (ServiceRequest.status == "revoked" && MessageHeader.reason.code == "new")
							{ RequestType = "im receiving a Safeguarding DNA response (noshow)" } 
							else
							{
								RequestType = "unknown"
								OperationOutcome.issue.code = "invariant"//A content validation rule failed
								throw exception with "REC_BAD_REQUEST"
								then return  HTTP.ResponseCode 400;
							}
							break;
						default:
							RequestType = "unknown"
							OperationOutcome.issue.code = "invariant"//A content validation rule failed
							throw exception with "REC_BAD_REQUEST"
							then return  HTTP.ResponseCode 400;
					}
			case "booking-request":
				if (MessageHeader.Reason.code== "new" && Appointment.Status == "booked")
					if(slot.IsFree())
					{RequestType = "Im Receiving a new booking.";}
					else
					{
						OperationOutcome.issue.code = "conflict"
						throw exception with "REC_CONFLICT"
						then return with HTTP.ResponseCode 409
					}
				else if (MessageHeader.Reason.code == "update")
					MessageHeaderIsUpdate = true;
					switch (Appointment.Status)
					{
						case "cancelled":
							RequestType = "Im Receiving a booking cancellation."
							break						
						case "entered-in-error":
							RequestType = "Im Receiving a booking cancellation."
							break
						default:
							OperationOutcome.issue.code = "invariant"//A content validation rule failed
							throw exception with "REC_BAD_REQUEST"
							then return with HTTP.ResponseCode 400;
							break;
					}
				else
				{
					OperationOutcome.issue.code = "invariant"//A content validation rule failed
					throw exception with "REC_BAD_REQUEST"
					then return with HTTP.ResponseCode 400;
				}
				break;
			case "booking-response":
						OperationOutcome.issue.code = "invariant"//A content validation rule failed
						throw exception with 'REC_BAD_REQUEST'
						then return with HTTP.ResponseCode 400
						break;
			default:
				OperationOutcome.issue.code = "invariant"//A content validation rule failed
				throw exception with 'REC_BAD_REQUEST'
				then return with HTTP.ResponseCode 400
				break;
		}
		
	}
    //Submit
	{
		
		if (Message == "update")
		{
			if (currentLocalData.LastUpdated > originaRequest.ReceivedDate)
			{
				OperationOutcome.issue.code = "conflict"
				throw exception with 'REC_CONFLICT'
				then return with HTTP.ResponseCode 409
				break;
			}		
			foreach (Entry in Bundle)
			{
				if (currentLocalData.Item.exists)
				{
					if (currentLocalData.LastUpdated > originaRequest.Received)
					{
						OperationOutcome.issue.code = "conflict"
						throw exception with 'REC_CONFLICT'
						then return with HTTP.ResponseCode 409
						break;
					}
					if(Entry.LastUpdated > currentLocalData.Item.meta.LastUpdated && Entry.fullUrl = currentLocalData.Item.fullUrl)
						currentLocalData.Item = Entry.Item
						Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated )
					else
						ignore
				}
				else
					Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated )					
			}
			Submit(currentLocalData.Bundle.meta.LastUpdated = Bundle.Meta.LastUpdated)
			return HTTP.ResponseCode 200 'OK'
		}
		else
			{
				foreach(Entry in Bundle)
				{
					Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated )
					Submit(currentLocalData.Bundle.meta.LastUpdated = Bundle.Meta.LastUpdated)
					return HTTP.ResponseCode 200 'OK'
				}
			}
	}	
}

    Payloads

    MessageHeader Resource

    Standard Patterns for BaRS Operations explains in detail how the MessageHeader resource must be used.

    The MessageHeader resource for the Referral Request should have the following resource elements set as follows:

    • MessageHeader.eventCoding - must be populated with 'servicerequest-request'
    • MessageHeader.reasonCode - must be 'new' or 'update'
    • MessageHeader.focus - must reference the ServiceRequest FHIR resource
    • MessageHeader.definition - must adhere to Referral Request Message definition

    ServiceRequest Resource

    The 'focus' resource in a referral is the ServiceRequest resource. When the request 'message bundle' is created by the Sender and processed by the Receiver, this is the starting point from which the referral is understood. It provides either the detail or references to all key FHIR resources, for example, the Patient, Encounter and Careplan. The guidance for this resource below provides more granular, element level, detail. A key point when a Sender builds the referral FHIR 'message bundle' is to ensure the MessageHeader.focus references the ServiceRequest resource.

    Encounter Resource

    The Encounter is used to represent the interaction between a patient and healthcare service provider. It links with numerous other resources, to reflect the assessment performed.

    In the initial referral request, the Sender will include an Encounter resource as the container for their assessment, which established the need for the referral. This encounter should include a reference to the Sender's assessment under encounter.identifier. Additionally, the encounter.episodeOfCare must be populated with a 'Journey ID' reference which can be used in subsequent referrals to allow the audit of the route a patient took through service providers to resolve their initial request for care.

    A second Encounter resource is used to transfer the human readable reference of the newly created referral, at the Receiver side. When a referral request is made, the Receiver should include a new, secondary, encounter resource with the status of 'planned' in their synchronous HTTP response (200) to the Sender's request. This new 'planned' encounter will have both an Id and an Identifier value, indicating the Receiver's local reference and human readable one, respectively. This secondary, 'planned', encounter is not mandatory (cardinality of 0..1), unlike the primary encounter resource (1..1) (See the Entity Relationship Diagrams for reference). The human readable (Identifier) reference is intended to allow Senders to provide something to the patient which they can take between services to support consistent joined up care, although, it is also a useful link for the services themselves to use when discussing a patient's transition of care. The local (Id) reference is not intended to be human readable but rather machine readable.

    CarePlan Resource

    The CarePlan resource is used in a referral request to communicate the next steps in care, linking both the 'problem' identified (Condition resource, careplan.addresses), following the assessment performed by the Sender, and the required action to move the patient's issue to resolution (Task resource, careplan.activity.reference). The Receiver will utilise the detail in this resource to summarise what the previous assessment ascertained about the patient, to be used in any subsequent consultation with the patient. This overall clinical narrative and assessment output is included in this resource, under element careplan.outcomeCodeableConcept.text, as 'freetext'.

    Condition Resource

    The Condition resource is used to encapsulate the overall 'problem' the referral intends to resolve for the patient. The detail provided here underpins the rationale for the CarePlan and is a central resource for the Receiver looking for information about the patient and reason for referral.

    The key information about the 'problem' is comprised of two components within this Application, condition.category and condition.code. The category is used to qualify the code value, providing additional context to interpret the issue identified. For example, in this Application, the category will stipulate this is a 'presenting complaint', highlighting the provenance of the 'problem' for the Receiver to start their consultation. This is in addition to other specific status fields on the resource.

    Task Resource

    The Task is used to direct the next action(s) required by the Sender making the referral. Task supports in fulfilling Careplan, which also references it. The narrative within the payload starts with the assessment performed by the Sender (Encounter), identifying a 'problem' (Condition) which a plan of care (CarePlan) is established to address. The Sender is unable to support the plan of care so transitions responsibility, via a referral (ServiceRequest), while directing the next requested action (Task).

    This Application utilises two elements within Task to direct the activity and timeframe, using Task.code and Task.restriction. The code will be a fixed value, indicating that a consultation is being request of the 'Community Pharmacist Consultation Service for minor illness' (Pharmacy First), dictating the action should take place within twenty-four hours, under the restriction.period element. The patient is responsible for attending the pharmacy so the timeframe is a guide, indicating when the request is expected to occur. The pharmacist will only contact the patient if they have concerns based on the referral content.

    Flag Resource

    The Flag resource is used to communicate prospective warnings of potential issues when providing care to the patient. The population of the Flag Resource is optional as not all subjects will have relevant issues.

    BaRS Senders should populate Flag resources and should make adequate provision in their solution to support key flags in BaRS Application workflows, for example, Safeguarding, for this Application. When populating this resource, Senders must include both flag.category and flag.code values using the specific BaRS CodeSystems.

    When a BARS Receiver processes information in a Flag resource;

    • they should populate a flag in their system, if their solution supports that flag
    • they must display the information in the Flag resource in a way that supports the associated workflow (i.e. the relevant end users can see it and act upon it)
    • rendering of Flag information must be in line with the Principles for rendering BaRS Payload.

    In the BaRS UEC Applications the level of consent is stipulated to be for 'Direct Care' only. A referral must contain a Consent resource and it must adhere to the example provided under the BaRS FHIR assets.

    Referral Payload

    Payload for requesting a referral, using Service Request

    This payload is used to transmit all the necessary information that is required for pharmacies to accept a patient referred into their service.



    > Bundle

    The Bundle resource is the container for the event message 

    typeΣ1..1codeBindingFixed Value
    timestampΣ1..1instant
    totalΣ I0..1unsignedInt
    Bundle https://simplifier.net/nhsbookingandreferrals/barsbundlemessage 1..1
    Bundle.id This id is generated by the originating sender of the message, retained in subsequent messages.. MUST 1..1 79120f41-a431-4f08-bcc5-1e67006fcae0
    Bundle.meta https://www.hl7.org/fhir/resource.html#Meta MUST 0..1
    Bundle.meta.profile This MUST be populated with the structure definition for BaRSBundleMessage : 'https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage
    Bundle.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 0..1 2023-03-08T12:01:08.4677672+00:00
    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. MUST 0..1 1.0.0-beta
    Bundle.type This must be populated with 'message' - FIXED VALUE MUST 1..1 message
    Bundle.timestamp the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Bundle.entry(s) Follow BaRS profile guidance for populating this element MUST 1..*
    Bundle.entry.fullUrl unique identifier for the resource entry. Transient id relative to the bundle MUST 0..1 urn:uuid:1cbdfb97-5859-48a4-8301-d54eab818d68
    Bundle.entry.resourceType Resources detailed in the message definition. MUST 0..1 MessageHeader,Patient, Encounter

    > Message Header

    A resource that describes the BaRS message being exchanged between two systems.

    definitionΣ0..1canonical(MessageDefinition)
    MessageHeader https://simplifier.net/nhsbookingandreferrals/barsmessageheaderservicerequestrequest 1..1
    MessageHeader.meta https://www.hl7.org/fhir/resource.html#Meta MUST 0..1
    MessageHeader.meta.profile This MUST be populated with the structure definition for BaRSMessageHeader-servicerequest-request. MUST 0..1 https://fhir.nhs.uk/StructureDefinition/BARSMEssageHeader-servicerequest-request
    MessageHeader.meta.lastUpdated All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 0..1 2023-03-08T12:01:08.4677672+00:00
    MessageHeader.extension This MUST be populated with details of the Clinical Decision Support System used SHOULD 0..*
    MessageHeader.extension.url This MUST be populated with 'https://fhir.nhs.uk/StructureDefinition/CDSSExtension' - FIXED VALUE SHOULD 1..1 https://fhir.nhs.uk/StructureDefinition/CDSSExtension
    MessageHeader.extension.extension SHOULD 0..*
    MessageHeader.extension.extension.url This MUST be populated with the pre-defined Clinical Decision Support System software url - FIXED VALUE SHOULD 1..1 RequesterCDSSSoftware
    MessageHeader.extension.extension.valueString This MUST be populated with the Clinical Decision Support System software name e.g. Pathways SHOULD 0..1 Pathways
    MessageHeader.extension.extension SHOULD 0..*
    MessageHeader.extension.extension.url This MUST be populated with the pre-defined Clinical Decision Support System software Version url - FIXED VALUE SHOULD 1..1 RequesterCDSSVersion
    MessageHeader.extension.extension.valueString This MUST be populated with the Clinical Decision Support System software Version name e.g. 30.2.0 SHOULD 0..1 30.2.0
    MessageHeader.eventcoding MUST 1..1
    MessageHeader.eventcoding.system This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/message-events-bars
    MessageHeader.eventcoding.code The status MUST be populated with 'servicerequest-request'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE MUST 0..1 servicerequest-request
    MessageHeader.destination MUST 0..1
    MessageHeader.destination.receiver MUST 0..1
    MessageHeader.destination.receiver.reference This MUST be populated with the full url to the Receiving Organisation resource. MUST 0..1 urn:uuid:10397afd-479c-42ea-9d5d-e4024481e0f8
    MessageHeader.destination.endpoint This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows the intended destination. MUST 1..1 https://fhir.nhs.uk/id/dos-service-id|1122334455
    MessageHeader.sender MUST 0..1
    MessageHeader.sender.reference This MUST be populated. Follow BaRS profile guidance for populating this element MUST 0..1 urn:uuid:07939a0c-2854-46ff-9282-ad906bc93679
    MessageHeader.source MUST 1..1
    MessageHeader.source.name This MUST be populated with the sending system supplier name MUST 0..1 NHS Trust
    MessageHeader.source.software This SHOULD be populated with the sending software application name SHOULD 0..1 Supplier Software
    MessageHeader.source.version This SHOULD be populated with the sending software version SHOULD 0..1 V1.0.0
    MessageHeader.source.contact SHOULD 0..1
    MessageHeader.source.contact.system This SHOULD be populated with the Contact Type - phone | fax | email | pager | url | sms | other SHOULD 0..1 phone
    MessageHeader.source.contact.value This SHOULD be populated with the Contact Type value SHOULD 0..1 +44 (0123) 123 4567
    MessageHeader.source.endpoint This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows where any response messages SHOULD be addressed. MUST 1..1 https://fhir.nhs.uk/id/dos-service-id|5566778899
    MessageHeader.reason MUST 0..1
    MessageHeader.reason.coding MUST 0..1
    MessageHeader.reason.coding.system This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/message-reason-bars' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/message-reason-bars
    MessageHeader.reason.coding.code This MUST be populated with 'new' in a new message and 'update' for an update. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars' MUST 0..1 new
    MessageHeader.reason.coding.display This SHOULD be populated with 'new' in a new message and 'update' for an update. SHOULD 0..1 New
    MessageHeader.focus MUST 0..*
    MessageHeader.focus.reference This MUST be populated with a reference to the ServiceRequest MUST 0..1 urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
    MessageHeader.definition This MUST be populated with the MessageDefinition the bundle is based on. This will be used for validation. Value - https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral MUST 0..1 https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral

    > Service Request

    This Resource is the focus of the Referral interaction

    instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
    instantiatesUriΣ0..*uri
    statusΣ ?!1..1codeBinding
    intentΣ ?!1..1codeBindingFixed Value
    categoryΣ1..1CodeableConcept
    priorityΣ0..1codeBinding
    doNotPerformΣ ?!0..1boolean
    codeΣ0..1CodeableConceptBinding
    orderDetailΣ I0..*CodeableConcept
    authoredOnΣ1..1dateTime
    performerTypeΣ0..1CodeableConcept
    locationCodeΣ0..*CodeableConcept
    reasonCodeΣ0..*CodeableConceptBinding
    bodySiteΣ0..*CodeableConceptBinding
    note0..*Annotation
    patientInstructionΣ0..1string
    ServiceRequest https://simplifier.net/nhsbookingandreferrals/barsservicerequestrequestcasetransfer 1..1
    ServiceRequest.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 236bb75d-90ef-461f-b71e-fde7f899802c
    ServiceRequest.meta https://www.hl7.org/fhir/resource.html#Meta MUST 0..1
    ServiceRequest.meta.profile This MUST be populated with the structure definition for BaRSServiceRequest-request-referral MUST 0..1 https://fhir.nhs.uk/StructureDefinition/BARSServiceRequest-request-referral
    ServiceRequest.meta.lastUpdated All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 0..1 2023-03-08T12:01:08.4677672+00:00
    ServiceRequest.basedOn MUST 0..*
    ServiceRequest.basedOnreference This MUST be populated with a reference to the CarePlan resource MUST 0..1 urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
    ServiceRequest.status This MUST be populated with one of three values: 'active', 'revoked' or 'entered-in-error'. 'revoked' is used when a SR is cancelled while 'entered-in-error' is used when sent to the wrong endpoint and needs to be removed. MUST 1..1 active
    ServiceRequest.intent This MUST be populated with 'plan' - FIXED VALUE MUST 1..1 plan
    ServiceRequest.category MUST 1..1
    ServiceRequest.category.coding MUST 0..*
    ServiceRequest.category.coding.system This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
    ServiceRequest.category.coding.code This MUST be populated with Code 'referral'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest' - FIXED VALUE MUST 0..1 referral
    ServiceRequest.category.coding.display This MUST be populated with Display 'Transfer of Care'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest' MUST 0..1 Transfer of Care
    ServiceRequest.category.coding BaRS Code System for Use Case MUST 0..*
    ServiceRequest.category.coding.system This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
    ServiceRequest.category.coding.code This MUST be populated with Code for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars' MUST 0..1 referraltopharmacy
    ServiceRequest.category.coding.display This MUST be populated with Display for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars' MUST 0..1 Referral to Pharmacy
    ServiceRequest.subject Follow BaRS profile guidance for populating this element MUST 1..1
    ServiceRequest.subject.reference This MUST be populated. Follow BaRS profile guidance for populating this element MUST 0..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    ServiceRequest.encounter MUST 0..1
    ServiceRequest.encounter.reference This MUST be populated with a Reference to the Encounter resource MUST 0..1 urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
    ServiceRequest.occurencePeriod Timeframe within which pharmacy must manage the referral (Urgency) SHOULD 0..1
    ServiceRequest.occurencePeriod.start The start of the period must be ‘now’. SHOULD 0..1 2023-03-08T12:01:08.4677672+00:00
    ServiceRequest.occurencePeriod.end The overall time by which the referral should be dealt with by the pharmacy. An overall 'urgency' or Service Level Agreement (SLA) of the referral could be determined based on the start and end values. If Task(s) has a restriction.period the shortest end value will determine when the next action should occur. SHOULD 0..1 2023-03-09T12:01:08.4677672+00:00
    ServiceRequest.authoredOn This MUST be populated with the date time the request transitioned to being actionable. In case it's 'blank' the date time SHOULD fall back to the submission time/system time of the SENDING system. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    ServiceRequest.requester MUST 0..1
    ServiceRequest.requester.reference This MUST be populated with a reference to the Practitioner resource. This is the Healthcare Professional making the request. This does not strictly need to be a clinician. MUST 0..1 urn:uuid:8c63d621-3424-4f57-8699-e8e22d32423g
    ServiceRequest.performer MUST 0..*
    ServiceRequest.performer.reference This MUST be populated with a reference to the requested HealthcareService resource MUST 0..1 urn:uuid:8c63d621-2344-4f57-8699-e8e22d44235h
    ServiceRequest.reasonCode This will ONLY be populated in a cancellation message with the reason for cancellation SHOULD 0..*
    ServiceRequest.reasonCode.text This SHOULD be populated. This will ONLY be populated in a cancellation message with the reason for cancellation and SHOULD only be used in conjunction with a corresponding status - revoked or entered-in-error SHOULD 0..1 Revoked as patient has been dealt with.

    > Encounter

    In this interaction this resource represents the sender’s encounter. Each Organisation within the patient’s journey will create a new encounter (Case). These Encounters are linked through the Journey ID which is unchanged throughout the patient’s Journey.
    For an incident with multiple patients, each patient would have its own encounter"

    statusΣ ?!1..1codeBinding
    classΣ1..1CodingBinding
    typeΣ0..*CodeableConceptBinding
    serviceTypeΣ0..1CodeableConceptBinding
    priority0..1CodeableConcept
    periodI0..1Period
    lengthI0..1Duration
    reasonCodeΣ0..*CodeableConceptBinding
    Encounter https://simplifier.net/hl7fhirukcorer4/ukcore-encounter 1..1
    Encounter.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 236bb75d-90ef-461f-b71e-fde7f899802c
    Encounter.meta This MUST be populated with https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Encounter.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter
    Encounter.meta.lastUpdated All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Encounter.Identifier SHOULD be the human readable identifier of the encounter. SHOULD 0..*
    Encounter.status This MUST be populated with 'finished' or 'triaged'. MUST 1..1 finished
    Encounter.class MUST 1..1
    Encounter.class.system This MUST be populated with CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE MUST 0..1 http://terminology.hl7.org/CodeSystem/v3-ActCode
    Encounter.class.code This MUST be populated with Code 'EMER'. See CodeSystem: 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE MUST 0..1 EMER
    Encounter.class.display This MUST be populated with Display 'Emergency'. See CodeSystem: 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE MUST 0..1 Emergency
    Encounter.subject MUST 0..1
    Encounter.subject.reference This MUST be populated with a reference to the Patient resource. MUST 1..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Encounter.episodeOfCare MUST 0..*
    Encounter.episodeOfCare.reference This MUST be populated with the Journey ID which links all encounters within the patient’s journey. This MUST be created at the patient’s first contact and passed in all subsequent referrals. MUST 1..1 9589fb37-87a2-48d8-968f-b371429208a8
    Encounter.period SHOULD 0..1
    Encounter.period.start This SHOULD be populated with the time the contact with the practitioner was established. This SHOULD be the contact immediately prior to the referral being sent. SHOULD 0..1 2023-03-08T12:01:08.4677672+00:00

    > CarePlan

    In this interaction the CarePlan resource is used to communicate triage outcome information and associated clinical information

    instantiatesCanonicalΣ0..*canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)
    instantiatesUriΣ0..*uri
    statusΣ ?!1..1codeBinding
    intentΣ ?!1..1codeBinding
    categoryΣ0..*CodeableConcept
    titleΣ0..1string
    descriptionΣ0..1string
    periodΣ I0..1Period
    createdΣ0..1dateTime
    CarePlan https://simplifier.net/hl7fhirukcorer4/ukcore-careplan 1..1
    CarePlan.id MUST only be generated by the Receiver as the id for the resource in the synchronous HTTP response. MUST 0..1 236bb75d-90ef-461f-b71e-fde7f899802c
    CarePlan.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    CarePlan.meta.profile UKCore MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan
    CarePlan.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    CarePlan.status This MUST be populated with the value ‘completed’ MUST 1..1 completed
    CarePlan.intent This MUST be populated with the value ‘plan’ MUST 1..1 plan
    CarePlan.subject MUST 1..1
    CarePlan.subject.reference This MUST be populated with a reference to the Patient MUST 1..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    CarePlan.encounter MUST 0..1
    CarePlan.encounter.reference This MUST be populated with a reference to the senders Encounter MUST 1..1 urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
    CarePlan.period MUST 0..1
    CarePlan.period.start Disposition date/Time. This MUST be populated with the datetime of the identification of the dispatch/disposition code. MUST 0..1 2023-03-08T12:01:08.4677672+00:00
    CarePlan.addresses MUST 0..*
    CarePlan.addresses.reference This MUST reference a Condition resource. This identifies which 'presenting complaint or issue' (as defined in the Information model) precipitated the generation of the CarePlan MUST 0..* urn:uuid:8d12c664-0b6c-4e9b-8b70-10ccc81dbd89
    CarePlan.activity MUST 0..*
    CarePlan.activity.outcomeCodeableConcept SHOULD 0..*
    CarePlan.activity.outcomeCodeableConcept.text This SHOULD be populated with the clinical narrative.
    If a triage assessment has been undertaken, using a CDSS, the Q&A output SHOULD be formatted and included as freetext in this element.    		 SHOULD 0..1 Who is this query about constipation about?: An adult or child over 10 years old\n Do you have constipation and any of the following apply to you?: None of the above\n\n Symptoms: 2/7 hx constipation\n\n Self-care / medication already tried: None\n\n Patient concerns: Unable to pass stool dor 2/7; straining.\n
    CarePlan.activity.reference This MUST reference a Task resource which defines the requested instruction to the Receiver. The Sender may include multiple tasks, each under a new activity - see Task resource guidance for more detail. MUST 0..1
    CarePlan.activity.reference.reference This MUST reference a Task resource indicating an instruction to the Receiver. MUST 0..1 urn:uuid:6bd421cf-e43f-4470-b12d-b592f82c4bfe

    > Patient

    This resource is used to communicate details about the patient who is the subject of the referral.
    It also includes contact information for third parties when required.

    activeΣ ?!0..1boolean
    nameΣ0..*HumanName
    genderΣ0..1codeBinding
    maritalStatus0..1CodeableConceptBinding
    photoI0..*Attachment
    Patient It also includes contact information for third parties when required.
    https://simplifier.net/hl7fhirukcorer4/ukcore-patient    		 1..1
    Patient.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 9589fb37-87a2-48d8-968f-b371429208a8
    Patient.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Patient.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient
    Patient.meta.LastUpdate This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Patient.identifier SHOULD 0..*
    Patient.identifier.system This SHOULD be populated with namespace for the Identifier SHOULD 1..1 https://fhir.nhs.uk/Id/nhs-number
    Patient.identifier.value This SHOULD be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available.If no NHS number is available this SHOULD be populated with the Local patient identifier. SHOULD 1..1 3478526985
    Patient.identifier.extension This extension is used to record the NHS number Verification status SHOULD 0..*
    Patient.identifier.extension.url This SHOULD be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE SHOULD 1..1 https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus
    Patient.identifier.extension.valueCodeableConcept SHOULD 0..1
    Patient.identifier.extension.valueCodeableConcept.coding SHOULD 0..1
    Patient.identifier.extension.valueCodeableConcept.coding.system This SHOULD be populated. Where used this MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE SHOULD 0..1 https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus
    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 SHOULD 0..1 number-present-and-verified
    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 SHOULD 0..1 Number present and verified
    Patient.name SHOULD 0..*
    Patient.name.use Follow UK Core guidance for populating this element SHOULD 0..1 official
    Patient.name.text Follow UK Core guidance for populating this element SHOULD 0..1 Mrs Julie Jones
    Patient.name.family Follow UK Core guidance for populating this element SHOULD 0..1 Jones
    Patient.name.given Follow UK Core guidance for populating this element SHOULD 0..1 Julie
    Patient.name.prefix Follow UK Core guidance for populating this element SHOULD 0..1 Mrs
    Patient.gender Follow UK Core guidance for populating this element SHOULD 0..1 female
    Patient.birthDate Follow UK Core guidance for populating this element SHOULD 0..1 1959-05-04
    Patient.address SHOULD 0..*
    Patient.address.use This SHOULD be populated. Where used 'home' MUST only be used for the patient's official residing address. 'temp' is used for alternative current locations with an address format, otherwise, a Location resource can be used to pinpoint a location without a building address SHOULD 0..1 home
    Patient.address.type Follow UK Core guidance for populating this element SHOULD 0..1 both
    Patient.address.text Follow UK Core guidance for populating this element SHOULD 0..1 22 Brightside Crescent, Overtown, West Yorkshire, LS10 4YU
    Patient.address.line Follow UK Core guidance for populating this element SHOULD 0..* 22 Brightside Crescent
    Patient.address.city Follow UK Core guidance for populating this element SHOULD 0..1 Overtown
    Patient.address.district Follow UK Core guidance for populating this element SHOULD 0..1 West Yorkshire
    Patient.address.postalCode Follow UK Core guidance for populating this element SHOULD 0..1 LS10 4YU
    Patient.contact This MUST be used to record telecom information for the patient and/or the patient's representative for the encounter MUST 0..*
    Patient.contact.extension MUST 0..*
    Patient.contact.extension.url This MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank' - FIXED VALUE MUST 0..1 https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank
    Patient.contact.extension.urlvaluePositiveInt This MUST be populated with the rank of the whole contact and MUST be populated with the value '1' for the primary person to contact for referral. There MUST be at least one contact for the referral. MUST 0..1 1
    Patient.contact.relationship MUST 0..*
    Patient.contact.relationship.coding MUST 0..*
    Patient.contact.relationship.coding.system This MUST be populated with the CodeSystem from the ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType'.
    Where the contact details relate to the patient this relationship MUST be populated with the value 'self'.
    Where the contact details relate to a patient's representative this SHOULD be populated with their relationship to the patient.
    If the relationship is not known this SHOULD be populated with the value 'Unknown'    		 MUST 0..1 https://simplifier.net/hl7fhirukcorer4/ukcore-personrelationshiptype-110
    Patient.contact.relationship.coding.code This MUST be populated with Code of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType'. MUST 0..1 EP
    Patient.contact.relationship.coding.display This MUST be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType'. MUST 0..1 EP
    Patient.contact.name SHOULD 0..1
    Patient.contact.name.family This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 Grayson
    Patient.contact.name.given This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 Jack
    Patient.contact.telecom MUST 0..*
    Patient.contact.telecom.system This MUST be populated for the rank 1 contact. There MUST be at least one contact phone number for the referral MUST 0..1 phone
    Patient.contact.telecom.value This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 0789 1234567
    Patient.contact.telecom.rank This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 1
    Patient.contact.gender This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 male
    Patient.Communication SHOULD 0..*
    Patient.Communication.Language MUST 1..1
    Patient.Communication.Language.coding MUST 1..1
    Patient.Communication.Language.coding.code This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 en
    Patient.Communication.Language.coding.system This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://fhir.hl7.org.uk/CodeSystem/UKCore-HumanLanguage
    Patient.Communication.Language.coding.display This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 English
    Patient.Communication.Language.preferred This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 TRUE
    Patient.extension SHOULD 0..*
    Patient.extension.url This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory
    Patient.extension.url.valueCodeableConcept SHOULD 0..1
    Patient.extension.url.valueCodeableConcept.coding SHOULD 0..1
    Patient.extension.url.valueCodeableConcept.coding.system This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://fhir.hl7.org.uk/CodeSystem/UKCore-EthnicCategory
    Patient.extension.url.valueCodeableConcept.coding.code This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 A
    Patient.extension.url.valueCodeableConcept.coding.display This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 British, Mixed British
    Patient.generalPractitioner This SHOULD be populated with a reference to the GP Surgery ONLY rather than a specific practitioner SHOULD 0..*
    Patient.generalPractitioner.reference This SHOULD be populated. Where populated this MUST reference to an Organisation resource SHOULD 0..1 urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4411

    > Condition

    This resource is used to communicate details about the problem or issue of the referral.

    clinicalStatusΣ ?! I0..1CodeableConceptBinding
    verificationStatusΣ ?! I0..1CodeableConceptBinding
    category0..*CodeableConceptBinding
    severity0..1CodeableConceptBinding
    codeΣ0..1CodeableConceptBinding
    bodySiteΣ0..*CodeableConceptBinding
    recordedDateΣ0..1dateTime
    Condition https://simplifier.net/HL7FHIRUKCoreR4/UKCore-Condition 1..*
    Condition.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 7aa5814d-d71f-4c9a-a956-03d89f25aae4
    Condition.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Condition.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1
    Condition.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Condition.clinicalStatus This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 active
    Condition.verificationStatus This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 unconfirmed
    Condition.category The qualifier of the problem or issue necessitating the referral request MUST 0..1
    Condition.category.coding.system This MUST be populated with CodeSystem - http://snomed.info/sct MUST 0..1 http://snomed.info/sct
    Condition.category.coding.code This MUST be populated with the Code (SNOMED) of the class of problem or issue MUST 0..1 33962009
    Condition.category.coding.display This MUST be populated with the human readable Display (SNOMED) of the class of problem or issue MUST 0..1 Presenting complaint
    Condition.code The 'presenting complaint or issue' (as defined in the Information model) that precipitated the generation of the associated CarePlan MUST 0..1
    Condition.code.text This MUST be populated with the freetext description of the problem or issue MUST 0..1 Vomiting
    Condition.subject MUST 1..1
    Condition.subject.reference This MUST be populated with a reference to the Patient MUST 1..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Condition.encounter MUST 0..1
    Condition.encounter.reference This MUST be populated with a reference to the senders Encounter MUST 0..1 urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
    Condition.note Follow UK Core guidance for populating this element SHOULD NOT 0..1

    > Task

    This resource is used to communicate details about Task/s that the Sender is requesting of the Receiver.

    instantiatesCanonicalΣ0..1canonical(ActivityDefinition)
    instantiatesUriΣ0..1uri
    groupIdentifierΣ0..1Identifier
    statusΣ ?!1..1codeBinding
    statusReasonΣ0..1CodeableConcept
    businessStatusΣ0..1CodeableConcept
    intentΣ1..1codeBinding
    priority0..1codeBinding
    codeΣ0..1CodeableConcept
    descriptionΣ0..1string
    executionPeriodΣ I0..1Period
    authoredOnI0..1dateTime
    lastModifiedΣ I0..1dateTime
    performerType0..*CodeableConceptBinding
    reasonCode0..1CodeableConcept
    note0..*Annotation
    Task https://simplifier.net/HL7FHIRUKCoreR4/UKCore-Task 1..*
    Task.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 a6450d17-cb7e-483b-8f71-b8201cfbcbd4
    Task.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Task.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1
    Task.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Task.status This MUST be populated with 'requested' - Fixed Value MUST 1..1 requested
    Task.intent This MUST be populated with 'order' - Fixed Value MUST 1..1 order
    Task.code This MUST be populated with the action (by the specific Pharmacy Service (Referral Type)) the Sender is requesting of the Receiver. If multiple actions (which are to occur within different timeframes) are to be requested these would be represented in independent Task resources. MUST 0..1
    Task.code.coding.system This MUST be populated with CodeSystem - http://snomed.info/sct MUST 0..1 http://snomed.info/sct
    Task.code.coding.code This MUST be populated with the Code (SNOMED) of action by the Pharmacy Service MUST 0..1 1577041000000100
    Task.code.coding.display This MUST be populated with the human readable Display (SNOMED) of action by the Pharmacy Service MUST 0..1 Community Pharmacist Consultation Service for minor illness (procedure)
    Task.description This SHOULD be populated with a human readable summary of the intended instruction of the Task, combining the key elements e.g. Task.code and Task.restriction.period SHOULD 0..1 'Patient will contact pharmacy service. If, upon receipt, the pharmacist has concerns over the patient's condition they should contact the patient.'
    Task.focus 0..1
    Task.focus.reference Used for New Medicines Service to indicate the MedicationStatement to provide guidance on MUST 0..1 urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
    Task.encounter SHOULD 0..1
    Task.encounter.reference This MUST be populated with a reference to the senders Encounter SHOULD 0..1 urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
    Task.authoredOn This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 2023-03-08T12:15:08+00:00
    Task.restriction.period This SHOULD be populated to indicate when time sensitive requests to be undertaken SHOULD 0..1
    Task.restriction.period.start This SHOULD be populated with the start of time sensitive requests for a task to be undertaken SHOULD 0..1 2023-03-08T12:45:08+00:00
    Task.restriction.period.end This SHOULD be populate with the latest time the task can be completed within SHOULD 0..1 2023-03-08T13:15:08+00:00

    > Organization

    This resource is used to communicate details about the sender and receiver organisations.

    activeΣ ?!0..1boolean
    typeΣ0..*CodeableConcept
    nameΣ I0..1string
    alias0..*string
    telecomI0..*ContactPoint
    addressI0..*Address
    Organisation https://simplifier.net/hl7fhirukcorer4/ukcore-organization 2..*
    Organization.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 5d897313-c62d-4e7e-92b7-b2199804fed3
    Organization.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Organization.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
    Organization.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Organization.identifier This SHOULD be populated with an organisation identifier e.g. ODS code SHOULD 0..*
    Organization.identifier.system This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://fhir.nhs.uk/id/ods-organization-code
    Organization.identifier.value This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 ABD01
    Organization.name This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 Organisation name

    > Practitioner

    This is used to carry details of the healthcare professional making the referral

    activeΣ0..1boolean
    nameΣ0..*HumanName
    telecomΣ I0..*ContactPoint
    addressΣ0..*Address
    genderΣ0..1codeBinding
    birthDateΣ0..1date
    photoI0..*Attachment
    communication0..*CodeableConceptBinding
    Practitioner https://simplifier.net/hl7fhirukcorer4/ukcore-practitioner 1..*
    Practitioner.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 51182cb1-b199-4222-85f5-16d5428f6358
    Practitioner.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Practitioner.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner
    Practitioner.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Practitioner.identifier This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..*
    Practitioner.identifier.system This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://fhir.nhs.uk/Id/sds-role-profile-id
    Practitioner.identifier.value This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 PT2489
    Practitioner.name SHOULD 0..*
    Practitioner.name.family Follow UK Core guidance for populating this element SHOULD 0..1 BLAKE
    Practitioner.name.given Follow UK Core guidance for populating this element SHOULD 0..1 Marcy
    Practitioner.telecom SHOULD 0..*
    Practitioner.telecom.system Follow UK Core guidance for populating this element SHOULD 0..1 phone
    Practitioner.telecom.value Follow UK Core guidance for populating this element SHOULD 0..1 0205568263
    Practitioner.telecom.use Follow UK Core guidance for populating this element SHOULD 0..1 work

    > Practitioner Role

    This is used to carry the role of the practitioner making the referral. Note this may be the call handler

    activeΣ0..1boolean
    periodΣ I0..1Period
    codeΣ0..*CodeableConceptBinding
    specialtyΣ0..*CodeableConceptBinding
    telecomΣ I0..*ContactPoint
    availabilityExceptions0..1string
    PractitionerRole https://simplifier.net/hl7fhirukcorer4/ukcore-practitionerrole 1..*
    PractitionerRole.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 1801e180-e6a1-4753-8a55-ab2d1cff6549
    PractitionerRole.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    PractitionerRole.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole
    PractitionerRole.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    PractitionerRole.practitioner SHOULD 0..1
    PractitionerRole.practitioner.reference This SHOULD be populated but MUST be populated for the Practitoner resource linked to serviceRequest.performer. SHOULD 0..1 urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
    PractitionerRole.Organisation SHOULD 0..1
    PractitionerRole.Organisation.reference This SHOULD be populated where the Organisation is known. Follow UK Core guidance for populating this element SHOULD 0..1 urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb51
    PractitionerRole.code SHOULD 0..*
    PractitionerRole.code.coding This SHOULD be populated when indicating the roles a practitioner can perform SHOULD 1..1
    PractitionerRole.code.coding.system This MUST be populated with the CodeSystem from the ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode' - FIXED VALUE SHOULD 0..1 https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode
    PractitionerRole.code.coding.code This MUST be populated with Code of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'. SHOULD 0..1 224508005
    PractitionerRole.code.coding.display This MUST be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'. SHOULD 0..1 Administrative healthcare staff
    PractitionerRole.healthcareService SHOULD 0..*
    PractitionerRole.healthcareService.reference This SHOULD be populated where the Organisation of the ServiceRequest.performer is not known. SHOULD 0..* urn:uuid:6f3cc6930da34578812ca36de01268f9

    > Flag

    The Flag resource is used to risks and special patient requirements e.g. transport requirements, accessibility requirements, and reasonable adjustments. It can also be used to carry information about safeguarding concerns.

    statusΣ ?!1..1codeBinding
    categoryΣ0..*CodeableConcept
    codeΣ1..1CodeableConcept
    periodΣ I0..1Period
    Flag https://simplifier.net/hl7fhirukcorer4/ukcore-flag 0..*
    Flag.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 77be46e3-7f01-4afe-b37d-7a301db6df63
    Flag.meta https://www.hl7.org/fhir/resource.html#Meta 1..1
    Flag.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 http://hl7.org/fhir/StructureDefinition/Flag
    Flag.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Flag.status A status of 'active' MUST be assigned MUST 1..1 active
    Flag.category This MUST be used to indicate the 'type' of Flag e.g. Safeguarding Concern etc. MUST 0..*
    Flag.category.coding This MUST be populated with the overarching Flag Category: e.g. Safeguarding or Reasonable Adjustment from CodeSystem 'https://fhir.nhs.uk/CodeSystem/flag-categories-bars' MUST 1..1
    Flag.category.coding.system This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/flag-categories-bars' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/flag-categories-bars
    Flag.category.coding.code This MUST be populated with the Code of the Flag Category. See CodeSystem https://fhir.nhs.uk/CodeSystem/flag-categories-bars MUST 0..1 RA
    Flag.category.coding.display This MUST be populated with the Display of the Flag Category. See CodeSystem https://fhir.nhs.uk/CodeSystem/flag-categories-bars MUST 0..1 Reasonable Adjustment
    Flag.code MUST 1..1
    Flag.code.coding This MUST be populated with the detail of what is being flagged in Flag Category. e.g. for Reasonable Adjustment (Flag Category): 'adjustforneedlephobia'(Code) 'Adjust for needle phobia'(Display). It would not be appropriate to indicate a Category of 'Safeguarding' and a Code of 'Reasonable Adjustment'. The Category and Code MUST correlate. MUST 1..1
    Flag.code.coding.system This MUST be populated with the Coding System for what is being flagged e.g. https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars MUST 0..1 https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars
    Flag.code.coding.code This MUST be populated with the relevant Code from the selected Flag code CodeSystem MUST 0..1 adjustforneedlephobia
    Flag.code.coding.display This MUST be populated with the Display text from the Flag code CodeSystem MUST 0..1 Adjust for needle phobia
    Flag.subject MUST 1..1
    Flag.subject.reference This MUST be populated with the subject that the flag refers to. Where the flag relates to the patient (e.g. reasonable adjustments) this will reference the Patient resource MUST 1..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Flag.period SHOULD 0..1
    Flag.period.start Follow UK Core guidance for populating this element SHOULD 0..1 2023-03-08T12:01:08.4677672+00:00
    Flag.period.end Follow UK Core guidance for populating this element MAY 0..1 2023-03-08T12:01:08.4677672+00:00

    > MedicationStatement

    This resource MAY be used to carry new medication prescribed at the encounter. This SHOULD NOT be used to carry Medication History obtained from external sources.

    statusΣ ?!1..1codeBinding
    statusReason0..*CodeableConcept
    categoryΣ0..1CodeableConceptBinding
    dateAssertedΣ0..1dateTime
    reasonCode0..*CodeableConcept
    MedicationStatement https://simplifier.net/hl7fhirukcorer4/ukcoremedicationstatement 0..*
    MedicationStatement.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 89e4a6d0-4054-4267-b86a-b7cf55c0d941
    MedicationStatement.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    MedicationStatement.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement
    MedicationStatement.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    MedicationStatement.status Follow UK Core guidance for populating this element MUST 1..1 active
    MedicationStatement.category MAY 0..1
    MedicationStatement.category.coding MUST 1..1
    MedicationStatement.category.coding.system Follow UK Core guidance for populating this element MAY 0..1 http://terminology.hl7.org/CodeSystem/medication-statement-category
    MedicationStatement.category.coding.code Follow UK Core guidance for populating this element MAY 0..1 outpatient
    MedicationStatement.category.coding.display Follow UK Core guidance for populating this element MAY 0..1 Outpatient
    MedicationStatement.medicationCodeableConcept MUST 1..1
    MedicationStatement.medicationCodeableConcept.coding
    MedicationStatement.medicationCodeableConcept.coding.system This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 https://dmd.nhs.uk/
    MedicationStatement.medicationCodeableConcept.coding.code This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 39732311000001104
    MedicationStatement.medicationCodeableConcept.coding.display This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 Amoxicillin 250mg capsules
    MedicationStatement.subject MUST 1..1
    MedicationStatement.subject.reference This MUST be a reference to the patient MUST 0..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    MedicationStatement.context MAY 0..1
    MedicationStatement.context.reference Follow UK Core guidance for populating this element MAY 0..1 urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
    MedicationStatement.effectiveDateTime This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 2021-09-23
    MedicationStatement.dateAsserted This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 2021-10-22
    MedicationStatement.reasonCode SHOULD 0..*
    MedicationStatement.reasonCode.coding MUST 1..1
    MedicationStatement.reasonCode.coding.system Follow UK Core guidance for populating this element SHOULD 0..1 http://snomed.info/sct
    MedicationStatement.reasonCode.coding.code Follow UK Core guidance for populating this element SHOULD 0..1 65363002
    MedicationStatement.reasonCode.coding.display Follow UK Core guidance for populating this element SHOULD 0..1 Otitis Media
    MedicationStatement.dosage SHOULD 0..*
    MedicationStatement.dosage.text Follow UK Core guidance for populating this element MAY 0..1 2 capsules 4 times a day.
    MedicationStatement.dosage.timing SHOULD 0..1
    MedicationStatement.dosage.timing.repeat MUST 0..1
    MedicationStatement.dosage.timing.repeat.frequency Follow UK Core guidance for populating this element SHOULD 0..1 4
    MedicationStatement.dosage.timing.repeat.period Follow UK Core guidance for populating this element SHOULD 0..1 1
    MedicationStatement.dosage.timing.repeat.period unit Follow UK Core guidance for populating this element SHOULD 0..1 d
    MedicationStatement.dosage.asNeededCodeableConcept SHOULD 0..1
    MedicationStatement.dosage.asNeededCodeableConcept.coding MUST 1..1
    MedicationStatement.dosage.asNeededCodeableConcept.coding.system Follow UK Core guidance for populating this element SHOULD 0..1 http://snomed.info/sct
    MedicationStatement.dosage.asNeededCodeableConcept.coding.code Follow UK Core guidance for populating this element SHOULD 0..1 16001004
    MedicationStatement.dosage.asNeededCodeableConcept.coding.display Follow UK Core guidance for populating this element SHOULD 0..1 Otalgia
    MedicationStatement.dosage.site MAY 0..1
    MedicationStatement.dosage.site.coding MUST 1..1
    MedicationStatement.dosage.site.coding.system Follow UK Core guidance for populating this element MAY 0..1 http://snomed.info/sct
    MedicationStatement.dosage.site.coding.code Follow UK Core guidance for populating this element MAY 0..1 123851003
    MedicationStatement.dosage.site.coding.display Follow UK Core guidance for populating this element MAY 0..1 Mouth region structure
    MedicationStatement.dosage.route SHOULD 0..1
    MedicationStatement.dosage.route.coding MUST 1..1
    MedicationStatement.dosage.route.coding.system Follow UK Core guidance for populating this element SHOULD 0..1 http://snomed.info/sct
    MedicationStatement.dosage.route.coding.code Follow UK Core guidance for populating this element SHOULD 0..1 26643006
    MedicationStatement.dosage.route.coding.display Follow UK Core guidance for populating this element SHOULD 0..1 Oral
    MedicationStatement.dosage.method SHOULD 0..*
    MedicationStatement.dosage.method.coding MUST 1..1
    MedicationStatement.dosage.method.coding.system Follow UK Core guidance for populating this element SHOULD 0..1 http://snomed.info/sct
    MedicationStatement.dosage.method.coding.code Follow UK Core guidance for populating this element SHOULD 0..1 421984009
    MedicationStatement.dosage.method.coding.display Follow UK Core guidance for populating this element SHOULD 0..1 Until finished
    MedicationStatement.dosage.doseAndRate SHOULD 0..*
    MedicationStatement.dosage.doseAndRate.doseQuantity SHOULD 0..1
    MedicationStatement.dosage.doseAndRate.doseQuantity.value Follow UK Core guidance for populating this element SHOULD 0..1 500
    MedicationStatement.dosage.doseAndRate.doseQuantity.unit Follow UK Core guidance for populating this element SHOULD 0..1 milligram
    MedicationStatement.dosage.doseAndRate.doseQuantity.system Follow UK Core guidance for populating this element SHOULD 0..1 http://unitsofmeasure.org
    MedicationStatement.dosage.doseAndRate.doseQuantity.code Follow UK Core guidance for populating this element SHOULD 0..1 mg

    > Observation

    This resource can be used to communicate measurements and simple assertions made about a patient.

    statusΣ ?!1..1codeBinding
    category0..*CodeableConceptBinding
    issuedΣ0..1instant
    dataAbsentReasonI0..1CodeableConceptBinding
    interpretation0..*CodeableConceptBinding
    method0..1CodeableConceptBinding
    Observation https://simplifier.net/hl7fhirukcorer4/ukcore-observation 0..*
    Observation.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 e3dd3833-5622-4cdd-bddf-97942c58d190
    Observation.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Observation.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation
    Observation.meta.lastUpdated This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Observation.status This MUST be populated and set to FINAL - FIXED VALUE MUST 1..1 final
    Observation.code MUST 1..1
    Observation.code.text This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 Expectations and wishes
    Observation.performer SHOULD 0..*
    Observation.performer.reference This SHOULD be populated. Where populated this MUST reference to a Practitioner resource SHOULD 0..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Observation.subject MUST 0..1
    Observation.subject.reference This MUST be populated with reference to a Patient resource MUST 0..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Observation.encounter SHOULD 0..1
    Observation.encounter.reference This SHOULD be populated. Follow UK Core guidance for populating this element SHOULD 0..1 urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
    Observation.effectiveDateTime Follow UK Core guidance for populating this element MAY 0..1 2023-03-08T12:01:08.4677672+00:00
    Observation.note Follow UK Core guidance for populating this element SHOULD NOT 0..*

    > Consent

    Resource used to communicate a healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time. This is limited to communicating consent to share information for Direct Care for this Release of BaRS

    statusΣ ?!1..1codeBinding
    scopeΣ ?!1..1CodeableConceptBinding
    categoryΣ1..*CodeableConceptBinding
    patientΣ I0..1Reference(UK Core Patient)
    dateTimeΣ0..1dateTime
    performerΣ I0..*Reference(UK Core Organization | UK Core Patient | UK Core Practitioner | UK Core PractitionerRole | UK Core RelatedPerson)
    organizationΣ I0..*Reference(UK Core Organization)
    policyRuleΣ I0..1CodeableConceptBinding
    Consent https://simplifier.net/hl7fhirukcorer4/ukcore-consent 1..*
    Consent.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 e267afc4-4310-4549-b66a-5bc4db08f09b
    Consent.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    Consent.meta.profile This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent
    Consent.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    Consent.status This MUST be populated. Follow UK Core guidance for populating this element MUST 1..1 active
    Consent.scope MUST 1..1
    Consent.scope.coding MUST 1..1
    Consent.scope.coding.system This MUST be populated with the System namespace for the CodeSystem 'http://terminology.hl7.org/CodeSystem/consentscope' - FIXED VALUE MUST 0..1 http://terminology.hl7.org/CodeSystem/consentscope
    Consent.scope.coding.code This MUST be populated with Code 'patient-privacy'. See CodeSystem 'http://terminology.hl7.org/CodeSystem/consentscope'. This is the only supported option for this BaRS release - FIXED VALUE MUST 0..1 patient-privacy
    Consent.Category MUST 1..*
    Consent.Category.coding MUST 1..1
    Consent.Category.coding.system This MUST be populated with the System namespace for the CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars' - FIXED VALUE MUST 0..1 https://fhir.nhs.uk/CodeSystem/consent-categories-bars
    Consent.Category.coding.code This MUST be populated with Code 'DRC'. See CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars'. This is the only supported option for this BaRS release - FIXED VALUE MUST 0..1 DRC
    Consent.Category.coding.display This MUST be populated with Display 'Direct Care'. See CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars'. This is the only supported option for this BaRS release - FIXED VALUE MUST 0..1 Direct Care
    Consent.patient MUST 0..1
    Consent.patient.reference This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
    Consent.policyRule MUST 0..1
    Consent.policyRule.coding MUST 1..1
    Consent.policyRule.coding.system This MUST be populated with the namespace for the CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE MUST 0..1 http://terminology.hl7.org/CodeSystem/v3-ActCode
    Consent.policyRule.coding.code This MUST be populated with Code 'IMPLIED'. See CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode'. This is the only supported option for this BaRS release - FIXED VALUE MUST 0..1 IMPLIED
    Consent.dateTime This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 26/11/2021

    > Healthcare Service

    The HealthcareService the request is being made of - the Receiver

    activeΣ ?!0..1boolean
    categoryΣ0..*CodeableConcept
    typeΣ0..*CodeableConcept
    specialtyΣ0..*CodeableConceptBinding
    nameΣ0..1string
    commentΣ0..1string
    extraDetails0..1markdown
    photoΣ I0..1Attachment
    telecomI0..*ContactPoint
    serviceProvisionCode0..*CodeableConcept
    program0..*CodeableConcept
    characteristic0..*CodeableConcept
    communication0..*CodeableConceptBinding
    referralMethod0..*CodeableConcept
    appointmentRequired0..1boolean
    availabilityExceptions0..1string
    HealthcareService https://simplifier.net/hl7fhirukcorer4/ukcore-healthcareservice 1..1
    HealthcareService.id This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response. MUST 0..1 93d0ff33-ce84-42fd-b98c-f326e55283e0
    HealthcareService.meta https://www.hl7.org/fhir/resource.html#Meta MUST 1..1
    HealthcareService.meta.profile MUST 1..1
    HealthcareService.meta.lastUpdated All resources MUST include 'lastUpdated' value, under meta section which must be the same timestamp for each resource when created from new, but must be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. MUST 1..1 2023-03-08T12:01:08.4677672+00:00
    HealthcareService.identifier This MUST be populated, indicating the external identifier of the Receiving HealthcareService MUST 0..* The Healthcare Service Identifier will be represented by a UEC DoS Service Identifier
    HealthcareService.identifier.system This MUST be populated with the System of the Receiving HealthcareService identifier MUST 0..1 https://fhir.nhs.uk/Id/dos-service-id
    HealthcareService.identifier.value This MUST be populated with the Value of the Receiving HealthcareService identifier MUST 0..1 ABD01
    HealthcareService.active This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 TRUE
    HealthcareService.providedBy SHOULD 0..1
    HealthcareService.providedBy.reference Link to the Organisation the request is being made of . This will commonly link to the MH.destination SHOULD 0..1 urn:uuid:d5ffd0cd-ec7e-48a1-84f1-91f4c0eb8fc5
    HealthcareService.name This MUST be populated. Follow UK Core guidance for populating this element MUST 0..1 Consulting psychologists and/or psychology services

    Entity Relationship Diagrams


    Entity maps detail the relationship of the resources and elements within resources in the payloads.

    The below diagram details the ServiceRequest - Referral Request - GP to Pharmacy





    The below diagram details a focus on the payload on GP to Pharmacy fields to drive priority and filtering.


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