Referrals into an Ambulance Service Trust (Application 6)

Important: This guide is currently under development

This is a preview of a developing guide for information only. With the exception of those involved in developing solutions for the first of type (private beta), It is not intended to be used until the completed v1.0.0 documentation for this application is released

If you are interested in developing a BaRS compliant solution right now for the use cases covered by this application, please use the contact form here and the team will be in touch

Versioning information

Application Version	Minimum Core Version	Minimum Guide Version	Minimum API Spec Version
Application 6 v1.0.0-beta.6	v1.1.x	v1.10.0	v1.1.0

Use Cases Supported

This application supports the use of the following use cases:

Note: when this application is used for Referrals from an AST Computer Aided Dispatch system (CAD) to an AST CAD it is known as 'CAD to CAD'

Use Case	Name	Code
CAD to CAD Out of Area Referral	CAD to CAD Out of Area Referral	A6T1
CAD to CAD Call Assist Request	CAD to CAD Call Assist Request	A6T2
CAD to CAD Mutual Aid Request	CAD to CAD Mutual Aid Request	A6T3

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 referral information data model is based on user research with NHS 111 service providers, 999 Ambulance Service Trusts, Clinical Assessment Services and clinical and administrative Emergency Department staff. We carried out this research in parallel with the Professional Records Standards Body (PRSB) who examined the wider brief of 'referrals from NHS 111 to any other care setting'

For the CAD to CAD use case, the data model was agreed by the CAD to CAD Reference Group following a period of user research involving site visits, Reference Group workshops and desk research. This was endorsed by the CAD to CAD Working Group and shared with the the following organisations:

National Ambulance Programme Board (NAPB)
National Ambulance Advisory Group (NAAG)
National Ambulance Information Group (NAIG)
National Ambulance Services Medical Directors' Group (NASMeD)
National Ambulance Digital Leaders Group (NADLG)
National Heads of EOC Group (NHoEOC)
National Information Governance Group
National Directors of Operations Group (NDOG)

For more information see Referrals into an Ambulance Service Trust(Application 6

Scope and Requirements

Scope Overview

This BaRS Application (Application 6) covers three use cases:

CAD to CAD Out of Area referral
CAD to CAD Call Assist Request
CAD to CAD Mutual Aid Request

For the public beta phase ONLY the CAD to CAD Out of Area referral use case is mandatory.

The payloads and workflow have been designed to support these services. 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
The service must be configured within the BaRS infrastructure (Endpoint Catalogue) before requests can be made to the service
For CAD to CAD Out of Area referrals the Home AST should be selected using the incident location and nationally agreed polygons

Referral

A referral Sender must interpret the Message Definition returned by the Receiver to check what use cases are supported before attempting to send a referral.
Referral Sender must ONLY send a use case specific referral that matches the intended use context and is supported by the Receiver i.e. MessageDefinition.useContext where the system value = usecases-categories-bars is mutualaidrequest(a6t3) or callassistrequest(a6t2) or outofareareferral(a6t1).
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 the service offers
The referral Sender must have the capability to send a referral at points in the call cycle that are appropriate for the acuity of the case
The referral Sender must include incident location information
The referral will contain primarily clinical information, indicating the need of the individual and should state the anticipated action required by the Receiving service
Supporting information, other than the assessment, is expected to be included in a referral, if collected, including:
- new or existing safeguarding concerns
- locally held Special Patient Notes
- external information sources used during initial assessment prior to referral
- scene safety information
- timing information to support the timely delivery of care and reporting
For Call Assist and Mutual Aid requests the referral can be rejected by the referral Receiver if they can't meet the requirements specified in the request

Referral Response (Status Update)

A referral response is sent by the referral Receiver back to the referral Sender to notify them of the current status of the case
A Referral response update is used to communicate each change in status
For Call Assist and Mutual Aid requests, the referral rejection is communicated in a referral response
The Receiver must send a Referral Response to the referral Sender each time the Encounter Status changes

API-M

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

Constraints

Supporting the use of Emergency Call Prioritisation Advisory Group (ECPAG) approved Clinical Decision Support Systems only (NHS Pathways, NHS Pathways Clinical Content Support (PaCCS) and Advanced Medical Priority Dispatch System (AMPDS))
No guidance provided on display of referral information beyond the Principles for rendering BaRS Payload
BaRS currently supports the communication of consent for direct care only
Certificates for Receiving messages to use nhs.uk domains only
Receiving endpoints are to be internet facing
Clinical Constraints exist - See Hazard Log

Requirements

Service Discovery

The service must support a unique identifier which the Sender extracts to engage in referral workflows

Referral Request

The referral Sender must specify the type of referral (use case) in the request
The referral Receiver must have the ability to specify the use cases that they are able to receive.
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
The referral Sender must send incident location information as part of their request
The referral Sender should send scene safety information as part of their request
Any new or existing safeguarding concerns, recorded as part of the assessment, must be included in the referral Sender's request
The referral Sender should support the communication of a triage/assessment undertaken by a clinician without the support of a CDSS
The referral Sender should identify where the triage/assessment has been undertaken by a clinician
The referral Sender must make available the human readable identifier for the referral, included in the HTTP synchronous response, to the end user
The referral Receiver must clearly identify any included safeguarding concern to the end user
The referral Receiver must accurately represent information made by the Sender to the end user
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 referral

The referral Sender must be capable of updating any referral made by them, within the current consultation or after the consultation event
The referral Sender must send a referral update each time critical information is added to the case
The referral Sender must retrieve the referral to be updated from the referral Receiver prior to update to ensure they are working with the most up-to date version and the referral has not already been been completed, or is at a point in the workflow where it it must not be updated
The referral Sender must provide visible confirmation to the end user of the status returned by the referral Receiver, i.e. whether the original referral was successfully updated or not
Where the update was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
Where the update 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 updating of the referral.  Business/clinical responsibility for informing the patient must remain with the referral Sender

Cancel referral

The referral Sender must be capable of cancelling any referral made by them, within the current consultation or after the consultation event
The referral Sender must retrieve the referral to be cancelled from the referral Receiver prior to cancellation to ensure they are working with the most up-to date version and it has not already been completed
The referral Sender must provide visible confirmation to the end user of the status returned by the referral Receiver, i.e. whether the original referral was successfully cancelled or not
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 must remain with the referral Sender

Incident Location

The referral Sender must include the incident location in the referral request
The Incident Location must include a co-ordinate (Eastings/Northings, Lat/Long or what3words equivalent) or a property location identifier (UPRN, Address and Postcode)
The referral Sender should send a UPRN for all addressable locations
The referral Sender should state if the Incident Location is provisional or confirmed
The referral Receiver must re-plot the location on receipt
The referral Receiver must use the UPRN to identify a location and record this locally

Other Locations

The Sender may include other locations in the referral request
All locations must include a co-ordinate (Eastings/Northings, Lat/Long or what3words equivalent) or a property location identifier (UPRN, Address and Postcode)

Timings

The referral Sender should send the time that BT Emergency Services answered the initial 999 call (BTStartTime)
The referral sender should send the Call Connect time (T0)
The referral sender should send the Call Connect Answer time (T1)
The referral sender should send the Incident Location confirmation time (T2)
The referral Sender must send the clock start time (T5)
The referral Sender should send the time Cardiopulmonary Resuscitation (CPR) started for cases where CPR was undertaken by a bystander

Scene Safety

The referral Sender should send scene safety information in the referral
Where scene safety questions have not been asked, the Flag resource relating to scene safety must be populated with 'UNK' unknown.
When the scene is unsafe the referral Sender must send the reason(s) for the scene being unsafe

Crew information

The referral Sender should send information relevant to the ambulance crew in the referral

Call Log information

The referral Sender should send Call Log information relevant to the referral Receiver in the referral

Agencies informed

The referral Sender should send information about which external agencies (e.g. Police, Coastguard) have been informed and at what time

Contacts

A minimum of one contact (patient or third party) with a contact method (phone, email, etc.) of phone must be provided in requests
All contacts must have a rank
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

Reject referral

For Call Assist and Mutual Aid requests, the referral Receiver must send a referral rejection when they cannot meet the requirements in the request
On receipt of a Referral rejection the referral Sender must process and display the referral rejection

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

Suppliers must adhere to the error handling guidance

Non Functional

Suppliers must adhere to the non functional requirements

How does it work?

This section describes how the primary operations used in this application work. The following diagrams illustrate the workflows and interactions of the following use cases :

CAD to CAD Out of Area referral
CAD to CAD Call Assist Request
CAD to CAD Mutual Aid Request

Actors

Use Case	Referral Sender	Referral Recipient
Out of Area referral	Call Receiving AST	Home AST
Call Assist Request	Home AST	Supporting AST
Mutual Aid Request	Home AST	Supporting AST

Out of Area calls

Calls may be re-routed by the BT Emergency Call Service to an Ambulance Service Trust (AST) outside of the geographic area of the incident (the Call Receiving AST) for the following reasons:

The Home AST has arrangements with out of area ASTs to take their calls when needed
A third party caller calls about a patient in another area
Calls where the incident is on the boundary between two ASTs

Call Assist Requests

A Home AST may request support from a Supporting AST when they cannot send a resource to an incident within their geographic boundary of responsibility. The Supporting AST may accept or reject this request.

If the Supporting AST rejects the request, the Home AST will make alternative arrangements
If the Supporting AST accepts the request:
- the Supporting AST is responsible for dispatching an appropriate resource within the time frame specified by the ARP Priority code
- the Home AST may close the case on their CAD

Mutual Aid Requests

A Home AST may request support from a Supporting AST when they cannot meet all of the resource requirements for an incident within their geographic boundary of responsibility. The Supporting AST may accept or reject this request.

If the Supporting AST rejects the request, the Home AST will make alternative arrangements
If the Supporting AST accepts the request:
- the Supporting AST is responsible for dispatching the requested resource within the time frame specified in the request
- the Home AST remains responsible for the case and for dispatching the resources not specified in the request

Note: The BaRS Referral may be used to support single patient Mutual aid requests. It is not intended to replace processes relating to Mutual Aid Requests to support Major Incidents with multiple patients.

This details a BaRS CAD to CAD Referral:

Receive Call

When a call is re-routed by BT Emergency Services, call details are also sent electronically to the referral Sender via the Enhanced Information Service for Emergency Calls (EISEC) interface.
For the Call Assist and Mutual aid use cases, the initial call may be received via BT Emergency Services EISEC interface or directly into the CAD e.g. Healthcare Professional (HCP) direct line

Create Case

On receipt of this information the referral Sender's CAD creates a case that is subsequently further populated by system end users, the associated telephony system and other interfaced systems e.g. Clinical Decision Support Systems (CDSS) such as NHS Pathways and Advanced Medical Priority Dispatch System (AMPDS).

Pre Triage Sieve (PTS)

On answering the call the referral Sender will undertake a Pre Triage Sieve (PTS) question set to facilitate the early identification of patients with a potentially life-threatening emergency, in order that immediate dispatch of an appropriate resource can take place at the earliest possible point in the call cycle. If a life-threatening emergency is identified by the PTS the referral Sender AST may make a BaRS referral at this point in the call cycle, and all subsequent information will be communicated in BaRS Referral updates (see Sending a BaRS Referral)

Reason for Call

The referral Sender will capture a Reason for Call based on what the patient or their representative tells them. This may also be known as 'What's the Problem' text or the Presenting complaint.

Nature of Call (NOC)

The referral Sender will capture a NOC code to facilitate the early identification of patients with a potentially life-threatening emergency. If a life-threatening emergency is identified by the NOC, the referral Sender AST may make a BaRS referral at this point in the call cycle, and all subsequent information will be communicated in BaRS Referral updates (see Sending a BaRS Referral below)

Confirm Location

The referral Sender will record the location of the incident and confirm using Gazetteer services. This is undertaken at the earliest opportunity and may be prior or subsequent to PTS and NOC.

Record demographics

The referral Sender will capture the patient's baseline demographics where possible. This may be followed up by a Personal Demographics Service (PDS) search later in the call cycle.

Complete Triage

The referral Sender will complete a triage of the patient to determine the acuity of the case. This will typically be undertaken by a call handler on the Computer Aided Dispatch (CAD) system, using an approved Clinical Decision Support System (CDSS), such as NHS Pathways or AMPDS. This is the point at which the Referral Sender AST will make a BaRS referral for non-life threatening emergencies; all subsequent information captured will be communicated in BaRS Referral updates (see Sending a BaRS Referral below)

Sending a BaRS Referral

The referral Receiver is identified based on nationally agreed polygons that set geographic boundaries of responsibility for each AST. Service discovery will use these polygons to ascertain the ServiceID of the referral Receiver.
The Service ID is used to query the BaRS Endpoint Catalogue to identify the referral Receiver's CAD system's endpoint details
The sender will check that the Receiver supports the intended Referral use case before sending.
The referral Sender will send the BaRS Referral to the referral Receiver, which includes information required by the referral Receiver to continue the patent's clinical care. This will also include the JourneyID created at the patient's first contact.

Create Case

The referral Receiver's CAD will create a new case (Encounter) on receipt of the BaRS Referral and populate it with the patient and clinical details provided in the referral

Acknowledge Receipt

The referral Receiver will send an acknowledgement back to the referral Sender, when it has successfully processed the payload. If it fails to do this it will send a BaRS error code. See failure scenarios for more detail.

Status Update (Referral Response)

The referral Receiver will send a series of status updates back to the referral Sender, to support tracking the progress of the case.

Continue updates

If additional or changed information about the case is captured by the referral Sender, subsequent to sending the BaRS Referral, they may send a BaRS Referral Update to ensure that the referral Receiver has the most up to date information.
If the referral Sender needs to cancel a Referral, for example the patient calls back and says they do not require an ambulance, they need to send a Cancellation.
On receipt of a Referral Update, the referral Receiver will send an acknowledgement back to the Sending AST on when it has successfully processed the payload. If it fails to do this it will send a BaRS error code. See failure scenarios for more detail.

Manage Stack

The referral Receiver will manage the case in accordance with the Ambulance Response Programme (ARP) Priority Level. This may include:
- Dispatching an appropriate resource within the specified time frame
- Validating the triage outcome
- Referring onward to another care setting e.g. Emergency Department
When the status of a case changes in the referral Receiver's CAD, a BaRS Status Update will be sent to the referral Sender so they are aware of the current case status.

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

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:

Interaction	Method	Payload Focus	Status Required (MessageHeader, ServiceRequest, Encounter)
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) = a6t1
			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 PractitionerRole (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 cancellation.

The Message Definition that defines the payload for this Application is: BARS Message Definition ServiceRequest - Request - Cancelled

If the update-to-cancel is taking place as part of a re-referral routine, once the cancellation is complete, the new referral request 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:

Interaction	Method	Payload Focus	Status Required (MessageHeader, ServiceRequest, Encounter)
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) = a6t1
			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 PractitionerRole (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 PractitionerRole (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 400
		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.coding[0].code) //https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
					{
						case "Referral":
							if (Careplan.status != "active" && CarePlan.intent != "plan" && Task.status != "requested")
							{
								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","in-progess")&& Encounter.class.code=="EMER")
							{ 
								switch(ServiceRequest.Category.coding[1].code)  //https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
								{
									case "a6t3":
										RequestType = "Im Receiving a new Mutual Aid Request";
									case:"a6t2":
										RequestType = "Im Receiving a new Call Assist Request";
									case:"a6t1":
										RequestType = "Im Receiving a new Out of Area Request";
								}									
							}
							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.coding[0].code) //https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
					{
						case "Referral":
							if(ServiceRequest.status.In("entered-in-error","revoked"))
							{RequestType = "im receiving a cancelled referral"}
							else if (Task.status != "requested")
							{
								RequestType = "unknown"
								OperationOutcome.issue.code = "invariant"//A content validation rule failed
								throw exception with "REC_BAD_REQUEST"
								then return  HTTP.ResponseCode 400
							}
							else if(!LocalServiceRequestData.ResourceId.Contains(ServiceRequest.id))//if ServiceRequest does not exist locally. 
							{
								RequestType = "unknown"
								OperationOutcome.issue.code = "not-found"//A content validation rule failed
								throw exception with "REC_NOT_FOUND"
								then return  HTTP.ResponseCode 400
							}
							else if(Encounter.Status.In("triaged","finished","in-progess")&& Encounter.class.code=="EMER")
							{ 
								switch(ServiceRequest.Category.coding[1].code)  //https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
								{
									case "a6t3":
										RequestType = "Im Receiving a new Mutual Aid Request update";
									case:"a6t2":
										RequestType = "Im Receiving a new Call Assist Request update";
									case:"a6t1":
										RequestType = "Im Receiving a new Out of Area Request update";
								}									
							}
							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 (ServiceRequest.status == "active")
					{
						if (MessageHeader.reason.code == "new")
						{
							switch(ServiceRequest.Category.coding[0].code) //https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
							{
								case "Referral":
								if(Encounter.Status.In("planned","finished","in-progess")&& Encounter.class.code=="EMER")
									{ 
										switch(ServiceRequest.Category.coding[1].code)  //https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
										{
											case "a6t3":
												RequestType = "Im Receiving a new Mutual Aid Request response";
											case:"a6t2":
												RequestType = "Im Receiving a new Call Assist Request response";
											case:"a6t1":
												RequestType = "Im Receiving a new Out of Area Request response";
											default:
												RequestType = "unknown"
												OperationOutcome.issue.code = "invariant"//A content validation rule failed
												throw exception with "REC_BAD_REQUEST"
												then return  HTTP.ResponseCode 400;
										}									
									}
								default:
								{
									RequestType = "unknown"
									OperationOutcome.issue.code = "invariant"//A content validation rule failed
									throw exception with "REC_BAD_REQUEST"
									then return  HTTP.ResponseCode 400;
								}
							}	
						}
						else (MessageHeader.reason.code == "update") // Not alpha
						{
							switch(ServiceRequest.Category.coding[0].code) //https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
							{
								case "Referral":
								if(Encounter.Status.In("planned","finished","in-progess")&& Encounter.class.code=="EMER")
									{ 
										switch(ServiceRequest.Category.coding[1].code)  //https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
										{
											case "a6t3":
												RequestType = "Im Receiving a  Mutual Aid Request update response";
											case:"a6t2":
												RequestType = "Im Receiving a  Call Assist Request update response";
											case:"a6t1":
												RequestType = "Im Receiving a  Out of Area Request update response";
											default:
												RequestType = "unknown"
												OperationOutcome.issue.code = "invariant"//A content validation rule failed
												throw exception with "REC_BAD_REQUEST"
												then return  HTTP.ResponseCode 400;
										}									
									}
								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 (ServiceRequest.status == "revoked")
				{
					if(Encounter.Status.In("cancelled")&& Encounter.class.code=="EMER")
					{ 
						switch(ServiceRequest.Category.coding[1].code)  //https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
						{
							case "a6t3":
								RequestType = "Im Receiving a new Mutual Aid Request rejection";
							case:"a6t2":
								RequestType = "Im Receiving a new Call Assist Request rejection";
							default:
								RequestType = "unknown"
								OperationOutcome.issue.code = "invariant"//A content validation rule failed
								throw exception with "REC_BAD_REQUEST"
								then return  HTTP.ResponseCode 400;
						}	
					}								
				}
				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;
				}	
				else 
				{
					RequestType = "unknown"
					OperationOutcome.issue.code = "invariant"//A content validation rule failed
					throw exception with "REC_BAD_REQUEST"
					then return  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)
						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 for Referrals

Referral Payload

The below details the specific guidance around the use of resources required to create a referral by the referral Sender. See ServiceRequest - Request Referral message definition for details of resources required for this payload.

Note that referral Senders will also have to build the capability to receive and process the Referral Response (Status update) payload.

For example Referral bundles please see:

Referral Request - CAD to CAD Out of area
Referral Request - CAD to CAD Mutual aid request
For additional example bundles please check BaRS Example Bundles

MessageHeader Resource

For detailed information on the use of MessageHeader please refer to the Standard Pattern Message Header.

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'
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 payload (bundle) is created by the Sender and processed by the Receiver, this is the starting point from which the request is understood. It provides either the detail and 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.

There are two coding entries within ServiceRequest.category which are key to driving workflow:

Denotes the type of referral e.g. Transfer of care
Denotes the use case and must be populated with the relevant use case from use-case CodeSystem. e.g. Out of area, Mutual Aid or Call Assist. Please refer to the guidance in use-case categories

Additionally, the ServiceRequest.category.text must be populated with details about the service request when the request is to support the Call Assist or Mutual Aid use cases.

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 carrier for the assessment, which established the need for the referral. This encounter should include a local human readable 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.

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 an Identifier value, indicating the Receiver's local human readable reference. See the Entity Relationship Diagrams for reference. The human readable (Identifier) reference is a useful link for the services 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.

Incident Location Resource

The Incident Location resource is used to transfer details of the incident location.

When the Sender populates the Incident Location resource:

They must populate the Location.extension with at least one property or non-property element from the following:
- Unique Property Reference Number (UPRN)
- Postcode Address Finder (PAF) key
- Eastings/Northings
- what3words
They should also populate the Location.extension with the percentage accuracy of the location
They should populate the Location.address for all property based locations
They should populate Location.address.line which is a repeatable element, with the order in which lines should appear in an address label
They should populate Location.name when there is a property name
They should populate Location.address.text with a text representation of the full address (including the address name), with each line separated by a comma

When a the Receiver processes information in an Incident Location resource:

They should consume and populate all address fields sent, into their system
They must display all address fields sent by the Sender

Location Resource

The Location resource is used to transfer details of location types other than the Incident Location

When the Sender populates the Location resource:

They must populate the Location.extension with at least one property or non-property element from the following:
- Unique Property Reference Number (UPRN)
- Postcode Address Finder (PAF) key
- Eastings/Northings
- what3words
They should populate the Location.address for all property based locations.
They should populate Location.address.line which is a repeatable element, with the order in which lines should appear in an address label
They should populate Location.name when there is a property name
They should populate Location.address.text with a text representation of the full address (including the address name), with each line separated by a comma

When a the Receiver processes information in a Location resource:

They should consume and populate all address fields sent, into their system
They must display all address fields sent by the Sender

Note: The Patient Address is communicated in in the Patient resource and would only be replicated in the Location resource if it is also a secondary location e.g. Rendezvous point

CarePlan Resource

The CarePlan resource is used in a Referral Request to communicate the Sender's triage outcome and any associated clinical information, based on the assessment performed by the Sender. The Receiver will utilise the detail in this resource to review what the previous assessment ascertained about the patient, and to inform any subsequent action.

Primarily, careplan.activity is the section which holds this information, whether it be coded or free text. The careplan.activity.outcomeCodeableConcept supports the transmission of AMPDS and Pathways coded outcomes and the clinical narrative. The element guidance for this resource below goes into the specific detail but, the Sender must include the following:

The selected AMPDS dispatch code and triage summary, or
The Pathways, Symptom Group (SG), Symptom Discriminator (SD) and Disposition (DX) codes, along with the Pathways consultation summary.
Further clinical narrative, provided outside of the AMPDS or Pathways assessment, can also be included under this element using 'text'
The Ambulance Response Programme (ARP) priority code

The CarePlan.period.start is used to transfer the clock start time for dispatch and must be populated populated with Clock start date/Time Definition as per AmbSys specification.

The careplan.author.reference should be populated with a reference to the PractionerRole when a triage has been validated or an assessment has been undertaken by a clinician. The careplan.author.reference must not be populated if the user undertaking the triage/assessment is NOT a clinical user.

Flag (Scene safety)

The Flag (Scene Safety) resource is used to communicate safety information about the incident location. The Flag.subject is the Incident Location

When populating this resource, Senders must include both flag.category and flag.code values using the specific BaRS CodeSystems

When the scene is unsafe the Flag.code.text must be populated with the free text reason(s) that the scene is unsafe.

When a Receiver processes information in a Flag (Scene Safety) resource;

they should populate a flag in their system schema, if their solution supports that flag
they must display the information in the Flag (Scene Safety) resource (including Flag.category and Flag.code) 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.

Flag Resource

The Flag resource is used to communicate prospective warnings of potential issues when providing care to the patient. The Flag.subject may be the Patient (e.g. Safeguarding concern) or the Location (e.g. location specific alerts). The population of the Flag is optional as not all subjects will have relevant issues.

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

When a the Receiver processes information in a Flag resource;

they should populate a flag in their system schema, if their solution supports that flag
they must display the information in the Flag resource (including Flag.category and Flag.code) 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.

Observation

The Observation resource is used to carry assertions supporting the assessment performed by the Sender. Senders should add clinical notes to the Careplan resource rather than Observation, especially where they expect a Receiver to act upon the information.

There are specific instances where an Observation must be used to convey information and examples are provided below to aid development:

Where Birth Sex is communicated it must be transferred in a Referral Request using an Observation. This information should only be transferred when considered clinically relevant and it is not considered as demographic information, as administrative gender would be. It should not be included as an extension on the patient resource, as described in UK Core.
Where Estimated Age is communicated it must be conveyed in an Observation.

The level of consent currently supported by BaRS is for 'Direct Care' only. In emergency care use cases this is usually implied consent. A Referral Request must contain a Consent resource and it must adhere to the example provided under the BaRS FHIR assets.

Questionnaire

A Questionnaire is an organised collection of questions intended to solicit information from patients, providers or other individuals involved in the healthcare domain. They may be simple flat lists of questions or can be hierarchically organised in groups and sub-groups, each containing questions. The Questionnaire defines the questions to be asked, how they are ordered and grouped, any intervening instructional text and what the constraints are on the allowed answers. The results of a Questionnaire can be communicated using the QuestionnaireResponse resource.

The Questionnaire resource is used to convey the Pre Triage Sieve and the potential responses as detailed below:

Pre Triage Sieve

Question	Answer	Code
Is the patient breathing?	Yes	78064003 Breathing
	No	1023001 Not Breathing
Is the patient awake (conscious)?	Yes	428913001 No loss of consciousness
	No	419045004 Loss of consciousness
Is their breathing noisy?	Yes	248573009 Noisy respiration
	No	248573009 48348007 Normal breath sounds
Is their breathing effective?	Yes	20716004 Respiratory rate normal (finding)
	No	20716004 Difficulty breathing (finding)

This is an example of the Pre triage Sieve questionnaire.

Only the nationally agreed answers and associated codes in this table are valid to be sent. No locally defined responses can be sent.

Nature of call (NOC) responses are not defined in a published Questionnaire but can be sent using a QuestionnaireResponse. See QuestionnaireResponse guidance.

Questionnaire Response

The Questionnaire Response resource is used to convey the PTS and NOC responses given by the patient (or their representative).

The extension questionnaireresponse-reason must be populated to indicate which data is contained within, as outlined in the resource element guidance below.

Using a nested set of questionnaireResponse.item, questionnaireResponse.linkId and questionnaireResponse.answer complex structured data can be generated and processed, by the Sender and Receiver, respectively. The element guidance for this resource below goes into detail but, essentially, the item and linkId can be continually nested to convey various types of information. The item indicates a new answer, linkId may correspond with the questionnaire question linkId, forging the relationship between the questionnaire and questionnaireResponse, and answer contains any the value recorded. The questionnaireResponse.item.answer datatype must correspond with that defined in the questionnaire.item.answerOption.

We have published examples of Pre Triage Sieve and Nature of Call questionnaire responses.

Pre Triage Sieve (PTS) responses will link directly to the associated published Questionnaire, while Nature of Call (NOC) responses are transfered in a QuestionnaireResponse without reference to a published Questionnaire.

Nature of Call (NOC)

Nature of call types are nationally agreed by ECPAG for ASTs using both AMPDS and NHS Pathways as their CDSS. Receivers MUST be able to process and display NOC types and their associated code for both NHS Pathways and AMPDS NOC types detailed below, as well as locally agreed NOC codes.

AMPDS NOC Types

Question	Answer (NOC type)	Code
What is the Nature of Call?	Choking	CHOM
	Dangerous Haemorrhage	DAHM
	Drowning	DROM
	Fitting now	FINM
	Hanging	HANM
	HCP/IFT C1	HI1M
	Ineffective Breathing	INBM
	Major Trauma	MATM
	Maternity Complications	MACM
	Medical (unconscious)	MEUM
	Severe Allergic Reaction	SARM
	Trauma (unconscious)	TRUM

This is an example of the Nature of Call questionnaire.

NHS Pathways NOC Types

Question	Answer (NOC type)	Code
What is the Nature of Call?	Anaphylaxis	ANAP
	Arrest/Peri Arrest (Cat1)	AP1P
	Asthma (life threatening)	ALTP
	Choking	CHOP
	Drowning	DROP
	Fitting Now	FINP
	Hanging	HANP
	HCP/IFT C1	HI1P
	Obstetric Emergency	OBEP
	Under 5 Severe Haemorrhage	5SHP
	Under 16 unconscious	16UP
	Unconscious pregnant >20 weeks	UNPP

This is an example of the Nature of Call questionnaire.

Condition

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 Condition resource is used to transfer the Presenting complaint. This is also referred to as:

The Reason for Call (text)
What's the problem? (text)

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.

Procedure

This resource is used to record the details of current and historical procedures performed on or for a patient. A procedure is an activity that is performed on, with, or for a patient as part of the provision of care.

The Procedure resource is used to communicate that Cardio Pulmonary Resuscitation by a bystander is being undertaken, and when it started.

Task

The Task is used to direct the next action(s) required by the Sender making the referral, when the assessment has been undertaken without using NHS Pathways or AMPDS CDSS. 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 time-frame, using Task.code and Task.restriction.period.

Communication

The Communication resource is a conveyance of information from a sender to a receiver. The information can include encoded data, text and optionally a related Patient and a related Encounter.

In this application it is used to transfer Call Log information and Crew Notes.

Referral Cancellation Payload

The ability to cancel a referral is a core workflow in BaRS. For details on the use of the standard pattern for cancellation please see the following Standard Patterns - Cancellation.

Payloads for Responses

Referral Response Payload (Status update)

This section provides guidance on the use of key resources, for the Receiver to create a Referral Response (Status update) to return to the Sender. See ServiceRequest - Response message definition for details of resources required for this payload.

Note that Receivers will also have to build the capability to receive and process the Referral Request and Cancellation payloads

For Referral Response example bundles see:

Referral Response - CAD to CAD Out of area
Referral Response - CAD to CAD Mutual Aid request rejection
For additional example bundles please check BaRS Example Bundles

MessageHeader Resource

For detailed information on the use of MessageHeader please refer to the Standard Pattern - Message Header.

The MessageHeader resource in the Referral Response should have the following resource elements set as follows:

MessageHeader.eventCoding - must be populated with 'servicerequest-response'
MessageHeader.reasonCode - must be 'new'
MessageHeader.focus - must reference the Responder's current Encounter FHIR resource
MessageHeader.definition - must adhere to Referral Response Message definition.
MessgeHeader.Response - must be the original request BundleID

ServiceRequest Resource

The ServiceRequest reflects that sent by the Requester, and maintains the active state of the referral. The ServiceRequest.status at this point would stay as 'active'.

There are two coding entries within ServiceRequest.category which are key to driving workflow:

Denotes the type of referral e.g. Transfer of care
Denotes the use case and must be populated with the relevant use case from use-case CodeSystem e.g. Out of area, Mutual Aid or Call Assist. Please refer to the guidance in use-case categories

Encounter Resource

The Responder's current Encounter is the focus resource in the Referral Response. This was originally the 'planned' Encounter created by the Receiver in the synchronous response to the Referral Request.

This Encounter is used to represent the interaction between the patient and the Receiver healthcare service provider.

When sending an Referral Response the Receiver must:

Include the Receiver's current Encounter as the focus resource of the Referral Response
Include the current Encounter.status on the Receiver's current Encounter. This is to indicate to the Sender the progress of the case.

Referral Response Payload (Reject referral)

This section provides guidance on the use of key resources, for the Receiver to create an Referral Response (Status update) to return to the Sender in order to reject a Mutual Aid Request or Call Assist Request. See ServiceRequest - Response message definition for details of resources required for this payload.

This follows the payload for the Referral Response (Status Update) with minor changes to the guidance for the Encounter Resource:

Encounter Resource

When sending an Referral Response the Receiver must:

Include the Receiver's current Encounter as the focus resource of the Referral Response
Include the current Encounter.status on the Receiver's current Encounter. This is to indicate to the Sender where a Call Assist or Mutual Aid request has been rejected.
Encounter.reasonCode to be included on the Receiver's current Encounter to provide the reason for rejection.

Important: The sections below show elements in key resources that extend UK Core. Where no table is present, the basic UK Core resource is used unaltered.

Referral Payload

Payload for requesting a referral, using Service Request

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

Please expand each resource below to view implementation guidance.

> Bundle

The Bundle resource is the container for the event message

BARSBundleMessage (Bundle)

https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle

type

Fixed Value

There are no (further) constraints on this element

Element id

Bundle.type

Fixed value

message

timestamp

1..

There are no (further) constraints on this element

Element id

Bundle.timestamp

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Bundle	The Bundle resource is the container for the event message 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.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.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	1..1	2023-03-08T12:01:08.4677672+00:00
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	0..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.

BARSMessageHeaderServiceRequestRequest (MessageHeader)		https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader	There are no (further) constraints on this element Data type https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader
event[x]			There are no (further) constraints on this element
system	1..		There are no (further) constraints on this element Element id MessageHeader.event[x].system
code	1..		There are no (further) constraints on this element Element id MessageHeader.event[x].code
destination	1..		There are no (further) constraints on this element Element id MessageHeader.destination
receiver			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.destination.receiver.reference
sender			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.sender.reference
identifier			There are no (further) constraints on this element
assigner			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.sender.identifier.assigner.reference
source			There are no (further) constraints on this element
extension	0..		There are no (further) constraints on this element Element id MessageHeader.source.extension Slicing Unordered, Open, by url(Value)
myExtension	0..	Extension(Complex)	There are no (further) constraints on this element Element id MessageHeader.source.extension:myExtension Data type Extension(Complex) Extension URL https://fhir.nhs.uk/StructureDefinition/CDSSExtension
endpoint			There are no (further) constraints on this element Element id MessageHeader.source.endpoint Comments The uri of the Requester’s endpoint
reason	1..		There are no (further) constraints on this element Element id MessageHeader.reason
coding			There are no (further) constraints on this element
system		Fixed Value	There are no (further) constraints on this element Element id MessageHeader.reason.coding.system Fixed value https://fhir.nhs.uk/CodeSystem/message-reason-bars
focus			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.focus.reference

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
MessageHeader	A resource that describes the BaRS message being exchanged between two systems 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	2023-03-08T12:01:08.4677672+00:00
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	https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-request
MessageHeader.extension	This SHOULD be populated with details of the Clinical Decision Support System used	SHOULD	0..*
MessageHeader.extension.url	This SHOULD 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 SHOULD be populated with the pre-defined Clinical Decision Support System software URL - FIXED VALUE	SHOULD	1..1	requesterCDSSSoftware
MessageHeader.extension.extension.valueString	This SHOULD 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 SHOULD be populated with the pre-defined Clinical Decision Support System software Version URL - FIXED VALUE	SHOULD	1..1	requesterCDSSVersion
MessageHeader.extension.extension.valueString	This SHOULD 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. 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

A resource to carry a request for a service to be performed and the associated use case. This Resource is the focus of the BaRS Referral Request interaction

BARSServiceRequestRequestReferral (ServiceRequest)		https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest	There are no (further) constraints on this element Data type https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest
intent		Fixed Value	There are no (further) constraints on this element Element id ServiceRequest.intent Fixed value plan
category	1..1		There are no (further) constraints on this element Element id ServiceRequest.category
subject		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient)	There are no (further) constraints on this element Element id ServiceRequest.subject Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient)
occurrence[x]			There are no (further) constraints on this element Element id ServiceRequest.occurrence[x]
occurrencePeriod		Period	There are no (further) constraints on this element Data type Period
authoredOn	1..		There are no (further) constraints on this element Element id ServiceRequest.authoredOn Comments DateTime the Referral Request was generated
performer			There are no (further) constraints on this element Element id ServiceRequest.performer Comments Referral To

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
ServiceRequest	https://simplifier.net/nhsbookingandreferrals/barsservicerequest-request-referral		1..1
ServiceRequest.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
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 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
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	Only use the following 3 values: active, revoked is used when a SR is cancelled, entered-in-error is used when sent to the wrong endpoint and need 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	BaRS Referral Type	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 'referral' FIXED VALUE	MUST	0..1	referral
ServiceRequest.category.coding.display	This MUST be populated with 'Transfer of Care'	MUST	0..1	Transfer of Care
ServiceRequest.category.coding	BaRS 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	A6T1
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	CAD to CAD Out of Area Referral
ServiceRequest.category.text	This should be populated with any details about the service request. This MUST be populated when the ServiceRequest.category.coding.code is populated with 'A6T2' or 'A6T3'	SHOULD	0..1	Please can you spare a Paramedic closer than 20 mins?
ServiceRequest.subject	Follow BaRS profile guidance for populating this element	MUST	1..1
ServiceRequest.subjectreference	This MUST be populated with a Reference to the Patient resource	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	MUST	0..1	urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
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	0..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	This MUST be populated with the Healthcare service that the Service request is going to	MUST	0..*
ServiceRequest.performer.reference	This MUST be populated Reference to HealthcareService resource	MUST	0..1	urn:uuid:8c63d621-2344-4f57-8699-e8e22d44235h
ServiceRequest.locationReference		MUST	0..*
ServiceRequest.locationReference.reference	This MUST link to the Incident Location resource	MUST	0..1	urn:uuid:8c63d621-4g67-4f57-8699-e8e22d44234i
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 JourneyID which is unchanged throughout the patient’s Journey.
For an incident with multiple patients, each patient would have its own encounter

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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 JourneyID which is unchanged throughout the patient’s Journey. For an incident with multiple patients, each patient would have its own encounter https://simplifier.net/hl7fhirukcorer4/ukcore-encounter		1..1
Encounter.id	MUST only be generated by the originating system of the encounter as the id for the resource in the original HTTP request. It MUST be echoed back when returning an encounter. Subsequent new Encounters will be generated by the originating system of that encounter.	MUST	0..1	236bb75d-90ef-461f-b71e-fde7f899802c
Encounter.meta	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.status	The current state of the sender's encounter (case) This MUST be populated with 'in-progress' when the (telephone) call is in progress This MUST be populated with 'triaged' when the (telephone) call is ended This MUST be populated with 'finished' when the case is closed on the CAD	MUST	1..1	in-progress
Encounter.statusHistory	List of past encounter statuses used for recording BT StartTime, T0 (Call Connect) and T1 (Call Answer)	MUST	0..*
Encounter.statusHistory.status	This MUST be populated with 'planned' when recording the BT StartTime This MUST be populated with 'arrived' when recording T0 Call Connect time This MUST be populated with 'in-progress' when recording T1 Call answer time	MUST	1..1	planned
Encounter.statusHistory.period	BT StartTime, T0 (Call Connect) and T1 (Call Answer) times
Encounter.statusHistory.period.start	This MUST be populated with the BT StartTime when the Encounter.status.history.status is 'planned' This MUST be populated with the T0 (Call Connect) time when the Encounter.status.history.status is 'arrived' This MUST be populated with the T1 (Call Answer) time when the Encounter.status.history.status is 'in-progress'	MUST	1..1	2023-03-08T12:01:08.4677672+00:00
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 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 JourneyID 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		MUST	0..1
Encounter.period.start	This MUST be populated with the Encounter start time.	MUST	0..1	2023-03-08T12:01:08.4677672+00:00
Encounter.location		MUST	0..*
Encounter.location.location	This MUST be populated with a Reference to the Incident Location Resource	MUST	1..1	9589fb37-87a2-48d8-968f-b371429208UK
Encounter.location.status	When the Incident Location is provisional this MUST NOT be populated When the Incident Location is confirmed this MUST be populated with 'Active'	SHOULD	0..1	active
Encounter.location.period.start	This SHOULD be populated with the time that the Incident Location status was Confirmed (T2)	SHOULD	0..1	2023-03-08T12:01:38.4677677+00:00

> CarePlan

In the Referral Request message the CarePlan resource is used to communicate triage outcome information and associated clinical information.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
CarePlan	In the Referral message the CarePlan resource is used to communicate triage outcome information and associated clinical information. 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	This MUST be populated. Follow UK Core guidance for populating this element	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 ‘active’	MUST	1..1	Active
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 resource	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	Clock start date/Time. This MUST be populated with the Clock start date/Time Definition as per AmbSys specification	MUST	0..1	2023-03-08T12:01:08.4677672+00:00
CarePlan.addresses	Reference to the Condition - Presenting Complaint (Reason for Call)	SHOULD	0..*	urn:uuid:7aa5814d-d71f-4c9a-a956-03d89f25aae4
CarePlan.activity	Action to occur as part of the plan	MUST	0..*
CarePlan.activity.outcomeCodeableConcept		MUST	0..*
CarePlan.activity.outcomeCodeableConcept.text	This SHOULD be populated with the clinical narrative.	SHOULD	0..1	CONSULTATION SUMMARY PRINTED ON 30/03/2022 16:57:48 CASE ID: 91bcfff6-5220-48c4-8861-3bf6e69e8748 NHS PATHWAYS R25.2.1 PATIENT: Julie Jones TELEPHONE: AGE GROUP: Adult GENDER: Female PARTY: 1 POSTCODE: DH1 2HP NOTES: SKILLSET: PaCCS CLINICIAN USER ID: julie.harris@nhs.net PATHWAY: PW1848 - PaCCS Ambulance Dispatch SYMPTOM GROUP: SG1137 - Palpitations SYMPTOM DISCRIMINATOR: SD4118 - AMB ambulance dispatch DISPOSITION: Dx016 - Non-emergency Ambulance Response (Category 4) SELECTED CARE SERVICE: No care service selected CONSULTATION SUMMARY: Palpitations Non-emergency ambulance response Someone staying with individual No indication scene unsafe [...]
CarePlan.activity.outcomeCodeableConcept.coding		SHOULD	0..1
CarePlan.activity.outcomeCodeableConcept.coding.system	* Pathways Symptom Group (SG) code MUST use ‘https://fhir.nhs.uk/Id/pathways-sg-code’ value * Pathways Symptom Discriminator (SD) code MUST use ‘https://fhir.nhs.uk/Id/pathways-sd-code’ value * Pathways Disposition (DX) code MUST use ‘https://fhir.nhs.uk/Id/pathways-dx-code’ value * Ambulance Response Programme (ARP) code MUST use ‘https://fhir.nhs.uk/Id/pathways-arp-code’ value * AMPDS Dispatch Code MUST use ‘https://fhir.nhs.uk/Id/ampds-code’ value	SHOULD	0..1	https://fhir.nhs.uk/CodeSystem/sd-codes
CarePlan.activity.outcomeCodeableConcept.coding.code	When you are passing an SG code this MUST be populated with the SG code When you are passing an SD code this MUST be populated with the SG code When you are passing an Dx code this MUST be populated with the Dx code When you are passing an ARP code this MUST be populated with the ARP code When you are passing an AMPDS dispatch code this MUST be populated with the AMPDS dispatch code	SHOULD	0..1	SD4033
CarePlan.activity.outcomeCodeableConcept.coding.display	When you are passing an SG code this MUST be populated the SG code description When you are passing an SD code this MUST be populated the SD code description When you are passing an Dx code this MUST be populated the Dx code description When you are passing an ARP code this MUST be populated the ARP code description When you are passing an AMPDS dispatch code this MUST be populated the AMPDS dispatch code description	SHOULD	0..1	AMB new/worsening breathlessness
CarePlan.activity.reference	This COULD 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. This MUST be populated when a non NHS Pathways or AMPDS supported triage outcome is being communicated	COULD	0..1
CarePlan.activity.reference.reference	This COULD reference a Task resource indicating an instruction to the Receiver	COULD	0..1	urn:uuid:6bd421cf-e43f-4470-b12d-b592f82c4bfe
CarePlan.author		SHOULD	0..1
CarePlan.author.reference	When the information in a CarePlan has been completed by a clinician then the author SHOULD be populated with the reference to the PractitionerRole	SHOULD	0..1	9589fb37-87a2-48d8-968f-b371429208a9

> Patient

his 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.

Command 'tree' could not render: Resource was not found for 'canonical=https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient'

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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. https://simplifier.net/hl7fhirukcorer4/ukcore-patient		1..1
Patient.id	It also includes contact information for third parties when required.	MUST	0..1	9589fb37-87a2-48d8-968f-b371429208a8
Patient.meta	https://simplifier.net/hl7fhirukcorer4/ukcore-patient	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	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	This is a human readable patient identifier. This MUST be populated with the NHS number when available. Additionally a Local Patient Identifier Should be populated where available. If no NHS number is available this Should be populated with the Local 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	https://simplifier.net/hl7fhirukcorer4/extensionukcorenhsnumberverificationstatus	SHOULD	0..1	https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept.coding.code	Follow UK Core guidance for populating this element	SHOULD	0..1	number-present-and-verified
Patient.identifier.extension.valueCodeableConcept.coding.display	Follow UK Core guidance for populating this element	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	Follow UK Core guidance for populating this element	SHOULD	0..*
Patient.address.use	Follow UK Core guidance for populating this element	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 should 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-ContactPreference
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://simplifier.net/hl7fhirukcorer4/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	http://terminology.hl7.org/CodeSystem/v2-0131
Patient.contact.relationship.coding.code	This MUST be populated with Code of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.	MUST	0..1	EP
Patient.contact.relationship.coding.display	This MUST be populated with Display of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/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.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	1..1	https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory
Patient.extension.valueCodeableConcept		SHOULD	0..1
Patient.extension.valueCodeableConcept.coding		SHOULD	0..*
Patient.extension.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.valueCodeableConcept.coding.code	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	A
Patient.extension.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 transfer the Presenting Complaint, also known as 'The reason for call' or 'What's the problem' text.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Condition	This resource is used to communicate details about the problem or issue of the referral. 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	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition
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
Condition.clinicalStatus.coding.code	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	active
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	SHOULD	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.coding.system	This COULD be populated with http://snomed.info/sct	COULD	0..1	http://snomed.info/sct
Condition.code.coding.code	This COULD be populated with the Code (SNOMED) of the class of problem or issue	COULD	0..1	16932000
Condition.code.coding.display	This COULD be populated with the human readable Display (SNOMED) of the problem or issue	COULD	0..1	Nausea and vomiting (disorder)
Condition.code.text	When passing the Reason for Call this SHOULD be populated with the free text description of the Reason for call	SHOULD	0..1	Nausea and 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

> Task

This resource is used to communicate details about Task/s (activities) that the Sender is requesting of the Receiver. For use when the initial assessment is undertaken without a CDDS.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Task	This resource is used to communicate details about Task/s (activities) that the Sender is requesting of the Receiver. For use when the initial assessment is undertaken without a CDDS. https://simplifier.net/HL7FHIRUKCoreR4/UKCore-Task		0..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	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Task
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 'plan' - Fixed Value	MUST	1..1	plan
Task.code	This MUST be populated with the action (by the specific Ambulance 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 COULD be populated with CodeSystem - http://snomed.info/sct	COULD	0..1	http://snomed.info/sct
Task.code.coding.code	This COULD be populated with the Code (SNOMED) of the task	COULD	0..1	715537001
Task.code.coding.display	This COULD be populated with the human readable Display (SNOMED) of the task	COULD	0..1	Transportation by ambulance
Task.description	This SHOULD be populated with a plain text representation of the task	SHOULD	0..1	Patient requires transport by ambulance
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.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Organization	This resource is used to communicate details about the sender and receiver organisations. 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 MUST be populated with an organisation identifier e.g. ODS code	MUST	0..*
Organization.identifier.system	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	https://fhir.nhs.uk/id/ods-organization-code
Organization.identifier.value	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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 request.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Practitioner	This is used to carry details of the healthcare professional making the request. 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	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 MUST be populated. Follow UK Core guidance for populating this element	MUST	0..*
Practitioner.identifier.system	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	https://fhir.nhs.uk/Id/sds-role-profile-id
Practitioner.identifier.value	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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 request. Note this may be the call handler.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
PractitionerRole	This is used to carry the role of the practitioner making the request. Note this may be the call handler. 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		MUST	0..1
PractitionerRole.practitioner.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
PractitionerRole.Organization		MUST	0..1
PractitionerRole.Organization.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb51
PractitionerRole.code		SHOULD	0..*
PractitionerRole.code.coding	This SHOULD be populated with the role that the practitioner is performing	SHOULD	0..1
PractitionerRole.code.coding.system	This SHOULD be populated with the CodeSystem from the ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'	SHOULD	0..1	https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode
PractitionerRole.code.coding.code	This SHOULD 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 SHOULD be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.	SHOULD	0..1	Administrative healthcare staff

> Flag

The Flag resource is used communicate to risks, alerts and special patient requirements e.g. additional patient information, reasonable adjustments, and safeguarding concerns . It can also be used to carry if an external agency has been contacted

NOTE: Use The 'Flag (Scene Safety)' resource to carry Scene Safety Information

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Flag	The Flag resource is used communicate to risks, alerts and special patient requirements e.g. additional patient information, reasonable adjustments, and safeguarding concerns . It can also be used to carry if an external agency has been contacted NOTE: Use The 'Flag (Scene Safety)' resource to carry Scene Safety Information https://simplifier.net/hl7fhirukcorer4/ukcore-flag		0..*
Flag.id	Use	MUST	0..1	77be46e3-7f01-4afe-b37d-7a301db6df63
Flag.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	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
Flag.encounter		MUST	0..1
Flag.encounter.reference	This MUST be a reference to the encounter in which the Flag was identified	MUST	0..1

> Flag (Scene Safety)

The Flag resource is used to communicate information about Scene safety risks.

BARSFlagSceneSafety (Flag)		http://hl7.org/fhir/StructureDefinition/Flag	There are no (further) constraints on this element Data type http://hl7.org/fhir/StructureDefinition/Flag
identifier			There are no (further) constraints on this element
assigner		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)	There are no (further) constraints on this element Element id Flag.identifier.assigner Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)
category	1..1		There are no (further) constraints on this element Element id Flag.category
coding			There are no (further) constraints on this element
system	1..	Fixed Value	There are no (further) constraints on this element Element id Flag.category.coding.system Fixed value https://fhir.nhs.uk/CodeSystem/flag-categories-bars
code	1..	Fixed Value	There are no (further) constraints on this element Element id Flag.category.coding.code Fixed value SS
code			There are no (further) constraints on this element
coding			There are no (further) constraints on this element
system	1..	Fixed Value	There are no (further) constraints on this element Element id Flag.code.coding.system Fixed value https://fhir.nhs.uk/CodeSystem/scene-safety-codes-bars
subject		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location)	There are no (further) constraints on this element Element id Flag.subject Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location)
identifier			There are no (further) constraints on this element
assigner		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)	There are no (further) constraints on this element Element id Flag.subject.identifier.assigner Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)
encounter		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter)	There are no (further) constraints on this element Element id Flag.encounter Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter)
identifier			There are no (further) constraints on this element
assigner		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)	There are no (further) constraints on this element Element id Flag.encounter.identifier.assigner Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)
author		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole)	There are no (further) constraints on this element Element id Flag.author Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner \| https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole)
identifier			There are no (further) constraints on this element
assigner		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)	There are no (further) constraints on this element Element id Flag.author.identifier.assigner Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization)

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Flag (Scene Safety)	The Flag resource is used to communicate information about Scene safety risks. https://simplifier.net/nhsbookingandreferrals/barsflag-scenesafety		1..*
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	MUST	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	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 populated with Scene Safety category	MUST	1..1
Flag.category.coding	Follow UK Core guidance for populating this element	MUST	1..1
Flag.category.coding.system	This is populated with the Flag Category: Scene Safety	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	SS
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	Scene Safety
Flag.code		MUST	1..1
Flag.code.coding	Follow UK Core guidance for populating this element	MUST	1..1
Flag.code.coding.system	This MUST be populated with the scene safety code - https://simplifier.net/nhsbookingandreferrals/scene-safety-codes-bars	MUST	0..1	https://fhir.nhs.uk/CodeSystem/scene-safety-codes-bars
Flag.code.coding.code	This MUST be populated with the relevant Code from the selected Flag code CodeSystem	MUST	0..1	U
Flag.code.coding.display	This MUST be populated with the Display text from the Flag code CodeSystem	MUST	0..1	The Scene is unsafe
Flag.code.text	This SHOULD be populated with a free text description of the scene safety. This MUST be populated with a free text description of why the scene in unsafe when the Flag.code.coding.code is populated with 'U'	SHOULD	0..1	Intoxicated patient
Flag.subject		MUST	1..1
Flag.subject.reference	Where the flag relates to the patient (e.g. reasonable adjustments) this will reference the Patient resource Where the flag references a location (e.g. Scene Safety) this will reference the Location resource representing the incident location	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
Flag.encounter		MUST	0..1
Flag.encounter.reference	This MUST be a reference to the encounter in which the Flag was identified	MUST	0..1	urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c

> 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.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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. https://simplifier.net/hl7fhirukcorer4/ukcore-medicationstatement		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.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Observation	This resource can be used to communicate measurements and simple assertions made about a patient. 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		MUST	0..1
Observation.encounter.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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 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

This resource represents the healthcare service provider of the receiver.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
HealthcareService	This resource represents the healthcare service provider of the receiver. https://simplifier.net/hl7fhirukcorer4/ukcore-healthcareservice		1..1
HealthcareService.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
HealthcareService.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService
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 can be represented by a UEC DoS Service Identifier or other locally agreed 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		MUST	0..1
HealthcareService.providedBy.reference	Link to the Organisation the request is being made of. This will commonly link to the MessageHeader.destination	MUST	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
HealthcareService.location		SHOULD	0..*
HealthcareService.location.reference	Follow UK Core guidance for populating this element	SHOULD	0..1	urn:uuid:860e4c37-4e36-45fb-8fca-41132cd937a5

> Incident Location

This resource MUST be used to record the incident location details.

Whilst the cardinality of each element is 0..1 at least one property or non-property location element should be populated.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Incident Location	This resource MUST be used to record the incident location details. Whilst the cardinality of each element is 0..1 at least one property or non-property location element should be populated. https://simplifier.net/hl7fhirukcorer4/ukcore-location	MUST	0..1
Location.id	This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.	MUST	0..1	80fc9139-473f-4664-ba86-c129ec1c0db9
Location.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
Location.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location
Location.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
Location.extension		SHOULD	0..1
Location.extension.url	https://fhir.nhs.uk/StructureDefinition/LocationExtension	MUST	1..1	https://fhir.nhs.uk/StructureDefinition/LocationExtension
Location.extension.extension		MUST	1..*
Location.extension.extension.url	When passing an UPRN code this MUST be populated with UPRN When passing a PAF key this MUST be populated with PAF When passing an Eastings co-ordinate code this MUST be populated with Eastings When passing a Northings co-ordinate code this MUST be populated with Northings When passing a what3words address this MUST be populated with what3words When passing a Location Accuracy this MUST be populated with the accuracy %.	MUST	1..1	UPRN
Location.extension.extension.valueString	When you are passing an UPRN this MUST be populated with the UPRN code for the incident location When you are passing a PAF key this MUST be populated with the PAF key value for the incident location When you are passing an Eastings co-ordinate this MUST be populated with the Eastings co-ordinate value for the incident location When you are passing a Northings co-ordinate this MUST be populated with Northings co-ordinate value for the incident location When you are passing a what3words address this MUST be populated with the what3words address for the incident location When you are passing the Location Accuracy this MUST be populated with the accuracy of the incident location	MUST	0..1	8755622
Location.name	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Briggate corner
Location.address		SHOULD	0..1
Location.address.line	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	20 The Headrow
Location.address.city	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Leeds
Location.address.postalCode	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	LS1 6PT
Location.address.country	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	UK
Location.position		SHOULD	0..1
Location.position.longitude	This is the Longitude, with WGS84 datum, of the incident location.	MUST	1..1	53.79957988
Location.position.latitude	This is the Latitude, with WGS84 datum, of the incident location.	MUST	1..1	-1.541754401
Location.position.altitude	This is the Altitude, with WGS84 datum, of the incident location.	MAY	0..1	11.123345345
Location.type.coding		MUST	1..1
Location.type.coding.system	This MUST be populated with https://fhir.nhs.uk/CodeSystem/location-types-bars	MUST	1..1	https://fhir.nhs.uk/CodeSystem/location-types-bars
Location.type.coding.code	This MUST be populated with 'ILOC' - FIXED VALUE	MUST	1..1	ILOC
Location.type.coding.display	This MUST be populated with 'Incident Location' - FIXED VALUE	MUST	0..1	Incident Location

> Location

This resource SHOULD be used to record details of locations that are NOT the incident location.

Whilst the cardinality of each element is 0..1 at least one property or non-property location element should be populated.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Location	This resource SHOULD be used to record details of locations that are NOT the incident location. Whilst the cardinality of each element is 0..1 at least one property or non-property location element should be populated. https://simplifier.net/hl7fhirukcorer4/ukcore-location	SHOULD	0..*
Location.id	This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.	MUST	0..1	80fc9139-473f-4664-ba86-c129ec1c0db9
Location.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
Location.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location
Location.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
Location.extension		SHOULD	0..1
Location.extension.url	https://fhir.nhs.uk/StructureDefinition/LocationExtension	MUST	1..1	https://fhir.nhs.uk/StructureDefinition/LocationExtension
Location.extension.extension		MUST	1..*
Location.extension.extension.url	When passing an UPRN code this MUST be populated with UPRN When passing a PAF key this MUST be populated with PAF When passing an Eastings co-ordinate code this MUST be populated with Eastings When passing a Northings co-ordinate code this MUST be populated with Northings When passing a what3words address this MUST be populated with what3words When passing a Location Accuracy this MUST be populated with the accuracy %.	MUST	1..1	UPRN
Location.extension.extension.valueString	When you are passing an UPRN this MUST be populated with the UPRN code for the location When you are passing a PAF key this MUST be populated with the PAF key value for the location When you are passing an Eastings co-ordinate this MUST be populated with the Eastings co-ordinate value for the location When you are passing a Northings co-ordinate this MUST be populated with Northings co-ordinate value for the location When you are passing a what3words address this MUST be populated with the what3words address for the location When you are passing the Location Accuracy this MUST be populated with the accuracy of the location	MUST	0..1	8755622
Location.name	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Briggate corner
Location.address		SHOULD	0..1
Location.address.line	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	20 The Headrow
Location.address.city	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Leeds
Location.address.postalCode	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	LS1 6PT
Location.address.country	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	UK
Location.position		SHOULD	0..1
Location.position.longitude	This is the Longitude, with WGS84 datum, of the incident location.	MUST	1..1	53.79957988
Location.position.latitude	This is the Latitude, with WGS84 datum, of the incident location.	MUST	1..1	-1.541754401
Location.position.altitude	This is the Altitude, with WGS84 datum, of the incident location.	MAY	0..1	11.123345345
Location.type.coding		SHOULD	0..*
Location.type.coding.system	This MUST be populated with https://fhir.nhs.uk/CodeSystem/location-types-bars	MUST	0..1	https://fhir.nhs.uk/CodeSystem/location-types-bars
Location.type.coding.code	This MUST be populated with the relevant Code from the selected Location Type CodeSystem	MUST	0..1	RLOC
Location.type.coding.display	This MUST be populated with the Display text from the Location Type CodeSystem	MUST	0..1	Rendezvous Location
Location.type.text	This SHOULD be populated with a free text Location Type where Location.type.coding.code = OLOC	SHOULD		Assembly Location

> AllergyIntolerance

This resource MAY be used to carry new Allergies confirmed at the senders encounter. This SHOULD NOT be used to carry Allergy History obtained from external sources.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
AllergyIntolerance	This resource MAY be used to carry new Allergies confirmed at the senders encounter. This SHOULD NOT be used to carry Allergy History obtained from external sources. https://simplifier.net/hl7fhirukcorer4/ukcore-allergyintolerance		0..*
AllergyIntolerance.id	This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.	MUST	0..1	12d61f8e-2239-4c56-add1-483d0b43559a
AllergyIntolerance.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
AllergyIntolerance.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.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
AllergyIntolerance.clinicalStatus		SHOULD	0..1
AllergyIntolerance.clinicalStatus.coding		MUST	1..1
AllergyIntolerance.clinicalStatus.coding.system	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus.coding.code	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	active
AllergyIntolerance.clinicalStatus.coding.display	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Active
AllergyIntolerance.verificationStatus		SHOULD	0..1
AllergyIntolerance.verificationStatus.coding		MUST	1..1
AllergyIntolerance.verificationStatus.coding.system	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus.coding.code	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	confirmed
AllergyIntolerance.verificationStatus.coding.display	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	Confirmed
AllergyIntolerance.type	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	allergy
AllergyIntolerance.category	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..*	medication
AllergyIntolerance.category.code		MUST	1..1
AllergyIntolerance.category.code.coding		MUST	1..1
AllergyIntolerance.category.code.coding.system	Follow UK Core guidance for populating this element	SHOULD	0..1	http://snomed.info.sct
AllergyIntolerance.category.code.coding.code	Follow UK Core guidance for populating this element	SHOULD	0..1	372687004
AllergyIntolerance.category.code.coding.display	Follow UK Core guidance for populating this element	SHOULD	0..1	Amoxicillin
AllergyIntolerance.patient		MUST	1..1
AllergyIntolerance.patient.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
AllergyIntolerance.encounter		SHOULD	0..1
AllergyIntolerance.encounter.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
AllergyIntolerance.recordedDate	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	2023-03-08T12:01:08.4677672+00:00
AllergyIntolerance.recorder		SHOULD	0..1
AllergyIntolerance.recorder.reference	Follow UK Core guidance for populating this element	MUST	1..1	urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
AllergyIntolerance.asserter		SHOULD	0..1
AllergyIntolerance.asserter.reference	Follow UK Core guidance for populating this element	MUST	1..1	Practitioner/UKCore-Practitioner-ConsultantSandraGose-Example
AllergyIntolerance.reaction		SHOULD	0..1
AllergyIntolerance.reaction.manifestation		MUST	1..*
AllergyIntolerance.reaction.manifestation.coding		MUST	1..1
AllergyIntolerance.reaction.manifestation.coding.system	Follow UK Core guidance for populating this element	SHOULD	0..1	http://snomed.info.sct
AllergyIntolerance.reaction.manifestation.coding.code	Follow UK Core guidance for populating this element	SHOULD	0..1	247472004
AllergyIntolerance.reaction.manifestation.coding.display	Follow UK Core guidance for populating this element	SHOULD	0..1	Urticarial rash
AllergyIntolerance.reaction.severity	Follow UK Core guidance for populating this element	SHOULD	0..1	mild

> Questionnaire

This resource is used to communicate the Pre Triage Sieve and Nature of Call Questions

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Questionnaire	This resource is used to communicate the Pre Triage Sieve and Nature of Call Questions		0..*
Questionnaire.id	This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.	MUST	0..1	65508934-c9e6-46d2-a393-af096b502daf
Questionnaire.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
Questionnaire.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Questionnaire
Questionnaire.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
Questionnaire.identifier	The Questionnaire SHOULD have an Identifier for reference	SHOULD	0..*
Questionnaire.identifier.value	If an Identifier is included in the resource it MUST have a value assigned	MUST	0..*	76b4622b-2b8b-4f24-aee5-2631c7695594
Questionnaire.version	This SHOULD be populated with a version for the Questionnaire to assist later reference, should the questions change	SHOULD	0..1	0.1
Questionnaire.name	This MUST be populated to allow for internal reference and display at the Receiving service	MUST	0..1	PTS
Questionnaire.title	This MUST be populated to allow for internal reference and display at the Receiving service	MUST	0..1	Pre Triage Sieve Questionnaire
Questionnaire.status	This MUST be populated and set to 'active' - FIXED value	MUST	1..1	active
Questionnaire.date	This MUST be populated with the date the Questionnaire was last revised	MUST	0..1	2023-12-19T14:00:00+00:00
Questionnaire.publisher	This MUST be populated with the name of the organisation who generated the Questionnaire	MUST	0..1	NHSE - BaRS
Questionnaire.description	This SHOULD be populated with a human readable description of what the questionnaire aims to support	SHOULD	0..1	PTS Questionnaire for CAD-to-CAD
Questionnaire.item	Items in the Questionnaire related to the questions which may be one or many in number	MUST	0..*
Questionnaire.item.linkId	This MUST be populated with the unique reference for the question. This is important because it is referenced in the QuestionnaireResponse, providing a link between the two resources	MUST	1..1	1
Questionnaire.item.text	This MUST be populated with the question text	MUST	0..1	Is the patient awake (conscious)?"
Questionnaire.item.type	This MUST be populated indicating the type of question being proposed which has implications for possible answers	MUST	1..1	choice
Questionnaire.item.enabledWhen	This MAY be populated and dictates the condition when a question displays based on previous answers	MAY	0..*
Questionnaire.item.enabledWhen.question	If enabledWhen is included, the related question, prompting this question to display, MUST be stipulated	MUST	1..1	0
Questionnaire.item.enabledWhen.operator	The condition of display, for example whether an answer equals a certain value, MUST also be included	MUST	1..1	=
Questionnaire.item.enabledWhen.answerCoding	The MUST be populated with the specific answer to the question which prompts this question to display	MUST	1..1
Questionnaire.item.enabledWhen.answerCoding.code	This MUST be populated with Code of the defined valueSet in the corresponding Questionnaire answer	MUST	0..1	78064003
Questionnaire.item.enabledWhen.answerCoding.display	This MUST be populated with Display of the defined valueSet in the corresponding Questionnaire answer	MUST	0..1	Breathing (observable entity)
Questionnaire.item.required	This MUST be populated to ensure the answer to the question is included in results	MUST	0..1	true
Questionnaire.item.answerOption	This MUST be populated and as a containing array for the available options for selection for the question being defined.	MUST	0..1
Questionnaire.item.answerOption.valueCoding	This MUST be populated to contain the coded values for the array. In BaRS defined Questionnaire, only valueCoding is support for this Application	MUST	0..1
Questionnaire.item.answerOption.valueCoding.system	This SHOULD be populated with CodeSystem - http://snomed.info/sct	SHOULD	0..1	http://snomed.info/sct
Questionnaire.item.answerOption.valueCoding.code	This MUST be populated with the Code of the optional value	MUST	0..1	428913001
Questionnaire.item.answerOption.valueCoding.display	This SHOULD be populated with the human readable Display of the optional value	SHOULD	0..1	No loss of consciousness (situation)

> QuestionnaireResponse

This resource is used to communicate the Pre Triage Sieve and Nature of Call Responses

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
QuestionnaireResponse	This resource is used to communicate the Pre Triage Sieve and Nature of Call Responses		0..*
QuestionnaireResponse.id	This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.	MUST	0..1	65508934-c9e6-46d2-a393-af096b502daf
QuestionnaireResponse.id.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
QuestionnaireResponse.id.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse
QuestionnaireResponse.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
QuestionnaireResponse.extension		MUST	0..*
QuestionnaireResponse.extension.url	This MUST be populated with Structure Definition 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-reason' - FIXED VALUE	MUST	1..1	http://hl7.org/fhir/StructureDefinition/questionnaireresponse-reason
QuestionnaireResponse.extension.valueCodeableConcept		MUST	0..*
QuestionnaireResponse.extension.valueCodeableConcept.text	This SHOULD be populated with the name of the questionnaire responses contained within. For the Nature-of-call response this MUST be set to 'Nature of Call (NOC)'	SHOULD	0..1	Pre Triage Sieve
QuestionnaireResponse.questionnaire	This MUST be populated with the Canonical value of the Questionnaire resource the responses relate to	MAY	0..1	https://fhir.nhs.uk/Questionnaire/PTS
QuestionnaireResponse.status	This MUST be populated with 'completed' - Fixed Value	MUST	1..1	completed
QuestionnaireResponse.subject	Follow UK Core guidance for populating this element	MUST	0..1
QuestionnaireResponse.subject.reference	This SHOULD be populated with a Reference to the Patient resource	MUST	0..1	urn:uuid:41e591ab-d333-4fb8-87b4-d35f740b6bfc
QuestionnaireResponse.encounter	Follow UK Core guidance for populating this element	MUST	0..1
QuestionnaireResponse.encounter.reference	This MUST be populated with a Reference to the Encounter resource which generated the responses	MUST	0..1	urn:uuid:32dda573-5bcd-44a7-ae62-6d26491a7e96
QuestionnaireResponse.authored	Date/Time added during encounter	MAY	0..1	2023-03-08T12:01:08.4677672+00:00
QuestionnaireResponse.author	Follow UK Core guidance for populating this element	SHOULD	0..1
QuestionnaireResponse.author.reference	This SHOULD be populated with a reference to the Practitioner who created as part of the assessment	SHOULD	0..1	urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
QuestionnaireResponse.source	Follow UK Core guidance for populating this element	SHOULD	0..1
QuestionnaireResponse.source.reference	This SHOULD be populated with a Reference to the Patient resource when they are answering the questions. Otherwise, for 3rd parties, it would require a Reference to the RelatedPerson resource	SHOULD	0..1	urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
QuestionnaireResponse.item		MUST	0..*
QuestionnaireResponse.item.linkid	This MUST be populated with 'linkId' of the corresponding Questionnaire question	MUST	1..1	0
QuestionnaireResponse.item.text	This MUST be populated with question text of the corresponding Questionnaire question	MUST	0..1	Is the patient breathing?
QuestionnaireResponse.item.answer	This MUST be populated with the answer to the corresponding Questionnaire question	MUST	0..*
QuestionnaireResponse.item.answer.valueCoding	This MUST be populated with the answer value from the answerOptions defined within the Questionnaire	MUST	0..1
QuestionnaireResponse.item.answer.valueCoding.system	This SHOULD be populated (and MUST be where it is defined in the Questionnaire answerOption) with the System namespace for the CodeSystem based on the defined answerOptions in the corresponding Questionnaire question	SHOULD	0..1	http://snomed.info/sct
QuestionnaireResponse.item.answer.valueCoding.code	This MUST be populated with Code of the defined answerOptions in the corresponding Questionnaire question	MUST	0..1	78064003
QuestionnaireResponse.item.answer.valueCoding.display	This SHOULD be populated (and MUST be where it is defined in the Questionnaire answerOption) with Display of the defined answerOptions in the corresponding Questionnaire question	SHOULD	0..1	Breathing (observable entity)

> Procedure

This resource is used to communicate details about procedures recorded for the referral.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Procedure	This resource is used to communicate details about procedures recorded for the referral. https://simplifier.net/HL7FHIRUKCoreR4/UKCore-Procedure		0..*
Procedure.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
Procedure.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
Procedure.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure
Procedure.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
Procedure.status	This MUST have a status of 'in-progress' - FIXED VALUE	MUST	1..1	in-progress
Procedure.code	Identification of the procedure	MUST	0..1
Procedure.code.coding.system	This SHOULD be populated with CodeSystem - http://snomed.info/sct	SHOULD	0..1	http://snomed.info/sct
Procedure.code.coding.code	This SHOULD be populated with the Code (SNOMED) of the procedure	SHOULD	0..1	89666000
Procedure.code.coding.display	This SHOULD be populated with the human readable Display (SNOMED) of the procedure	SHOULD	0..1	Cardiopulmonary resuscitation (procedure)
Procedure.code.text	Plain text representation of the procedure	COULD	0..1	CPR
Procedure.subject		MUST	1..1
Procedure.subject.referrence	This MUST contain a reference to the Patient.	MUST	1..1	7aa5814d-d71f-4c9a-a956-03d89f25aa32
Procedure.encounter		MUST	0..1
Procedure.encounter.reference	This MUST contain a reference to the Encounter	MUST	0..1	urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
Procedure.performed	When the procedure was performed	MUST	0..1
Procedure.performedPeriod.start	The time the procedure was started	MUST	0..1	2023-03-08T12:01:08.4677672+00:00

> Communication

This resource is used to communicate details about crew notes for the referral.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Communication	This resource is used communicate crew notes and call log entries relevant to the referral. https://simplifier.net/HL7FHIRUKCoreR4/UKCore-Communication		0..*
Communication.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
Communication.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
Communication.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Communication
Communication.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
Communication.status	This MUST be populated with 'completed' - FIXED VALUE	MUST	1..1	completed
Communication.topic	The communication topic
Communication.topic.text	This MUST be populated with a free text description of the communication topic	MUST	0..1	Crew Note or Call Log Entry
Communication.encounter		MUST	0..1
Communication.encounter.reference	This MUST be populated with a reference to the Encounter	MUST	0..1	urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
Communication.sent	The DateTime the note was recorded	MUST	0..1	2023-03-08T12:01:08.4677672+00:00
Comminication.payload	The communication payload	MUST	0..*
Communication.payload.contentString	This MUST be populated with the detail of the communication.	MUST	1..1	Patient

Response Payload

Payload for a Referral Response

This payload is used to communicate the following:

Business acknowledgement of the receipt and progression of a case through status updates
- When a case has been accepted and is waiting for a resource to be allocated
- When a case has a resource allocated
- When a resource for a case is cancelled
- When a resource has cleared the scene
- When a case has been rejected by the Receiver (Mutual Aid Request and Call Assist Request
  ONLY)

Please expand each resource below to view implementation guidance.

> Bundle

    <p>The Bundle resource is the container for the event message.</p>
    BARSBundleMessage (Bundle) https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle There are no (further) constraints on this element
Data typehttps://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle
type Fixed Value There are no (further) constraints on this element
Element idBundle.type
Fixed valuemessage
timestamp 1.. There are no (further) constraints on this element
Element idBundle.timestamp

    <p>

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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.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.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	1..1	2023-03-08T12:01:08.4677672+00:00
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	0..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.

BARSMessageHeaderServiceRequestRequest (MessageHeader)		https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader	There are no (further) constraints on this element Data type https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader
event[x]			There are no (further) constraints on this element
system	1..		There are no (further) constraints on this element Element id MessageHeader.event[x].system
code	1..		There are no (further) constraints on this element Element id MessageHeader.event[x].code
destination	1..		There are no (further) constraints on this element Element id MessageHeader.destination
receiver			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.destination.receiver.reference
sender			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.sender.reference
identifier			There are no (further) constraints on this element
assigner			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.sender.identifier.assigner.reference
source			There are no (further) constraints on this element
extension	0..		There are no (further) constraints on this element Element id MessageHeader.source.extension Slicing Unordered, Open, by url(Value)
myExtension	0..	Extension(Complex)	There are no (further) constraints on this element Element id MessageHeader.source.extension:myExtension Data type Extension(Complex) Extension URL https://fhir.nhs.uk/StructureDefinition/CDSSExtension
endpoint			There are no (further) constraints on this element Element id MessageHeader.source.endpoint Comments The uri of the Requester’s endpoint
reason	1..		There are no (further) constraints on this element Element id MessageHeader.reason
coding			There are no (further) constraints on this element
system		Fixed Value	There are no (further) constraints on this element Element id MessageHeader.reason.coding.system Fixed value https://fhir.nhs.uk/CodeSystem/message-reason-bars
focus			There are no (further) constraints on this element
reference	1..		There are no (further) constraints on this element Element id MessageHeader.focus.reference

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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-response-short	MUST	0..1	https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-response
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 SHOULD be populated with details of the Clinical Decision Support System used	SHOULD	0..*
MessageHeader.extension.url	This SHOULD 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 SHOULD be populated with the pre-defined Clinical Decision Support System software URL - FIXED VALUE	SHOULD	1..1	requesterCDSSSoftware
MessageHeader.extension.extension.valueString	This SHOULD 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 SHOULD be populated with the pre-defined Clinical Decision Support System software Version URL - FIXED VALUE	SHOULD	1..1	requesterCDSSVersion
MessageHeader.extension.extension.valueString	This SHOULD 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-response'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE	MUST	0..1	servicerequest-response
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.response		MUST	1..1
MessageHeader.response.identifier	This MUST be populated with the identifer if the original Bundle ID	MUST	1..1	urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
MessageHeader.response.code	This MUST be populated with a code of 'ok' - FIXED VALUE	MUST	1..1	ok
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. Value - https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-response-referral-short	MUST	0..1	https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-response-short

> Service Request

A resource to carry a request for a service to be performed and the associated use case. This Resource is the focus of the BaRS Referral Request interaction.

BARSServiceRequestRequestReferral (ServiceRequest)		https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest	There are no (further) constraints on this element Data type https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest
intent		Fixed Value	There are no (further) constraints on this element Element id ServiceRequest.intent Fixed value plan
category	1..1		There are no (further) constraints on this element Element id ServiceRequest.category
subject		Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient)	There are no (further) constraints on this element Element id ServiceRequest.subject Data type Reference(https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient)
occurrence[x]			There are no (further) constraints on this element Element id ServiceRequest.occurrence[x]
occurrencePeriod		Period	There are no (further) constraints on this element Data type Period
authoredOn	1..		There are no (further) constraints on this element Element id ServiceRequest.authoredOn Comments DateTime the Referral Request was generated
performer			There are no (further) constraints on this element Element id ServiceRequest.performer Comments Referral To

Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
ServiceRequest	https://simplifier.net/nhsbookingandreferrals/barsservicerequest-request-referral		1..1
ServiceRequest.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
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 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
ServiceRequest.status	Only use the following 3 values: active, revoked is used when a SR is cancelled, entered-in-error is used when sent to the wrong endpoint and need 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	BaRS Referral type	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 'referral' FIXED VALUE	MUST	0..1	referral
ServiceRequest.category.coding.display	This MUST be populated with 'Transfer of Care'	MUST	0..1	Transfer of Care
ServiceRequest.category.coding	BaRS 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	A6T1
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	CAD to CAD Out of Area Referral
ServiceRequest.category.text	This should be populated with any details about the service request. This MUST be populated when the ServiceRequest.category.coding.code is populated with 'A6T2' or 'A6T3'	SHOULD	0..1	Please can you spare a Paramedic closer than 20 mins?
ServiceRequest.subject	Follow BaRS profile guidance for populating this element	MUST	1..1
ServiceRequest.subjectreference	This MUST be populated with a Reference to the Patient resource	MUST	0..1	urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
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	0..1	2023-03-08T12:01:08.4677672+00:00
ServiceRequest.performer	This SHOULD be populated with the Healthcare service that the Service request is going to	SHOULD	0..*
ServiceRequest.performer.reference	This SHOULD be populated Reference to HealthcareService resource	SHOULD	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 Receiver's encounter. This is the focus resource for this response.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Encounter	https://simplifier.net/hl7fhirukcorer4/ukcore-encounter		1..1
Encounter.id	MUST only be generated by the originating system of the encounter as the id for the resource in the original HTTP request. It MUST be echoed back when returning an encounter. Subsequent new Encounters will be generated by the originating system of that encounter.	MUST	0..1	236bb75d-90ef-461f-b71e-fde7f899802c
Encounter.meta	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.status	The status must be set to the current Encounter status: - When the case is waiting for a resource to be allocated OR a resource has been cancelled, this MUST be populated with 'planned' - When the case has had a resource allocated this MUST be populated with 'in-progress' - For a case where the resource has cleared the scene this MUST be populated with 'finished' - Where a Mutual Aid or Call Assist request is being rejected, this MUST be populated with 'cancelled'	MUST	1..1	in-progress
Encounter.statusHistory	List of past and current encounter statuses	MUST	0..*
Encounter.statusHistory.status	The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them	MUST	1..1	planned
Encounter.statusHistory.period	The time that the encounter was in the specified status.
Encounter.statusHistory.period.start	The time that the encounter started in the specified status.	MUST	1..1	2023-03-08T12:01:08.4677672+00:00
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 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 JourneyID 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		MUST	0..1
Encounter.period.start	This MUST be populated with the Encounter start time.	MUST	0..1	2023-03-08T12:01:08.4677672+00:00
Encounter.reasonCode	Reason for Rejection -This MUST be populated if the response it a rejection.	MUST	0..1
Encounter.reasonCode.system	This MUST be populated with the following system - https://fhir.nhs.uk/CodeSystem/rejection-reason-bars	MUST	0..1	https://fhir.nhs.uk/CodeSystem/rejected-reasons-bars
Encounter.reasonCode.code	This MUST be populated with a value from https://fhir.nhs.uk/CodeSystem/rejection-reason-bars	MUST	0..1	RRNA
Encounter.reasonCode.display	This MUST be populated with the code description	MUST	0..1	Requested resource not available within timescale
Encounter.reasonCode.text	This SHOULD be populated with a free text reason for cancellation. This MUST be populated if the Encounter.reasonCode.code is populated with 'OTH'	SHOULD	0..1	We have a paramedic but not available for 30 mins

> 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.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Patient	https://simplifier.net/hl7fhirukcorer4/ukcore-patient		1..1
Patient.id	It also includes contact information for third parties when required.	MUST	0..1	9589fb37-87a2-48d8-968f-b371429208a8
Patient.meta	https://simplifier.net/hl7fhirukcorer4/ukcore-patient	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	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	This is a human readable patient identifier. This MUST be populated with the NHS number when available. Additionally a Local Patient Identifier Should be populated where available. If no NHS number is available this Should be populated with the Local 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	https://simplifier.net/hl7fhirukcorer4/extensionukcorenhsnumberverificationstatus	SHOULD	0..1	https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept.coding.code	Follow UK Core guidance for populating this element	SHOULD	0..1	number-present-and-verified
Patient.identifier.extension.valueCodeableConcept.coding.display	Follow UK Core guidance for populating this element	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	Follow UK Core guidance for populating this element	SHOULD	0..*
Patient.address.use	Follow UK Core guidance for populating this element	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 should 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-ContactPreference
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://simplifier.net/hl7fhirukcorer4/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	http://terminology.hl7.org/CodeSystem/v2-0131
Patient.contact.relationship.coding.code	This MUST be populated with Code of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.	MUST	0..1	EP
Patient.contact.relationship.coding.display	This MUST be populated with Display of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/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.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	1..1	https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory
Patient.extension.valueCodeableConcept		SHOULD	0..1
Patient.extension.valueCodeableConcept.coding		SHOULD	0..*
Patient.extension.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.valueCodeableConcept.coding.code	This SHOULD be populated. Follow UK Core guidance for populating this element	SHOULD	0..1	A
Patient.extension.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

> Organization

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

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
Organization	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 MUST be populated with an organisation identifier e.g. ODS code	MUST	0..*
Organization.identifier.system	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	https://fhir.nhs.uk/id/ods-organization-code
Organization.identifier.value	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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 sending the response or performing the action that triggers the response.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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	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 MUST be populated. Follow UK Core guidance for populating this element	MUST	0..*
Practitioner.identifier.system	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	https://fhir.nhs.uk/Id/sds-role-profile-id
Practitioner.identifier.value	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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 sending the response or performing the action that triggers the response.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
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		MUST	0..1
PractitionerRole.practitioner.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	0..1	urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
PractitionerRole.Organization		MUST	0..1
PractitionerRole.Organization.reference	This MUST be populated. Follow UK Core guidance for populating this element	MUST	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	0..1
PractitionerRole.code.coding.system	This SHOULD 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 SHOULD 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 SHOULD be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.	SHOULD	0..1	Administrative healthcare staff

> Healthcare Service

This resource represents the healthcare service provider of the receiver.

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Data Item	Implementation Guidance	Necessity	Profile Cardinality	Example Value(s)
HealthcareService	https://simplifier.net/hl7fhirukcorer4/ukcore-healthcareservice		0..*
HealthcareService.meta	https://www.hl7.org/fhir/resource.html#Meta	MUST	1..1
HealthcareService.meta.profile	This MUST be populated. Follow UK Core guidance for populating this element	MUST	1..1	https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService
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 can be represented by a UEC DoS Service Identifier or other locally agreed 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		MUST	0..1
HealthcareService.providedBy.reference	Link to the Organisation the request is being made of . This will commonly link to the MH.destination	MUST	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
HealthcareService.location		SHOULD	0..*
HealthcareService.location.reference	Follow UK Core guidance for populating this element	SHOULD	0..1	urn:uuid:860e4c37-4e36-45fb-8fca-41132cd937a5

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 - CAD to CAD

The below diagram details the ServiceRequest - Referral Response - CAD to CAD

NHS Booking and Referral Standard

Referrals into an Ambulance Service Trust (Application 6)

Use Cases Supported

Introduction

Overview

Data model endorsements

Scope and Requirements

Scope Overview

Functional Scope

Requirements

Audit

Error Handling

Non Functional

How does it work?

Actors

Out of Area calls

Call Assist Requests

Mutual Aid Requests

This details a BaRS CAD to CAD Referral:

Receive Call

Create Case

Pre Triage Sieve (PTS)

Reason for Call

Nature of Call (NOC)

Confirm Location

Record demographics

Complete Triage

Sending a BaRS Referral

Create Case

Acknowledge Receipt

Status Update (Referral Response)

Continue updates

Manage Stack

Make a Referral

Cancel a Referral

Bundle Processing - detailed

Payloads for Referrals

Referral Payload

MessageHeader Resource

ServiceRequest Resource

Encounter Resource

Incident Location Resource

Location Resource

CarePlan Resource

Flag (Scene safety)

Flag Resource

Observation

Consent

Questionnaire

Pre Triage Sieve

Questionnaire Response

Nature of Call (NOC)

AMPDS NOC Types

NHS Pathways NOC Types

Condition

Procedure

Task

Communication

Referral Cancellation Payload

Payloads for Responses

Referral Response Payload (Status update)

MessageHeader Resource

ServiceRequest Resource

Encounter Resource

Referral Response Payload (Reject referral)

Encounter Resource

Referral Payload

Payload for requesting a referral, using Service Request

Response Payload

Payload for a Referral Response

Entity Relationship Diagrams