NHS Booking and Referral Standard

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

Urgent Referral Payload

Applications using this Definition

111-ED

999-CAS Referral


What is it for?

The Payloads in this definition are used for workflows that refer patients into or between urgent care services.


What is it made up of?

There are two payloads in this definition.

  1. the request stage of the workflow

  2. the response stage of the workflow


Payload Definitions


BARS MessageDefinition ServiceRequest-Request Referral

When making a request to transfer a patient to a service the BARSMessageDefinition-ServiceRequest-Request Referral Message Definition is used to define how the bundle should be built.

This Message Definition is built with the following specific values:

FHIR Element Cardinality Element Guidance Additional Guidance
url 1..1 Business Identifier for a given MessageDefinition
status 1..1 active
date 1..1 Date last changed
useContext 1..1 We are expecting the UseContext to be a DOS ID
useContext.code.system 1..1 https://fhir.nhs.uk/CodeSystem/dos-id
useContext.code.code 1..1 dos-id
event.system 1..1 https://fhir.nhs.uk/CodeSystem/message-events-bars
event.code 1..1 servicerequest-request
focus 2..* Bundle and MessageHeader resources must be included in a message type Bundle
focus.code 1..1 Type of resource
focus.profile 1..1 Profile that must be adhered to by focus
focus.min 1..1 Minimum number of focuses of this type
focus.max 1..1 Maximum number of focuses of this type

Table

MessageDefinition.id[0]11882ae2-211f-49ee-acbe-e319304d80cd
MessageDefinition.url[0]https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral
MessageDefinition.name[0]BARS Message Definition ServiceRequest - Request Referral
MessageDefinition.title[0]BARS Message Definition ServiceRequest - Request Referral
MessageDefinition.status[0]active
MessageDefinition.date[0]2022-02-11
MessageDefinition.version[0]1.0.0-alpha
MessageDefinition.eventCoding[0].system[0]https://fhir.nhs.uk/CodeSystem/message-events-bars
MessageDefinition.eventCoding[0].code[0]servicerequest-request
MessageDefinition.useContext[0].code[0].system[0]https://fhir.nhs.uk/CodeSystem/dos-id
MessageDefinition.useContext[0].code[0].code[0]dos-id
MessageDefinition.useContext[0].valueCodeableConcept[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/variant-state
MessageDefinition.useContext[0].valueCodeableConcept[0].coding[0].code[0]positive
MessageDefinition.focus[0].code[0]Bundle
MessageDefinition.focus[0].profile[0]https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage
MessageDefinition.focus[0].min[0]1
MessageDefinition.focus[0].max[0]1
MessageDefinition.focus[1].code[0]MessageHeader
MessageDefinition.focus[1].profile[0]https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-request
MessageDefinition.focus[1].min[0]1
MessageDefinition.focus[1].max[0]1
MessageDefinition.focus[2].code[0]ServiceRequest
MessageDefinition.focus[2].profile[0]https://fhir.nhs.uk/StructureDefinition/BARSServiceRequest-request-referral
MessageDefinition.focus[2].min[0]1
MessageDefinition.focus[2].max[0]1
MessageDefinition.focus[3].code[0]Patient
MessageDefinition.focus[3].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient
MessageDefinition.focus[3].min[0]1
MessageDefinition.focus[3].max[0]1
MessageDefinition.focus[4].code[0]Encounter
MessageDefinition.focus[4].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter
MessageDefinition.focus[4].min[0]1
MessageDefinition.focus[4].max[0]1
MessageDefinition.focus[5].code[0]CarePlan
MessageDefinition.focus[5].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan
MessageDefinition.focus[5].min[0]1
MessageDefinition.focus[5].max[0]1
MessageDefinition.focus[6].code[0]Location
MessageDefinition.focus[6].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location
MessageDefinition.focus[6].min[0]0
MessageDefinition.focus[6].max[0]1
MessageDefinition.focus[7].code[0]Organization
MessageDefinition.focus[7].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
MessageDefinition.focus[7].min[0]2
MessageDefinition.focus[7].max[0]*
MessageDefinition.focus[8].code[0]Practitioner
MessageDefinition.focus[8].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner
MessageDefinition.focus[8].min[0]1
MessageDefinition.focus[8].max[0]*
MessageDefinition.focus[9].code[0]PractitionerRole
MessageDefinition.focus[9].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole
MessageDefinition.focus[9].min[0]1
MessageDefinition.focus[9].max[0]*
MessageDefinition.focus[10].code[0]Observation
MessageDefinition.focus[10].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation
MessageDefinition.focus[10].min[0]0
MessageDefinition.focus[10].max[0]*
MessageDefinition.focus[11].code[0]Flag
MessageDefinition.focus[11].profile[0]http://hl7.org/fhir/StructureDefinition/Flag
MessageDefinition.focus[11].min[0]0
MessageDefinition.focus[11].max[0]*
MessageDefinition.focus[12].code[0]MedicationStatement
MessageDefinition.focus[12].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement
MessageDefinition.focus[12].min[0]0
MessageDefinition.focus[12].max[0]*
MessageDefinition.focus[13].code[0]AllergyIntolerance
MessageDefinition.focus[13].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
MessageDefinition.focus[13].min[0]0
MessageDefinition.focus[13].max[0]*
MessageDefinition.focus[14].code[0]QuestionnaireResponse
MessageDefinition.focus[14].profile[0]http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse
MessageDefinition.focus[14].min[0]0
MessageDefinition.focus[14].max[0]*
MessageDefinition.focus[15].code[0]Consent
MessageDefinition.focus[15].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent
MessageDefinition.focus[15].min[0]1
MessageDefinition.focus[15].max[0]*
MessageDefinition.focus[16].code[0]HealthcareService
MessageDefinition.focus[16].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService
MessageDefinition.focus[16].min[0]1
MessageDefinition.focus[16].max[0]1

XML

<MessageDefinition xmlns="http://hl7.org/fhir">
    <id value="11882ae2-211f-49ee-acbe-e319304d80cd" />
    <url value="https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral" />
    <version value="1.0.0-alpha" />
    <name value="BARS Message Definition ServiceRequest - Request Referral" />
    <title value="BARS Message Definition ServiceRequest - Request Referral" />
    <status value="active" />
    <date value="2022-02-11" />
    <useContext>
        <code>
            <system value="https://fhir.nhs.uk/CodeSystem/dos-id" />
            <code value="dos-id" />
        </code>
        <valueCodeableConcept>
            <coding>
                <system value="http://terminology.hl7.org/CodeSystem/variant-state" />
                <code value="positive" />
            </coding>
        </valueCodeableConcept>
    </useContext>
    <eventCoding>
        <system value="https://fhir.nhs.uk/CodeSystem/message-events-bars" />
        <code value="servicerequest-request" />
    </eventCoding>
    <focus>
        <code value="Bundle" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="MessageHeader" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-request" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="ServiceRequest" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/BARSServiceRequest-request-referral" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="Patient" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="Encounter" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="CarePlan" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan" />
        <min value="1" />
        <max value="1" />
    </focus>
    <focus>
        <code value="Location" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location" />
        <min value="0" />
        <max value="1" />
    </focus>
    <focus>
        <code value="Organization" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
        <min value="2" />
        <max value="*" />
    </focus>
    <focus>
        <code value="Practitioner" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
        <min value="1" />
        <max value="*" />
    </focus>
    <focus>
        <code value="PractitionerRole" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
        <min value="1" />
        <max value="*" />
    </focus>
    <focus>
        <code value="Observation" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
        <min value="0" />
        <max value="*" />
    </focus>
    <focus>
        <code value="Flag" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Flag" />
        <min value="0" />
        <max value="*" />
    </focus>
    <focus>
        <code value="MedicationStatement" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement" />
        <min value="0" />
        <max value="*" />
    </focus>
    <focus>
        <code value="AllergyIntolerance" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
        <min value="0" />
        <max value="*" />
    </focus>
    <focus>
        <code value="QuestionnaireResponse" />
        <profile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
        <min value="0" />
        <max value="*" />
    </focus>
    <focus>
        <code value="Consent" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent" />
        <min value="1" />
        <max value="*" />
    </focus>
    <focus>
        <code value="HealthcareService" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService" />
        <min value="1" />
        <max value="1" />
    </focus>
</MessageDefinition>

JSON

{
    "resourceType": "MessageDefinition",
    "id": "11882ae2-211f-49ee-acbe-e319304d80cd",
    "url": "https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral",
    "name": "BARS Message Definition ServiceRequest - Request Referral",
    "title": "BARS Message Definition ServiceRequest - Request Referral",
    "status": "active",
    "date": "2022-02-11",
    "version": "1.0.0-alpha",
    "eventCoding": {
        "system": "https://fhir.nhs.uk/CodeSystem/message-events-bars",
        "code": "servicerequest-request"
    },
    "useContext":  [
        {
            "code": {
                "system": "https://fhir.nhs.uk/CodeSystem/dos-id",
                "code": "dos-id"
            },
            "valueCodeableConcept": {
                "coding":  [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/variant-state",
                        "code": "positive"
                    }
                ]
            }
        }
    ],
    "focus":  [
        {
            "code": "Bundle",
            "profile": "https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage",
            "min": 1,
            "max": "1"
        },
        {
            "code": "MessageHeader",
            "profile": "https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-request",
            "min": 1,
            "max": "1"
        },
        {
            "code": "ServiceRequest",
            "profile": "https://fhir.nhs.uk/StructureDefinition/BARSServiceRequest-request-referral",
            "min": 1,
            "max": "1"
        },
        {
            "code": "Patient",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
            "min": 1,
            "max": "1"
        },
        {
            "code": "Encounter",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter",
            "min": 1,
            "max": "1"
        },
        {
            "code": "CarePlan",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan",
            "min": 1,
            "max": "1"
        },
        {
            "code": "Location",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location",
            "min": 0,
            "max": "1"
        },
        {
            "code": "Organization",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
            "min": 2,
            "max": "*"
        },
        {
            "code": "Practitioner",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
            "min": 1,
            "max": "*"
        },
        {
            "code": "PractitionerRole",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
            "min": 1,
            "max": "*"
        },
        {
            "code": "Observation",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation",
            "min": 0,
            "max": "*"
        },
        {
            "code": "Flag",
            "profile": "http://hl7.org/fhir/StructureDefinition/Flag",
            "min": 0,
            "max": "*"
        },
        {
            "code": "MedicationStatement",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement",
            "min": 0,
            "max": "*"
        },
        {
            "code": "AllergyIntolerance",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance",
            "min": 0,
            "max": "*"
        },
        {
            "code": "QuestionnaireResponse",
            "profile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse",
            "min": 0,
            "max": "*"
        },
        {
            "code": "Consent",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent",
            "min": 1,
            "max": "*"
        },
        {
            "code": "HealthcareService",
            "profile": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService",
            "min": 1,
            "max": "1"
        }
    ]
}

Referral Request workflow

When building a bundle from this message definition the following resources are included:


As can be seen from the diagram, the bundle is made up of the following resources:

BARS Bundle Message

FHIR Element Cardinality Element Guidance Additional Guidance
type 1..1 fixed value "message" The bundle type further expects the next resource to be a MessageHeader
timestamp 1..1 The date/time that the bundle was assembled

useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
typeΣ1..1codeBindingFixed Value
timestampΣ1..1instant
totalΣ I0..1unsignedInt
relationΣ1..1string
urlΣ1..1uri
fullUrlΣ0..1uri
resourceΣ0..1Resource
modeΣ0..1codeBinding
scoreΣ0..1decimal
methodΣ1..1codeBinding
urlΣ1..1uri
ifNoneMatchΣ0..1string
ifModifiedSinceΣ0..1instant
ifMatchΣ0..1string
ifNoneExistΣ0..1string
statusΣ1..1string
locationΣ0..1uri
etagΣ0..1string
lastModifiedΣ0..1instant
outcomeΣ0..1Resource
typeΣ1..*CodingBinding
whenΣ1..1instant
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
targetFormat0..1codeBinding
sigFormat0..1codeBinding
data0..1base64Binary


BARS MessageHeader - ServiceRequest-Request

The MessageHeader resource carries information such as the sender and receiver as is a wrapper for the message. The event.system and event.code will match the MessageDefinition corresponding values. The definition element has a direct link to the MessageDefinition that will be used to check validation of the Bundle contents.

CDSS Extension

FHIR Element Cardinality Element Guidance Additional Guidance
event.system 1..1 https://fhir.nhs.uk/CodeSystem/message-events-bars
event.code 1..1 servicerequest-request
destination 1..*
destination.endpoint 1..1
source 1..1
source.endpoint 1..1
reason 1..1
reason.coding.system 0..1 https://fhir.nhs.uk/CodeSystem/message-reason-bars
reason.coding.code 0..1 new or update
definition 0..1 MessageDefinition Link to the MessageDefinition for this message

messageHeaderInstructionI0..*Extension(Coding)
systemFixed Value
code1..Fixed Value
eventCodingCoding
eventUriuri
nameΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
endpointΣ1..1url
referenceΣ I1..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I1..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
referenceΣ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
myExtensionI0..*Extension(Complex)
nameΣ0..1string
softwareΣ0..1string
versionΣ0..1string
contactΣ I0..1ContactPoint
endpointΣ1..1url
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
identifierΣ1..1id
codeΣ1..1codeBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I1..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
definitionΣ0..1canonical(MessageDefinition)


BARS ServiceRequest-Request Referral

The ServiceRequest carries the information on the type of Referral, determined by the Category.

FHIR Element Cardinality Element Guidance Additional Guidance
status 1..1 active
intent 1..1 plan
category 1..1
category.coding.system 0..1 https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
category.coding.code 0..1 referral
subject 1..1 UK Core Patient
authoredOn 1..1 dateTime Date request signed

sourceOfServiceRequestI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
instantiatesUriΣ0..*uri
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
statusΣ ?!1..1codeBinding
intentΣ ?!1..1codeBindingFixed Value
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1codeFixed Value
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
codeΣ0..1CodeableConceptBinding
orderDetailΣ I0..*CodeableConcept
quantityQuantityQuantity
quantityRatioRatio
quantityRangeRange
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
occurrencePeriodPeriod
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
authoredOnΣ1..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
performerTypeΣ0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
locationCodeΣ0..*CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
codingΣ0..*Coding
textΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
bodySiteΣ0..*CodeableConceptBinding
note0..*Annotation
patientInstructionΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string


UKCore-HealthcareService resource

http://hl7.org/fhir/StructureDefinition/HealthcareService

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

Defines the UK Core constraints and extensions on the HealthcareService resource for the minimal set of data to query and retrieve healthcare service information.

This profile allows exchange of details of a healthcare service available at a location.

HealthcareService
FHIR Element Cardinality Element Guidance Additional Guidance
identifier.system 1..1 http://fhir.nhs.uk/Id/dos-service-id
identifier.code 1..1 dos-id
active 1..1 fixed value "true"
providedBy.reference 0..1 Organization providing the service
name 0..1 Name of HealthcareService

UKCore-Encounter resource

https://fhir.nhs.uk/StructureDefinition/UKCore-Encounter

Defines the UK Core constraints and extensions on the Encounter resource for the minimal set of data to query and retrieve encounter information.

This profile allows exchange of information about an interaction between an individual and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of an individual.


UKCore-CarePlan resource

https://fhir.nhs.uk/StructureDefinition/UKCore-CarePlan

Defines the UK Core constraints and extensions on the CarePlan resource for the minimal set of data to query and retrieve a patient’s Care Plan.


UKCore-Patient resource

https://fhir.nhs.uk/StructureDefinition/UKCore-Patient

Defines the UK Core constraints and extensions on the Patient resource for the minimal set of data to query and retrieve an individual’s demographic information.

This profile allows exchange of demographics and other administrative information about an individual receiving care or other health-related services.


UKCore-PractitionerRole resource

https://fhir.nhs.uk/StructureDefinition/UKCore-PractitionerRole

Defines the UK Core constraints and extensions on the PractitionerRole resource for the minimal set of data to query and retrieve practitioner role information.

This profile allows exchange of a specific set of roles, specialties and services that a practitioner may perform at an organisation for a period of time.


UKCore-Practitioner resource

https://fhir.nhs.uk/StructureDefinition/UKCore-Practitioner

Defines the UK Core constraints and extensions on the Practitioner resource for the minimal set of data to query and retrieve practitioner information.

This profile allows exchange of information about all individuals who are engaged in the healthcare process and healthcare-related services as part of their formal responsibilities and this profile is used for attribution of activities and responsibilities to these individuals.


UKCore-Organization resource

https://fhir.nhs.uk/StructureDefinition/UKCore-Organization

Defines the UK Core constraints and extensions on the Organization resource for the minimal set of data to query and retrieve organisation information.

This profile allows exchange of a formally or informally recognised grouping of people or organisations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, etc.


UKCore-MedicationStatement resource

https://fhir.nhs.uk/StructureDefinition/UKCore-MedicationStatement

Defines the UK Core constraints and extensions on the MedicationStatement resource for the minimal set of data to query and retrieve medication statement information.

This profile allows exchange of a record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the individual may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the individual, significant other (such as a family member or spouse), or a clinician.


UKCore-AllergyIntolerance resource

https://fhir.nhs.uk/StructureDefinition/UKCore-AllergyIntolerance

Defines the UK Core constraints and extensions on the AllergyIntolerance resource for the minimal set of data to query and retrieve allergy information.

Profile Purpose This profile allows a record of a clinical assessment of an allergy or intolerance; a propensity, or a potential risk to an individual, to have an adverse reaction on future exposure to the specified substance, or class of substance.

Where a propensity is identified, to record information or evidence about a reaction event that is characterised by any harmful or undesirable physiological response that is specific to the individual and triggered by exposure of an individual to the identified substance or class of substance.

Substances include but are not limited to a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

This resource is used to record physical conditions. It MUST not be used to record preferences for or against types of treatment, for example on religious grounds. For such use cases consider the use of the FHIR Consent resource.


UKCore-Flag resource

http://hl7.org/fhir/StructureDefinition/Flag

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

Defines the UK Core constraints on the Flag resource to provide information on prospective warnings of potential issues when providing care to the patient.


UKCore-QuestionnaireResponse resource

https://fhir.nhs.uk/StructureDefinition/UKCore-QuestionnaireResponse

Defines the UK Core constraints and extensions on the QuestionnaireResponse resource for the minimal set of data to query and retrieve a complete or partial list of answers to a set of questions completed when responding to a questionnaire.

This profile describes a structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to.


UKCore-Observation resource

https://fhir.nhs.uk/StructureDefinition/UKCore-Observation

Defines the UK Core constraints and extensions on the observation resource for the minimal set of data to query and retrieve generic observation information.


https://fhir.nhs.uk/StructureDefinition/UKCore-Consent

Defines the UK Core constraints and extensions on the Consent resource for the minimal set of data to query and retrieve consent information.


Referral Response Payload

Content TBC

NHS 111 (including CAS) to ED

This guidance is specific to the NHS 111 (including CAS) to ED application. It should be applied alongside the core guidance.

BARS ServiceRequest-Request Referral

FHIR Element Cardinality Element Guidance Additional Guidance
supportingInfo 0..1 This is used to indicate RejectedServices (Flag and Questionnaire Repsonse) or link to an Appointment resource
reference 0..1 reference to Rejected Service Questionnaire or Flag or, alternatively, link to an Appointment
display 0..1 Display info

UKCore-Encounter resource

FHIR Element Cardinality Element Guidance Additional Guidance
start 0..1 This SHOULD be populated with the time the contact with the practicioner was established. This SHOULD be the contact immediately prior to the referral being sent.

UKCore-CarePlan resource

FHIR Element Cardinality Element Guidance Additional Guidance
system 0..1 * Pathways Symptom Group (SG) code use ‘https://fhir.nhs.uk/Id/pathways-sg-code’ value
code 0..1 When you are passing an SG code this MUST be populated with the SG code.
display 0..1 When you are passing an SG code this MUST be populated the SG code description
system 0..1 * Pathways Symptom Discriminator (SD) code use ‘https://fhir.nhs.uk/Id/pathways-sd-code’ value
code 0..1 When you are passing an SD code this MUST be populated with the SD code
display 0..1 When you are passing an SD code this MUST be populated the SD code description
system 0..1 * Pathways Disposition (DX) code use ‘https://fhir.nhs.uk/Id/pathways-dx-code’ value
code 0..1 When you are passing an Dx code this MUST be populated with the Dx code
display 0..1 When you are passing an Dx code this MUST be populated the Dx code description

UKCore-Organisation resource

FHIR Element Cardinality Element Guidance Additional Guidance
value 0..1 Sender ODS code for reference

UKCore-QuestionnaireResponse resource

This resource is used to communicate links to external sources of clinical information used in the triage/assessment of the patient that would be useful to the recipient. It is also used to communicate details of services rejected by the patient.

999 AST to CAS Referral

This guidance is specific to the 999 AST to CAS Referral application. It should be applied alongside the core guidance.

UKcore-Encounter resource

FHIR Element Cardinality Element Guidance Additional Guidance
start 0..1 This SHOULD be populated with the Call Connect time (T0). If this is not available it SHOULD be populated with the Call Answer Time (T1)

UKCore-CarePlan resource

FHIR Element Cardinality Element Guidance Additional Guidance
system 0..1 * Pathways Symptom Group (SG) code use ‘https://fhir.nhs.uk/Id/pathways-sg-code’ value
code 0..1 When you are passing an SG code this MUST be populated with the SG code
display 0..1 When you are passing an SG code this MUST be populated the SG code description
system 0..1 * Pathways Symptom Discriminator (SD) code use ‘https://fhir.nhs.uk/Id/pathways-sd-code’ value
code 0..1 When you are passing an SD code this MUST be populated with the SD code
display 0..1 When you are passing an SD code this MUST be populated the SD code description
system 0..1 * Pathways Disposition (DX) code use ‘https://fhir.nhs.uk/Id/pathways-dx-code’ value
code 0..1 When you are passing an Dx code this MUST be populated with the Dx code
display 0..1 When you are passing an Dx code this MUST be populated the Dx code description
system 0..1 * Ambulance Response Programme (ARP) code use ‘https://fhir.nhs.uk/Id/pathways-arp-code’ value
code 0..1 When you are passing an ARP code this MUST be populated with the ARP code
display 0..1 When you are passing an ARP code this MUST be populated the ARP code description
system 0..1 * AMPDS Dispatch Code use ‘https://fhir.nhs.uk/Id/ampds-code’ value
code 0..1 When you are passing an AMPDS dispatch code this MUST be populated with the AMPDS dispatch code
display 0..1 When you are passing an AMPDS dispatch code this MUST be populated the AMPDS dispatch code description

UKCore-Organisation resource

FHIR Element Cardinality Element Guidance Additional Guidance
value 0..1 Sender ODS code in the event that they need to receive an ambulance request.

UKCore-QuestionnaireResponse resource

This resource is used to communicate links to external sources of clinical information used in the triage/assessment of the patient that would be useful to the recipient.

999 AST to CAS Validation

LastUpdatedDate

Every resource will include a lastUpdated date in the meta tag. This is to be used for tracking and updating.

<meta>
    <versionId value="1.0.0-alpha" />
    <lastUpdated value="2021-11-26T15:00:00+00:00" />
    <profile value="https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage" />
</meta>

Journey ID

The Journey ID uses the episodeOfCare resource.

Each Encounter between systems can reference the same originating episodeOfCare, allowing grouping of all the Encounters to one flow.

The FHIR episodeOfCare resource would be created at the beginning of the patient journey when the Encounter is created and leads onto a ServiceRequest or other appropriate flow.

This snippet of coding shows the episodeOfCare within the Encounter referencing a GUID that will be used throughout the patients journey.

<episodeOfCare>
    <!--      Resource reference to an EpisodeOfCare Journey ID      -->
    <reference value="d877b820-e72b-44d1-a627-195f54bfc606" />
</episodeOfCare>

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