NHS Digital FHIR Medicines

Prescription Cancellations

EPSCancelDiagram

1. Prescriber - Send Prescription

This is sent to FHIR Operation process-message as a prescription-order Message.

The example outpatient prescription Prescription Order Outpatient Multiple Medications consists of four Medications and has nominated pharmacy FX478

Medication ID (SNOMED) Medication Name Prescribed Quantity Unit of Measure
321196004 Diazepam 2mg tablets 28 Tablet
322236009 Paracetamol 500mg tablets 100 Tablet
321152004 Temazepam 10mg tablets 14 Tablet
36126511000001106 Morphine 10mg modified-release tablets 28 Tablet

2. Dispenser - Release Prescription.

The Pharmacy releases the prescription by calling the FHIR Operation release

POST /Task/$release

Example of the payload NominatedPharmacyReleaseRequest


3. Prescriber - Prescription MedicationRequest Cancellation

An electronic prescription MedicationRequest can be cancelled after submission to EPS provided the prescription has not been downloaded or processed by a dispenser.

To cancel a prescription the prescribing system is required to send a prescription-order-update cancellation message to the FHIR Operation process-message. A cancellation is at individual item level. Cancellation is applicable to all types of electronic prescriptions (i.e. acute, continuous prescribing and continuous dispensing prescriptions).

Example cancellation message Prescription Order Outpatient Cancel which cancels the Morphine medication.

Medication ID (SNOMED) Medication Name Prescribed Quantity Unit of Measure
36126511000001106 Morphine 10mg modified-release tablets 28 Tablet

Note: this prescription is being cancelled by a clerical worker and the original prescriber is now down as the responsible party.


4. Prescriber - Prescription Cancellation Response

The immediate response to a cancellation messge is a prescription-order-response FHIR Message. Example message Prescription Order Outpatient Response


5 Prescriber - Contact Pharmacy

Prescriptions sent to a nominated pharmacy are likely to be collected before they have been cancelled. This has happened in the above example and the prescriber SHOULD contact the pharmacy to cancel the prescription.


6 Dispenser - Dispense Proposal Withdrawal

As no Medications have been dispensed, the pharmacy can return the entire prescription back to EPS. This is performed sending a FHIR Task to EPS Task endpoint. Note the full prescription must be returned to allow a single MedicationRequest to be cancelled.

PUT /Task

Example payload Task Return Prescription Order


7 Prescriber - Prescription Current Status

As the prescription has now been returned to EPS, the EPS Prescription Tracker will now show the current status.


8 Dispenser - Re-Release Prescription

The dispenser can now download the modified prescription for dispensing. This is similar to step 2.

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