NHS Digital FHIR Medicines

Prescription Order Cancel

FHIR Exchange API Event Type FHIR (Bundle) Message Definition
FHIR Messaging POST /$process-message prescription-order-update prescription-order-update

Electronic prescriptions can be cancelled by any prescriber (or staff) who has the correct authorisation on their smartcard. This can be done at any point until the prescription is dispensed and given to the patient.

The prescription-order-update message is similar to the prescription-order message and the main differences are the CommunicationRequest and Provence resources are not required.

Only one MedicationRequest can be cancelled, it is not possible to cancel the entire prescription-order. To cancel the entire prescription-order, multiple prescription-order-update messages must be used, one for each MedicationRequest in the prescription-order.

The same MedicationRequest resource used within the prescription-order message can be reused with the following amendments:

Source Data Item FHIR Element Additional Conformance
meta.lastUpdated Date of cancellation
status MUST be cancelled
statusReason.coding.code MUST be present and use a code from DM-MedicationRequest-Status-Reason
statusReason.text SHOULD be present. If not present statusReason.coding.display will be used.
Cancellation requestor extension (ResponsiblePractitioner) NHSDigital-PractitionerRole Person and their organization requesting cancellation of the prescription item. This is MUST be present if the requestor is not the same as the author. GMC Reference Number MUST NOT be used as a Practitioner identifier

When a prescription has already been downloaded by the patient's nominated pharmacy it cannot be cancelled and EPS will send a cancellation rejected message back to the prescriber.

The prescriber should then contact the dispenser to return the whole prescription to the NHS Spine. If this is possible (the medication has not been dispensed), the dispenser returns the prescription to EPS and then EPS sends a subsequent cancellation to the prescriber.

Build Notes

Prescription Order Response

The response to a prescription-order-update is a prescription-order-response FHIR Message and is defined in prescription-order-response

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