NHS Digital FHIR Medicines

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


This message definition describes the rules for a Prescription Order Update interactions used in a FHIR Messaging exchange. It us used to cancel a prescription.

Event Coding

System Code
Message Events prescription-order-update


Any code from Message Reason Code Prescription.

Prescription - Cancel

The MessageHeader.reason should be cancel


The FHIR Message Bundle MUST contain one MessageHeader resource conforming to NHSDigital-MessageHeader


Profile Min Max
NHSDigital-MedicationRequest 1 1 MedicationRequest.requester MUST conform to the NHSDigital-PractitionerRole-SDS profile for Prescription Cancellation messages
NHSDigital-Patient 1 1
NHSDigital-PractitionerRole 1 * GMC Reference Number MUST NOT be used as a Practitioner identifier
Response Required
Allowed Responses
<MessageDefinition xmlns="http://hl7.org/fhir">
    <id value="prescription-order-update" />
    <url value="https://fhir.nhs.uk/MessageDefinition/prescription-order-update" />
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="c81b88dc-760e-4b1e-9cdb-c5f853630664" />
    <version value="1.0.0" />
    <name value="NHSDigitalPrescriptionOrderUpdate" />
    <title value="Pharmacy/Treatment Order Update" />
    <status value="active" />
    <date value="2020-08-28" />
    <description value="An update to a prescription-order message" />
        <system value="https://fhir.nhs.uk/CodeSystem/message-event" />
        <code value="prescription-order-update" />
        <display value="Prescription Order Update" />
    <category value="consequence" />
        <code value="MedicationRequest" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest" />
        <min value="1" />
        <max value="1" />
    <responseRequired value="always" />
        <message value="https://fhir.nhs.uk/MessageDefinition/prescription-order-response" />
    "resourceType": "MessageDefinition",
    "id": "prescription-order-update",
    "url": "https://fhir.nhs.uk/MessageDefinition/prescription-order-update",
    "identifier":  [
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "c81b88dc-760e-4b1e-9cdb-c5f853630664"
    "version": "1.0.0",
    "name": "NHSDigitalPrescriptionOrderUpdate",
    "title": "Pharmacy/Treatment Order Update",
    "status": "active",
    "date": "2020-08-28",
    "description": "An update to a prescription-order message",
    "eventCoding": {
        "system": "https://fhir.nhs.uk/CodeSystem/message-event",
        "code": "prescription-order-update",
        "display": "Prescription Order Update"
    "category": "consequence",
    "focus":  [
            "code": "MedicationRequest",
            "profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest",
            "min": 1,
            "max": "1"
    "responseRequired": "always",
    "allowedResponse":  [
            "message": "https://fhir.nhs.uk/MessageDefinition/prescription-order-response"
back to top