NHS Digital FHIR Medicines


This message definition describes the rules for a Prescription Order interactions used in a FHIR Messaging exchange.

Event Coding

System Code
Message Events prescription-order


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


Profile Min Max Notes
NHSDigital-MedicationRequest 1 4 MedicationRequest.requester MUST conform to the NHSDigital-PractitionerRoleEPSLegal profile for Prescription Order messages
NHSDigital-Patient 1 1
NHSDigital-PractitionerRole 1 * GMC Reference Number MUST NOT be used as a Practitioner identifier
NHSDigital-CommunicationRequest 0 * This is for legacy support of patient messages (e.g. surgery opening times and repeat medication lists) as would appear on printed prescriptions. It is also used in primary care to communicate repeat medication lists.
NHSDigital-Provenance 0 1 MUST for $process-message API. This holds the electronic prescription signature.
NHSDigital-Location 0 * Prescription Address
Response Required
Allowed Responses
Prescription Order Homecare Prepare homecare example (used with `prepare` endpoint to obtain digital signature
Prescription Order Homecare Repeat Medication homecare repeat medication example with digital signature
Prescription Order Homecare using Medication resource homecare example using a Medication resource instead of a CodeableConcept.
Prescription Order Outpatient Acute Medication Outpatient example with acute medication.
Prescription Order Outpatient Multiple Medications Outpatient acute four item prescription, including one Schedule 2 controlled drug
Prescription Order Outpatient Endorsement Outpatient example with endorsed acute medication.
Prescription Order Community No Nominated Pharmacy Community repeat dispensing prescription with no nominated pharmacy.
Prescription Order Community Nurse Prescriber Community acute prescription, nurse prescriber with legal authenticator.
Prescription Order GP with patient notes GP acutue prescription with patient notes and repeat medications list.
<MessageDefinition xmlns="http://hl7.org/fhir">
    <id value="prescription-order" />
    <url value="https://fhir.nhs.uk/MessageDefinition/prescription-order" />
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="c81b88dc-760e-4b1e-9cdb-c5f853630664" />
    <version value="1.0.0" />
    <name value="NHSDigitalPrescriptionOrder" />
    <title value="Pharmacy/Treatment Order" />
    <status value="active" />
    <date value="2020-05-27" />
    <description value="Ordering of medications" />
    <base value="https://fhir.hl7.org.uk/MessageDefinition/prescription-order" />
        <system value="https://fhir.nhs.uk/CodeSystem/message-event" />
        <code value="prescription-order" />
        <display value="Prescription Order" />
    <category value="consequence" />
        <code value="MedicationRequest" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest-Message" />
        <min value="1" />
        <max value="4" />
        <code value="CommunicationRequest" />
        <profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
        <min value="0" />
        <max value="*" />
    <responseRequired value="on-error" />
        <message value="https://fhir.nhs.uk/MessageDefinition/prescription-order-update" />
    "resourceType": "MessageDefinition",
    "id": "prescription-order",
    "url": "https://fhir.nhs.uk/MessageDefinition/prescription-order",
    "identifier":  [
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "c81b88dc-760e-4b1e-9cdb-c5f853630664"
    "version": "1.0.0",
    "name": "NHSDigitalPrescriptionOrder",
    "title": "Pharmacy/Treatment Order",
    "status": "active",
    "date": "2020-05-27",
    "base": "https://fhir.hl7.org.uk/MessageDefinition/prescription-order",
    "eventCoding": {
        "system": "https://fhir.nhs.uk/CodeSystem/message-event",
        "code": "prescription-order",
        "display": "Prescription Order"
    "description": "Ordering of medications",
    "category": "consequence",
    "focus":  [
            "code": "MedicationRequest",
            "profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest-Message",
            "min": 1,
            "max": "4"
            "code": "CommunicationRequest",
            "profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest",
            "min": 0,
            "max": "*"
    "responseRequired": "on-error",
    "allowedResponse":  [
            "message": "https://fhir.nhs.uk/MessageDefinition/prescription-order-update"
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