NHS England FHIR Implementation Guide (deprecated)

Important Announcement regarding this Implementation Guide
  • As of 04/10/2023, this implementation guide has been deprecated and all development on the legacy NHS England FHIR Implementation Guide assets has ceased.
  • Therefore, vendors looking to start new implementations or looking to update existing implementations should use the new NHS England Implementation Guide. Vendors continuing to implement legacy NHS England FHIR Implementation Guide based solutions do so at their own risk and on the understanding that no maintenance or support will be available.

FHIR Documents

This is the FHIR method of exchanging clinical documents. where content to be exchanged is wrapped by a Composition that provides the context of the content, and that has a fixed presentation for a human reader. The document framework is provided to help with computer-assisted human to human communication uses - which are not uncommon in healthcare.

Typically, exchanging documents is associated with exchanging clinical information across NHS organisation and care setting boundaries (e.g., Transfer of Care), while data-based exchange using the RESTful API is appropriate within where there are well established clinical governance arrangements.

The FHIR document is a FHIR Bundle with the type of document

Profile url
https://fhir.nhs.uk/StructureDefinition/NHSDigital-Bundle-FHIRDocument

identifierΣ0..1Identifier
typeΣ1..1codeBindingFixed Value
timestampΣ0..1instant
totalΣ I0..1unsignedInt
fullUrlΣ1..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
fullUrlΣ0..1uri
resourceΣ I0..1NHSDigitalComposition
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
fullUrlΣ0..1uri
resourceΣ I0..1NHSDigitalPatient
signatureΣ0..1Signature

The FHIR Documents are exchanged using FHIR Messaging (which is also a FHIR Bundle of type of message), as shown in the diagram below:

fhir-document-bundle

The NHSDigital-Composition is subdivided into sections which are equivalent to PRSB headings.

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