Electronic Prescription Service (EPS) Implementation Guide

MessageDefinition

prescription-order

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

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

MessageHeader.eventCoding

System Code
Message Events prescription-order 
"eventCoding": {
    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
    "code": "prescription-order",
    "display": "Prescription Order"
}

MessageHeader.focus

Profile Min Max Notes
NHSDigital-MedicationRequest
See note below		 1 4 The following elements must be the same for each MedicationRequest in the Bundle:
- extension:NHSBSAprescriptionType
- status
- intent
- category
- subject
- requester
- groupIdentifier
- courseOfTherapyType, when the value is continuous-repeat-dispensing
- dispenseRequest.validityPeriod
NHSDigital-CommunicationRequest 0 * This is for legacy support of patient messages (e.g. surgery opening times and repeat medication lists) that would of been printed on the right hand side of paper prescriptions.
NHSDigital-Provenance 0 1 MUST for $process-message endpoint. This holds the Advanced Electronic Signature (AES) for the prescription.
Response Required
always
Allowed Responses
NHSDigital-OperationOutcome
<MessageDefinition xmlns="http://hl7.org/fhir">
<id value="prescription-order" />
<url value="https://fhir.nhs.uk/MessageDefinition/prescription-order" />
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="c81b88dc-760e-4b1e-9cdb-c5f853630664" />
</identifier>
<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" />
<eventCoding>
<system value="https://fhir.nhs.uk/CodeSystem/message-event" />
<code value="prescription-order" />
<display value="Prescription Order" />
</eventCoding>
<category value="consequence" />
<focus>
<code value="MedicationRequest" />
<profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest-Message" />
<min value="1" />
<max value="4" />
</focus>
<focus>
<code value="CommunicationRequest" />
<profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-CommunicationRequest" />
<min value="0" />
<max value="*" />
</focus>
<responseRequired value="on-error" />
<allowedResponse>
<message value="https://fhir.nhs.uk/MessageDefinition/prescription-order-update" />
</allowedResponse>
</MessageDefinition>
{
"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",
"description": "Ordering of medications",
"base": "https://fhir.hl7.org.uk/MessageDefinition/prescription-order",
"eventCoding": {
"system": "https://fhir.nhs.uk/CodeSystem/message-event",
"code": "prescription-order",
"display": "Prescription Order"
},
"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"
}
]
}

Note

The underlying conformance profile for the NHSDigital-MedicationRequest is https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest-Message. This profile mandates the use of a referenced resources for subject and requester.

image-message-prescription-order

prescription-order-update

This message definition describes the rules for a Prescription Order Update interactions used in a FHIR Messaging exchange. It is used to cancel a single prescribed medication item.

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

MessageHeader.eventCoding

System Code
Message Events prescription-order-update 
"eventCoding": {
    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
    "code": "prescription-order-update",
    "display": "Prescription Order Update"
}

MessageHeader.reason

The MessageHeader.reason should be cancel.

"reason": {
    "coding": [
        {
            "system": "https://fhir.nhs.uk/CodeSystem/message-reason-prescription",
            "code": "cancel",
            "display": "Cancel"
        }
    ]
}

MessageHeader.focus

Profile Min Max Notes
NHSDigital-MedicationRequest 1 1 The NHSDigital-Provenance and NHSDigital-CommunicationRequest resources do not need to be included in the Bundle.
Response Required
always
Allowed Responses
prescription-order-response
NHSDigital-OperationOutcome
<MessageDefinition xmlns="http://hl7.org/fhir">
<id value="prescription-order-update" />
<url value="https://fhir.nhs.uk/MessageDefinition/prescription-order-update" />
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="c81b88dc-760e-4b1e-9cdb-c5f853630664" />
</identifier>
<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" />
<eventCoding>
<system value="https://fhir.nhs.uk/CodeSystem/message-event" />
<code value="prescription-order-update" />
<display value="Prescription Order Update" />
</eventCoding>
<category value="consequence" />
<focus>
<code value="MedicationRequest" />
<profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest" />
<min value="1" />
<max value="1" />
</focus>
<responseRequired value="always" />
<allowedResponse>
<message value="https://fhir.nhs.uk/MessageDefinition/prescription-order-response" />
</allowedResponse>
</MessageDefinition>
{
"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"
}
]
}

image-message-prescription-order-update

prescription-order-response

This message definition describes the rules for a Prescription Order Response interactions used in a FHIR Messaging exchange. This is used as a response to the prescription-order-update message. As this relates to a single MedicationRequest, this response will only ever contain a single MedicationRequest.

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

MessageHeader.eventCoding

System Code
Message Events prescription-order-response 
"eventCoding": {
    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
    "code": "prescription-order-response",
    "display": "Prescription Order Response"
}

MessageHeader.focus

Profile Min Max
NHSDigital-MedicationRequest 1 1
<MessageDefinition xmlns="http://hl7.org/fhir">
<id value="prescription-order-response" />
<url value="https://fhir.nhs.uk/MessageDefinition/prescription-order-response" />
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="c81b88dc-760e-4b1e-9cdb-c5f853630664" />
</identifier>
<version value="1.1.0" />
<name value="NHSDigitalPrescriptionOrderResponse" />
<title value="Pharmacy/Treatment Order Response" />
<status value="retired" />
<date value="2025-10-14" />
<description value="response to a prescription-order-update message" />
<eventCoding>
<system value="https://fhir.nhs.uk/CodeSystem/message-event" />
<code value="prescription-order-response" />
<display value="Prescription Order Response" />
</eventCoding>
<category value="notification" />
<focus>
<code value="MedicationRequest" />
<profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest" />
<min value="1" />
<max value="1" />
</focus>
</MessageDefinition>
{
"resourceType": "MessageDefinition",
"id": "prescription-order-response",
"url": "https://fhir.nhs.uk/MessageDefinition/prescription-order-response",
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "c81b88dc-760e-4b1e-9cdb-c5f853630664"
}
],
"version": "1.1.0",
"name": "NHSDigitalPrescriptionOrderResponse",
"title": "Pharmacy/Treatment Order Response",
"status": "retired",
"date": "2025-10-14",
"description": "response to a prescription-order-update message",
"eventCoding": {
"system": "https://fhir.nhs.uk/CodeSystem/message-event",
"code": "prescription-order-response",
"display": "Prescription Order Response"
},
"category": "notification",
"focus": [
{
"code": "MedicationRequest",
"profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest",
"min": 1,
"max": "1"
}
]
}

image-message-prescription-order-response

dispense-notification

This message definition describes the rules for a Dispense Notification interactions used in a FHIR Messaging exchange.

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

MessageHeader.eventCoding

System Code
Message Events dispense-notification 
"eventCoding": {
    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
    "code": "dispense-notification",
    "display": "Dispense Notification"
}

MessageHeader.response

Mandatory UUID from the prescription release response Parameters.id that contained the prescription being dispensed.

"response": {
    "identifier": "a5d77265-8ba5-4c74-b8ce-ea0dbaafbdb8",
    "code": "ok"
}

MessageHeader.focus

Profile Min Max Notes
NHSDigital-MedicationDispense
See note below		 1 * Multiple instances of this resource are used when more than one product have been dispensed for the single prescribed medication. For example different brands (AMP/AMPP) of the same generic drug (VMP).
Response Required
always
Allowed Responses
NHSDigital-OperationOutcome
<MessageDefinition xmlns="http://hl7.org/fhir">
<id value="bf729ea8-280b-4109-b2f5-02ce8e51d870" />
<url value="https://fhir.nhs.uk/MessageDefinition/dispense-notification" />
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="bf729ea8-280b-4109-b2f5-02ce8e51d870" />
</identifier>
<version value="1.0.0" />
<name value="NHSDigitalDispenseNotification" />
<title value="Pharmacy/Treatment Dispense" />
<status value="active" />
<date value="2020-10-02" />
<description value="Notification of dispensed medication" />
<eventCoding>
<system value="https://fhir.nhs.uk/CodeSystem/message-event" />
<code value="dispense-notification" />
<display value="Dispense Notification" />
</eventCoding>
<category value="notification" />
<focus>
<code value="MedicationDispense" />
<profile value="https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense-Message" />
<min value="1" />
<max value="*" />
</focus>
</MessageDefinition>
{
"resourceType": "MessageDefinition",
"id": "bf729ea8-280b-4109-b2f5-02ce8e51d870",
"url": "https://fhir.nhs.uk/MessageDefinition/dispense-notification",
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "bf729ea8-280b-4109-b2f5-02ce8e51d870"
}
],
"version": "1.0.0",
"name": "NHSDigitalDispenseNotification",
"title": "Pharmacy/Treatment Dispense",
"status": "active",
"date": "2020-10-02",
"description": "Notification of dispensed medication",
"eventCoding": {
"system": "https://fhir.nhs.uk/CodeSystem/message-event",
"code": "dispense-notification",
"display": "Dispense Notification"
},
"category": "notification",
"focus": [
{
"code": "MedicationDispense",
"profile": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense-Message",
"min": 1,
"max": "*"
}
]
}

Note

The underlying conformance profile for the NHSDigital-MedicationDispense is https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense-Message. This profile mandates the use of a contained resource for authorizingPrescription.

image-message-dispense-notification

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