Pathology Reports Without a Validated NHS Number

Purpose

A validated NHS number remains the preferred method of patient identification when exchanging pathology reports through the Pathology and Laboratory Medicine Reporting FHIR API.

In exceptional circumstances, a validated NHS number may be unavailable. In these cases, a pathology report may still be exchanged using a non-authoritative reporting pattern aligned with the Patient Data Manager (PDM) processing model.

Design Principles

• A validated NHS number remains the preferred and normal route.
• An unvalidated NHS number SHALL be treated as unavailable.
• The alternative route is an operational exception and SHALL only be used when a validated NHS number is unavailable.
• Sufficient demographic information SHALL be supplied to support patient matching.
• Existing authoritative NHS-number processing SHALL remain unchanged.

Reporting Patterns

Validated NHS Number Available

Where a validated NHS number is available:

• A Patient resource SHALL NOT be included within the Document Bundle.
• Patient-linked resources SHALL identify the patient using subject.identifier.
• All NHS numbers carried within the Bundle SHALL match.
• The report SHALL be processed as an authoritative pathology report.

Validated NHS Number Unavailable

Where a validated NHS number is unavailable:

• A Patient resource SHALL be included within the Document Bundle.
• The Patient resource SHALL conform to patient-eu-lab.
• The Patient SHALL contain one or more identifiers that are not NHS numbers.
• The Patient SHALL contain supporting demographic information.
• Patient-linked resources SHALL reference the Patient resource using subject.reference.
• The report SHALL be processed as a non-authoritative pathology report.

Bundle Rules