Supporting Healthcare Workflow

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

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Basic Healthcare Workflow

In abstract form, workflow between providers and practitioners consists of a Request being exchanged and replies are returned.


These requests and events can be sent independently of each other. Example nationally defined requests and events can be found in:

  • Requests

    • Booking and Referrals Service (BARS)
    • Electronic Prescription Service (EPS)
    • Electronic Referral Service (eRS)
    • Urgent & Emergency Care (UEC)

  • Events

    • Transfer of Care (TOC)
    • COVID 19 Medical Exemptions and Test Results
    • Immunisation History FHIR API
    • Digital Medicines (Community Pharmacy)
    • Urgent & Emergency Care (UEC)
    • National Event Management System (NEMS)

These national APIs are often related. For example: an eRS Referral will often have a corresponding ToC Discharge letter or a UEC Referral has a corresponding Digital Medicines Encounter Letter.

Healthcare Workflow with Clinical Process

A more detailed version is shown below, this also includes clinical workflow processes such as:

  • Finding a care provider
  • Review the Request which includes viewing the patient care records
  • Event notifications which are in addition to the events listed above and will include Admission, Discharge and Transfer events (ADT).

Review of the patients care records will involve a mix of services and applications, including:

  • Accessing the GP record: GP Connect or IM1
  • Summary Care Record
  • Use of Clinical Portals
  • Access to NHS Digital APIs.

This guide describes common patterns that are implemented to support health and social care workflows.

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