Implementation guide for interoperable medicines

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

Example 2: MedicationDispense

Note: Example validated against UKCore, dm+d and SNOMED-CT on 23 May 2025.

Actors

Provider System = Hospital pharmacy system

Consumer System = Outpatient EPMA system

Example

<Bundle xmlns="http://hl7.org/fhir">
<id value="f3374004-b796-4d0d-949d-3574b0103ec9" />
<type value="message" />
<timestamp value="2021-05-07T16:15:32+00:00" />
<entry>
<fullUrl value="urn:message-header-167434" />
<resource>
<MessageHeader>
<id value="urn:message-header-167434" />
<eventCoding>
<system value="http://hl7.org/fhir/message-events" />
<code value="individual-requirements-1" />
<display value="Individual Requirements" />
</eventCoding>
<source>
<endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
</source>
<focus>
<reference value="urn:medication-disp-56756345423" />
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:patient-3204221854" />
<resource>
<Patient>
<id value="urn:patient-3204221854" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="3204221854" />
</identifier>
<name>
<use value="official" />
<text value="Mr Scott Chegg" />
<family value="Chegg" />
<given value="Scott" />
<prefix value="Mr" />
</name>
<gender value="male" />
<birthDate value="1960-04-02" />
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:staff-0002" />
<resource>
<Practitioner>
<id value="urn:staff-0002" />
<name>
<text value="Dr Allo Kate" />
<family value="Kate" />
<given value="Allo" />
<prefix value="Dr" />
</name>
<qualification>
<code>
<coding>
<system value="https://fhir.hl7.org.uk/Id/gpc-number" />
<code value="123543" />
<display value="General Pharmaceutical Council" />
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-824211000001107" />
<resource>
<Medication>
<id value="urn:medication-824211000001107" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="824211000001107" />
<display value="Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-disp-56756345423" />
<resource>
<MedicationDispense>
<id value="urn:medication-disp-56756345423" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f" />
</identifier>
<status value="in-progress" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="outpatient" />
<display value="outpatient" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-824211000001107" />
<display value="Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)" />
</medicationReference>
<subject>
<reference value="urn:patient-3204221854" />
<display value="Mr Scott Chegg" />
</subject>
<performer>
<actor>
<reference value="urn:staff-0002" />
<display value="Dr Allo Kate" />
</actor>
</performer>
<authorizingPrescription>
<reference value="urn:med-req-342355475687898" />
</authorizingPrescription>
<quantity>
<value value="1" />
<unit value="pre-filled disposable injection" />
<system value="http://snomed.info/sct" />
<code value="3318611000001103" />
</quantity>
<whenPrepared value="2021-05-07T16:15:32+00:00" />
<dosageInstruction>
<timing>
<event value="2020-05-01" />
<repeat>
<count value="1" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="59380008" />
<display value="Anterior abdominal wall structure" />
</coding>
</site>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="78421000" />
<display value="Intramuscular route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="Inject" />
</coding>
</method>
</dosageInstruction>
</MedicationDispense>
</resource>
</entry>
</Bundle>
{
"resourceType": "Bundle",
"id": "f3374004-b796-4d0d-949d-3574b0103ec9",
"type": "message",
"timestamp": "2021-05-07T16:15:32+00:00",
"entry": [
{
"fullUrl": "urn:message-header-167434",
"resource": {
"resourceType": "MessageHeader",
"id": "urn:message-header-167434",
"eventCoding": {
"system": "http://hl7.org/fhir/message-events",
"code": "individual-requirements-1",
"display": "Individual Requirements"
},
"source": {
"endpoint": "urn:nhs-uk:addressing:ods:T48NT"
},
"focus": [
{
"reference": "urn:medication-disp-56756345423"
}
]
}
},
{
"fullUrl": "urn:patient-3204221854",
"resource": {
"resourceType": "Patient",
"id": "urn:patient-3204221854",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "3204221854"
}
],
"name": [
{
"use": "official",
"text": "Mr Scott Chegg",
"family": "Chegg",
"given": [
"Scott"
],
"prefix": [
"Mr"
]
}
],
"gender": "male",
"birthDate": "1960-04-02"
}
},
{
"fullUrl": "urn:staff-0002",
"resource": {
"resourceType": "Practitioner",
"id": "urn:staff-0002",
"name": [
{
"text": "Dr Allo Kate",
"family": "Kate",
"given": [
"Allo"
],
"prefix": [
"Dr"
]
}
],
"qualification": [
{
"code": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/Id/gpc-number",
"code": "123543",
"display": "General Pharmaceutical Council"
}
]
}
}
]
}
},
{
"fullUrl": "urn:medication-824211000001107",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-824211000001107",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "824211000001107",
"display": "Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)"
}
]
}
}
},
{
"fullUrl": "urn:medication-disp-56756345423",
"resource": {
"resourceType": "MedicationDispense",
"id": "urn:medication-disp-56756345423",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f"
}
],
"status": "in-progress",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "outpatient",
"display": "outpatient"
}
]
},
"medicationReference": {
"reference": "urn:medication-824211000001107",
"display": "Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)"
},
"subject": {
"reference": "urn:patient-3204221854",
"display": "Mr Scott Chegg"
},
"performer": [
{
"actor": {
"reference": "urn:staff-0002",
"display": "Dr Allo Kate"
}
}
],
"authorizingPrescription": [
{
"reference": "urn:med-req-342355475687898"
}
],
"quantity": {
"value": 1,
"unit": "pre-filled disposable injection",
"system": "http://snomed.info/sct",
"code": "3318611000001103"
},
"whenPrepared": "2021-05-07T16:15:32+00:00",
"dosageInstruction": [
{
"timing": {
"event": [
"2020-05-01"
],
"repeat": {
"count": 1
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "59380008",
"display": "Anterior abdominal wall structure"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "78421000",
"display": "Intramuscular route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "Inject"
}
]
}
}
]
}
}
]
}
Bundle.id[0]f3374004-b796-4d0d-949d-3574b0103ec9
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]http://hl7.org/fhir/message-events
Bundle.entry[0].resource[0].event[0].code[0]individual-requirements-1
Bundle.entry[0].resource[0].event[0].display[0]Individual Requirements
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]urn:medication-disp-56756345423
Bundle.entry[1].fullUrl[0]urn:patient-3204221854
Bundle.entry[1].resource[0].id[0]urn:patient-3204221854
Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[1].resource[0].identifier[0].value[0]3204221854
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Scott Chegg
Bundle.entry[1].resource[0].name[0].family[0]Chegg
Bundle.entry[1].resource[0].name[0].given[0]Scott
Bundle.entry[1].resource[0].name[0].prefix[0]Mr
Bundle.entry[1].resource[0].gender[0]male
Bundle.entry[1].resource[0].birthDate[0]1960-04-02
Bundle.entry[2].fullUrl[0]urn:staff-0002
Bundle.entry[2].resource[0].id[0]urn:staff-0002
Bundle.entry[2].resource[0].name[0].text[0]Dr Allo Kate
Bundle.entry[2].resource[0].name[0].family[0]Kate
Bundle.entry[2].resource[0].name[0].given[0]Allo
Bundle.entry[2].resource[0].name[0].prefix[0]Dr
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/gpc-number
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].code[0]123543
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Pharmaceutical Council
Bundle.entry[3].fullUrl[0]urn:medication-824211000001107
Bundle.entry[3].resource[0].id[0]urn:medication-824211000001107
Bundle.entry[3].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].code[0].coding[0].code[0]824211000001107
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)
Bundle.entry[4].fullUrl[0]urn:medication-disp-56756345423
Bundle.entry[4].resource[0].id[0]urn:medication-disp-56756345423
Bundle.entry[4].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[4].resource[0].identifier[0].value[0]urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f
Bundle.entry[4].resource[0].status[0]in-progress
Bundle.entry[4].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[4].resource[0].category[0].coding[0].code[0]outpatient
Bundle.entry[4].resource[0].category[0].coding[0].display[0]outpatient
Bundle.entry[4].resource[0].medication[0].reference[0]urn:medication-824211000001107
Bundle.entry[4].resource[0].medication[0].display[0]Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)
Bundle.entry[4].resource[0].subject[0].reference[0]urn:patient-3204221854
Bundle.entry[4].resource[0].subject[0].display[0]Mr Scott Chegg
Bundle.entry[4].resource[0].performer[0].actor[0].reference[0]urn:staff-0002
Bundle.entry[4].resource[0].performer[0].actor[0].display[0]Dr Allo Kate
Bundle.entry[4].resource[0].authorizingPrescription[0].reference[0]urn:med-req-342355475687898
Bundle.entry[4].resource[0].quantity[0].value[0]1
Bundle.entry[4].resource[0].quantity[0].unit[0]pre-filled disposable injection
Bundle.entry[4].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].quantity[0].code[0]3318611000001103
Bundle.entry[4].resource[0].whenPrepared[0]2021-05-07T16:15:32+00:00
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].event[0]2020-05-01
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].count[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].code[0]59380008
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].code[0]78421000
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intramuscular route
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].code[0]422145002
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Inject
Bundle
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