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: Bundle - Medication on Transfer

Note: Example validated against UKCore, dm+d and SNOMED-CT on 23 May 2025.
<Bundle xmlns="http://hl7.org/fhir">
<id value="52e9c212-403a-40d5-a29c-bf8bda88a812" />
<identifier>
<system value="urn:[organisation_name]:[system_name]" />
<value value="urn:1089540d-7bd6-42cc-bfc1-e35b70b29d47" />
</identifier>
<type value="message" />
<timestamp value="2021-05-16T09:12:53+00:00" />
<entry>
<fullUrl value="urn:message-header-32423423" />
<resource>
<MessageHeader>
<id value="urn:message-header-32423423" />
<eventCoding>
<system value="http://hl7.org/fhir/message-events" />
<code value="current-medication" />
<display value="Current Medication" />
</eventCoding>
<source>
<name value="ACME Clinical Systems" />
<software value="ACME ePMA" />
<version value="3.5.68" />
<endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
</source>
<focus>
<reference value="urn:medication-statement-12323434534" />
</focus>
<focus>
<reference value="urn:medication-statement-34544333" />
</focus>
<focus>
<reference value="urn:medication-statement-12354564" />
</focus>
<focus>
<reference value="urn:medication-statement-0931203120" />
</focus>
<focus>
<reference value="urn:medication-statement-3464323423" />
</focus>
<focus>
<reference value="urn:medication-statement-7674545645" />
</focus>
<focus>
<reference value="urn:medication-statement-234545645" />
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:patient-00123943" />
<resource>
<Patient>
<id value="urn:patient-00123943" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="00123943" />
</identifier>
<name>
<use value="official" />
<text value="Miss Cedeep Laya" />
<family value="Laya" />
<given value="Cedeep" />
<prefix value="Miss" />
</name>
<gender value="female" />
<birthDate value="1979-04-13" />
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:staff-0002" />
<resource>
<Practitioner>
<id value="urn:staff-0002" />
<name>
<text value="Dr Maikeu Better" />
<family value="Better" />
<given value="Maikeu" />
<prefix value="Dr" />
</name>
<qualification>
<code>
<coding>
<system value="https://fhir.hl7.org.uk/Id/gmc-number" />
<code value="2145879" />
<display value="General Medical Council" />
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-345345345" />
<resource>
<Medication>
<id value="urn:medication-345345345" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="222311000001102" />
<display value="Ventolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd)" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-12323434534" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-12323434534" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="community" />
<display value="community" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-345345345" />
<display value="Ventolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd)" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2019-12-13T15:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<timing>
<repeat>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="2" />
<unit value="dose" />
<system value="http://snomed.info/sct" />
<code value="3317411000001100" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-554312" />
<resource>
<Medication>
<id value="urn:medication-554312" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="3178611000001100" />
<display value="Becotide 100 inhaler (GlaxoSmithKline UK Ltd)" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-34544333" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-34544333" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="community" />
<display value="community" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-554312" />
<display value="Becotide 100 inhaler (GlaxoSmithKline UK Ltd)" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2020-01-07T10:12:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<timing>
<repeat>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="1" />
<unit value="dose" />
<system value="http://snomed.info/sct" />
<code value="3317411000001100" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-9908182" />
<resource>
<Medication>
<id value="urn:medication-9908182" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="42109611000001109" />
<display value="Paracetamol 500mg tablets" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-12354564" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-12354564" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="community" />
<display value="community" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-9908182" />
<display value="Paracetamol 500mg tablets" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2021-05-07T13:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<timing>
<repeat>
<frequencyMax value="4" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<asNeededBoolean value="true" />
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="2" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-115643534" />
<resource>
<Medication>
<id value="urn:medication-115643534" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="775545008" />
<display value="Diazepam" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-0931203120" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-0931203120" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="inpatient" />
<display value="inpatient" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-115643534" />
<display value="Diazepam" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2021-05-07T13:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<timing>
<repeat>
<count value="1" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="5" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-442343243" />
<resource>
<Medication>
<id value="urn:medication-442343243" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="774586009" />
<display value="Amoxicillin" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-3464323423" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-3464323423" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="inpatient" />
<display value="inpatient" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-442343243" />
<display value="Amoxicillin" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2021-05-07T13:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<additionalInstruction>
<text value="1 hour before the procedure" />
</additionalInstruction>
<timing>
<repeat>
<count value="1" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="3" />
<unit value="gram" />
<system value="http://unitsofmeasure.org" />
<code value="g" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-3342366" />
<resource>
<Medication>
<id value="urn:medication-3342366" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="39112311000001102" />
<display value="Chlorhexidine gluconate 0.2% mouthwash" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-7674545645" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-7674545645" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="inpatient" />
<display value="inpatient" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-3342366" />
<display value="Chlorhexidine gluconate 0.2% mouthwash" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2021-05-07T13:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<additionalInstruction>
<text value="to be used as a mouthwash" />
</additionalInstruction>
<timing>
<repeat>
<frequency value="4" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="Oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="10" />
<unit value="millilitre" />
<system value="http://unitsofmeasure.org" />
<code value="ml" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-85635324" />
<resource>
<Medication>
<id value="urn:medication-85635324" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="775768002" />
<display value="Enoxaparin" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-statement-234545645" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-234545645" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="inpatient" />
<display value="inpatient" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-85635324" />
<display value="Enoxaparin" />
</medicationReference>
<subject>
<reference value="urn:patient-00123943" />
<display value="Miss Cedeep Laya" />
</subject>
<dateAsserted value="2021-05-07T13:00:25+00:00" />
<informationSource>
<reference value="urn:staff-0002" />
<display value="Dr Maikeu Better" />
</informationSource>
<dosage>
<timing>
<repeat>
<frequency value="12" />
<period value="1" />
<periodUnit value="h" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="34206005" />
<display value="Subcutaneous route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="422145002" />
<display value="Inject" />
</coding>
</method>
<doseAndRate>
<doseQuantity>
<value value="60" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</doseAndRate>
</dosage>
</MedicationStatement>
</resource>
</entry>
</Bundle>
{
"resourceType": "Bundle",
"id": "52e9c212-403a-40d5-a29c-bf8bda88a812",
"identifier": {
"system": "urn:[organisation_name]:[system_name]",
"value": "urn:1089540d-7bd6-42cc-bfc1-e35b70b29d47"
},
"type": "message",
"timestamp": "2021-05-16T09:12:53+00:00",
"entry": [
{
"fullUrl": "urn:message-header-32423423",
"resource": {
"resourceType": "MessageHeader",
"id": "urn:message-header-32423423",
"eventCoding": {
"system": "http://hl7.org/fhir/message-events",
"code": "current-medication",
"display": "Current Medication"
},
"source": {
"name": "ACME Clinical Systems",
"software": "ACME ePMA",
"version": "3.5.68",
"endpoint": "urn:nhs-uk:addressing:ods:T48NT"
},
"focus": [
{
"reference": "urn:medication-statement-12323434534"
},
{
"reference": "urn:medication-statement-34544333"
},
{
"reference": "urn:medication-statement-12354564"
},
{
"reference": "urn:medication-statement-0931203120"
},
{
"reference": "urn:medication-statement-3464323423"
},
{
"reference": "urn:medication-statement-7674545645"
},
{
"reference": "urn:medication-statement-234545645"
}
]
}
},
{
"fullUrl": "urn:patient-00123943",
"resource": {
"resourceType": "Patient",
"id": "urn:patient-00123943",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "00123943"
}
],
"name": [
{
"use": "official",
"text": "Miss Cedeep Laya",
"family": "Laya",
"given": [
"Cedeep"
],
"prefix": [
"Miss"
]
}
],
"gender": "female",
"birthDate": "1979-04-13"
}
},
{
"fullUrl": "urn:staff-0002",
"resource": {
"resourceType": "Practitioner",
"id": "urn:staff-0002",
"name": [
{
"text": "Dr Maikeu Better",
"family": "Better",
"given": [
"Maikeu"
],
"prefix": [
"Dr"
]
}
],
"qualification": [
{
"code": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/Id/gmc-number",
"code": "2145879",
"display": "General Medical Council"
}
]
}
}
]
}
},
{
"fullUrl": "urn:medication-345345345",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-345345345",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "222311000001102",
"display": "Ventolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd)"
}
]
}
}
},
{
"fullUrl": "urn:medication-statement-12323434534",
"resource": {
"resourceType": "MedicationStatement",
"id": "urn:medication-statement-12323434534",
"status": "active",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "community",
"display": "community"
}
]
},
"medicationReference": {
"reference": "urn:medication-345345345",
"display": "Ventolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd)"
},
"subject": {
"reference": "urn:patient-00123943",
"display": "Miss Cedeep Laya"
},
"dateAsserted": "2019-12-13T15:00:25+00:00",
"informationSource": {
"reference": "urn:staff-0002",
"display": "Dr Maikeu Better"
},
"dosage": [
{
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "Oral"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 2,
"unit": "dose",
"system": "http://snomed.info/sct",
"code": "3317411000001100"
}
}
]
}
]
}
},
{
"fullUrl": "urn:medication-554312",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-554312",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "3178611000001100",
"display": "Becotide 100 inhaler (GlaxoSmithKline UK Ltd)"
}
]
}
}
},
{
"fullUrl": "urn:medication-statement-34544333",
"resource": {
"resourceType": "MedicationStatement",
"id": "urn:medication-statement-34544333",
"status": "active",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "community",
"display": "community"
}
]
},
"medicationReference": {
"reference": "urn:medication-554312",
"display": "Becotide 100 inhaler (GlaxoSmithKline UK Ltd)"
},
"subject": {
"reference": "urn:patient-00123943",
"display": "Miss Cedeep Laya"
},
"dateAsserted": "2020-01-07T10:12:25+00:00",
"informationSource": {
"reference": "urn:staff-0002",
"display": "Dr Maikeu Better"
},
"dosage": [
{
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "Oral"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "dose",
"system": "http://snomed.info/sct",
"code": "3317411000001100"
}
}
]
}
]
}
},
{
"fullUrl": "urn:medication-9908182",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-9908182",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "42109611000001109",
"display": "Paracetamol 500mg tablets"
}
]
}
}
},
{
"fullUrl": "urn:medication-statement-12354564",
"resource": {
"resourceType": "MedicationStatement",
"id": "urn:medication-statement-12354564",
"status": "active",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "community",
"display": "community"
}
]
},
"medicationReference": {
"reference": "urn:medication-9908182",
"display": "Paracetamol 500mg tablets"
},
"subject": {
"reference": "urn:patient-00123943",
"display": "Miss Cedeep Laya"
},
"dateAsserted": "2021-05-07T13:00:25+00:00",
"informationSource": {
"reference": "urn:staff-0002",
"display": "Dr Maikeu Better"
},
"dosage": [
{
"timing": {
"repeat": {
"frequencyMax": 4,
"period": 1,
"periodUnit": "d"
}
},
"asNeededBoolean": true,
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "Oral"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 2,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
]
}
},
{
"fullUrl": "urn:medication-115643534",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-115643534",
"code": {
"coding": [
{
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Bundle.entry[14].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[14].resource[0].dosage[0].route[0].coding[0].display[0]Oral
Bundle.entry[14].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]10
Bundle.entry[14].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]millilitre
Bundle.entry[14].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[14].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]ml
Bundle.entry[15].fullUrl[0]urn:medication-85635324
Bundle.entry[15].resource[0].id[0]urn:medication-85635324
Bundle.entry[15].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[15].resource[0].code[0].coding[0].code[0]775768002
Bundle.entry[15].resource[0].code[0].coding[0].display[0]Enoxaparin
Bundle.entry[16].fullUrl[0]urn:medication-statement-234545645
Bundle.entry[16].resource[0].id[0]urn:medication-statement-234545645
Bundle.entry[16].resource[0].status[0]active
Bundle.entry[16].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[16].resource[0].category[0].coding[0].code[0]inpatient
Bundle.entry[16].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[16].resource[0].medication[0].reference[0]urn:medication-85635324
Bundle.entry[16].resource[0].medication[0].display[0]Enoxaparin
Bundle.entry[16].resource[0].subject[0].reference[0]urn:patient-00123943
Bundle.entry[16].resource[0].subject[0].display[0]Miss Cedeep Laya
Bundle.entry[16].resource[0].dateAsserted[0]2021-05-07T13:00:25+00:00
Bundle.entry[16].resource[0].informationSource[0].reference[0]urn:staff-0002
Bundle.entry[16].resource[0].informationSource[0].display[0]Dr Maikeu Better
Bundle.entry[16].resource[0].dosage[0].timing[0].repeat[0].frequency[0]12
Bundle.entry[16].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[16].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]h
Bundle.entry[16].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[16].resource[0].dosage[0].route[0].coding[0].code[0]34206005
Bundle.entry[16].resource[0].dosage[0].route[0].coding[0].display[0]Subcutaneous route
Bundle.entry[16].resource[0].dosage[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[16].resource[0].dosage[0].method[0].coding[0].code[0]422145002
Bundle.entry[16].resource[0].dosage[0].method[0].coding[0].display[0]Inject
Bundle.entry[16].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]60
Bundle.entry[16].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[16].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[16].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]mg
Bundle
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