<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="0906e705-4a97-4701-b78c-00d68064ea79" />
  <url value="https://fhir.virtually.healthcare/Questionnaire/NHSBSA-Claim" />
  <version value="0.0.2" />
  <title value="NHSABSA-Claim" />
  <status value="draft" />
  <subjectType value="Patient" />
  <item>
    <linkId value="REFERRAL_REFERENCE" />
    <text value="The NHS 111 call centre or online reference for the referral. Size max. 255. Mandatory for types EMG_MED, MIN_ILL, EMG_MED_UEC and MIN_ILL_UEC. Should not be supplied for type FLU_VAC, COVID_VAC. For GP Referrals should be supplied as 'GP-'  {Unique_identifier}. Recommended format: 'GP-' + {Caller_Identifier} + '-' + {generated_identifier}, e.g. GPNHSBSA-123456XYZ" />
    <type value="string" />
    <required value="true" />
  </item>
  <item>
    <linkId value="MEDICATION_SUPPLY_TYPE" />
    <text value="Over the counter/Minor Ailments Service/Patient Group Direction" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="REFERRER_ORG_TYPE" />
    <text value="Type of referring organisation" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="REFERRER_CASE_REF" />
    <text value="The case reference number from the referring organisation. Optional if Referral Case ID (REFERRAL_REFERENCE) is present" />
    <type value="string" />
    <required value="false" />
  </item>
  <item>
    <linkId value="DISPOSITION_CODE" />
    <text value="Dx code from the 111 system resulting from the NHS Pathways" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="CONSULTATION_METHOD" />
    <text value="Type of consultation conducted" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="CONSULTATION_OUTCOME" />
    <text value="The outcome of the consultation conducted" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="OTHER_CONSULTATION_OUTCOME" />
    <text value="Free text value for other outcome of the consultation conducted and mandatory only if value of CONSULTATION_OUTCOME is selected as OTHER(Other)." />
    <type value="string" />
    <required value="false" />
  </item>
  <item>
    <linkId value="SIGNPOSTED_TO" />
    <text value="Details of Where patient has been signposted to" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="OTHER_SIGNPOSTED_TO" />
    <text value="Free text value for other signposted to and mandatory only if value of SIGNPOSTED_TO is selected as option OTHER" />
    <type value="string" />
    <required value="false" />
  </item>
  <item>
    <linkId value="ESCALATED_TO" />
    <text value="Where patient has been referred to (escalated)" />
    <type value="choice" />
    <required value="false" />
  </item>
  <item>
    <linkId value="INCIDENT" />
    <text value="Confirmation of whether the pharmacist would like to report an incident or send a message to CPCS commissioners." />
    <type value="boolean" />
    <required value="false" />
  </item>
  <item>
    <linkId value="PRESENTING_COMPLAINT_OR_ISSUES" />
    <text value="The health problem or issue experienced by the patient. Freetext values with max size 250 chars." />
    <type value="string" />
    <required value="false" />
  </item>
  <item>
    <linkId value="ONWARD_REFERRAL_REASON" />
    <text value="Reason (free text value) for onward referral. Max size 250." />
    <type value="string" />
    <required value="false" />
  </item>
</Questionnaire>