Schema: ReferralRequest Resource

Introduction

The headings below list the elements of the ReferralRequest resource and describe how to populate and consume them.

Important: Any element not specifically listed below will NOT be populated or consumed. A full list of elements not used is available here.

Tip: You’ll find it helpful to read it in conjunction with the underlying ReferralRequest profile definition.

ReferralRequest Elements

id

The logical identifier of the ReferralRequest resource.

meta.profile

The ReferralRequest profile URL.

Fixed value https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ReferralRequest-1

identifier

This will be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data).

If the referral was made via the e-Referral Service and a Unique Booking Reference Number (UBRN) exists for the referral, then it will be included as an identifier. The system identifier for this is https://fhir.nhs.uk/Id/ubr-number.

basedOn

Indicates any plans or prior referrals that this referral is intended to fulfill.

status

Fixed value of unknown. Referrals ‘entered in error’ will not be included.

intent

Fixed value of order.

priority

A mapping is applied to the priority codes to align it to the e-Referral Service priority types. This will be populated where the source system has a referral priority which matches the e-Referral Service priority codes or can be mapped to those priority codes. If there is a priority code for the referral but it is incompatible with the e-Referral Service priorities, this element will be excluded and the priority will be supplied in the note element.

serviceRequested

This will NOT be populated with the source system’s main code for the referral, which will be returned in the reasonCode element. This MAY be populated if the GP clinical system also holds a distinct entry for the type of service requested.

subject

A reference to the patient who is the subject of the referral.

context

The Consultation within which the referral was recorded.

authoredOn

The main date for the referral as entered by the end user in accordance with the date of referral guidance.

requester

The details of the person, practitioner or organisation responsible for the decision to refer the patient or, if is not attributed specifically, then populate with the recorder.

requester.agent

The preferred agent is the practitioner responsible for the decision to refer the patient. If the referral is not attributed to a practitioner, then any of the other resource options MAY be used as most appropriate. If the referral does not clearly identify responsibility for the referral decision or action, this will be the user who recorded the referral.

requester.onBehalfOf

This will be populated if the requester.agent is a practitioner and the Organization associated with the referenced Practitioner is not the GP practice responsible for the referral. This element SHOULD be absent if the requester.agent is not a practitioner.

specialty

This will NOT be populated with the source system’s main code for the referral, which will be returned in the reasonCode element. This MAY be populated if the GP clinical system holds a distinct entry for the clinical or practitioner specialty requested by the referral.

recipient

This will be populated with the practitioner and/or organisation the patient has been referred to, if that is recorded in a suitable coded format. If the referral recipient details are in a form which cannot be returned as a referenced resource, the details will be populated to the note as key value pairs.

reasonCode

This will be populated with the source system’s main coded entry for the referral. Additional, coded or text entries which are clearly captured as reasons for referral MAY be included.

description

The free text description associated with the referral.

supportingInfo

Reference to the referral letter(s) and any other supporting documents or resources which are not covered by other more specific elements, for instance this could include reference to linked observations or test results.

This does not apply to a linked problem. The problem will be included in the bundle and reference to the referralRequest. The referralRequest will NOT reference to the problem.

note

Any additional information recorded against the referral which is not accommodated by other elements. This could include additional categorisation of the referral or notes recorded against the referral after it has been made such as details of progress or outcomes.