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Merge branch 'develop' into 20260703-DD-IG-1.12.0
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‎guides/Live-ImplementationGuide-BaRS/Home/Analysis/Releases/Technical-Release-Notes/TRN-APP8/1.0.0-alpha.3.page.md‎

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| Change | Description | Impact |
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|-------------------------------------------|-------------------------------------------------|-------------------------------------------------------------------------|
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| Patient Identifier Resource | Updates to Referral Payload Implementation Guidance for multiple elements to improve clarity.|<mark style="background-color: Yellow">correction</mark>
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| Scope and Requirements | Minor text changes and link to Hazard Log added|<mark style="background-color: Yellow">correction</mark>
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### Payload Change Log
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| FHIR Element | Previous | Current | Other | Referral/Booking | Rationale | Impact |
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|------------------------------------------------------|----------|------------|---------|------------------|-------------------------------------------------------------------------------------------------|----------|
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| Patient.identifier.system | This SHOULD be populated with namespace for the Identifier. | This MUST be populated with namespace for the Identifier. | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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| Patient.identifier.value | This SHOULD be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available.If no NHS number is available this SHOULD be populated with the Local patient identifier. | This MUST be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available. | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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| Patient.identifier.extension.url | This SHOULD be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE | This MUST be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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| Patient.identifier.extension.valueCodeableConcept.coding.system | This SHOULD be populated. Where used this MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE | This MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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| Patient.identifier.extension.valueCodeableConcept.coding.code | This SHOULD be populated. Where used this MUST be 'number-present-and-verified' or 'number-present-but-not-traced', else no NHS number MUST be sent. No other statuses are permitted. | This MUST be populated. This MUST be 'number-present-and-verified' only. No other statuses are permitted. | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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| Patient.identifier.extension.valueCodeableConcept.coding.display | This SHOULD be populated. Where used this MUST be populated with 'Number present and verified' or 'Number present but not traced'. No other statuses are permitted. |This MUST be populated. This MUST be populated with 'Number present and verified'. No other statuses are permitted. | Update | Referral Response |Change | <mark style="background-color: Yellow">correction</mark> |
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<hr>
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<br>

‎guides/Live-ImplementationGuide-BaRS/Home/Applications/BaRS-Applications/Applications/BaRS-APP8/Referral-Payload.page.md‎

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| Patient.meta.profile | This MUST be populated. Follow UK Core guidance for populating this element | MUST | 1..1 | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient |
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| Patient.meta.LastUpdate | This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. | MUST | 1..1 | 2023-03-08T12:01:08.4677672+00:00 |
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| Patient.identifier | | MUST | 0..* | |
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| Patient.identifier.system | This SHOULD be populated with namespace for the Identifier | MUST | 1..1 | https://fhir.nhs.uk/Id/nhs-number |
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| Patient.identifier.value | This SHOULD be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available.If no NHS number is available this SHOULD be populated with the Local patient identifier. | MUST | 1..1 | 3478526985 |
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| Patient.identifier.system | This MUST be populated with namespace for the Identifier | MUST | 1..1 | https://fhir.nhs.uk/Id/nhs-number |
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| Patient.identifier.value | This MUST be populated with a human readable patient identifier. This MUST be populated with the NHS number. | MUST | 1..1 | 3478526985 |
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| Patient.identifier.extension | This extension is used to record the NHS number Verification status | MUST | 0..* | |
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| Patient.identifier.extension.url | This SHOULD be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE | MUST | 1..1 | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus |
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| Patient.identifier.extension.url | This MUST be populated. This MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE | MUST | 1..1 | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus |
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| Patient.identifier.extension.valueCodeableConcept | | MUST | 0..1 | |
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| Patient.identifier.extension.valueCodeableConcept.coding | | MUST | 0..* | |
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| Patient.identifier.extension.valueCodeableConcept.coding.system | This SHOULD be populated. Where used this MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE | MUST | 0..1 | https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus |
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| Patient.identifier.extension.valueCodeableConcept.coding.code | This SHOULD be populated. Where used this MUST be 'number-present-and-verified' else no NHS number MUST be sent. No other statuses are permitted. | MUST | 0..1 | number-present-and-verified |
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| Patient.identifier.extension.valueCodeableConcept.coding.display | This SHOULD be populated. Where used this MUST be populated with 'Number present and verified'. No other statuses are permitted. | MUST | 0..1 | Number present and verified |
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| Patient.identifier.extension.valueCodeableConcept.coding.system | This MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE | MUST | 0..1 | https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus |
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| Patient.identifier.extension.valueCodeableConcept.coding.code | This MUST be populated. This MUST be 'number-present-and-verified' only. No other statuses are permitted. | MUST | 0..1 | number-present-and-verified |
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| Patient.identifier.extension.valueCodeableConcept.coding.display | This MUST be populated. This MUST be populated with 'Number present and verified'. No other statuses are permitted. | MUST | 0..1 | Number present and verified |
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| Patient.name | | SHOULD | 0..* | |
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| Patient.name.use | Follow UK Core guidance for populating this element | SHOULD | 0..1 | official |
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| Patient.name.text | Follow UK Core guidance for populating this element | SHOULD | 0..1 | Mrs Julie Jones |

‎guides/Live-ImplementationGuide-BaRS/Home/Applications/BaRS-Applications/Applications/BaRS-APP8/Scope-and-Requirements.page.md‎

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- BaRS currently supports the communication of consent for direct care only
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- Certificates for Receiving messages to use nhs.uk domains only
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- Receiving endpoints are to be internet facing
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- Clincial Constraints exist - See Hazard Log
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- Clincial Constraints exist - See [Hazard Log](https://digital.nhs.uk/developer/api-catalogue/booking-and-referral-fhir/onboarding-support-information#downloads)
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- No element level 'updates' to requests are supported. A new request must be generated to change information in the referral request
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- No digital support to remove or cancel a referral are offered (this would need to be achieved manually)
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- The service discovery tool for establishing services for onward care must be the [e-RS Service Search API A010](https://digital.nhs.uk/developer/api-catalogue/e-referral-service-fhir#post-/STU3/HealthcareService/$ers.searchHealthcareServicesForPatient)
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### Requirements
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Definitions used in these requirements:
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- The referral Sender is the system/organisation making the referral request
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- The referral Receiver is the system/organisation the referral is being sent to, in this specific case - the broker (e-RS)
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- The end user is a person in an organisation using BaRS
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**Service Discovery**
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- Where more than one service is shortlisted, the maximum number of services allowed on a given shortlist is 20.
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**Referral**
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- The referral Receiver **must** accept the referral request regardless of whether the patient is known to the service provider
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- The referral Receiver **must** only accept potential patients who **<ins>have</ins>** a national validated identifier e.g. NHS Number
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- The national identifier **must** have a [verification status](https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-nhsnumberverificationstatus) of 'Number present and verified'.
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- Any new or existing safeguarding concern, recorded as part of the assessment, **must** be included in the referral Sender's request
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- Any new or existing safeguarding concern, recorded as part of the assessment, **must** be included in the referral request
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- The referral Receiver **must** clearly identify any included safeguarding concern to the end user
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- The referral Receiver **must** accurately represent information made by the Sender to the end user.
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- The referral Sender **must** make available the human readable identifier for the referral, included in the HTTP synchronous response, to the end user

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