Assessment Discharge and Withdrawal - FHIR

Use this integration to support transfer of care from hospital to social services for patients with care and support needs, as described in the Care Act 2014. It enables the exchange of structured information between hospitals and social care organisations.

You can send:

• hospital assessment notices to inform social services that an assessment of a patient's care and support needs is required
• hospital discharge notices to confirm a patient's proposed discharge date
• withdrawal notices to withdraw a previous assessment or discharge notice

You can also send an admissions notice with this integration so a hospital can inform social services that a patient has been admitted.

This is a messaging integration which uses MESH to send and receive messages.

Information Standard SCCI2075 defines the minimum data sets that you must use for Assessment, Discharge and Withdrawal (ADW) notices. For additional message guidance on the implementation and use of ADW FHIR messages and some divergences from this ADW Information Standard, see Assessment Discharge and Withdrawal - FHIR API.

This integration is in production but deprecated. Do not begin any development work using this API.

This integration can only be used where there is a legal basis to do so. Make sure you have a valid use case before you go too far with your development. 

You must have made this request before you can go live (see 'Onboarding' below).

The following API is related to this integration:

• Message Exchange for Social Care and Health (MESH) API - use this API to transfer messages and large files securely across health and social care organisations

This integration is in production but deprecated, meaning:

• new integrations are not allowed
• we will not make any updates to it
• it is still available for use
• service levels still apply

We do not have any plans to retire it.

This specification is deprecated following changes to the discharge process guidance during 2020 to reflect Discharge to Assess (D2A). If you have any concerns, contact [email protected].

This integration uses MESH which is a silver service, meaning it is operational 24 hours a day, 365 days a year but only supported during business hours (8am to 6pm), Monday to Friday excluding bank holidays.

For more details, see service levels.

This integration sends a FHIR DSTU2 payload over MESH.

For more details, see FHIR.

You can access this integration via:

• the Health and Social Care Network (HSCN)
• the internet

For more details, see Network access for APIs.

This integration uses MESH which is an application-restricted API.

This integration does not perform any end user authentication or authorisation checks. Rather, the calling system is expected to perform them. The authorisation rules are specified in our national Role Based Access Control (RBAC) database.

For more details see our national Role Based Access Control (RBAC) database on the registration authorities and smartcards page.

This integration uses MESH.

We have developed an Interoperability Toolkit (ITK) ADW-MESH validator to help you check that your messages are valid according to ITK FHIR schemas and requirements before they are set over MESH.

As a developer, you are most likely to want to connect to MESH using either the MESH client or the MESH API.

For more details about using the MESH client, see MESH client.

For the MESH API, there are several independent, externally accessible instances of MESH you can use for testing. For full details, see MESH API - Environments and testing.

This integration is deprecated and is not available for new onboarding.

For a full list of interactions for this integration, see Social Care Assessment, Discharge and Withdrawal.

This FHIR messaging specification is based on and is intended to be used alongside the FHIR DSTU2 specification, published in September 2015.

The following MESH workflow IDs are used to send the admission, assessment, discharge and withdrawal notifications in England:

For additional guidance on interactions for this integration, see the Social care DMS - additional messaging guidance.