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Creating a new NHS England: NHS England and NHS Digital merged on 1 February 2023. More about the merger.

Pathology Messaging - FHIR

Share pathology results from a Laboratory Information Management System (LIMS) to the requestor in NHS primary or secondary care settings.


Pathology  system
Pathology system
NHS healthcare system
NHS healthcare system
4. receive pathology
results message
4. receive pathology...
1. send request for
pathology results
1. send request for...
3. send pathology
results message
3. send pathology...
2. receive request for
pathology results
2. receive request for...
Text is not SVG - cannot display Content diagram showing how the Pathology Messaging - FHIR API works.


Use this integration to share pathology results from a Laboratory Information Management System (LIMS) to the requestor, typically a healthcare worker in NHS primary or secondary care.

Initially it focuses on haematology and clinical biochemistry test reporting - also known as chemical pathology.

This integration uses MESH to send and receive pathology results.

It is intended to replace the current Pathology Messaging - EDIFACT API and supersedes Laboratory HL7 V3 (see the Message Implementation Manual under Domains -> Health and Clinical Management -> Laboratory).

Who can use this

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 do this before you can go live (see ‘Onboarding’ below).


This integration is not available in production and is experimental - an early version in development.

Service level

This integration uses MESH which is a silver service, meaning it is operational 24 x 7 x 365 but only supported during business hours (8am to 6pm), Monday to Friday excluding bank holidays.

For more details, see service levels.


This integration uses asynchronous messaging. The messages take the form of FHIR STU3 messages sent via MESH.

For more details, see FHIR and MESH.

Network access

You can access this integration via:

For more details see Network access for APIs.

Security and authorisation

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

The 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.

Environments and testing

This integration uses 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 not available for onboarding yet.


For a full list of interactions for this integration, see National Pathology FHIR Messaging Specifications.

Last edited: 21 October 2022 3:39 pm