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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
send test results
send test results
receive test results
receive test results
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, in terms of pathology specialisms it focuses on: 

  • clinical biochemistry (also known as chemical pathology), haematology, immunology, and transfusion medicine
  • microbiology – this includes bacteriology, virology, and serology

Further pathology specialism coverage is currently under review.

This integration uses MESH to send and receive pathology results.  In addition to messaging, FHIR supports other methods of exchanging data, including the use of RESTful APIs. This approach may be considered in the future.

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).


  • FHIR profiles relevant to pathology interoperability (ServiceRequest, DiagnosticReport, Specimen and Observation) have gone through the UK Core clinical and technical assurance process. Consequently, FHIR R4 UK Core profiles of resources specific to laboratory medicine are now available for use.
  • Implementation guidance is under active development by NHS England and content may be added or updated on a regular basis. Please email us at [email protected] if you need any assistance.

Service level

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 uses asynchronous messaging. The messages take the form of FHIR R4 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 available for onboarding.


For a full list of interactions for this integration, see Pathology FHIR Implementation Guide. For further information, visit the Pathology standards and information website.

Last edited: 14 September 2023 5:35 pm