Skip to main content

Reasonable Adjustment Flag - FHIR API

Access the Reasonable Adjustment Flag - a national record which indicates that a patient requires reasonable adjustments and includes relevant details.

Page content

Overview

Use this API to access and update the Reasonable Adjustment Flag - a national record which indicates that a patient requires reasonable adjustments and optionally includes details of impairments and adjustments to be considered.

You can:

  • check if a Reasonable Adjustment Flag exists
  • read a Reasonable Adjustment Flag
  • create a Reasonable Adjustment Flag
  • update a Reasonable Adjustment Flag
  • remove a Reasonable Adjustment Flag

The Flag consists of three parts:

  • Details of consent to share the Flag and how this was obtained. Consent may have been given by the patient or via a 'best interest decision' under the Mental Capacity Act (2005). In some cases consent can also be obtained from a lasting power of attorney for health and welfare or a court appointed deputy.
  • Details of impairments, which enable clinicians to understand the range of adjustments the patient may require. Note that the patient may decline to say what their impairments are.
  • Details of reasonable adjustments to services which are needed by the patient when providing their care.

This API can only be used by relevant health and care staff providing direct care, authenticated with an NHS smartcard or equivalent.

The existance of a Flag is intended to be visible to all staff who have access to the patient record. The contents of the Flag may only be visible to clinical staff - as determined by role-based access controls (RBAC). For more details see Registration authorities and smartcards.

To find out more about how the Flag works, categories and types of adjustments and the recording of impairments see How the Reasonable Adjustment Flag works.

To watch a video of a Reasonable Adjustment Flag being created in SCRa see Creating a Reasonable Adjustment Flag on the NHS Spine.

Who can use this API

This API 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).

Related APIs

To use this API, you will need the patient's NHS number, which can be retrieved by using the following API:

When using this API, we also recommend that you consider using these related APIs:

API Status and Roadmap

This API is in alpha - expect further breaking changes.

The API is currently available for sandbox testing, but not integration testing or for production use.

To see our roadmap, or to suggest, comment or vote on features for this API, see our interactive product backlog.

If you have any other queries, please contact us.

Technology

This API is RESTful.

It also conforms to the FHIR (STU3) global standard for health care data exchange. Specifically it conforms to FHIR Release 3.

You don’t need to know much about FHIR to use this API - FHIR APIs are just RESTful APIs that follow specific rules. In particular:

  • array names are singular, for example line not lines for address lines
  • data items that are country-specific and thus not included in the FHIR global base resources are usually wrapped in an extension object

Resources

For information on the resources used within the Reasonable Adjustment Flag API see Reasonable Adjustment Flag FHIR specification.

Network Access

This API is available on the internet and, indirectly, on the Health and Social Care Network (HSCN). To use this API with NHS smartcards (see below) you do need an HSCN connection, although internet-facing alternatives are available.

For more details see Network access for APIs.

Security and authorisation

This API is user-restricted, meaning an end user must be present and authenticated to use it.

The end user must be:

The API uses OAuth 2.0 to authorise the calling system. It supports the following security patterns:

For more details, see user-restricted APIs.

You must implement role-based access controls (RBAC) within your application to determine whether the end user is allowed to see (and update) the details of the record or only to know of its existence.

For more details see Registration authorities and smartcards.

Environments and testing

Purpose Base URL
Sandbox https://sandbox.service.nhs.uk/reasonable-adjustment-flag/FHIR/STU3
Integration test (available Jan 2021) https://int.service.nhs.uk/reasonable-adjustment-flag/FHIR/STU3
Production (available Mar 2021) https://api.service.nhs.uk/reasonable-adjustment-flag/FHIR/STU3

Sandbox testing

Our sandbox environment:

  • is for early developer testing
  • only covers a limited set of scenarios
  • is stateless, so it does not actually persist any updates
  • is open access, so does not allow you to test authorisation

For more details on sandbox testing, or to try out the sandbox using our "Try this API" feature, see the documentation for each endpoint.

Integration testing

Our integration test environment:

  • is for formal integration testing
  • is stateful, so persists updates
  • includes authorisation, with options for user-restricted access (with or without smartcards)

To test updating patient details, you must set up your own test data.

For more details see integration testing with our RESTful APIs.

Onboarding

You need to get your software approved by us before it can go live with this API. We call this onboarding. The onboarding process can sometimes be quite long, so it’s worth planning well ahead.

We will provide further details about how to onboard onto the API in January 2021.

Using this API

To check if a Reasonable Adjustment Flag exists:

  • get consent details - if they exist, the overall record exists

To get a Reasonable Adjustment Flag:

  • get consent details
  • get reasonable adjustment details - which might not exist
  • get impairments - which might not exist

To create a Reasonable Adjustment Flag:

  • add consent details - doing this also creates the overall record
  • optionally, add reasonable adjustments
  • optionally, add impairments

To update a Reasonable Adjustment Flag:

  • get the relevant part(s) of the record first - you’ll need the version number for the update
  • update consent details, reasonable adjustments or impairments as appropriate

To remove a Reasonable Adjustment Flag:

  • remove Reasonable Adjustment Flag record - this single operation will remove the record in its entirety

Endpoints

Create Flag and add consent details

post 
/Consent

Overview

Use this endpoint to create a Reasonable Adjustment Flag for a patient and add details regarding the patient's consent to share it, as well as how this was obtained.

For full details of the request payload for this endpoint, see RARecord-Consent-1.

Request

Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Body
Required

Content type: application/fhir+json

Example

Schema

Name Description
object
resourceType
string
Example: Consent
meta
object
profile
array
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Consent-1
extension
array
object
url
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-ProxyRole-1
valueCodeableConcept
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ProxyRole-1
code
string
Example: lpa
display
string
Example: Lasting power of attorney personal welfare
status
string
Example: active
category
array
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1
code
string
Example: reasonable adjustment flag
display
string
Example: Reasonable Adjustment Flag
patient
object
reference
string
Example: demographics.spineservices.nhs.uk/STU3/Patient/999999998
policy
array
object
authority
string
Example: https://www.gov.uk/
uri
string
Example: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/535024/data-security-review.pdf
purpose
array
object
system
string
Example: https://snomed.info/sct
code
string
Example: 370856009
display
string
Example: Limiting access to confidential patient information

Response

HTTP status: 201

Reasonable Adjustment Flag created and consent details added.

Headers
Name Description
ETag

String

Record version identifier enclosed in quotes and preceded by 'W/'. For example, W/"2".

Corresponds to meta.versionId attribute in the patient resource body.

When you retrieve a patient resource, you get a version number for the resource (in the ETag response header and in the versionId field in the response). You must then pass the resource's version number in any update request (in the If-Match response header) made for the patient.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Date

Date (date-time)

The current date.
Last-Modified

Date (date-time)

The date the resource was last modified.

Example: 2018-07-23T11:00:00Z

Location

String

The location of the resource.

Example: https://clinicals.spineservices.nhs.uk/STU3/[type]/[id]/_history/[vid]

Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Add reasonable adjustments

post 
/Flag

Overview

Use this endpoint to create a Reasonable Adjustment Flag against the patient record on the NHS Spine. This will describe the adjustment that the patient needs and will either be a coded national adjustment as defined by SNOMED CT, or an adjustment which has been manually keyed by a clinician. To find out more about the different types of adjustments see How the Reasonable Adjustment Flag works.

For full details of this API resource see RARecord-Flag-1.

Request

Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Body
Required

Content type: application/fhir+json

Example

Schema

Name Description
object
resourceType
string
Example: Flag
meta
object
profile
array
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1
extension
array
object
url
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1
valueCodeableConcept
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1
code
string
Example: comms
display
string
Example: Communication
status
string
Example: active
category
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1
code
string
Example: reasonable adjustment flag
display
string
Example: Reasonable Adjustment Flag
code
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1
code
string
Example: requiresinformationineasyread
display
string
Example: Requires information in Easyread
subject
object
reference
string
Example: demographics.spineservices.nhs.uk/STU3/Patient/999999998

Response

HTTP status: 201

Successful response.

Headers
Name Description
ETag

String

Record version identifier enclosed in quotes and preceded by 'W/'. For example, W/"2".

Corresponds to meta.versionId attribute in the patient resource body.

When you retrieve a patient resource, you get a version number for the resource (in the ETag response header and in the versionId field in the response). You must then pass the resource's version number in any update request (in the If-Match response header) made for the patient.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Date

Date (date-time)

The current date.
Last-Modified

Date (date-time)

The date the resource was last modified.

Example: 2018-07-23T11:00:00Z

Location

String

The location of the resource.

Example: https://clinicals.spineservices.nhs.uk/STU3/[type]/[id]/_history/[vid]

Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Add impairments

post 
/List

Overview

Use this endpoint to create a list of impairments held within the Reasonable Adjustment Flag stored on the NHS Spine. These impairments will likely have been captured during the discussion between the clinician and the patient or their carer. Patients may however decline to provide details of their impairments if they do not want to share them. To capture an impairment the member of staff selects an impairment type and then provides additional information using a free text field. For more details regards impairments see How the Reasonable Adjustment Flag works.

For full details of this API resource see CareConnect-RARecord-List-1

Request

Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Response

HTTP status: 201

Successful response.

Headers
Name Description
Etag

String

Record version identifier enclosed in quotes and preceded by 'W/'. For example, W/"2".

Corresponds to meta.versionId attribute in the patient resource body.

When you retrieve a patient resource, you get a version number for the resource (in the ETag response header and in the versionId field in the response). You must then pass the resource's version number in any update request (in the If-Match response header) made for the patient.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Date

Date (date-time)

The current date.
Last-Modified

Date (date-time)

The date the resource was last modified.

Example: 2018-07-23T11:00:00Z

Location

String

The location of the resource.

Example: https://clinicals.spineservices.nhs.uk/STU3/[type]/[id]/_history/[vid]

Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Get consent details

get 
/Consent

Overview

Use this endpoint to read details regarding the patient's consent to share a Reasonable Adjustment Flag record, as well as how this was obtained. Consent may have been given by the patient or via a 'best interest decision' under the Mental Capacity Act (2005). In some cases consent can also be obtained from a lasting power of attorney for health and welfare, or a court appointed deputy. Consent is usually obtained by a suitable member of staff discussing the Reasonable Adjustment Flag with the patient, their carer or the appropriate patient representative. The member of staff will then record the type of consent captured, along with some free text details providing more information about who provided the consent.

For full details of this API resource see RARecord-Consent-1

Request

Query parameters
Name Description
patient

String

The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a valid NHS number.

Example: 9692247317

Required
status

String

The status of the patient resource. Active or Inactive.

Example: active

Required
category

String

The category of the resource being interacted with.

Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1|reasonable%20adjustments%20flag

Required
Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Response

HTTP status: 200

Successful response.

Headers
Name Description
Date

Date (date-time)

The current date.
Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Get reasonable adjustments

get 
/Flag

Overview

Use this endpoint to view a Reasonable Adjustment Flag against the patient record on the NHS Spine. This will describe the adjustment that the patient needs and will either be a coded national adjustment as defined by SNOMED CT, or an adjustment which has been manually keyed by a clinician. To find out more about the different types of adjustments see How the Reasonable Adjustment Flag works.

For full details of this API resource see RARecord-Flag-1.

Request

Query parameters
Name Description
patient

String

The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a valid NHS number.

Example: 9692247317

Required
status

String

The status of the patient resource. Active or Inactive.

Example: active

Required
category

String

The category of the resource being interacted with.

Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1|reasonable%20adjustments%20flag

Required
Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Response

HTTP status: 200

Successful response.

Headers
Name Description
Date

Date (date-time)

The current date.
Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Examples

The response from a successful request (0 flags).

The response from a successful request (1 flag).

The response from a successful request (2 flags).

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Get impairments

get 
/List

Overview

Use this endpoint to read a list of impairments held within the Reasonable Adjustment Flag information stored on the NHS Spine. These impairments will likely have been captured during the discussion between the clinician and the patient or their carer. Patients may however decline to provide details of their impairments if they do not want to share them. To capture an impairment the member of staff selects an impairment type and then provides additional information using a free text field. For more details regards impairments see How the Reasonable Adjustment Flag works.

For full details of this API resource see CareConnect-RARecord-List-1

Request

Query parameters
Name Description
patient

String

The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a valid NHS number.

Example: 9692247317

Required
status

String

The status of the patient resource. Active or Inactive.

Example: active

Required
code

String

code

Example: http://snomed.info/sct|1094391000000102&_format=json

Required
Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

Response

HTTP status: 200

Successful response.

Headers
Name Description
Date

Date (date-time)

The current date.
Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Remove Reasonable Adjustment Flag record

post 
/$removerarecord

Overview

Use this endpoint to remove a Reasonable Adjustment Flag from the NHS Spine. To remove a flag you must provide a reason for it being removed, for example the flag may have been created in error, or the flag may no longer apply to the patient.

For a patient it is represented as CodeSystem-RARecord-RemovalReason-1. This triggers the system to inactivate all Reasonable Adjustment Flag resources contained within the patient record.

Request

Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

If-Match

String

Latest known version identifier enclosed in quotes preceded by W/. Send the value of the patient's ETag response header on patient retrieval when updating a patient. This is to ensure that any updates are applied against an up-to-date version of the patient resource.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Required
Body
Required

Content type: application/fhir+json

Example

Schema

Name Description
object

A container for a remove RA record request.
resourceType
string
required

FHIR Resource type.

Allowed values: Parameters
Example: Parameters
parameter
array
required

A parameter in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
object
name
string
required

Name of parameter

Example: removerarecord
part
array
required

A list of parameters parts.
anyOf
object
name
string
Example: nhsNumber
valueString
string
Example: 999999998
object
name
string
Example: removalReason
valueCodeableConcept
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-RemovalReason-1
code
string
Example: DoesntApply
display
string
Example: The Reasonable Adjustment Flag no longer applies to the patient
object
name
string
Example: supportingComment
valueString
string
Example: No longer applies

Response

HTTP status: 200

Successful response.

Headers
Name Description
Date

Date (date-time)

The current date.
Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Update consent details

put 
/Consent/{consentID}

Overview

Use this endpoint to update details regarding the patient's consent to share a Reasonable Adjustment Flag record, as well as how this was obtained. Consent may have been given by the patient or via a 'best interest decision' under the Mental Capacity Act (2005). In some cases consent can also be obtained from a lasting power of attorney for health and welfare, or a court appointed deputy. Consent is usually obtained by a suitable member of staff discussing the Reasonable Adjustment Flag with the patient, their carer or the appropriate patient representative. The member of staff will then record the type of consent captured, along with some free text details providing more information about who provided the consent.

For full details of this API resource see RARecord-Consent-1

Request

Path parameters
Name Description
consentID

String

The id of the record. To retrieve the consentID, you need to do a GET /Consent first. The successful response from GET /Consent endpoint contains the consentID. See the example of successful response in Get consent details section. See the example below to know the consentID from that response.

Example: 9692247317.11eccc9b-4a6f-4467-a76b-1b8a82bafd65

Required
Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

If-Match

String

Latest known version identifier enclosed in quotes preceded by W/. Send the value of the patient's ETag response header on patient retrieval when updating a patient. This is to ensure that any updates are applied against an up-to-date version of the patient resource.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Required
Body
Required

Content type: application/fhir+json

Example

Schema

Name Description
object
resourceType
string
Example: Consent
id
string
Example: 2acb0536-0a8f-48c9-8a2f-6ee82860f186
meta
object
versionId
string
Example: aa755bd6-2be9-4971-972a-6724879c5cb1
lastUpdated
string
Example: 2018-07-24T10:01:00+00:00
profile
array
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Consent-1
contained
array
object
resourceType
string
Example: Provenance
id
string
Example: 43124f67-b09d-453d-b889-a5e2e8780b9e
meta
object
profile
array
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1
target
array
object
reference
string
Example: Consent/2acb0536-0a8f-48c9-8a2f-6ee82860f186
recorded
string
Example: 2018-07-24T10:05:33+00:00
agent
array
object
role
array
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1
code
string
Example: R1974
display
string
Example: Community Learning Disabilities Nurse
whoReference
object
reference
string
Example: https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9
display
string
Example: Nurse N
onBehalfOfResource
object
reference
string
Example: https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7
display
string
Example: Some Hospital Learning Disability Support Department
extension
array
anyOf
object
url
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1
extension
array
object
url
string
Example: created
valueReference
object
reference
string
Example: #43124f67-b09d-453d-b889-a5e2e8780b9e
object
url
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-RemovalReason-1
extension
array
anyOf
object
url
string
Example: removalReason
valueCodeableConcept
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/RARecord-RemovalReason-1
code
string
Example: Error
display
string
Example: The Reasonable Adjustment Flag was created in error
object
url
string
Example: supportingComment
valueString
string
Example: Requires Large Print rather than Easy Read
object
url
string
Example: https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1
valueCodeableConcept
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1
code
string
Example: comms
display
string
Example: Communication
status
string
Example: inactive
category
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConsentCategory-1
code
string
Example: reasonable adjustment Consent
display
string
Example: Reasonable Adjustment Consent
code
object
coding
array
object
system
string
Example: https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1
code
string
Example: requiresinformationineasyread
display
string
Example: Requires information in Easyread
subject
object
reference
string
Example: demographics.spineservices.nhs.uk/STU3/Patient/999999998

Response

HTTP status: 200

Successful response.

Headers
Name Description
ETag

String

Record version identifier enclosed in quotes and preceded by 'W/'. For example, W/"2".

Corresponds to meta.versionId attribute in the patient resource body.

When you retrieve a patient resource, you get a version number for the resource (in the ETag response header and in the versionId field in the response). You must then pass the resource's version number in any update request (in the If-Match response header) made for the patient.

Pattern: /^W\/"[0-9]+"$/

Example: W/"2"

Date

Date (date-time)

The current date.
Last-Modified

Date (date-time)

The date the resource was last modified.

Example: 2018-07-23T11:00:00Z

Content-Type

String

The content type of the response.

Example: application/fhir+json

Body

Content type: application/json

Example

The response from a successful request.

HTTP status: 400

Invalid parameters.

Body

Content type: application/fhir+json

Example

Invalid NHS number for patient supplied.

Schema

Name Description
object

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field.
resourceType
string
read-only

FHIR Resource Type.

Default: OperationOutcome
issue
array

List of issues that have occurred.

Min items: 1
object
severity
string
required

Severity of the error.

Allowed values: fatal, error, warning, information
Example: error
code
string
required

FHIR error code.

Allowed values: invalid, structure, required, value, invariant, security, login, unknown, expired, forbidden, suppressed, processing, not-supported, duplicate, multiple-matches, not-found, deleted, too-long, code-invalid, extension, too-costly, business-rule, conflict, transient, lock-error, no-store, exception, timeout, incomplete, throttled, informational
Example: invalid
details
object

Internal error code.
coding
array
object
read-only
system
string

URI of the coding system specification.

Example: https://fhir.nhs.uk/R4/CodeSystoperationOutcome.yamlem/Spine-ErrorOrWarningCode
version
string

Version of the coding system in use.

Example: 1
code
string

Symbol in syntax defined by the system.

Example: INVALID_VALUE
display
string

Representation defined by the system.

Example: Provided value is invalid
diagnostics
string

Additional diagnostic information about the issue.

Example: Invalid value - 2019-01 in field 'birthDate'
expression
string

FHIRPath of element(s) related to the error.

Example: Patient.name.given
HTTP status: 4XX

Outcome of an operation that does not result in a resource or bundle being returned (e.g. error, async/batch submission). There are a number of possible error codes that can be returned along with a more detailed description in the display field. There are general outcomes:

Code Response Code Description
ACCESS_DENIED 401 Used when the user does not have permission for a particular request. e.g. when their ASID does not have the correct interactions attached to it.
UNABLE_TO_CALL_SERVICE 408 For a synchronous request, the downstream domain processing has not completed within the configured timeout period.
UNSUPPORTED_SERVICE 400 The service the user requested is an endpoint that does not exist - so is unsupported. e.g. /Patient/9999999999/Pets
RESOURCE_NOT_FOUND 404 The resource was not found.
INVALID_RESOURCE_ID 400 The resource ID was not valid. For example a NHS number is presented which is not a valid NHS number.
INVALIDATED_RESOURCE 404 The resource has been invalidated so could not be returned.

Update outcomes:

Code Response Code Description
PRECONDITION_FAILED 412 Request missing basic requirements such as If-Match header (or invalid headers).
RESOURCE_VERSION_MISMATCH 409 The resource version has changed since your last read, so the update has been rejected.
FORBIDDEN_UPDATE 403 The user is not permitted to update certain resources or elements - a detailed description will be added to the display. For example - updating a sensitive patient or adding a formal death notification is only permitted from certain systems.
VALIDATION_ERROR 400 This it the "default" error thrown when no others are applicable.
INVALID_UPDATE 400 The update was invalid - a detailed description will be added to the display.
MISSING_VALUE 400 There was a missing value in the request. For example - a name update that is missing the surname. The missing value will be presented in the display.
INVALID_VALUE 400 There was an invalid value in the request. For example - a name update where the surname is too long. The invalid value and field will be presented in the display.
UNSUPPORTED_VALUE 400 There was an unsupported value in the request. The value may be valid in the schema - however it could be a legacy value that we do not allow to be set anymore. For example - setting the death notification status to 'removed'. The invalid value and field will be presented in the display.
TOO_FEW_VALUES_SUBMITTED 400 The field in question has a minimum number of items and the user sent too few.
TOO_MANY_VALUES_SUBMITTED 400 The field in question has a maximum number of items and the user sent too many.
ADDITIONAL_PROPERTIES 400 The user sent additional properties within the dictionary. For example sending a patient patch and attempting to add 'pets', which is not an allowed field within the patient resource.

Polling outcomes:

Code Response Code Description
POLLING_ID_NOT_FOUND 404 When polling the ID was not found - or it was not applicable such as a non polling ID.
POLLING_MESSAGE_FAILURE 422 When polling an ID, a message was found to be in a failed state, so there is nothing else to be done and should be considered a failure.

Update reasonable adjustments

put 
/Flag/{flagID}

Overview

Use this endpoint to update a Reasonable Adjustment Flag against the patient record on the NHS Spine. This will describe the adjustment that the patient needs and will either be a coded national adjustment as defined by SNOMED CT, or an adjustment which has been manually keyed by a clinician. You can also use this endpoint to delete an existing adjustment. To find out more about the different types of adjustments see How the Reasonable Adjustment Flag works.

For full details of this API resource see RARecord-Flag-1.

Request

Path parameters
Name Description
flagID

String

The id of the flag. To retrieve the flagID, you need to do a GET /Flag first. The successful response from GET /Flag endpoint contains the flagID. See the example of successful response in Get reasonable adjustments section. See the example below to know the flagID from that response.

Example: 9692247317.b1fe6cc0-7bf5-453c-a396-1ae97cfad72a

Required
Headers
Name Description
Authorization

String (^Bearer\ [[:ascii:]]+$)

An OAuth 2.0 bearer token.

Note: This parameter is required unless interacting with the Sandbox.

Example: Bearer g1112R_ccQ1Ebbb4gtHBP1aaaNM

NHSD-Session-URID

String

The user role ID (URID) for the current session. Also known as a user role profile ID (URPID).

If you are using User-restricted RESTful APIs - NHS login combined authentication and authorisation, See determin the user's role guidance. If you are using User-restricted RESTful APIs - NHS login separate authentication and authorisation, See determin the user's role guidance.

This field is optional.

Pattern: /^[0-9]+$/

Example: 555021935107

X-Correlation-ID

String

A globally unique identifier (GUID) for the request, which we use to trace the request if you contact our helpdesk. Mirrored back in a response header. Avoid . characters.

Example: 11C46F5F-CDEF-4865-94B2-0EE0EDCC26DA

X-Request-ID

String

A globally unique identifier (GUID) for the request, which we use to de-duplicate repeated requests. Must be a universally unique identifier (UUID) (ideally version 4). If you re-send a failed request, use the same value in this header. Mirrored back in a response header.

Required in all environments except sandbox.

Pattern: /^[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}$/

Example: 60E0B220-8136-4CA5-AE46-1D97EF59D068

If-Match