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Creating a new NHS England: NHS England and NHS Digital merged on 1 February 2023. More about the merger.
Scenario/problem Recommended pattern
Clinician requires access to information generated and stored in an external care setting. For example:
  • GP requires access to information recorded by a health visitor
  • A&E clinician requires access to medicines and allergies information recorded by a GP
Request / Response
Clinician requires access to documents generated and stored in an external care setting. For example:
  • paramedic requires access to mental health care plan created by mental health trust
  • hospital clinician requires access to radiography image created in another hospital trust
Request / Response

Clinician needs to be able to check for the existence of records and/or documents created and held within an external care setting.

For example, a clinician needs to check if an end-of-life care plan exists for a patient in their care.

Registry / Repository

A lookup is required to identify which care settings hold specific types of records about patients.

For example, GP system needs to be able to identify which child health system holds records on a patient so they can subsequently retrieve a history of height and weight measurements.

Registry / Repository

A Clinician has created new information that needs to be shared with an external care setting, but the clinician does not require an acknowledgement that the information has been processed (the clinician only needs to know that the information will reach its intended recipient).

For example a hospital trust sending patient discharge summary to GP system.

Information push
A healthcare repository needs to be updated when information is captured in a care setting and the requestor does not need to know the outcome, only that the update will be fulfilled. For example:
  • update of patient mobile phone number in PDS
  • creation of vaccination record in central registry
Information push
A Clinician is requesting that a task/activity be completed in an external care setting and requires acknowledgement that the task/activity has been completed. For example:
  • referral of a patient - confirmation required that the referral has been accepted/rejected or whether additional information needs to be supplied
  • ordering of a test with confirmation required that the test kit has been dispatched
  • prescription order with a notification returned when it has been dispensed
Request / Response
Information created in a system needs to be shared with potentially multiple care settings/clinicians to drive specific care activities, but the information source does need to know who will receive the information or require acknowledgement that the information was received by the external care setting. For example:
  • patient hospital admission information sent by a trust - information could be used by social care organisation to place a temporary stop on patient services, such as home care, meals on wheels or by a GP to update their local record
  • change in address sent by demographic service - information could be used by child health services to identify patients who have left or transferred into their service to trigger the patient transfer process
Publish / Subscribe

Citizen requires access to information held about them to support self-care.

For example citizen requires access to medicines prescribed to them so they can provide this information to a supplier of a repeat prescription service. 

Request / Response
Citizen requires access to generic (publicly available) healthcare data. For example:
  • available clinical services in their local area
  • information about a specific clinical condition
Request / Response
Citizen needs to request a clinical service. For example:
  • book a covid-19 test
  • book a vaccination appointment
Request / Response
An aggregate view of information created in multiple settings (and therefore not held within a single system repository) to support clinical decision support. For example:
  • vaccination call/recall
  • child health failsafe
Shared Repository

Single view of master data (such as citizens, staff, organisation) required to ensure information held across all care settings is consistent. For example:

  • demographic data in PDS
  • organisation data in ODS
Shared Repository

Last edited: 2 August 2021 2:54 pm