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Transfer of Care Initiative

To support the delivery of high quality care, there's an increasing need to share information more efficiently and consistently across health and social care.

Transfer of Care Initiative resource library
A resource library of downloadable implementation guidance and supporting materials

Implementing eDischarge summaries in England
As part of the NHS England Standard Contract, providers must have aligned their eDischarge summaries with the nationally published specification.

Implementing Emergency Care discharge summaries in England
As part of the NHS England Standard Contract, providers must have aligned their Emergency Care discharges with the nationally published specification.

Implementing Outpatient clinic letters in England
As part of the NHS England Standard Contract, providers must have aligned their Outpatient clinic letters with the nationally published specification.


The Transfer of Care Initiative aims to improve patient care by promoting and encouraging the use of professional and technical document standards.

Professional standards

Professional record standards for electronic record keeping are a fundamental element of successful IT enabled care and interoperability.

In order to record, share and access health data consistently across care settings, the structure and content of electronic health records needs to be standardised. The Professional Record Standards Body (PRSB) produce standards for the way care records should be structured.

We are developing and implementing The Academy of Medical Royal College (AoMRC) Professional Standards, as part of the Transfer of Care initiative.
The AoMRC Standards were adopted by the PRSB and are supported by The National Information Board framework for action (November 2014) which states:

'We propose the adoption of the Academy of Royal Medical Colleges' publication Standards for the clinical structure and content of patient records, with a requirement that all organisations and clinical systems should implement the standards'.

Technical standards

The long-term strategy is to send Transfer of Care documents by direct electronic transmission, nationwide, including SNOMED CT encoded diagnosis, procedures, allergies and dm+d encoded medication information.

Providers are reminded that as detailed in the NHS England Standard Contract (technical guidance section 39.22) that by1 October 2018, they must have aligned their acute inpatient and day case discharges, Emergency Care discharges, Mental Health discharges and OutPatient Clinic Letters with the nationally published specifications and be sending these by electronic transmission using a structured message specification.

NHS Digital has taken the decision to move directly to Fast Healthcare Interoperability Resources (FHIR) based structured document standards for Transfer of Care, deprecating the current HL7 v3 CDA Transfer of Care specifications.

FHIR has become the international industry standard so the decision has been taken to migrate to FHIR now to prevent a more complex migration in the future which would result in greater clinical risk and higher costs for NHS providers and NHS clinical system suppliers.

The Transfer of Care FHIR messages will use ITK (Interoperability Toolkit) 3.0 which can be downloaded from GitHub.

For further advice and support, contact

Benefits of standards

Using standards in electronic healthcare records allows clinical information to be recorded, exchanged and accessed consistently to deliver high quality care to patients. Other benefits include:

  • improved patient care and safety due to the availability of complete, accurate and timely information
  • reduction in the risk of missing or inappropriate critical clinical information
  • reduction in costs by removing the administrative task of correcting information

Video - why the Transfer of Care Initiative matters

icon Download a transcript of this video [162.97KB]

Latest news and updates

June 2016

Quick guide to implementing eDischarge summary headings. icon Download a quick guide for managers [306.06KB]  leading the implementation of AoMRC headings in eDischarge summaries.

New self-assessment tool for AoMRC headings. To help your organisation check itself against the mandatory AoMRC headings in eDischarge summaries, icon download our self-assessment compliance tool [81.5KB]

More information

Transfer of Care resource library

Find out about and download our eDischarge Summary and Transfer of Care resources.

eDischarge summaries

Find out about eDischarge summaries, along with advice on how to implement them and how to self-assess your organisation.

Emergency Care discharge summaries

Find out about Emergency Care discharge summaries including advice on how they should be implemented in England

Transfer of Care Outpatient clinic letter

Find out about Outpatient Clinic Letters including advice on how they should be implemented in England

For more information, or to register on our mailing list, contact

Join our NHS Interoperability Toolkit group on LinkedIn.

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