Introduction
This page provides an overview of the onboarding for the various Digital Care Services Interoperability Standards and requirements.
Onboarding / Assurance Processes
Supplier Conformance Assessment List (SCAL)
The SCAL acts as a dynamic vehicle for distributed ownership of the established risk mitigations, it is created as part of a one-time preparatory activity for onboarding suppliers and then completed by service providers during the onboarding. The SCAL typically contains a Risk Log, Hazard Log, Requirements and questions around Information Governance and Cyber Security, it is seen as an enabler towards creating the desired efficient, appropriate, and flexible assurance and technical compliance model.
Tailored Assurance
A Tailored Assurance approach will be taken when the SCAL is not considered to be the most effective or efficient method for onboarding a service provider to a service or API. It defines the assurance approach with a focus on the activities to assure technical and clinical risks associated with integrating with that service or API. It is often further underpinned by the assurance executed as part of the Overarching Standards work.
Interoperability Toolkit (ITK)
The Interoperability Toolkit (ITK) conformance process is designed to be straightforward, focusing on demonstrating conformance to relevant technical specifications and standards.
Further information on ITK is available at the following URL: https://digital.nhs.uk/services/interoperability-toolkit
External Assurance
Assurance of these Interoperability Requirements are managed and executed outside of NHS Digital e.g. MHRA Yellow Card Reporting.
Not Directly Onboarded
These interoperability requirements have no direct onboarding / assurance approach.
Assurance Approaches / Toolkit
Each of the interoperability requirements below will have a defined assurance approach or toolkit for achieving compliance with each specification. As these are used beyond Digital Care Services then they cannot be held centrally, therefore the Digital Care Services Service Provider is advised to speak to the nominated point of contact listed for each requirement to ensure that they have been sent the latest version of the approach or toolkit.
Interoperability Requirements
Message Exchange for Social Care and Health (MESH)
There are 3 options for suppliers when implementing MESH, these are:
MESH UI - Ideal for the transfer of small files. This is pre-assured so there is no further assurance required.
MESH Client - Ideal for the transfer of large files. This is pre-assured so there is no further assurance required
MESH API - Ideal for the transfer of large files. This is an option for those service providers who have the technical skills to integrate MESH into their systems, it is onboarded via SCAL.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Further information on MESH is available at the following URL: https://digital.nhs.uk/services/message-exchange-for-social-care-and-health-mesh
Personal Demographics Service (PDS)
The Personal Demographics Service is the national electronic database of NHS patient details such as name, address, date of birth, registered GP, and NHS number.
New Service providers on the Digital Care Services Framework are expected to integrate with the PDS via the PDS FHIR API. There are 3 modes of access, these are:
Application Restricted Access - An end user may or may not be present. The application is authenticated, not the user.
Healthcare Worker Access - Requires an end-user to be present, authenticated, and authorised.
Patient Access - A citizen may access their record and update a restricted list of fields - Not currently available but being developed as of now (May 2022)
All integrations with PDS FHIR API will be onboarded via SCAL. There are currently 3 SCALs available, these are:
Application Restricted
Healthcare Worker Access - Search & Retrieve
Healthcare Worker Access - Search, Retrieve & Update
A future SCAL is planned to support the enablement of Patient Access within a supplier system.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Further information on integrating and onboarding with the PDS FHIR API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/personal-demographics-service-fhir
GP Connect
GP Connect is a service that lets GP practices and authorised clinical staff share and view GP practice clinical information and data between IT systems.
Service Providers on the Digital Care Services Framework are expected to integrate with GP Connect via the various API's offered, depending on the business capability. There are 5 business capabiltities using synchronous FHIR API's one messaging capability, utilsing asynchronous FHIR messages via MESH.
More detail on the GP Connect Specifications for Developers can be found at the following URL: https://digital.nhs.uk/services/gp-connect/gp-connect-specifications-for-developers
Consumer
All Digital Care Services Service Providers acting as consumers will be onboarded with the relevant business capabilities via a SCAL, more information can be found at the following URL: https://github.com/nhsconnect/gpc-consumer-support/wiki. Consumers will follow an onboarding journey through the supported test environments before deployment to Live.
Solution Assurance key contact for Digital Care Services is Amit Chawla (amit.chawla2@nhs.net)
Provider
All Digital Care Services Service Providers acting as providers will be onboarded with the relevant business capabilities via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is Amit Chawla (amit.chawla2@nhs.net)
Care Identity Service (CIS2)
NHS CIS2 makes use of current technology to provide a number of ways for health and care professionals in England to authenticate their identity when accessing national clinical information systems.
Digital Care Services Service Providers will be onboarded via a SCAL.
Key programme contact is via iamplatforms@nhs.net
More detail on the programme can be found Care Identity authentication - NHS Digital
Summary Care Record (SCR)
The Summary Care Record is an electronic record of important patient information, created from GP medical records. SCRs can be seen and used by authorised staff in other areas of the health and care system involved in the patient's direct care.
New Digital Care Services Service Providers who need to integrate with the SCR service should do so via the SCR FHIR API.
Digital Care Services Service Providers will be onboarded via a SCAL - Not yet available (May 22).
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the SCR FHIR API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/summary-care-record-fhir
National Event Monitoring Service (NEMS)
The National Event Monitoring Service works with other interoperability services including the National Record Locator which allows authorised users to find specific patient records that are held on different health care systems.
Digital Care Services Service Providers will be onboarded via a SCAL
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with NEMS FHIR API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/national-events-management-service-fhir
National Record Locator Service (NRLS)
The National Record Locator Service is a national index of pointers to patient records. It enables an authorised clinician, care worker and/or administrator, in any health or care setting, to access a patient’s information to support that patient’s direct care.
Digital Care Services Service Providers will be onboarded via a SCAL
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with NRL FHIR API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/national-record-locator-fhir
NHS Login
Use this API to enable patients and the public to access multiple digital health and social care services with NHS login, a single re-usable login.
Digital Care Services Service Providers will be onboarded via a SCAL and assured using the NHS Login Integration Toolkit
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with NHS Login can be found at the following URL: https://github.com/nhsconnect/nhslogin
Female Genital Mutilation - Information Sharing (FGM-IS)
Digital Care Services Service Providers use this API to share Female Genital Mutilation (FGM) information for children under 18 with relevant NHS professionals across England.
Digital Care Services Service Providers will be onboarded via a SCAL - not yet available (May 2022)
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the FGM-IS API will be provided when available. Please note that this is NOT a day 1 requirement for New Market Entrants.
e-Referral Service (eRS) FHIR API - Referrer
The NHS e-Referral Service (e-RS) provides an easy way for patients to choose their first hospital or clinic appointment with a specialist. Bookings can be made online, using the telephone, or directly in the GP surgery at the time of referral.
Digital Care Services Service Providers will be onboarded via a SCAL
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Assurance key contact for the eRS programme is via the mailbox ersapi.assurance@nhs.net
Further information on integrating and onboarding with the eRS FHIR API can be found at the following URL: https://digital.nhs.uk/services/e-referral-service
Electronic Prescription Service (EPS) - Prescribing
Digital Care Services Service Providers can access the Electronic Prescription Service (EPS) - the national service used to send electronic prescriptions from secondary care (outpatient) prescribers to dispensers such as pharmacies. You can prepare a prescription for signing, create a prescription or cancel a prescription.
All integrations with EPS FHIR API will be onboarded via SCAL.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the EPS FHIR API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/electronic-prescription-service-fhir
Signing API
The signing API has been developed to take away the complexity of suppliers having to develop their own signing solution, it also allows changes to be managed centrally e.g. hashing algorithms. The first use case for the signing API is with the EPS FHIR API.
Digital Care Services Service Providers will be onboarded via a SCAL - Not yet available (May 22)
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the Signing API will be provided when available
National Data Opt-Out (NDOP)
Digital Care Services Service Providers can use the National Data Opt-Out Service to identify patients' preferences and control sharing of their data by healthcare organisations for planning and research purposes.
Compliance with NDOP will be onboarded via SCAL.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Pathology
Digital Care Services Service Providers can use the Pathology Edifact API to receive pathology test results in GP practices from laboratories.
Pathology messages are sent and received via MESH.
NHS Digital have also developed and assured an adapter to support Pathology messaging.
Digital Care Services Service Providers may use the adapter or alternatively develop their own (which will require additional assurance).
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the Pathology Edifact API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/pathology-messaging-edifact
Bowel Cancer Screening
Digital Care Services Service Providers can use the Bowel Cancer Screening Edifact API to receive bowel cancer screening test results in GP practices from the screening system, specifically faecal occult blood test (FOBT) results.
It's designed for the transmission of structured bowel cancer screening results to primary care GP systems from the screening system, using UN/EDIFACT based messages sent over MESH.
NHS Digital have also developed and assured an adapter to support Pathology messaging.
Digital Care Services Service Providers may use the adapter or alternatively develop their own (which will require additional assurance).
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with the Bowel Cancer Screening Edifact API can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/bowel-cancer-screening-edifact
National Health Application and Infrastructure Services (NHAIS)
Digital Care Services Service Providers can use the NHAIS API to manage GP registrations and other patient data.
NHAIS messages are sent and received via MESH.
NHS Digital have also developed and assured an adapter to support NHAIS messaging.
Digital Care Services Service Providers may use the adapter or alternatively develop their own (which will require additional assurance).
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Patient Switching Standard (GP2GP)
Digital Care Services Service Providers can use this API to transfer patients' electronic health records between old and new practices when they change GPs.
NHS Digital have also developed and assured adaptors to support the Patient Switching Standard and GP2GP messaging via HL7 v3 API.
Digital Care Services Service Providers may use the adaptors or alternatively develop their own (which will require additional assurance).
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
General Practice Extraction Service (GPES)
The General Practice Extraction Service (GPES) collects information for a wide range of purposes, including provision of direct care, GP payments and planning & research purposes. It works with the Calculating Quality Reporting Service (CQRS) and GP clinical systems as part of the GP Collections service.
Digital Care Services Service Providers will be assured against each extract as described in the Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
GP Data Collections (GPDC)
GPDC is the mechanism for receiving requests for GPES extracts and returning the extracts themselves to the GPES team.
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
eMED3
The Statement of Fitness for Work (known as a Med 3 form or ‘fit note’) is used throughout Great Britain. Fit notes are issued by doctors, usually GPs, for Statutory Sick Pay or Social Security purposes. As a part of a medical consultation, a GP may assess a patient’s medical condition to determine their fitness for work. The fit note provides return to work advice for the patient and their employer and can also be used to support a claim to health-related benefits.
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Digital Medicines and Pharmacy FHIR Payload
The Digital Medicines initiative aims to positively transform the way that Patients manage their medicines, promote new models of care as well as improve the medicines supply chain and the provision of medicines data.
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach including Technical and Clinical assurance. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
Interface Mechanism (IM1)
IM1 is a mechanism for accessing data held in GP Systems. A system or application is required to provide IM1 interfaces if ANY of the following are true:
It offered IM1 interfaces under Digital Care Services
It offers ALL Foundation capabilities under Digital Care Services
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
GP Data for Planning and Research (GPDfPR)
The purpose of GP Data for Planning and Research (GPDfPR) is to support the data needs of the health and social care system including policy development, public health, planning and commissioning of services and research. This new collection is designed to reduce the number of requests for access to data received by General Practice.
Digital Care Services Service Providers will be onboarded via a Tailored Assurance Approach. The approach will detail the technical and clinical assurance activities to be carried out by NHS Digital alongside the service provider.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
NHS 111 Post Event Messaging (111 PEM)
NHS 111 is a free 24/7/365 call centre service for patients with urgent medical concerns. The service is provisioned on a regional basis and run by several different organisations nationally.
111 call handling services use specific software systems that are outside the scope of the GP IT Futures framework.
A call to 111 may result in an ambulance call out, or a referral to one of several care settings:
a local emergency department
an Out of Hours (OOH) service
the patient's registered GP
All of these will result in a 111 report message (Post Event Message) being sent to the patient's GP Practice. A referral to the GP will additionally trigger a 111 referral message (also known as a Transfer of Care) sent to the GP practice.
111 PEM messaging is assured via tailored assurance incorporating Interoperability Toolkit (ITK) and end to end assurance. An adapter has been developed and assured by NHS Digital.
A Digital Care Services Service Provider who chooses not to use the adapter must undertake ITK accreditation themselves.
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with 111 PEM can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/nhs-111
Clinical Document Architecture (CDA)
CDA is an XML-based HL7 standard for exchange of clinical information.
The only mandated use of CDA in general practice IT is receipt of 111 CDA referrals and reports. However many localities have implemented solutions to ingest external documents in various formats including CDA. For this reason suppliers may consider implementing CDA handling functionality for other use cases and payloads.
CDA is assured alongside 111 PEM (including ITK).
Solution Assurance key contact for Digital Care Services is via the SA Compliance mailbox functional.assurance@nhs.net
More information on integrating with CDA can be found at the following URL: https://digital.nhs.uk/developer/api-catalogue/nhs-111