eMED3-01

Capture and edit New eMED3 data in accordance with eMED3 Data Entry

eMED3-02

Ability to cancel the transaction at any time during the data entry process.

Upon cancelling, Practice User to be informed that by cancelling no record of the eMED3 transaction will be kept and the form, if printed, is to be destroyed. Practice User is to be asked if they wish to continue with cancelling. If NO, the user to be returned to the data entry form.

eMED3-03

Create eMED3 forms (as per eMED3 Template (2022)) in an unalterable format (compatible with GP2GP transfer) populated with the eMED3 data recorded in eMED3-01 and as defined in eMED3 Data Items Usage.

eMED3 forms only to be created when all mandatory data items as defined in eMED3 Date Entry have been recorded.

eMED3-04

eMED3-05

Print eMED3 forms created as per eMED3 - 03. The form to be printed in the format specified by eMED3 Template (2022)  with data populating the appropriate fields as defined in eMED3 (Fit Notes) - v1.2.1#eMED3 Data Items Usage , in the eMED3 Data Entry table and in eMEDD3 Template (2022) with Mappings.

For <Patient.title>, suppliers can choose to display the title by striking through the appropriate alternative titles on the form (Mr, Mrs, Ms, Miss) or by simply printing only the relevant title as held on the Patient Record.  This can include titles other than those listed on the form (e.g. ‘Dr.’, ‘Prof’, ‘Lord’).

eMED3 forms only to be printed when all mandatory data items as defined in eMED3 Data Entry have been recorded.

eMED3-06

• Barcode to be a four segmented two-Dimensional Data Matrix (ISO/IEC 16022) Barcode of 1.7cm square in size
• Each field to be delimited by a ‘|’ character ('pipe symbol')
• To avoid delimiter collision, escape characters to be used (i.e.’\|’)
• Only data which is printed on the form will be encoded as per the 2D Barcode Data elements table
• Data to be included in the order listed as per the 2D Barcode Data elements table
• Information to be stored on the barcode to be truncated if required in order to fit within the maximum characters the barcode can allow

For Standards relating to barcode implementation, see:

• ISB1077 - AIDC for Patient Identification
• ISB0108 - AIDC: Automatic Identification and Data Capture

eMED3-07

eMED3-08

All eMED3 data and created eMED3 forms to be saved to the patient record as per eMED3 Data Items Usage .

Data can be saved before printing, after printing or (to the user) simultaneously as long as the requirements are met.

eMED3-09

Record that eMED3 form was 'issued by hand' (e.g. when retroactively capturing data for a paper-based MED3 form). This function to adhere to requirements eMED3-01, eMED3-08 and to eMED3 Data Entry, with the following exceptions:

1. • Admin Code to be recorded as one of:

     • 751751000000104 - MED3 (2010) issued by hand, may be fit for work (finding)

     • 751731000000106 - MED3 (2010) issued by hand, not fit for work (finding)

   •  Printing is not mandatory, but Practice User to be offered the option to print the statement  
     • If they choose to print eMED3 Data Entry to be adhered to (also see eMED3-10 and eMED3-05 )

eMED3-10

When printing eMED3 forms (see eMED3-05 ) which are recorded as 'issued by hand', the words “ISSUED BY HAND” to be included overlaid in grey scale format and in the background on the printed form.

eMED3-11

eMED3-12

eMED3-13

Print Duplicate of saved eMED3 form (see eMED3-03 ) ensuring the word “DUPLICATE” is included overlaid in grey scale format and in the background on the printed form.

eMED3-14

eMED3-15

For all Duplicate eMED3 forms created, update the Patient record by saving the following data items:

• Depending on whether the original statement was Not Fit for Work (NFW) or May Be Fit for work (MFW), record the applicable <AdminCode> and its <AdminText> for Duplicate:
  • 751641000000105 - eMED3 (2010) duplicate issued, may be fit for work (finding)
  • 751621000000103 - eMED3 (2010) duplicate issued, not fit for work (finding)
• Record <DuplicatePrinted> flag and ensure the <PrintedFlag> is NOT recorded.
• Save all other structured data associated with the original statement (using all the original dates)

eMED3-16

Solution to generate a <LinkingID> to be used as a linking identifier allowing DWP to identify all data relating to the same Patient without identifying him or her.

The <LinkingID> to be in the form of a DCE UUID and stored with each eMED3 transaction in the Patient’s record.

eMED3-17

eMED3-18

eMED3-19

eMED3-20

eMED3-21

The structure and enveloping of the extracted content to be consistent with the following eMED3 Activity File XML Schema: 

• EMED3-v2-7 SCHEMA.txt

eMED3-22

XML-based eMED3 Activity Files will be transferred to NHS Digital on a weekly basis via Messaging Exchange for Social Care and Health (MESH). 

eMED3-23

eMED3-24

Scheduled extracts to commence from the first Sunday following the eMED3 service going live and weekly thereafter

eMED3-25

Each new submission to be an extract of all eMED3 transaction activity which has occurred since the last extract (unless this is the first extract being taken). 

Suppliers to not populate extracts with data any older than is covered by the standard extract cycle defined in eMED3-23.

eMED3-26

Each eMED3 Activity File Construction  to comprise an envelope and a payload. 

The payload to be the extracted statistical content as defined in eMED3 Activity File Payload .

Where there are no eMED3 transaction records i.e. a null return as detailed in the Schema, an eMED3 Activity File to still be provided.

The practice envelope to contain the data itemised in eMED3 Activity File Envelope .

eMED3-27

Data about patients who have registered a Type 1 opt-out (as per National data opt-out programme) will not be included in the eMED3 data extract, unless the patient has withdrawn this at a later date. 

Opt-out is recorded in the Patient Record currently using the following (Type 1) patient objection code (in SNOMED CT): 

827241000000103 - Dissent from secondary use of GP patient identifiable data

Withdrawal of this opt-out is recorded on the patient record currently using the following (Type 1) patient objection code (in SNOMED CT):

827261000000102 - Withdraw dissent from secondary use of GP patient identifiable data

The date of the most recent (Type 1) patient objection code i.e. the event data associated with the (Type 1) patient objection code, will be used to determine if data is to be included.

Date

Flag

<AssessmentDate>

Code

Text

Code

<AdminCode>

<AdminText>

<CodingSystem>

Admin Code Description 

Code

Code

Text

<DiagCode>

<DiagCodeText>

<Diag.Printed.Text>

• This field is the principal diagnosis causing the statement to be issued
  
• <DiagCode>, <DiagCodeText> and <Diag.Printed.Text> are all MANDATORY data items
• <Diag.Printed.Text> defaults to <DiagCodeText>, but can be amended
• Text not to exceed number of characters that can be printed within the box in Arial pt.8.5

Not Fit for Work (NFW)

Flag

<NFWFlag>

Tick in the box

• Tick box to be offered for the authorised professional (doctor, nurse, physiotherapist, occupational therapist, or pharmacist) to indicate the Patient is NOT fit for work (<NFWFlag>)
• Mandatory to select one of NFW or MFW tick boxes, and only one is to be ticked by the user and then the appropriate flag set
• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

May Be Fit for work (MFW)

Flag

<MFWFlag>

Tick in the box

• Tick box to be offered for the authorised professional (doctor, nurse, physiotherapist, occupational therapist, or pharmacist) to indicate the Patient MAY be fit for work (<MFWFlag>).
• Mandatory to select one of NFW or MFW tick boxes, and only one is to be ticked by the user and then the appropriate flag set
• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

Text

Text

<NFW.Remarks>

Or

<MFW.Comments>

If <NFWFlag> is set: 

• Comments are OPTIONAL;
• <MFWPhaseRtn>, <MFWAlteredHrs>, <MFWAmendDuties> and <MFWAdaptWorkplace> tick boxes to be DISABLED
• Free text entered to be saved as <NFW.Remarks>
• Text not to exceed number of characters that can be printed within the box in Arial pt.8.5

If <MFW.flag> is set: 

• Comments are MANDATORY;
• <MFWPhaseRtn>, <MFWAlteredHrs>, <MFWAmendDuties> and <MFWAdaptWorkplace> tick boxes to be ENABLED
• Free text entered to be saved as <MFW.Comments>
• Text not to exceed number of characters that can be printed within the box in Arial pt.8.5

• If <NFWFlag> is set, then box to be DISABLED
• If <MFWFlag> is set, then box to be ENABLED 
  • Tick box is optional. 
  • Can be ticked in combination with other MFW boxes or left unticked

• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

• If <NFWFlag> is set, then box to be DISABLED
• If <MFWFlag> is set, then box to be ENABLED 
  • Tick box is optional. 
  • Can be ticked in combination with other MFW boxes or left unticked 

• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

• If <NFWFlag> is set, then box to be DISABLED
• If <MFWFlag> is set, then box to be ENABLED 
  • Tick box is optional. 
  • Can be ticked in combination with other MFW boxes or left unticked 

• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

• If <NFWFlag> is set, then box to be DISABLED
• If <MFWFlag> is set, then box to be ENABLED 
  • Tick box is optional. 
  • Can be ticked in combination with other MFW boxes or left unticked

• If not ticked, this to be indicated on the form for both the box and its title (e.g. by changing it to background grey scale, over-writing with a double strikethrough)

Number

Number

Number

Flag

Flag

<ValidPeriodDays>

<ValidPeriodWeeks>

<ValidPeriodMonths>

<ValidPeriodIndefinite>

<NFWSixMonthFlag>

• Enables the user to define the period of time for which the statement is valid from the <AssessmentDate>
• Mandatory to record this field or record <ValidPeriodStartDate> and <ValidPeriodEndDate>
• Options are:
  • No. of Days
  • No. of Weeks
  • No. of Months
  • Indefinite

• Duration to be stored as appropriate data item: <ValidPeriodDays>, <ValidPeriodWeeks>, <ValidPeriodMonths> or <ValidPeriodIndefinite>
• If Duration >= 13 weeks or 3 months, or value = indefinite, then prompt user to confirm the Patient has been unfit for work for at least 6 months preceding the <AssessmentDate>. 
  • If confirmed, the specified extended period to be allowed and the <NFWSixMonthFlag> set
  • If not confirmed, the Solution to allow the authorised professional (doctor, nurse, physiotherapist, occupational therapist, or pharmacist) to re-enter the date range subject to all the same rules defined for this field
• If the Duration <= 14 days, this field to be left blank and the Solution to automatically fill in the <ValidPeriodStartDate> and <ValidPeriodEndDate> fields as per defined rules for these fields

Date

Date

Flag

<ValidPeriodStartDate>

<ValidPeriodEndDate>

<NFWSixMonthFlag>

• User can enter both <ValidPeriodStartDate> and <ValidPeriodEndDate> or they can specify just <ValidPeriodEndDate>.
• If they enter only <ValidPeriodEndDate>, then <ValidPeriodStartDate> to default <AssessmentDate>
• If Duration >= 13 weeks or 3 months, or value = indefinite, then prompt user to confirm the Patient has been unfit for work for at least 6 months preceding the <AssessmentDate> 
  • If confirmed, the specified extended period to be allowed and the <NFWSixMonthFlag> set
  • If not confirmed, the Solution to allow the authorised professional (doctor, nurse, physiotherapist, occupational therapist, or pharmacist) to re-enter the date range subject to all the same rules defined for this field

Flag

Date

<FollowUpAssessment>

<Follow.up.date>

• Ticked if a follow-up assessment is required at the end of the period. 
  • If ticked <FollowUpAssessment> flag to be set 
  • <Follow.up.date> to be recorded although this date is not printed, but can be used for future reference 

• As per eMED3 form layout as shown in eMED3 Template (2022) with Mappings , one of the following lines of text to be printed, as appropriate:

I will/will not need to assess your fitness for work again at the end of this period.

I will/will not need to assess your fitness for work again at the end of this period.

Calculated

Date

Time

<UniqueID>

<StatementDate

<StatementTime>

Flag

<PrintedFlag>

• Signifies end of transaction 
• Option enabled after PRINT option has been selected for the user to confirm the statement printed successfully
• Once clicked, <PrintedFlag> is recorded
• If not already saved, data items are generated and all data saved as per eMED3-08