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Care Navigation

Care Navigation

ID

C67

Version

2.0.0

Type

Capability

Category

Health or care organisation management

Status

Effective

Effective Date

May 13, 2026

Contracting Vehicle(s)

Digital Pathways Solution Registry

Description

Enables Health or Care Professionals to appropriately process and respond to Online Patient Consultations using a pre-configured Care Navigation Workflow.

Outcomes

For a Patient/Service User:

Consistent user experience of requesting assistance using Online Consultation tools.

For Primary Care:

Ability to process Online Consultation requests using pre-configured Workflow.

Enable the Health or Care Organisation to respond to Online Consultations efficiently.

Enable navigating the Online Patient Consultations and Requests to the right Health or Care Professional in a multidisciplinary team.

For the wider NHS and social care system:

Enable consistent processing of Online Patient Consultations and Requests.

MUST Epics - Describes the minimum functionality required to deliver a Capability.

E00549 - configure Care Navigation Workflow

As a Health or Care Professional

I want to configure Care Navigation Workflows

So that I can control the processing of Online Consultation requests

Acceptance criterion 1: configure Care Navigation Workflow

Given the Health or Care Professional is permitted to configure Care Navigation Workflows

When the Health or Care Professional selects to configure a Care Navigation Workflow

Then the Care Navigation Workflow is configured

Acceptance criterion 2: view Care Navigation Workflow

Given the Health or Care Professional is permitted to view existing Care Navigation Workflows

When the Health or Care Professional selects to view an existing Care Navigation Workflow

Then the details of the selected Care Navigation Workflow are displayed

Acceptance criterion 3: disable Care Navigation Workflow

Given the Health or Care Professional is permitted to disable Care Navigation Workflows

When the Health or Care Professional selects to disable a Care Navigation Workflow

Then the selected Care Navigation Workflow is disabled

Acceptance criterion 4: enable Care Navigation Workflow

Given the Health or Care Professional is permitted to enable Care Navigation Workflows

When the Health or Care Professional selects to enable a Care Navigation Workflow

Then the selected Care Navigation Workflow is enabled

E00549 - Supporting Information

  • A Care Navigation Workflow can be described as:

    • A pre-configured pathway of events to be completed by one or more Health or Care Professionals or Organisations, to process an episode of care. It MAY include some or all the following and more:

      • Receive structured or semi-structured requests from Patients

      • Filter the information manually or based on predefined rules

      • Ability to refer or signpost the request to different services or appropriate Health or Care Professionals either manually or based on predefined rules

      • Assessment of the request either by a human or system triggering actions or tasks based on predefined rules

    • These Workflows can be manual or automated or a mix of both

  • Examples of configuring a Care Navigation Workflow MAY include, but are not limited to:

    • Create a new Care Navigation Workflow

    • Amend an existing Care Navigation Workflow

  • Examples of details of a Care Navigation Workflow MAY include, but are not limited to:

    • Tasks involved in a Care Navigation Workflow

    • Decision points in a Care Navigation Workflow

    • Various actors/resources involved in a Care Navigation Workflow

    • Periods of availability or unavailability by Organisation in a Care Navigation Workflow

    • Periods of availability or unavailability by Health or Care Professional in a Care Navigation Workflow

    • Routing of Online Consultation requests to specific team or roles

E00550 - process Online Consultation requests using Care Navigation Workflow

As a Health or Care Professional

I want to process Online Consultation requests using the configured Care Navigation Workflows

So that the Online Consultation requests are directed to the appropriate Health or Care Professional or service

Acceptance criterion 1: process Online Consultation requests using Care Navigation Workflow

Given a Care Navigation Workflow has been configured

When an Online Consultation request is created by a Patient

Then the Online Consultation request is processed as per the configured Care Navigation Workflow

E00551 - assign Online Consultation requests to Health or Care Professional manually

As a Health or Care Professional

I want to assign Online Consultation requests to a Health or Care Professional or a group of Health or Care Professionals

So that the Online Consultation requests can be directed to the appropriate Health or Care Professional(s)

Acceptance criterion 1: view all Online Consultation requests

Given the Health or Care Professional is permitted to view all Online Consultation requests

When the Health or Care Professional selects to view all Online Consultation requests

Then all Online Consultation requests are displayed

Acceptance criterion 2: assign Online Consultation requests to a Health or Care Professional

Given the Health or Care Professional is permitted to assign Online Consultation requests

When the Health or Care Professional selects to assign an Online Consultation request to a Health or Care Professional

Then the Online Consultation request is assigned

Acceptance criterion 3: assign Online Consultation requests to a group of Health or Care Professionals

Given the Health or Care Professional is permitted to assign Online Consultation requests

When the Health or Care Professional selects to assign an Online Consultation request to a group of Health or Care Professionals

Then the Online Consultation request is assigned

Acceptance criterion 4: view Online Consultation requests assigned to a Health or Care Professional

Given Online Consultation requests are assigned to a Health or Care Professional

When the Health or Care Professional selects to view the assigned Online Consultation requests for the Health or Care Professional

Then the assigned Online Consultation request are displayed

Acceptance criterion 5: view Online Consultation requests assigned to a group of Health or Care Professionals

Given Online Consultation requests are assigned to a group of Health or Care Professionals

And the Health or Care Professional is part of the group of Health or Care Professionals

When the Health or Care Professional selects to view the assigned Online Consultation requests to the group of Health or Care Professionals

Then the assigned Online Consultation requests are displayed

E00551 - Supporting Information

  • Example scenarios of manually assigning an Online Consultation request MAY include, but are not limited to:

    • When a Health or Care Professional is unavailable

    • When an Online Consultation request is wrongly assigned

    • When Online Consultation requests are assigned to specific Health Care Professional roles or groups for review

E00552 - assign Online Patient Requests to Health or Care Professional manually

As a Health or Care Professional

I want to assign Online Patient Requests to a Health or Care Professional or a group of Health or Care Professionals

So that the Online Patient Requests can be directed to the appropriate Health or Care Professional(s)

Acceptance criterion 1: view all Online Patient Requests

Given the Health or Care Professional is permitted to view all Online Patient Requests

When the Health or Care Professional selects to view all Online Patient Requests

Then all Online Patient Requests are displayed

Acceptance criterion 2: assign Online Patient Requests to a Health or Care Professional

Given the Health or Care Professional is permitted to assign Online Patient Requests

When the Health or Care Professional selects to assign an Online Patient Request to a Health or Care Professional

Then the Online Patient Request is assigned

Acceptance criterion 3: assign Online Patient Requests to a group of Health or Care Professionals

Given the Health or Care Professional is permitted to assign Online Patient Requests

When the Health or Care Professional selects to assign an Online Patient Request to a group of Health or Care Professionals

Then the Online Patient Request is assigned

Acceptance criterion 4: view Online Patient Requests assigned to a Health or Care Professional

Given Online Patient Requests are assigned to a Health or Care Professional

When the Health or Care Professional selects to view the assigned Online Patient Requests for the Health or Care Professional

Then the assigned Online Patient Requests are displayed

Acceptance criterion 5: view Online Patient Requests assigned to a group of Health or Care Professionals

Given Online Patient Requests are assigned to a group of Health or Care Professionals

And a Health or Care Professional is part of the group of Health or Care Professionals

When the Health or Care Professional selects to view the assigned Online Patient Requests to the group of Health or Care Professionals

Then the assigned Online Patient Requests are displayed

E00552 - Supporting Information

  • Example scenarios of manually assigning an Online Patient Request MAY include, but are not limited to:

    • When a Health or Care Professional is unavailable

    • When an Online Patient Request is wrongly assigned

    • When Online Patient requests are assigned to specific Health Care Professional roles or groups for review

E00553 - record outcome of Online Consultation request manually

As a Health or Care Professional

I want to record outcomes to Online Consultation requests

So that I can record the appropriate conclusion to Online Consultations

Acceptance criterion 1: configure available outcomes for Online Consultations

Given the Health or Care Professional is permitted to configure available outcomes for Online Consultation requests

When the Health or Care Professional selects to configure the available outcomes for an Online Consultation requests

Then the available outcomes for Online Consultation requests are configured

Acceptance criterion 2: record outcome of Online Consultation requests manually

Given the Health or Care Professional is permitted to record outcomes of Online Consultation requests

When the Health or Care Professional selects to record an outcome to the Online Consultation request

Then the outcome is recorded

E00553 - Supporting Information

  • Examples of configuration MAY include, but are not limited to:

    • Adding a new outcome for an Online Consultation

    • Deleting an existing outcome for an Online Consultation

    • Editing an existing outcome for an Online Consultation

    • Disabling an existing outcome for an Online Consultation

    • Enabling an existing outcome for an Online Consultation

E00554 - send automated notification to the Patient when there is a response to their Online Consultation request

As a Health or Care Professional

I want an automated notification to be sent to the Patient when I respond to their Online Consultation request

So that Patients are informed that there is a response to their Online Consultation request

Acceptance criterion 1: send automated notification to a Patient when there is a response to their Online Consultation request

Given the Health or Care Professional is permitted to respond to Online Consultation requests

When the Health or Care Professional has recorded a response to an Online Consultation request

Then an automated notification is sent to the Patient

E00554 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

E00554 - Supporting Information

  • Examples of notification methods MAY include:

    • NHS App message

    • Email

    • SMS

    • Letter

  • Notifications can be made in regards to:

    • Online Consultation requests

    • Online Patient Requests

E00558 - view history of Care Navigation conducted for Online Consultation requests

As a Health or Care Professional

I want to view the history of Care Navigation conducted for Online Consultation requests

So that I can review the information used to reach the current state of an Online Consultation request

Acceptance criterion 1: view history of Care Navigation conducted for Online Consultation requests

Given the Health or Care Professional is permitted to view the history of Care Navigation conducted for Online Consultation requests

When the Health or Care Professional selects to view the history of Care Navigation conducted for an Online Consultation request

Then the dates and times of creation and updates are displayed

And the names of Health or Care Professionals involved throughout the Care Navigation journey are displayed

And how the request was processed is displayed

And criteria and reasons used to reach the outcome or current state is displayed

E00558 - Supporting Information

  • Examples of how an Online Consultation request may be processed MAY include, but are not limited to:

    • Manually

    • Automatically

    • Semi-automatically

E00559 - view history of Care Navigation conducted for Online Patient Requests

As a Health or Care Professional

I want to view the history of Care Navigation conducted for Online Patient Requests

So that I can review the information used to reach the current state of an Online Patient Request

Acceptance criterion 1: view history of Care Navigation conducted for Online Patient Requests

Given the Health or Care Professional is permitted to view the history of Care Navigation conducted for Online Patient Requests

When the Health or Care Professional selects to view the history of Care Navigation conducted for an Online Patient Requests

Then the dates and times of creation and updates are displayed

And the names of Health or Care Professionals involved throughout the Care Navigation journey are displayed

And how the request was processed is displayed

And criteria and reasons used to reach the outcome or current state is displayed

E00559 - Supporting Information

  • Examples of how an Online Patient Request may be processed MAY include, but are not limited to:

    • Manually

    • Automatically

    • Semi-automatically

E00772 - record outcome of Online Consultation to the Electronic Patient Record (EPR) of the Patient

As a Health or Care Professional

I want to record the outcomes of Online Consultations to the Electronic Patient Record (EPR) of the Patient

So that I have a complete record of interactions with the Patient

Acceptance criterion 1: record outcome of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

Given the outcome of an Online Consultation has been recorded by the Health or Care Professional

When the Health or Care Professional selects to record the outcome of the Online Consultation to the Electronic Patient Record (EPR) of the Patient

Then the outcome of the Online Consultation is recorded to the Electronic Patient Record (EPR) of the Patient

E00772 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

  • Solutions which integrate with the GP Core Clinical Solution to adhere to:

E00778 - save electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

As a Health or Care Professional

I want to add electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

So that I have a record of the Online Consultation history in the Patient's Electronic Patient Record (EPR)

Acceptance criterion 1: select electronic files included as part of an Online Consultation to be saved to the Electronic Patient Record (EPR) of the Patient

Given the Health or Care Professional is permitted to save electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

And electronic files have been included as part of an Online Consultation

When the Health or Care Professional selects to save the electronic files to the Electronic Patient Record (EPR) of the Patient

Then the Health or Care Professional is able to select the electronic files from the Online Consultation to be saved to the Electronic Patient Record (EPR) of the Patient

Acceptance criterion 2: save selected electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

Given the Health or Care Professional is permitted to save electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

And the Health or Care Professional has selected electronic files to be saved to the Electronic Patient Record (EPR) of the Patient

When the Health or Care Professional selects to save the selected electronic files included as part of an Online Consultation to the Electronic Patient Record (EPR) of the Patient

Then the selected electronic files are saved to the Electronic Patient Record (EPR) of the Patient

E00778 - Supporting Information

  • Examples of file formats MAY include, but are not limited to:

    • .JPEG

    • .PNG

    • .DOCX

    • .PDF

    • .MP4

E00778 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

  • Solutions which integrate with the GP Core Clinical Solution to adhere to one of the following:

  • Where a decision has been made not to save the attachment to the Electronic Patient Record (EPR) of the Patient, the Solution will not retain any files

MAY Epics - Describes additional functionality associated with the Capability. Suppliers should consider all MAY Epics as part of their User Research.

E00795 - send automated notification to the Patient Representative when there is a response to the Patient’s Online Consultation request

As a Health or Care Professional

I want an automated notification to be sent to the Patient Representative when I respond to the Patient's Online Consultation request

So that Patient Representatives are informed that there is a response to the Patient’s Online Consultation request

Acceptance criterion 1: send automated notification to a Patient Representative when there is a response to the Patient's Online Consultation request

Given the Health or Care Professional is permitted to respond to Online Consultation requests

And the Online Consultation Request was created by a Patient Representative

When the Health or Care Professional has recorded a response to an Online Consultation request

Then an automated notification is sent to the Patient Representative

E00795 - Supporting Information

  • Examples of notification methods MAY include:

    • NHS App message

    • Email

    • SMS

    • Letter

  • Notifications can be made in regards to:

    • Online Consultation requests

    • Online Patient Requests

E00555 - respond to Online Consultation requests using a template

As a Health or Care Professional

I want to respond to Online Consultation requests using a template

So that my responses are consistent

Acceptance criterion 1: configure Online Consultation request response template

Given the Health or Care Professional is permitted to configure the Online Consultation request response templates

When the Health or Care Professional selects to configure an Online Consultation request response template

Then the Online Consultation request response template is configured

Acceptance criterion 2: respond to Online Consultation requests using a template

Given the Health or Care Professional is permitted to respond to Online Consultation requests

And Online Consultation requests response templates are configured

When the Health or Care Professional selects to respond to an Online Consultation request using an Online Consultation request response template

Then the response is drafted using the selected Online Consultation request response template

E00555 - Supporting Information

  • Examples of configuration MAY include, but are not limited to:

    • Enable an existing Online Consultation request response template

    • Disable an existing Online Consultation request response template

    • Creating new Online Consultation request response template

    • Amending new Online Consultation request response template

    • Deleting new Online Consultation request response template

  • Examples of templates MAY include, but are not limited to:

    • Predefined non-editable templates

    • Templates with editable parts

E00556 - include electronic files in Online Consultation responses

As a Health or Care Professional

I want to include electronic files in Online Consultation request responses

So that Patients can access and respond to these electronic files

Acceptance criterion 1: include electronic files in Online Consultation responses

Given the Health or Care Professional is permitted to include electronic files in Online Consultation responses

When the Health or Care Professional selects to include an electronic file in an Online Consultation response

Then the electronic file is shared with the Patient as part of the Online Consultation response

E00556 - Additional Implementation Details

Solutions MUST comply with the following when implementing this Epic:

  • Documents are to be made available in a timely manner and in non-proprietary formats

  • If the Solution accepts proprietary formats, they are to be converted to non-proprietary formats as required

  • The Solution will ensure the integrity of converted documents and preserve any additional context

E00556 - Supporting Information

  • Examples of electronic file formats MAY include, but are not limited to:

    • .JPEG

    • .PNG

    • .DOCX

    • .PDF

    • .MP4

  • For information relating to the use of links and attachments in Patient communications, see GP-IG-18-10 in Information Governance

E00557 - include links in Online Consultation responses

As a Health or Care Professional

I want to include links in Online Consultation responses

So that Patients can access and use these links

Acceptance criterion 1: include links in Online Consultation responses

Given the Health or Care Professional is permitted to include links in Online Consultation responses

When the Health or Care Professional selects to include a link in an Online Consultation response

Then the link is shared with the Patient as part of the Online Consultation response

E00557 - Supporting Information

  • Examples of links MAY include, but are not limited to:

    • Links to health forms

    • Links to medical awareness topics

  • For information relating to the use of links and attachments in Patient communications, see GP-IG-18-10 in Information Governance

E00560 - automatically prioritise Online Consultation requests using Care Navigation Workflow

As a Health or Care Professional

I want Online Consultation requests to be prioritised automatically using Care Navigation Workflow

So that I am aware of the priority of Online Consultation request

Acceptance criterion 1: automatically prioritise Online Consultation requests using Care Navigation Workflow

Given automatic prioritisation of Online Consultation requests is configured using Care Navigation Workflow

When an Online Consultation request is created

Then the priority of the Online Consultation request is automatically recorded as configured in the Care Navigation Workflow

E00561 - automatically assign Online Consultation requests using Care Navigation Workflow

As a Health or Care Professional

I want Online Consultation requests to be automatically assigned to a Health or Care Professional or group of Health or Care Professionals using Care Navigation Workflow

So that the Online Consultation requests are directed to the appropriate Health and Care Professional

Acceptance criterion 1: automatically assign Online Consultation requests using Care Navigation Workflow

Given automatic assignment of Online Consultation requests is configured using Care Navigation Workflow

When an Online Consultation request is created

Then the Online Consultation request is automatically assigned as configured in the Care Navigation Workflow

E00562 - Health or Care Professional records coded clinical terms for Online Consultations

As a Health or Care Professional

I want to record coded clinical terms for Online Consultations

So that structured coding can be used for Online Consultations to help categorisation, interoperability and reporting

Acceptance criterion 1: record coded clinical terms for Online Consultations

Given the Health or Care Professional is permitted to record coded clinical terms for Online Consultations

When the Health or Care Professional selects to record a coded clinical term for an Online Consultation

Then the coded clinical term is recorded for the Online Consultation

Acceptance criterion 2: record coded clinical terms for information within Online Consultations

Given the Health or Care Professional is permitted to record coded clinical terms for information within Online Consultations

When the Health or Care Professional selects to record a coded clinical term for information within an Online Consultation

Then the coded clinical term is recorded within the Online Consultation

E00562 - Supporting Information

  • Examples of coded clinical terms within an Online Consultation MAY include, but are not limited to:

    • For medical conditions

    • For symptoms

    • Outcome of the Online Consultation

  • See Data Standards for requirements relating to the implementation of coded clinical terms

E00563 - automated suggestion of coded clinical terms for Online Consultations

As a Health or Care Professional

I want the Online Consultation Solution to suggest appropriate coded clinical terms for Online Consultations

So that automated assistance is provided in recording the coded clinical terms for Online Consultations

Acceptance criterion 1: create the rules for automatically suggesting a coded clinical term for Online Consultations

Given the Health or Care Professional is permitted to create rules for automatically suggesting a coded clinical term for Online Consultations

When the Health or Care Professional selects to create a rule for automatically suggesting a coded clinical term for Online Consultations

Then the automated suggestion of coded clinical term for Online Consultation rule is created

Acceptance criterion 2: accept automatically suggested coded clinical term for an Online Consultation

Given the Health or Care Professional is permitted to record coded clinical terms for Online Consultations

When the automatically suggested coded clinical terms are presented to the Health or Care Professional for the Online Consultation

And the Health or Care Professional selects to accept a suggested coded clinical term

Then the accepted coded clinical term is recorded for the Online Consultation

Acceptance criterion 3: reject automatically suggested coded clinical term for an Online Consultation

Given the Health or Care Professional is permitted to record coded clinical terms for Online Consultations

When the automatically suggested coded clinical terms are presented to the Health or Care Professional for the Online Consultation

And the Health or Care Professional selects to reject a suggested coded clinical term

Then the rejected coded clinical term is not recorded for the Online Consultation

E00563 - Supporting Information

  • See Data Standards for requirements relating to the implementation of coded clinical terms

E00565 - view all Online Consultation requests for a Patient

As a Health or Care Professional

I want to view all Online Consultation requests for a Patient

So that I can get better understanding of the Patient’s history of Online Consultation requests

Acceptance criterion 1: view all Online Consultation requests for a Patient

Given the Health or Care Professional is permitted to view Online Consultation requests for Patients