Background

The Community Pharmacy Clinical Services Supplementary Care Standard, introduced in RM197, is being developed further in this Roadmap Item to include the ‘Referral Management - Community Pharmacy’ Capability. The Standards ‘111’, ‘Booking and Referral Standard (BaRS)’ and ‘Personal Demographics Service (PDS)’ will be mandated as part of the Supplementary Care Standard.

Outline Plan

The Supplementary Care Standard; including all Capabilities, Epics and Interoperability Standards will be developed further as requirements are finalised.

The following Epics have associated dates attached by which Suppliers must be compliant:

• E00674 - view Community Pharmacy Inbound Referrals from GP Practices for Patients (this includes receiving referrals from GP Practice utilising the Booking and Referral Standard (BaRS) Standard)

  • Milestone 3a - 31/03/2024

  • Milestone 3b - 31/05/2024

• Full Compliance with the Community Pharmacy Clinical Services Supplementary Care Standard (as per the Effective Date)

  • 30/08/2024

Summary of Change

The following sections will be removed from the Effective 111 Standard as part of this Roadmap Item:

• Overview

• Integration Pattern

• Message Transport

• Endpoint Discovery

• Message Recipient Behaviour

Introduction

NHS 111 is an online call centre service for Patients with urgent medical concerns. 

This Standard is used for point-to-point messaging to share information between NHS 111 and other Health or Care Organisations, such as GP Practices, Community Pharmacies and ambulance services when a Patient interacts with NHS 111. 

For further information, see NHS 111 - API Catalogue.

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.

The current interoperability requirement for GP IT Solution providers is to receive and ingest NHS 111 CDA messages sent by 111 provider systems.

In future, direct Appointment Bookings into GP Practices will be made from 111 providers using GP Connect. 

Requirements

Suppliers of Solutions for Health or Care Organisations such as GP Practices and Community Pharmacies implement the Receiver requirements. To implement the 111 Report Receiver requirements, you can either use the NHS 111 Report Adaptor or directly implement the requirements without using the Adaptor. It is recommended that anyone who has not already implemented this Standard uses the NHS 111 Report Adaptor.

Note: Only 111 Providers implement the Sender requirements, which is outside the scope of this Standard.

To comply with the 111 standard there are currently two implementation options: 

1. Using NHS 111 Report adaptor

2. Without using NHS 111 Report adaptor 

These requirements cover the ingestion of NHS111 CDA messages from 111 providers. 

Using NHS 111 Report Adaptor

Without Using NHS 111 Report Adaptor

Message Specification Implementation

Dependent on your care setting/system the messages received differ. The table below shows which ITK messages you are required to implement based on the Capability you are delivering.

The adaptor covers all of these message types and can be implemented either with GP Practice or Community Pharmacy.

See NHS 111 - Implementations specification for further information.

Both types of interaction use the NHS111 CDA Domain Message Specification (DMS) version 2.0 message.  The Interaction ID determines the type of interaction:

Note the ITK CDA documentation refers to generic CDA messages, but for 111 interactions the specific 111-flavour of CDA is required.  

Message Recipient Behaviour

See Clinical Document Architecture (CDA)  for behaviours defined in the ITK.

All suppliers are encouraged to work towards compliance with the latest version as above.

Capability to BaRS Core/Applications mapping

GP Suppliers

Community Pharmacy Suppliers

Functionality Mapping

Dependencies

PDS FHIR API

For Suppliers of new GP and Community Pharmacy (using Healthcare worker access) services or applications:

Creating a compliant implementation requires implementing the following dependent interface standards:

• Authentication and Access - using NHS Care Identity Service 2 API

• SDS FHIR API 

Full Specification

• Community Pharmacy Clinical Services Supplementary Care Standard

• Referral Management - Community Pharmacy

• Consultation Management - Community Pharmacy

• Booking and Referral Standard (BaRS)

• 111

• Personal Demographics Service (PDS)

Assurance Approach

In order to achieve assured status against a Supplementary Care Standard a Supplier must go through an assurance process which includes:

• Capability Assessments

• Standards Assurance

• Some limited Non-Functional Solutions Assurance

• First of Type (where necessary from a service perspective)

The assurance undertaken for a Supplementary Care Standard is confined to elements of the software which are concerned with the service in question. Therefore the presence of a Supplementary Care Standard does not necessarily mean that assurance of a whole Supplier Solution has occurred under the DSIC, unless that is stated elsewhere.