#### NHS 111
Domain Message Specification

### Change History

#### Version: 2.1; Status: RC1

- Ambulance Request message can now be used for a CAD to CAD (999 to 999) Ambulance Request.
  - Updated Guidance for the Creation of an NHS 111 Ambulance Request & CAD to CAD Ambulance Request on Associated Specifications
  - Updated About to advertise the change
  - Updated Messages page to state the Ambulance Request also can be used for CAD to CAD
  - Note that a CAD to CAD Ambulance Request has same interaction identifier as NHS 111 Ambulance Request message.

#### Version: 2.0; Status: RC1

- COCD_TP146050GB01 - Permission To View
  - The template COCD_TP146050GB01 Permission To View has been made available to the Repeat Caller Query (QUPA_MT000001GB01) and Repeat Caller Response (PRPA_MT000001GB01) messages. All associated artefacts regenerated.
- Vocabularies
  - Display names for vocabulary PermissionToViewOutcome have been updated. This vocabulary now has an 'active' status.
  - The vocabulary CDAObservationType now has an 'active' status.
- Profiles
  - The configuration profiles have been upversioned to reflect the above changes.
- Examples
  - QUPA_MT000001GB01 - payload and wrapped examples updated to include Permission to View outcome.
  - PRPA_MT000001GB01 - all payload examples updated to include Permission to View outcome.

#### Version: 2.0; Status: Draft A

- COCD_TP146050GB01 - Permission To View
  - New template to support Permission To View created and applied to NHS111 Report (POCD_MT200001GB02) and NHS 111 Ambulance Request (REPC_MT200001GB02).
  - New vocabulary PermissionToViewOutcome to support Permission To View template.
  - NHS 111 CDA Document (POCD_MT200001GB02) - all payload examples
  - REPC_MT200001GB02 NHS 111 Ambulance Request Payload and Wrapped Payload
  - REPC_MT200001GB02 NHS 111 Ambulance Request with location identified using the gazetteer Payload

#### Version: 1.1; Status: RC2

- Specification
  - Rebranded to HSCIC
  - All guidance documentation is now under the associated specification tab

#### Version: 1.0; Status: RC2

- ClinicalDocument.title
  - Data type relaxed from ST.Title to ST to help with Repeat Caller Database document retrieval
- Document Renderer
  - Document renderer updated in line with programme requirements
- Guidance document for creating ambulance request
  - Corrected spelling of "informat" to "Informant"
- NHS111Report examples
  - Corrected the examples around documenting the device that created the blob attachment. Examples should read manufacturerModelName element = Pathways and softwareName element = 2.4. Not manufacturerModelName displayName attribute =Pathways and softwareName displayName attribute =2.4.
- Ambulance Request Examples
  - AssigningAuthorityName added to example
- Web Service names in ITK Implementation page
  - Web service names in the ITK Implementation page corrected to reflect those in the wsdl (NHS-111-v3-0.wsdl)
- Location details
  - For both NHS 111 Report and Ambulance request, template COCD_TP145222GB01 up-versioned to COCD_TP145222GB02 to enable the carrying of a location identifier field. This field is used to carry the gazetteer identifiers when an ambulance request is sent, that has used the gazetteer to look up the location details. In these cases, the gazetteer unique identifier and X and Y coordinates are sent to ambulance service. In all other cases (when an ambulance request is sent not using the gazetteer, or a NHS111 report is sent), the address details are filled out as per the specification.
- CDA Document text section and titles
  - Text section now also carries Special Patient Notes.
  - Guidance document updated to include
  - Title of case summary to be "Case Summary"
  - Title of special patient notes to be "Special Patient Notes"
  - Section of "Patient's Reported Condition" allowed (as reported by the patient), although this may be incorporated into the case summary and not require its own section)
  - The case summary should not include demographic information
- Preferred contact details
  - Guidance documents for the NHS111 Report and Ambulance Request now say that the preferred contact should be marked with a "use" attribute of "EC" - Emergency Contact
- Change to Ambulance dispatch codes
  - codes now read R1 - Red 1, R2 - Red 2, G2 - Green 2, G3 - Green 3, G4 - Green 4
- New interaction to support Repeat caller to GP
  - A new interaction has been included for when a patient is recognised as a repeat caller and the details need to be passed onto a GP for a call back within one hour. In this case, all the reports from the Repeat Caller database and the report of the current call are sent to OOH as multiple payloads within the same distribution envelope.
- Repeat Caller Query and Response
  - Two new message definitions and interactions added to support a query to the Repeat Caller service, and a response. Guidance document for the creation of the query included.
- NHS111 Report and Ambulance Request
  - NHS111 Report and ambulance request now have support for additional information such as Special Patient Notes (in the case of NHS111 Report this is in the guidance document; in the case of the ambulance request, a new class has been added to the model)
- Message NHS111 Report
  - Changed CodedEntry for the transmission of a complete triage assessment to hold the system and software version that created the triage. This change introduces an new template with a mandatory link to the system and software that produced the triage data.The CDA model has been up-versioned to POCD_RM200001GB02.
- Message NHS111 Ambulance Request
  - Introduction of a new class to transmit the final triage disposition code. The class is optional in the model, as the same model schema serves an interim and final message.The model has been up-versioned to REPC_RM20000GB02.
- Associated artefacts - Message creation guidance
  - Guidance updated and up-versioned.Examples updated and up-versioned to include changes to schema and updated and up-versioned the wsdl file.
- Associated artefacts
  - Reference files updated and up-versioned. Note: the profileId in the examples reference v2 of the relevant profile and the interaction id in the examples reference v2 of the relevant interaction

#### Version: 1.0; Status: RC1

- CDA Guidance Document
  - Updated to add further advise and guidance around ClinicalDocument\code. Updated to include new participation class (ReferredTo). Update to reflect new recipient templates. Updated with Consent guidance. Note that Consent is now mandated
- Schema Changes
  - Schema in this pack will show differences to schema issued in draft A. Many of the changes are due to the tightening of schema (for example enumerating possible values). Where this has occurred, then the schema version has stayed the same. (This reduces the impact of change). The recipient schemas (COCD_TP145202GB02; COCD_TP145203GB03; COCD_TP145204GB03) have all been up-versioned, as the schemas now include an optional address, and other schema tightening. Consent schema (COCD_TP146226GB02 has been changed and upversioned). Service Event schema (COCD_TP146227GB02 has been changed and upversioned - although not recommended for use in this specification at present) CDA document conformance model (POCD_MT2000001GB01.xsd) has several tightenings (but is same version). Ambulance main message (REPC_MT200001GB01.xsd has several tightenings (but is same version).
- Model changes
  - Recipient Templates - All recipient templates have been up-versioned. The up-versioned template introduces an optional address attribute in the IntendedRecipient class. Participant Template - Addition of an optional participant template choice. This is used to add a "Referred To" participation in the message instance. NHS 111 messages should use the "DocumentParticipantUniversal" template to hold the organisation and actual physical location to which the patient was referred as a result of the NHS 111 triage. Correction of relationship class name from ClinicalDocument to ParentDocument. Class name is now "relatedDocument" ClinicalDocument/code and ClinicalDocument/title - further guidance added when using multiple SNOMED CT codes to describe a Document. Tabular views have all been refreshed to add additional advise and guidance. These tabular view changes have resulted in some schema tightening.
- Message Definitions ITK Implementation and Service Names
  - Removal of Receiver Responsibility to send an ITK Business Acknowledgement from all interactions. Service name of Ambulance Request changed to "RequestAmbulanceDispatch-v1-0". Service name of NHS 111 CDA document changed to "SendNHS111Report-v1-0". Inclusion of wsdl to document "RequestAmbulanceDispatch-v1-0" and "SendNHS111Report-v1-0".
- Transforms
  - A new page (References > Transforms) has been created to document 2 important transforms included in the Domain Message Specification.
- Associated Specifications
  - The definition of Generic (on-the-wire) CDA and details on how to nullify a document have been hived off into their own stand-alone Domain Message Specifications. For details of on-the-wire CDA model and schemas look in the "Generic CDA" pack. For details of the Nullification document look in the "Nullification" pack. Note there is NO CHANGE to the definitions of either Generic CDA or Nullification.
- Guidance Documents
  - Addition of Guidance documentation detailing how to create a NHS 111 CDA document and Ambulance Request attribute by attribute. Also included "Technical Guidance for Templated CDA Domains", which explains the templating mechanism used in CDA documents.
- Navigation Tabs
  - Retains Change History. Added Glossary (formerly on the top level of the navigation tabs). Added User Guide (a guide to the the navigation of Domain Message Specifications). Added Message Creation Guidance (2 detailed documents to aid message development). Message Definitions.- Navigation Remains the same Associated Specifications - Replaces the "Generic" tab. The Associated Specifications page now links off to (opens in new tab/window) specifications for generic CDA and Nullification References - Has the equivalent tabs to the old pack "References" > "NHS 111" and the addition of a "Transforms" tab that documents important transforms included in the pack
- Examples
  - Examples added, including fully documented examples and fully wrapped examples. See "Message Definitions" > "ITK Implementation" (section 5). Note that "Templated" payloads are on-the-wore payloads (excluding the distribution envelope) that have been transformed into conformance examples by using the transform "TrueCDAToCDALike_v2.xsl" - included in the Transforms tab).

#### Version: 1.0; Status: Draft A

- Specification
  - Initial Draft for comment