Technical requirements and standards

Technical requirements and standards

Pharmacy and prescribing system suppliers align with minimum requirements (e.g. EPS specifications) that set out what must, should, and can be done.

Suppliers also can innovate beyond what is specified based on user requests e.g. improving usability, and based upon user feedback to them. Community Pharmacy IT Group supports pharmacy systems (and systems within other health care settings) integrating with NHS IT and other IT that enables pharmacy teams to further optimize the care they can provide for their patients.

This webpage for pharmacy contractors and suppliers sets out some of those integrations and technical requirements that enable pharmacy systems to work with other IT.

See also: Overview about standards and interoperability.

A-Z

APIs

The creation of Application Programming Interfaces (APIs) along with specifications and technical requirements can help provide system suppliers with a blueprint for inter-operating.

In some cases NHS Digital may be involved with being commissioned to develop APIs and make these available for system suppliers to make use of.

Apps

See the Apps webpage and its sections: Apps standards and Developer info.

Clinical referral information standard (PRSB)

PRSB continues to develop this standard that sets out how communicate electronic referrals e.g. from GPs to hospitals.

Read more at: PRSB’s Clinical Referral Info webpage.

Computable dose instructions standards

Core information standard (PRSB)

The core information standard defines a set of information that can potentially be shared with electronic health records systems – for sharing between systems in different sites and settings, among professionals and people using services.

It will be tested within some LHCR systems.

Read more at: PRSB’s Core Info standard webpage.

CPCF (tbc)

Community Pharmacy Contractual Framework (CPCF) IT requirements information may be added in future if these become available.

Community Pharmacy IT Group believes additional CPCF specifications are a key priority to help fulfil the ambition of CPCF.

Specifications or toolkit equivalents (ideally published at least 6-12 months before new services begin) should be a standard for all future services including CPCF ones. This would also help pharmacy IT suppliers to be better able to build standard interfaces for receipt of information and recording of information to central

See also: the CPCS section, the pharmacy information flows dataset section, and the  ‘List of CPCF/CPCS’ section of suppliers webpage

CPCS

A CPCS Technical Toolkit was published for the NHS Community Pharmacist Consultation Service (CPCS). This outlines the NHS IT standards which pharmacy IT suppliers must follow to offer an appropriate CPCS IT solution.

The toolkit was developed by NHS England and NHS Improvement (NHSE&I) with input from other NHS organisations and stakeholders including PSNC and the Community Pharmacy IT Group (CP ITG). Community pharmacy contractors providing the CPCS will need to procure their own IT support from those IT systems in the market offering CPCS functionality.Four  pharmacy IT suppliers are expected to provide validated solutions. Sonar Informatics and PharmOutcomes already have the functionality to receive CPCS referral messages, support the creation of clinical records and submit claims to the NHS Business Services Authority (NHSBSA). However, Positive Solutions and Cegedim are also working to develop this functionality in Autumn 2021.

See also: the CPCF section, and the pharmacy information flows dataset section.

See also: ‘List of CPCF/CPCS’ section of suppliers webpage.

developer.nhs.uk (HDN)

Health Developer Network (HDN, developer.nhs.uk) includes info, links and tools to help developers create software for health and social care.

HDN API hub contents

The HDN API hub has included.

 

Assessment, Discharge and Withdrawal

Information required to build ADW Messages to support the exchange of structured information between healthcare and social care organisations.

Clinical Decision Support

Implementation guidance for the Clinical Decision Support APIs

Clinical Documents

FHIR Profiles for the exchange of clinical documents.

Clinical Documents (CDA)

CDA specifications have now been deprecated and replaced with a FHIR based specification.

Development and Testing Tooling

A set of tools for developers to assist with the testing of FHIR based specifications.

Diagnostic Data Services

Diagnostic Data Services report message

Digital Child Health

Information required to build and send the Digital Child Health event messages.

Digital Maternity

Information required to enable the exchange of Digital Maternity data.

Digital Medicines

FHIR specifications and implementation guidance.

Directory of Services

APIs provided by the Directory of Services for accessing service information

End of Life

Information required to build and send the End of Life atomic units of information.

EPS Dispensers Directory of Service

API providing information about EPS dispensing services and includes search functionality which lists dispensers who should be able to provide dispensing services for a patient with a given location and urgency.

EPS Tracker

Access to non-confidential metadata for electronic prescriptions managed through the national Electronic Prescription Service.

Events Management

Information required to publish, subscribe and receive event messages to and from the Events Management Service.

FGM

Messaging for the national Female Genital Mutilation Risk Indication System

FHIR Reference Server

This FHIR server acts as a reference server for all nationally defined FHIR profiles and value sets for use across a range of local and national FHIR implementations.

GP Connect

GP Connect aims to support better clinical care by opening up information and data held within GP Practice IT systems for use across health and social care.

Interoperability Toolkit (ITK)

The ITK is a set of common messaging specifications, frameworks and implementation guides to support interoperability within local organisations and across local health and social care communities.

Message Implementation Manuals (MiMs)

The MiM is the formal specification of the HL7v3 messaging on the Spine.

MESH API

The Message Exchange for Social care and Health (MESH) component of the Spine allows messages and files to be delivered to registered recipients. This is the HTTP API used by MESH.

NHS Identity

NHS Digital’s implementation of the OpenID Connect API specifications for authenticating health and care professionals.

NHS e-Referral Service

The NHS e-Referral Service has released a range of Application Programming Interfaces (APIs) and Ecosystem resources to support third party solution integration.

National Data Opt-Out

The National Data Opt-out Programme has defined an API to capture a patient’s preferences for use of their data, which will be held in a national data store on the Spine. Initially, this API will be used by a new national portal, but in future it will be made available to other consumers to manage these preferences for a patient.

National Early Warning Score (NEWS2)

NEWS2 is the latest version of the National Early Warning Score (NEWS), this improves the detection and response to clinical deterioration in patients and is a key element of patient safety and improving patient outcomes.

National Population Failsafe Management

National Failsafe Population Management is intended assist with population tracking and population screening, for example via the National Failsafe Alert.

National Pathology

The National Pathology FHIR Messaging Specification supports the ability to share pathology results in NHS primary and secondary care settings. This release focuses on haematology and clinical biochemistry (also known as chemical pathology) test reporting.

National Record Locator

The National Record Locator aims to provide healthcare professionals and providers with a facility to identify and locate ‘local’ patient records which have been registered on the service

NHS Website APIs

API developer portal for NHS Choices APIs.

NHS Scheduling (and appointments)

Profiles to allow searching for free slots and booking appointments.

Organisation Data

The data provided via this API is taken from the data managed by the Organisation Data Service (ODS) within NHS Digital.

Spine Core FHIR Framework

The Spine Core FHIR API Framework provides common behaviours and services used across FHIR APIs delivered on Spine. This specification also covers other Spine services that complement or are used alongside Spine FHIR APIs.

Spine Mini Services

Spine Mini Services

Transfer of Care

Information required to build Transfer of Care Documents for several areas of care.

 

For up-to-date HDN info read more at HDN (developer.nhs.uk).

Digital Technology Assessment Criteria (DTAC)

The NHSX DTAC helps staff, patients and citizens identify digital health tools which are determined as meeting a baseline level of requirement for clinical safety, data protection, cyber security, interoperability and accessibility. For more about the DTAC read details within the ‘App standards’ section of the Apps webpage (even though the DTAC relates to apps and other technologies).

Discharge Medicines Service (DMS) MYS API

From 15th February 2021, NHS Trusts were able to refer patients who would benefit from extra guidance around new prescribed medicines for provision of the DMS at their community pharmacy.

Summary data on each DMS provided will have to be provided to support the evaluation of the impact of the service, contract monitoring and post-payment verification.

In time, your pharmacy IT system may support collation of that data** or alternatively, the PSNC DMS worksheet (see the DMS webpage resources section) will also allow you to make clinical records for the service and collate the summary data for submission to the NHSBSA.

NHSBSA  and NHSE&I supported by NHS Digital and PSNC, started work with pharmacy IT system suppliers in October 2020 to support the development of an Application Programming Interface (API) which will transfer the DMS summary data from pharmacy IT systems to the NHSBSA’s Manage Your Service portal, so the information does not need to be manually entered into MYS by contractors.

There is an NHSBSA objective to progress the specification work further during summer and autumn 2021, and for a ‘go-live date’ ideally by autumn 2021 dependent upon supplier developments. PSNC is continuing to push for NHSBSA and suppliers to progress this work at the earliest opportunity.

NHBSA have produced a DMS API spec and sent it out to pharmacy suppliers, and plan for additional work to also develop the API within the BSA.

NHSBSA has requested that suppliers advise NHSBSA as to when they are expected to put this on their roadmap. NHSBSA reported to PSNC (September 2021) that it is continuing to await supplier responses from all of the suppliers that were contacted.

dm+d

The NHS standard dictionary for medicines licensed in the UK. Electronic systems that exchange or share information about medicines relating directly to a patient’s care must adhere to this standard by using dm+d identifiers and descriptions when transferring information.

See: dm+d NHS medicines database

Directory of Services (DoS)

The Directory of Services (DoS) contains information for a wide range of health and care services across England e.g. opening hours, services available etc.

The DoS provides APIs to allow third party systems to retrieve service information from the DoS. Read more about DoS and Application Programming Interfaces (APIs).

Only users who comply with the DoS acceptable use policy are allowed to use the DoS.

Read more at:

Dose syntax

EPS, tracker, token and endorsing specs

NHS Digital EPS specs

EPS endorsing guide

NHS Business Services Authority (NHSBSA) maintain the EPS endorsing guide.

NHSBSA endorsing guide specification (webpage and pdf document).

NHSBSA engage with stakeholders prior to making changes to the EPS endorsing guide specification. Prescribing and pharmacy system suppliers have been asked to align to the EPS endorsing guide.

See also: EPS endorsing and submission.

 

EPS Tracker and other requirements

Systems may also integrate with EPS Tracker and other EPS Application programming interfaces.

Digital token future standards

Community Pharmacy IT Group (CP ITG)’s updated Views on the next generation of EPS had set out priority items for exploration including: “Enable paperless prescription processing (digital tokens developed and suitable guidance and standards in place) (EPS Phase 4 prescriptions and NHS Digital token specification [2008] updated to specify digital token requirements).”

Some GP practice apps might display barcodes and IDs but may do so without those digital tokens having been formally approved by NHS Digital, given that the current Token specs outline paper requirements.

CP ITG is keen to hear views about Phase 4 digital tokens, and other prescribing / dispensing digital tokens. Contact it@psnc.org.uk if you’d like to submit views about future token standards – e.g. for items which NHS Digital could consider adding to the future Digital token specifications. See also: psnc.org.uk/tokens.

Everyday Interactions (PHE)

Outlines public health impact ‘pathways’ to support pharmacy teams and others to record what they ‘do’ in their interactions with patients, what data can be collated and also the possible impacts from these interactions. These pathways could be of interest to pharmacy contractors and their system suppliers. The pathway templates include: Obesity, alcohol, dementia, and smoking.

See: Everyday Interactions

FHIR

A platform specification that defines a set of capabilities used across the healthcare process, in all jurisdictions, and in lots of different contexts.

See: FHIR standard

GP2GP

Allows patients’ electronic health records to be transferred directly, securely, and quickly between their old and new practices, when they change GP practices.

See: GP2GP service

GP Connect

GP Connect is an NHS Digital managed service that currently allows GP practices and certain other authorised clinical staff to share and view certain appointments information, electronic health records information and data between IT systems.

It uses standards that enable interoperability between different clinical systems (e.g. it can facilitate collaborative work of two sets of GP practice staff that use two different GP systems).

Read more at:

GP notifications from pharmacy systems (e.g. flu vaccination)

Direct notifications can be communicated between clinical IT systems (e.g. from pharmacy system to GP practice system) to improve patients’ experiences and care outcomes, and to bring other health-related benefits.

The Professional Record Standards Body (PRSB) has worked with NHS Digital, PSNC, clinicians from across primary care, and others to develop several standards for electronic transfer of information which could be sent from pharmacy systems to GP practice systems.

The use of Flu vaccination service PRSB-developed notification is currently being piloted by NHS Digital within Leeds and further information is set out below.

NHS Digital’s Digital medicine specification versions includes developed specifications to support communication of:

  • Pharmacy immunisation administration (including flu vaccination)
  • Pharmacy emergency medication supply
  • Pharmacy New Medicine Service (NMS)
  • Pharmacy medication review
  • Pharmacy digital minor illness referral service
  • Pharmacy appliance use review

Read more at:

GP notifications to pharmacy systems (e.g. GP CPCS)

Hand-held devices

Community Pharmacy IT Group (CP ITG) has supported the move of pharmacy systems so these can be used on hand-held devices including the use of NHS IT systems such as EPS, SCR and PMR work to enable elimination of need for paper and more use of mobile devices.

See NHS Identity section of this webpage (or the NHS Identity webpage), for more about some of the technical requirements.

HL7

Dedicated to providing a framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information.

See: HL7 UK

Interface mechanism (IM1) NHS

IM1 pairing standards can help integration with NHS Patient Facing Service (PFS, ‘online services’). It also is a technical tool and process that allows digital suppliers to directly talk to GP clinical systems, both reading data from the systems and putting data into the systems.

See: IM1.

Interoperability Toolkit (ITK)

The Interoperability Toolkit (ITK) is a set of common specifications, frameworks and implementation guides. It supports system standards and interoperability within local organisations and across local health and social care communities.

The Community Pharmacy IT Group (CP ITG) has discussed with pharmacy system suppliers the need for greater alignment with ITK technical requirements.

Read more at:

Local Health and Care Records (LHCRs)

In the future, pharmacy system suppliers as well as other clinical system suppliers may be able to display information from LHCRs. Initially it is expected LHCRs will mainly be used in many sectors via online portal systems.

Integration standardsCommunity Pharmacy IT Group (CP ITG) have identified that there needs to be a standard approach for supplier integration with any LHCR system so that the same supplier can easily integrate with many of the LHCR systems if integrated with a single one of them. This feedback was passed to NHS Digital to help inform its standards work.

Read more at:

Manage Your Service (MYS) APIs

See:

  • Discharge Medicines Service (DMS) MYS API (above)

Medicine and Allergy/Intolerance Data Transfer (ISN)

NHSX commissioned NHS Digital to produce an Information Standard which puts in place definitions that could be used when a health professional sends or receives patient medication and allergy/intolerance information, by computer system, between care locations.

NHS Digital initially published the standard on 30th September 2021 and proposed an implementation period of 1st October 2021 to 31st March 2023.

CP ITG suppliers were notified about the standard and some related engagement opportunities which were to occur near the time of the standard’s initial publication.

Read more: Medicine and Allergy/Intolerance Data Transfer.

If you’d like to feed into the standard’s development for PSNC and CP ITG please contact it@psnc.org.uk.

NHS App

System suppliers and developers may look for opportunities to integrate their systems or apps with NHS App.

Read more at:

NHS identity (NHS staff authentication)

NHS Identity is an authentication system being piloted that provides a small number of health and care professionals in England to prove their identity when accessing national clinical information systems e.g. Summary Care Record (SCR).

NHS Identity will continue to be expanded and other developers such as Patient Medication Record (PMR) system providers or website developers may consider integrating with it in the future or using other authentication options.

Read more at:

NHS login (patient app authentication)

NHS Digital have enabled a single system for verifying the identity of those requesting access to digital health records and services, to authenticate people for access to information about themselves and those they care for. NHS login will support future NHS Digital national programmes, local initiatives.

Read more at:

NHSmail email

CP ITG’s PMR wishlist included NHSmail integration as a highly requested item.

NHSmail may support the sending of secure mobile messages to patients or other health and care organisations.

Read more at:

NHSmail SMS messages and application accounts

See information on the NHSmail webpage about how: System suppliers or contractors may set-up application accounts for pharmacy contractors so that the clinical system can auto-send SMS text messages to patients (e.g. medicines ‘being prepared’, ‘ready for collection’ or ‘delivered’).

NHS number

The NHS Number is the unique patient identifier in operation in the NHS. It is used to efficiently share patient information across and within organisations. It is composed of ten digits: e.g. 123 456 7890

See: NHS number

NHS online / Patient Facing Services

PMR wishlist

It becomes ever more critical that pharmacy teams get the most out of their patient medication record (PMR) systems and help to feed into the development of those by emailing their system suppliers and also sharing feedback to help further develop the wish list.

Following discussions at its meetings and feedback from pharmacy teams, the Community Pharmacy IT Group (CP ITG) published:

PMR wish list, info and briefing.

ODS (F) code

The contractor code is a pharmacy’s unique identifying code which appears at the top of the schedule of payments document that is received from the Pricing Authority each month. The code is officially known as the ODS code, and was previously called the OCS code, NACS code or F code.

See: ODS (F) code

Pharmacy information flows dataset (PRSB)

The PRBS website set out this dataset.

It also relates to the Digital Medicines specification published at HDN.

These datasets may be amended further.

Real-time exemption (RTEC)

Real Time Exemption Checking (RTEC) is a technical solution enabling the PMR system to automatically find out whether a patient has a known exemption that can auto-apply to their EPS prescription. If the PMR system confirms an exemption, the EPS prescription is auto-flagged as exempt so that the patient won’t need to make a written exemption status declaration. If the system cannot identify an exemption the pharmacy team and the patient will use the usual process.

Read more at:

Scheduling and appointments

NHS Scheduling API information is held at Health Developer Network’s (HDN, developer.nhs.uk) API hub.

See also: the GP Connect section of this webpage. GP Connect standards include scheduling ones.

SNOMED CT

SNOMED CT (clinical terms) is a clinical vocabulary readable by computers. SNOMED was an acronym for Systematized Nomenclature Of Medicines. SNOMED CT is largely considered as a brand name rather than an acronym.

It is used in electronic health records, SNOMED CT is the most comprehensive and precise terminology product in the world, with extensive adoption across the globe.

SNOMED CT gives clinical IT systems a single shared language, which makes exchanging information between systems easier, safer and more accurate. It contains all the clinical terms needed for the whole NHS, from procedures and symptoms through to clinical measurements, diagnoses and medications.

In England, all GP systems capture clinical terms using SNOMED CT. The UK edition of SNOMED CT also contains the UK extensions. These provide terms specifically required in the UK, such as UK screening procedures, assessment scales and British English spellings.

Read and learn more:

Summary Care Record (SCR) 1-click specs

System suppliers can integrate the use of SCR information so that SCR information can be accessed more quickly and easily for when required.

All pharmacy EPS suppliers were provided with details about how to integrate SCR 1-click and some suppliers have started to integrate.

Read more at:

WES and standard system settings

NHS applications require certain internet browser versions, windows versions and settings. The standard NHS system settings are determined by NHS Digital’s Warranted Environment Specification (WES) information. Read more at: psnc.org.uk/settings.

Further info and disclaimers

Additional related PSNC webpages:

Disclaimer: Those technical requirements available continue to develop. This webpage is not comprehensive and fuller or newer info may be held: by NHS Digital, at the NHS Digital website, at the developer.nhs.uk website and elsewhere. NHS Digital frequently have a role with developing NHS IT technical requirements when they are commissioned to do so.

If you have queries on this webpage, or wish to suggest possible specification changes (in case of future amendment opportunities) or you require more information, please contact it@psnc.org.uk. To share and hear views about digital developments, join the CP Digital email group today.

 

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