EMIS Partner API - FileRecord call - file size limits

Hello,

For context, this issue refers to a document processing platform that integrates into EMIS Web via the Partner API.

We’ve been dealing with an issue with adding attachments to the FileRecord call. For context, we file patient documents as attachments to a consultation block, which gets filed into the patient’s record.

The <Consultation> object looks a bit like this (I’ve omitted other <ConsultationElement> instances for brevity):

    
<Consultation>
	<GUID>324c25c9-28c7-4598-8a2c-371e5628a423</GUID>
	<AssignedDate>24/12/2025 00:00:00</AssignedDate>
	<DatePart>4</DatePart>
	<UserID>
		<RefID>3797</RefID>
	</UserID>
	<LocationID>
		<RefID>10</RefID>
	</LocationID>
	<LocationTypeID>
		<RefID>1807271000006114</RefID>
	</LocationTypeID>
	<Duration>0</Duration>
	<TravelTime>0</TravelTime>
	<PolicyID>-1</PolicyID>
	<OriginalAuthor>
		<User>
			<RefID>3797</RefID>
		</User>
		<SystemDate>24/12/2025</SystemDate>
	</OriginalAuthor>
	<ElementList>
		<ConsultationElement>
			<RefID>2</RefID>
			<Header>
				<Term>Document</Term>
			</Header>
			<Attachment>
				<RefID>2</RefID>
				<GUID>8b3fa060-3fed-4491-afcb-5f486d23d04c</GUID>
				<AssignedDate>24/12/2025</AssignedDate>
				<AuthorID>
					<RefID>3797</RefID>
				</AuthorID>
				<OriginalAuthor>
					<User>
						<RefID>3797</RefID>
					</User>
					<SystemDate>24/12/2025</SystemDate>
				</OriginalAuthor>
				<DisplayTerm>Otorhinolaryngology service</DisplayTerm>
				<DescriptiveText>Kings Hospital.pdf</DescriptiveText>
				<PolicyID>-1</PolicyID>
				<Code>
					<Value>310149003</Value>
					<Scheme>SNOMED</Scheme>
					<Term>Otorhinolaryngology service</Term>
				</Code>
				<TermID>
					<Value>310149003</Value>
					<Scheme>SNOMED</Scheme>
					<Term>Otorhinolaryngology service</Term>
				</TermID>
				<Title>Kings Hospital.pdf</Title>
				<Address>C:\Users\imfarazmalik\medprompt\medprompt-emis\docs\FileRecordAttachment_NjBhNTc1MDQtMWFjMS00NmE4LTkzNGYtNjEyN2E4NTZhMzhh.pdf</Address>
				<DDSIdentifier>028f459b-9d5f-4766-93d9-9a651ab3392e</DDSIdentifier>
			</Attachment>
		</ConsultationElement>
	</ElementList>
</Consultation>

You can see that we try and pass the document directly, which encounters the 5MB file size limit on EMIS Web.

However, we recently became aware that other document processing platforms use a different strategy that bypasses this entirely – they send in the document to EMIS Web via NHS MESH first. We suspect the flow might look something like this:

What we’re thinking is that the <Attachment> element will reference a document already received and stored by EMIS Web, therefore no file bytes need to travel with the Partner API call. Could anyone shed light on this mechanism, specifically what the MESH ACK may look like and whether it carries the DDSIdentifier back to the sender?

@mayfield.g.kev hoping you might be familiar with this?

I’ve not tried this but it sounds logical.

The first part I presume your using Kettering XML?

Yes, that would be the idea. Just was hoping someone may have tried this, and knows the mechanism for sending a <DDSIdentifier> with MESH, or receiving it back via MESH.

If your using Kettering XML you can put a message id or report identifier into the payload.

EMIS may persist that and so you could query attachments in EMIS to find your ID which should then have a DDS Identifier. I’ve not tried this but EMIS has been retaining our ID’s in other interactions.