Referral and Document exchanges between organisations

Looking for a bit of feedback (this is a work in progress).

We’re looking at standardising referrals and document exchanges between trusts and started developing FHIR ReferralRequest and DocumentReference profiles. These are based on NHS Digital eRS API (ReferralRequest) and NRLS (DocumentReference) profiles but have a number of tweaks to make them more generic and also linking them to traditional HL7v2 and IHE XDS. (We’re planning to use InterOpen profiles if they exist)

N3 connection is needed to access the profiles:

We’re not expecting other organisations to FHIR at the moment and more than likely use HL7v2 messages such as REF^I12 and MDM^T02 instead but if an organisation/supplier wants to use FHIR we have sketched out these Bundles: [Will change towards NHS Digital CDA level 1 when it becomes available]

We’ve used Furore Forge for the profling ( and Endeavour Health FHIR profile generator to build the web pages ( Github

Hi Kevin,

Sounds good. Are you able to define what Referral use cases you are intending to cover initially? e.g. GP referrals into secondary care?

Acute Trust to Acute/Tertiary trust is the initial one but being influenced GP to secondary care (via e-Referral Service).

For workflow something like this. The REF^I12 (or FHIR ReferralRequest Bundle) is sent and is subsequently accepted or rejected by RRI^I12 (FHIR ReferralRequest). (See for more details)

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