Sharing Consultations with primary care (GP)

Does anyone know if the Transfer of Care can be used by non secondary care providers?

I’m working for a supplier who is currently using FHIR R4 and so would prefer to continue to use structured data (and do the conversion to html and FHIR STU3)

I’ve tried following the documentation and know Outpatient letter would work for use but … can we use it?

We don’t want to use GP Connect messaging - which is similar but just uses html or pdf documents.

This is roughly what we are trying to do.

We start off with structured data and try to use structured API’s.
If we can’t, we start falling back to other options.

I think we are not allowed to use FHIR Documents (transfer of care) as we are not an acute provider. So will need to send PDF’s.

Approach Pro Cons
FHIR REST API or IM1 Is structured data and would go into the clinicians record.
Future proof if we focus on sharing (not distributing) our records.
Also expect a push for GP suppliers to support this approach natively.
Is FHIR R4 and so like the other API’s we are using or NHS Digital API’s we propose to use.
Needs an interface on the recipient’s PC. (Supplier may change this)
Would probably need to use email to alert the recipient that a record has arrived. This email has a link to code to import the consultation
ITK Transfer of Care Official standard. Is both structured and also a html document.
Uses simple MESH transport mechanism
Do not believe we are allowed to use this (secondary care only?).
Old version of HL7 FHIR (not a big deal but we are R4 not STU3)
Do not believe GP suppliers process the structured data
GP Connect Send Document Official standard
Low tech solution - is a html, image or PDF
Uses simple MESH transport mechanism
Unstructured is not good for receiving GP.
Questionable long term viability. (Not standard FHIR STU3/R4)
Kettering XML Like GP Connect Send Document
less onboarding requirement
Uses simple MESH transport mechanism
As above
Email As above.
Simple low tech
Can combine with the RESTful structured approach.
Has the same issues as fax in that it doesn’t support automation.

Not sure whether it is just not allowed or whether its just a case of asking for the TOC workflow group to be added to the relevant MESH mailbox. If your ‘non secondary care’ provider has a MESH mailbox than try requesting the relevant TOC workgroup be added via, I think that’s the correct address.
I know, for example, many GP Practices do not have the TOC workflow group on their mailboxes. Use this to check (HSCN connection):[INSERT_ODS]/TOC_DISCH_DMS

If the workflow exits on the mailbox then you’ll see the organisation details in the body of the response, otherwise you’ll get something like this:

“query_id”: “20211209115713620328_2942E8_1573485259”,

Just noticed I put the integration environment address in the post. Please use the live environment to do lookups[INSERT_ODS]/[WorkFlowID]