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Packagefhir.r4.nhsengland.programme
Resource TypeQuestionnaireResponse
IdGPReg-QuestionnaireResponse-Example.json
FHIR VersionR4

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Source1

{
  "resourceType": "QuestionnaireResponse",
  "id": "GPReg-QuestionnaireResponse-Example",
  "status": "completed",
  "authored": "2024-05-02T12:00:52.711Z",
  "item": [
    {
      "linkId": "5564099927552",
      "text": "Who is registering with a GP?",
      "answer": [
        {
          "valueCoding": {
            "display": "Myself"
          }
        }
      ]
    },
    {
      "linkId": "3099707112786",
      "text": "Matching patient to their record",
      "item": [
        {
          "linkId": "2673545464189",
          "text": "What is the name of the person being registered?",
          "item": [
            {
              "linkId": "2526886552536",
              "text": "Title",
              "answer": [
                {
                  "valueCoding": {
                    "system": "https://fhir.medirecords.com/CodeSystem/mr-patient-name-title-code",
                    "code": "315890000",
                    "display": "Mr"
                  }
                }
              ]
            },
            {
              "linkId": "8025625545792",
              "text": "First name",
              "answer": [
                {
                  "valueString": "Omar"
                }
              ]
            },
            {
              "linkId": "2444645364061",
              "text": "Last Name",
              "answer": [
                {
                  "valueString": "Khan"
                }
              ]
            }
          ]
        },
        {
          "linkId": "5721234742686",
          "text": "What is the your date of birth",
          "answer": [
            {
              "valueDate": "1970-01-01"
            }
          ]
        },
        {
          "linkId": "2535971200955",
          "text": "Do you know your NHS Number?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        },
        {
          "linkId": "6043124139100",
          "text": "Are you registering with a UK GP for the first time",
          "answer": [
            {
              "valueBoolean": true
            }
          ]
        }
      ]
    },
    {
      "linkId": "3189857950482",
      "text": "Personal Details",
      "item": [
        {
          "linkId": "7570130246483",
          "text": "Do you have a current UK address",
          "answer": [
            {
              "valueBoolean": true,
              "item": [
                {
                  "linkId": "3834031732678",
                  "text": "What is your current UK address?",
                  "item": [
                    {
                      "linkId": "7091443873030",
                      "text": "House number or name (optional)",
                      "answer": [
                        {
                          "valueString": "7"
                        }
                      ]
                    },
                    {
                      "linkId": "5086068712017",
                      "text": "Postcode",
                      "answer": [
                        {
                          "valueString": "LS1 4AP"
                        }
                      ]
                    },
                    {
                      "linkId": "1187115804415",
                      "text": "Select an address",
                      "item": [
                        {
                          "linkId": "8052908008533",
                          "text": "Street",
                          "answer": [
                            {
                              "valueString": "Wellington Place"
                            }
                          ]
                        },
                        {
                          "linkId": "9119357682451",
                          "text": "Town",
                          "answer": [
                            {
                              "valueString": "Leeds"
                            }
                          ]
                        }
                      ]
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "8454185457892",
          "text": "What are your Contact Details",
          "item": [
            {
              "linkId": "8530163235785",
              "text": "Mobile telephone number",
              "answer": [
                {
                  "valueString": "07759121832"
                }
              ]
            },
            {
              "linkId": "7870443952741",
              "text": "Email",
              "answer": [
                {
                  "valueString": "omar.khan2@nhs.net"
                }
              ]
            }
          ]
        },
        {
          "linkId": "5729238155283",
          "text": "Do you go to any of the following for your education?",
          "answer": [
            {
              "valueCoding": {
                "display": "None of the above"
              }
            }
          ]
        },
        {
          "linkId": "2352413897998",
          "text": "Is anyone else involved in your care?",
          "answer": [
            {
              "valueCoding": {
                "display": "None of the above"
              }
            }
          ]
        },
        {
          "linkId": "3509733064094",
          "text": "What is your sex as recorded on your NHS record?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://hl7.org/fhir/administrative-gender",
                "code": "male",
                "display": "Male"
              }
            }
          ]
        },
        {
          "linkId": "4800938448822",
          "text": "What is your ethnic group?",
          "answer": [
            {
              "valueCoding": {
                "display": "Asian or Asian British"
              }
            }
          ]
        },
        {
          "linkId": "9558300594974",
          "text": "Do you need a language interpreter for your GP appointments?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        },
        {
          "linkId": "5319955577563",
          "text": "Would you like to choose or change a pharmacy for your prescriptions?",
          "answer": [
            {
              "valueBoolean": false,
              "item": [
                {
                  "linkId": "3216525415675",
                  "text": "Do you want to get your prescription items direct from {NAME OF SURGERY}?",
                  "answer": [
                    {
                      "valueBoolean": false
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "3094394035878",
          "text": "Have you ever been a member of the UK Armed Forces or are a family member registered with the Defence Medical Services?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        },
        {
          "linkId": "9420407152267",
          "text": "Do you have an emergency contact?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        },
        {
          "linkId": "7951535385611",
          "text": "Are you returning from overseas?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        },
        {
          "linkId": "630742013280",
          "text": "Have you recently moved to the UK from abroad?",
          "answer": [
            {
              "valueBoolean": false,
              "item": [
                {
                  "linkId": "9940642971679",
                  "text": "Do you know your chargeable status?",
                  "answer": [
                    {
                      "valueBoolean": true
                    }
                  ]
                },
                {
                  "linkId": "1651487045545",
                  "text": "Where were you born?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://snomed.info/sct",
                        "code": "315421000",
                        "display": "Born in England"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "1767348738163",
          "text": "Have you ever lived at a previous UK address?",
          "answer": [
            {
              "valueBoolean": false
            }
          ]
        }
      ]
    },
    {
      "linkId": "7105669556528",
      "text": "Health Questions",
      "item": [
        {
          "linkId": "52791651942",
          "text": "Have you got all your immunisations?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "ASKU",
                "display": "asked but unknown"
              }
            }
          ]
        },
        {
          "linkId": "6562566176631",
          "text": "Do you have any existing or pre-existing medical conditions?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "Y",
                "display": "Yes"
              },
              "item": [
                {
                  "linkId": "4169218027019",
                  "text": "Alzheimers disease or dementia, asthma, cancer, diabetes, epilepsy, heart disease, high blood pressure, stroke, thyroid disease, other",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://snomed.info/sct",
                        "code": "195967001",
                        "display": "Asthma"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "6142346747594",
          "text": "Do you have any allergies?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "6396554185648",
          "text": "Do you have any mental health conditions?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "4702985370646",
          "text": "Do you have any disabilities?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "8295392298267",
          "text": "Do you have a carer?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "2716331756046",
          "text": "Are you a carer?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "9937009784866",
          "text": "Do you or your carer need to be communicated with in an accessible form?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "8641971664330",
          "text": "Do you or your carer need any reasonable adjustments to make your visit to the GP surgery accessible?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "3663339285400",
          "text": "Do you currently take any prescription medication?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "N",
                "display": "No"
              }
            }
          ]
        },
        {
          "linkId": "6402543436632",
          "text": "What is your height?",
          "answer": [
            {
              "valueQuantity": {
                "value": 175,
                "unit": "centimeters"
              }
            }
          ]
        },
        {
          "linkId": "3301301896866",
          "text": "What is your weight?",
          "answer": [
            {
              "valueQuantity": {
                "value": 75,
                "unit": "kilogram",
                "code": "kg",
                "system": "http://unitsofmeasure.org"
              }
            }
          ]
        },
        {
          "linkId": "2141293065983",
          "text": "How often do you drink alcohol or have a drink containing alcohol?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "105542008",
                "display": "Non - drinker"
              },
              "item": [
                {
                  "linkId": "9335384644242",
                  "text": "How many units of alcohol do you drink on a typical day when you are drinking?",
                  "answer": [
                    {
                      "valueInteger": 0
                    }
                  ]
                },
                {
                  "linkId": "31954461608",
                  "text": "How often have you had six or more units of alcohol on a single occasion in the last year?",
                  "answer": [
                    {
                      "valueCoding": {
                        "display": "Never"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "2254100394705",
          "text": "Have you ever smoked?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0532",
                "code": "Y",
                "display": "Yes"
              },
              "item": [
                {
                  "linkId": "8799894644724",
                  "text": "What best describes you?",
                  "answer": [
                    {
                      "valueCoding": {
                        "system": "http://snomed.info/sct",
                        "code": "8517006",
                        "display": "Former smoker"
                      },
                      "item": [
                        {
                          "linkId": "2343533367553",
                          "text": "When did you stop smoking?",
                          "answer": [
                            {
                              "valueDate": "2024-05-01"
                            }
                          ]
                        }
                      ]
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId": "4270314232487",
          "text": "Do you want important information from your GP record to be available to other health and care professionals?",
          "answer": [
            {
              "valueCoding": {
                "system": "http://snomed.info/sct",
                "code": "773031000000109",
                "display": "Express consent for core Summary Care Record dataset upload"
              }
            }
          ]
        }
      ]
    }
  ],
  "questionnaire": "https://fhir.nhs.uk/England/StructureDefinition/England-Questionnaire-RegisterGPSurgeryv2"
}