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FHIR IG Statistics: Questionnaire/eRS-Referral-Request

Packagevirtually.healthcare
TypeQuestionnaire
IdeRS-Referral-Request
FHIR VersionR4
Sourcehttps://fhir.virtually.healthcare/https://build.fhir.org/ig/Virtually-Healthcare/HL7-FHIR-Implementation-Guide/Questionnaire-eRS-Referral-Request.html
URLhttps://fhir.virtually.healthcare/Questionnaire/eRS-Referral-Request
Version0.1.1-current
Statusdraft
Date2025-04-28T07:12:35+00:00
TitleeRS Referral Form
Realmuk
DescriptionRepresentation of eRS Referral Request as a Questionnaire [A011: Create Referral (Deprecated)](https://developer.nhs.uk/apis/e-Referrals/explore_endpoint_a011.html)

Resources that use this resource

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Questionnaire eRS-Referral-Request

Profile: Questionnaire

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Representation of eRS Referral Request as a Questionnaire [A011: Create Referral (Deprecated)](https://developer.nhs.uk/apis/e-Referrals/explore_endpoint_a011.html)Questionnairehttps://fhir.virtually.healthcare/Questionnaire/eRS-Referral-Request#0.1.1-current
... 1Patient Details0..1group
.... 1.1NHS Number1..1stringDefinition: ServiceRequest.subject.identifier:NHSNumber.value
... 2Referring Clinician0..1string
.... 2.1SDS User Id (from SmartCard)1..1stringDefinition: ServiceRequest.requester.identifier.value
... 3Referral Details0..1groupDefinition: ServiceRequest
.... 3.1Clinic/Service Type0..1choiceDefinition: ServiceRequest.code
Options: 2 options
.... 3.2Priority0..1choiceDefinition: ServiceRequest.priority
Options: 3 options
.... 3.3Selected Services (eRS Service Id)0..*choiceDefinition: ServiceRequest.performer.identifier.value
Options: 2 options
.... 3.4Request Type1..1choiceDefinition: ServiceRequest.code
Options: 2 options
.... 3.5Referral Pathway Start0..1dateDefinition: ServiceRequest.authoredOn
.... 3.6Organisation or clinician providing the service0..1group
..... 3.6.1SDS User Id (from SmartCard)0..1stringDefinition: ServiceRequest.performer.identifier.value
... 4Supporting Information0..1group
.... 4.1Attachments0..*groupDefinition: ServiceRequest.supportingInfo:ReferralLetter
..... 4.1.1Attachment Location1..1url
..... 4.1.2Attachment Type1..1choiceOptions: 4 options
.... 4.2Service Selection Criteria0..1groupDefinition: ServiceRequest.supportingInfo
..... 4.2.1Specialty0..1choiceOptions: 1 option
..... 4.2.2Services near postcode0..1stringiconiconDefinition: ServiceRequest.supportingInfo
..... 4.2.3Distance Limit0..1integerDefinition: ServiceRequest.supportingInfo
.... 4.3Age and Gender Appropriate0..1booleanDefinition: ServiceRequest.supportingInfo
.... 4.4Maximum wait time for appointment0..1integerDefinition: ServiceRequest.supportingInfo
.... 4.5First Patient Reminder Letter Follow Up1..1integerDefinition: ServiceRequest.supportingInfo
.... 4.6Commissioning Provisioning0..1choiceDefinition: ServiceRequest.supportingInfo
Options: 4 options
.... 4.7Intention to add referral letter1..1choiceDefinition: ServiceRequest.supportingInfo
Options: 2 options

doco Documentation for this format

Options Sets

Answer options for 3.1

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-ClinicType-1#GENERAL_SURGERY ("General Surgery")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-ClinicType-1#HEART_FAILURE ("Heart Failure")

Answer options for 3.2

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1#ROUTINE ("Routine")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1#TWO_WEEK_WAIT ("2 Week Wait")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1#URGENT ("Urgent")

Answer options for 3.3

  • http://fhir.nhs.net/Id/ers-service#12000
  • http://fhir.nhs.net/Id/ers-service#12001

Answer options for 3.4

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-RequestType-1#ADVICE_AND_GUIDANCE_REQUEST ("Advice and Guidance Request")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-RequestType-1#APPOINTMENT_REQUEST ("Appointment Request")

Answer options for 4.1.2

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1#REFERRER ("Referrer")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1#PROVIDER ("Provider")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1#ADVICE_REQUEST ("Advice Request")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1#GUIDANCE_RESPONSE ("Guidance Response")

Answer options for 4.2.1

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-Specialty#CARDIOLOGY ("Cardiology")

Answer options for 4.6

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1#ALL_AVAILABLE_FOR_BOOKING ("All available for Booking")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1#ALL_SERVICES ("All Services")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1#LOCALLY_COMMISSIONABLE ("Locally Commissionable")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1#NATIONALLY_AVAILABLE ("Nationally Available")

Answer options for 4.7

  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-ReferralLetterIntention-1#NEED_TO_ADD_LATER ("Need to add later")
  • https://fhir.nhs.uk/STU3/CodeSystem/eRS-ReferralLetterIntention-1#NOT_INTENDING_TO_ADD ("Not intending to add")

Source

{
  "resourceType": "Questionnaire",
  "id": "eRS-Referral-Request",
  "meta": {
    "profile": [
      "https://fhir.virtually.healthcare/StructureDefinition/Questionnaire"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "url": "https://fhir.virtually.healthcare/Questionnaire/eRS-Referral-Request",
  "version": "0.1.1-current",
  "title": "eRS Referral Form",
  "status": "draft",
  "date": "2025-04-28T07:12:35+00:00",
  "publisher": "Virtually Healthcare",
  "contact": [
    {
      "name": "Virtually Healthcare",
      "telecom": [
        {
          "system": "url",
          "value": "https://virtually.healthcare"
        }
      ]
    }
  ],
  "description": "Representation of eRS Referral Request as a Questionnaire [A011: Create Referral (Deprecated)](https://developer.nhs.uk/apis/e-Referrals/explore_endpoint_a011.html)",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "GB",
          "display": "United Kingdom of Great Britain and Northern Ireland"
        }
      ]
    }
  ],
  "code": [
    {
      "system": "http://snomed.info/sct",
      "code": "3457005",
      "display": "Patient referral"
    }
  ],
  "item": [
    {
      "linkId": "1",
      "text": "Patient Details",
      "type": "group",
      "item": [
        {
          "linkId": "1.1",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.subject.identifier:NHSNumber.value",
          "text": "NHS Number",
          "type": "string",
          "required": true
        }
      ]
    },
    {
      "linkId": "2",
      "text": "Referring Clinician",
      "type": "string",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "2.1",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.requester.identifier.value",
          "text": "SDS User Id (from SmartCard)",
          "type": "string",
          "required": true
        }
      ]
    },
    {
      "linkId": "3",
      "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest",
      "text": "Referral Details",
      "type": "group",
      "item": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "3.1",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.code",
          "text": "Clinic/Service Type",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-ClinicType-1",
                "code": "GENERAL_SURGERY",
                "display": "General Surgery"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-ClinicType-1",
                "code": "HEART_FAILURE",
                "display": "Heart Failure"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "3.2",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.priority",
          "text": "Priority",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1",
                "code": "ROUTINE",
                "display": "Routine"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1",
                "code": "TWO_WEEK_WAIT",
                "display": "2 Week Wait"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-Priority-1",
                "code": "URGENT",
                "display": "Urgent"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "3.3",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.performer.identifier.value",
          "text": "Selected Services (eRS Service Id)",
          "type": "choice",
          "repeats": true,
          "readOnly": false,
          "answerOption": [
            {
              "valueCoding": {
                "system": "http://fhir.nhs.net/Id/ers-service",
                "code": "12000"
              }
            },
            {
              "valueCoding": {
                "system": "http://fhir.nhs.net/Id/ers-service",
                "code": "12001"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "3.4",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.code",
          "text": "Request Type",
          "type": "choice",
          "required": true,
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-RequestType-1",
                "code": "ADVICE_AND_GUIDANCE_REQUEST",
                "display": "Advice and Guidance Request"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-RequestType-1",
                "code": "APPOINTMENT_REQUEST",
                "display": "Appointment Request"
              }
            }
          ]
        },
        {
          "linkId": "3.5",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.authoredOn",
          "text": "Referral Pathway Start",
          "type": "date"
        },
        {
          "linkId": "3.6",
          "text": "Organisation or clinician providing the service",
          "type": "group",
          "item": [
            {
              "linkId": "3.6.1",
              "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.performer.identifier.value",
              "text": "SDS User Id (from SmartCard)",
              "type": "string"
            }
          ]
        }
      ]
    },
    {
      "linkId": "4",
      "text": "Supporting Information",
      "type": "group",
      "item": [
        {
          "linkId": "4.1",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo:ReferralLetter",
          "text": "Attachments",
          "type": "group",
          "repeats": true,
          "item": [
            {
              "linkId": "4.1.1",
              "text": "Attachment Location",
              "type": "url",
              "required": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "drop-down",
                        "display": "Drop down"
                      }
                    ]
                  }
                }
              ],
              "linkId": "4.1.2",
              "text": "Attachment Type",
              "type": "choice",
              "required": true,
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1",
                    "code": "REFERRER",
                    "display": "Referrer"
                  }
                },
                {
                  "valueCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1",
                    "code": "PROVIDER",
                    "display": "Provider"
                  }
                },
                {
                  "valueCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1",
                    "code": "ADVICE_REQUEST",
                    "display": "Advice Request"
                  }
                },
                {
                  "valueCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1",
                    "code": "GUIDANCE_RESPONSE",
                    "display": "Guidance Response"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId": "4.2",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "Service Selection Criteria",
          "type": "group",
          "item": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/questionnaire-item-control",
                        "code": "drop-down",
                        "display": "Drop down"
                      }
                    ]
                  }
                }
              ],
              "linkId": "4.2.1",
              "text": "Specialty",
              "type": "choice",
              "answerOption": [
                {
                  "valueCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-Specialty",
                    "code": "CARDIOLOGY",
                    "display": "Cardiology"
                  }
                }
              ]
            },
            {
              "linkId": "4.2.2",
              "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
              "text": "Services near postcode",
              "type": "string",
              "readOnly": true
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
                  "valueCoding": {
                    "system": "http://unitsofmeasure.org",
                    "code": "[mi_br]",
                    "display": "[mi_br]"
                  }
                }
              ],
              "linkId": "4.2.3",
              "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
              "text": "Distance Limit",
              "type": "integer"
            }
          ]
        },
        {
          "linkId": "4.3",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "Age and Gender Appropriate",
          "type": "boolean"
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-unit",
              "valueCoding": {
                "system": "http://unitsofmeasure.org",
                "code": "d",
                "display": "d"
              }
            }
          ],
          "linkId": "4.4",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "Maximum wait time for appointment",
          "type": "integer"
        },
        {
          "linkId": "4.5",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "First Patient Reminder Letter Follow Up",
          "type": "integer",
          "required": true
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "4.6",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "Commissioning Provisioning",
          "type": "choice",
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1",
                "code": "ALL_AVAILABLE_FOR_BOOKING",
                "display": "All available for Booking"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1",
                "code": "ALL_SERVICES",
                "display": "All Services"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1",
                "code": "LOCALLY_COMMISSIONABLE",
                "display": "Locally Commissionable"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-CommissioningProvisioning-1",
                "code": "NATIONALLY_AVAILABLE",
                "display": "Nationally Available"
              }
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "http://hl7.org/fhir/questionnaire-item-control",
                    "code": "drop-down",
                    "display": "Drop down"
                  }
                ]
              }
            }
          ],
          "linkId": "4.7",
          "definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo",
          "text": "Intention to add referral letter",
          "type": "choice",
          "required": true,
          "answerOption": [
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-ReferralLetterIntention-1",
                "code": "NEED_TO_ADD_LATER",
                "display": "Need to add later"
              }
            },
            {
              "valueCoding": {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-ReferralLetterIntention-1",
                "code": "NOT_INTENDING_TO_ADD",
                "display": "Not intending to add"
              }
            }
          ]
        }
      ]
    }
  ]
}