WARNING
This guidance is under active development by NHS England and content may be added or updated on a regular basis.This FHIR IG is ahead of the current PatientFlag API specification build. Please refer to that document for technical build and integration requirements, and to the PatientFlag programme for roadmap information.
Patient Flag Data Model
A Patient Flag API record is made up of a Flag resource and any other additional resources that provide supplementary information.
Reasonable Adjustments
The RA record is made up of PatientFlag, PatientFlagAdjustment, contained Provenance and Condition resources.
Authorised healthcare workers can:
- Retrieve a set of top-level Flags (just the Flags with no associated resources)
- Retrieve a specific Reasonable Adjustment Flag with associated resources
- Add a top-level Reasonable Adjustment Flag
- Add a top-level Flag (and associated Adjustment, Impairment or Condition resources)
- Add/remove associated resources (with the dependency that a top-level flag must already be added/removed)
- Remove a top-level Flag (which will remove all associated resources)
The presence of and entitlement to reasonable adjustments is represented by a PatientFlag resource. It can be interpreted as meaning 'this patient has reasonable adjustments'.
Individual adjustments are represented as ProgrammeFlag resource instances. They can be interpreted as meaning e.g.'this patient requires Easy read'.
Patients may record Impairments for which they wish to have reasonable adjustments applied as Condition resources. Patients may optionally request details of underlying conditions are recorded and shared where this enhances healthcare. These too are represented as Condition resources.
Provenance of all resources that make up an RA record must be stored. This is modelled here as a contained resource, and as such has no lifetime outside of the constituent RA record resources.
Female Genital Mutilation
The FGM record is made up of a PatientFlag resource and a contained Provenance.
Authorised healthcare workers can:
- query to determine if a patient has a FGM family history indicator
- create a FGM family history indicator for a patient
- must be gender
female,unknownorindeterminateaccording to PDS - must be under the age of 18 according to PDS
- must not already have a FGM family history indicator on FGM-IS
- must have a verified NHS number
- must be gender
- delete a FGM family history indicator for a patient
The FGM flag is interpreted as:
- an indicator that a child with female genitalia has a family history of FGM
- the date that the FGM assessment was carried out
Provenance of the resource that makes up an FGM record must be stored. This is modelled here as a contained resource, and as such has no lifetime outside of the constituent FGM record resource.
