NHS 111 - Tabular View

[1..1] [M] classCode (CS { CNE: RoleClass } )
{ Fixed="PAT" }

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as a role of patient.

Implementation in XML Instance

The XML attribute classCode is fixed to " PAT ".

[0..4] addr (SET<AD>)

Model Attribute Description

The HL7 attribute addr uses a set of addresses for the patient (this is limited to a maximum of 4 types to reduce display issues in rendering CDA documents).

The HL7 attribute addr allows structured and unstructured addresses to be carried. Only structured addresses are recommended to be used.

Implementation in XML Instance

There are a number of forms of structured address. The three shown here are the recommended formats for patient addresses, they are listed in no particular order.

The XML element addr is populated as follows:

When using the structured address in the style of PDS the XML element addr shall contain five XML elements streetAddressLine:

The first XML element streetAddressLine shall contain the premises name
The second XML element streetAddressLine shall contain the number and thoroughfare
The third XML element streetAddressLine shall contain the locality
The fourth XML element streetAddressLine shall contain the post town
The fifth XML element streetAddressLine shall contain the county

The first XML element streetAddressLine or the second XML element streetAddressLine and the fourth XML element streetAddressLine are mandatory to be populated.

The XML element postalCode can be used to carry a postcode
The XML element addressKey can be used to carry a PAF key

When using the fully structured address format then the XML element addr shall be populated as follows:

The XML element houseNumber shall contain the house/building number or name
The XML element streetName shall contain the street name
The XML element city shall contain the city name
The XML element county shall contain the county
The XML element country shall contain the country name
The XML element postalCode shall contain the postcode
The XML element addressKey shall contain the address key

Note that unpopulated XML elements should not be present.

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included.

The first XML element streetAddressLine shall contain the first address line
The second XML element streetAddressLine shall contain the second address line
The third XML element streetAddressLine shall contain the third address line
and so on ....

Note that unpopulated XML elements should not be present.

The XML element addr also allows an XML attribute use and this should be used to further define the patient address type when required. Only the use values listed below are recommended to be used for patient addresses.

Code	Definition
WP	Work place - An office address. First choice for business related contacts during business hours.
TMP	Temporary address - A temporary address; may be good for visit or mailing.
PHYS	Physical visit address - Used primarily to visit an address.
PST	Postal address - Used to send mail.
H	Home address - The person's home address; attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.
HP	The primary home address - An address to reach a person after business hours.
HV	A vacation home - An address to reach a person while on vacation.

When the XML attribute use of the XML element addr contains the value "PHYS" then the following two XML elements of the XML element addr may be populated.

The XML element desc of the XML element addr may contain a description of the address; this may be used for things like directions for the address.
The XML element additionalLocator of the XML element addr may contain additional location information such as longitude and latitude coordinates.

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times for an address:

A point in time when the contact address details are valid
A start and end time

Just including hours and minutes to indicate opening hours of an office for a work address
Using dates for indicating a contact address is only for a certain period of time.

A start time only to indicate when the contact address is valid from.
An end time only to indicate that the contact address is only valid until a certain date.

[1..*] [M] id (SET<II>)

Model Attribute Description

The HL7 attribute id allows identification of the patient using the NHS number or a local identifier if the NHS number is not available.

Implementation in XML Instance

When the NHS number is available then the XML element id should be populated as below:

For a verified NHS Number:

The XML attribute root shall contain the OID " 2.16.840.1.113883.2.1.4.1 "

The XML attribute extension shall contain the 10 digit NHS number.

For an unverified NHS Number:

The XML attribute root shall contain the OID " 2.16.840.1.113883.2.1.3.2.4.18.23 "

The XML attribute extension shall contain the 10 digit NHS number.

Where the NHS number is not available, in order to identify the patient, one or more identifiers including local identifiers can be used, where this is the case then the XML element id is populated as follows:

The XML attribute root shall contain the OID " 2.16.840.1.113883.2.1.3.2.4.18.24 "

The XML attribute extension shall contain the local patient identifier

The XML attribute assignedAuthorityName shall contain the assigning organisation in the format of ODSCode:ODSName, for example:

assigningAuthorityName="RA9:SOUTH DEVON HEALTHCARE NHS TRUST"

[0..*] telecom (SET<TEL>)

Model Attribute Description

The HL7 Attribute telecom specifies contact details for the patient in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

The XML value attribute of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

For a telephone number the actual telephone number would be prefixed with tel:
For a fax number the actual fax number would be prefixed with fax:
For an email address the actual email address would be prefixed with mailto:

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended to be used for the patient contact details:

Code	Definition
AS	Answering service - an automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.
EC	Emergency contact - A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.
H	Home - A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.
HP	Home primary - the primary contact to reach a person after business hours.
HV	Home vacation - A vacation home, to reach a person while on vacation.
WP	Work place - An office address. First choice for business related contacts during business hours
PG	Pager - A paging device suitable to solicit a callback or to leave a very short message.
MC	Mobile contact - A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.

The XML element useablePeriod of the XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

A point in time when the contact details are valid
A start and end time

Just including hours and minutes to indicate opening hours of an office for work contacts
Using dates for indicating a contact is only for a certain period of time.

A start time only to indicate when the contact details are valid from.
An end time only to indicate that the contact details are only valid until a certain date.

[1..1] [M] templateId (II)
{ Fixed="COCD_TP145201GB01#PatientRole" }

Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:

The XML attribute root is fixed to the OID " 2.16.840.1.113883.2.1.3.2.4.18.2 "
The XML attribute extension is fixed to " COCD_TP145201GB01#PatientRole "

[1..1] [M] patientPatient (Patient)

A link to the patient class.

[0..1] providerOrganization (Organization)

A link to the organisation class that provides the care.

[1..1] [M] classCode (CS { CNE: EntityClass } )
{ Fixed="PSN" }

Model Attribute Description

The HL7 attribute classCode describes this class as a person.

Implementation in XML Instance

The XML attribute classCode is fixed to " PSN ".

[1..1] [M] determinerCode (CS { CNE: EntityDeterminer } )
{ Fixed="INSTANCE" }

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of a person.

Implementation in XML Instance

The XML attribute determinerCode is fixed to " INSTANCE ".

[1..1] [R] administrativeGenderCode (CV { CNE:Sex } )

Model Attribute Description

The HL7 attribute administrativeGenderCode uses a code from the Sex vocabulary to indicate the gender of the patient.

This code is for administrative purposes only and does not imply a particular genetic or physical sex.

Implementation in XML Instance

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element administrativeGenderCode as follows:

The XML attribute code shall contain a code from the Sex vocabulary
The XML attribute codeSystem shall contain the fixed OID " 2.16.840.1.113883.2.1.3.2.4.16.25 "
The XML attribute displayName shall carry the description associated with the code in the Sex vocabulary.

When the patient's gender cannot be sent because there is no information to populate the XML element admininistrativeGenderCode available on the sending system, then an appropriate XML attribute nullFlavor of the XML element admininistrativeGenderCode may used.

The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor Definition

UNK Unknown - A proper value is applicable, but not known

ASKU Asked but unknown - Information was sought but not found (e.g., patient was asked but didn't know)

NAV Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.

NASK Not asked - This information has not been sought (e.g., patient was not asked)

MSK Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons.
There may be an alternate mechanism for gaining access to this information.

[1..1] [R] birthTime (TS)

Model Attribute Description

The HL7 attribute birthTime specifies the patient's date of birth.

Implementation in XML Instance

The XML attribute value of the XML element birthTime shall be populated a time stamp in the format yyyymmddhhmm where:

yyyy is the year
mm is the month
dd is the day
hh is the hour
mm is the minute

At least the year must be present.

The XML attribute value of the XML element birthTime should be populated to the level of detail that is available on the sending system.

When the patient's date of birth cannot be sent because there is no information to populate the XML element birthTime available on the sending system, then an XML attribute nullFlavor of the XML element birthTime can be used. The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor	Definition
UNK	Unknown - A proper value is applicable, but not known
ASKU	Asked but unknown - Information was sought but not found (e.g. patient was asked but didn't know)
NAV	Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.
NASK	Not asked - This information has not been sought (e.g., patient was not asked)
MSK	Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons. There may be an alternate mechanism for gaining access to this information.

[1..*] [R] name (SET<PN>)

Model Attribute Description

The HL7 attribute name provides names associated with the person who is the patient.

Implementation in XML Instance

The Person Name Structured with optional Use and optional Valid Time flavour of the PN data type is the recommended format for the patient's name. This information is carried in the XML element name as follows:

The XML element prefix should contain the patient's title
The XML element given should contain the patient's forenames; there can be as many occurrences of the XML element as required
The XML element family should contain the patient's surname
The XML element suffix may contain any suffix for the patient

Additionally the XML attribute use of the XML element name should be used to indicate the type of name; the recommended codes to be used are listed below:

Note some of the codes listed are NHS extensions, these are marked with an *

Code	Definition
L	Legal
A	Artist / stage
I	Indigenous/Tribal
R	Religious
PREVIOUS-BIRTH *	Birth name
PREVIOUS-MAIDEN *	Maiden name
PREVIOUS-BACHELOR *	Bachelor name
PREVIOUS *	Other previous name
PREFERRED *	Preferred name

Additionally the XML element validTime of the XML element name may be used to indicate the time when the name is valid/was valid for the patient, some uses are shown below:

A point in time when the name details are known to be valid
A start and end time

To represent the period of time the patient is/was known by this name

A start time only to indicate when the name is/was valid from for the patient
An end time only to indicate that the name is/was only valid for the patient until a certain date

When no patient name is available to the sending system to then an appropriate XML attribute nullFlavor may be used to populate the XML element name. The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor	Definition
UNK	Unknown - A proper value is applicable, but not known
ASKU	Asked but unknown - Information was sought but not found (e.g., patient was asked but didn't know)
NAV	Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.
NASK	Not asked - This information has not been sought (e.g. patient was not asked)
MSK	Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons. There may be an alternate mechanism for gaining access to this information.

[1..1] [M] templateId (II)
{ Fixed="COCD_TP145201GB01#patientPatient" }

Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:

The root attribute is fixed to the OID " 2.16.840.1.113883.2.1.3.2.4.18.2 "
The extension attribute is fixed to " COCD_TP145201GB01#patientPatient

[0..*] languageCommunication (LanguageCommunication)

A link to LanguageCommunication class.

[0..1] languageCode (CS { CNE:HumanLanguage } )

Model Attribute Description

The HL7 attribute languageCode uses a code taken from the HL7 HumanLanguage vocabulary to describe a language used by the patient.

Implementation in XML Instance

The Coded Only data type flavour of Simple Value data type is used to carry this information as follows:

The XML code attribute of the XML code element shall contain a code from the HL7 HumanLanguage vocabulary.

[0..1] modeCode (CE { CWE:LanguageAbilityMode } )

Model Attribute Description

The HL7 attribute modeCode uses a code taken from the HL7 LanguageAbilityMode vocabulary or an alternative vocabulary to describe: the mode the patient can communicate in the language stated in the HL7 attribute languageCode.

Implementation in XML Instance

When the HL7 LanguageAbilityMode vocabulary is used then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element modeCode as follows:

The XML attribute code shall contain a code from table below
The XML attribute codeSystem shall contain the OID " 2.16.840.1.113883.5.60 "
The XML attribute displayName shall carry the displayName associated with the code in the table below

Code	DisplayName
ESGN	Expressed signed
ESP	Expressed spoken
EWR	Expressed written
RSGN	Received signed
RSP	Received spoken
RWR	Received written

When an alternative vocabulary is used and an OID is available then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element modeCode as follows:

The XML attribute code shall contain a code from the alternative vocabulary
The XML attribute codeSystem shall contain the OID for the alternative vocabulary
The XML attribute displayName shall carry the display name or description associated with the code in the alternative vocabulary

When an alternative vocabulary is used and an OID is not available then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element modeCode as follows:

The XML attribute code shall contain a code from the alternative vocabulary
The XML attribute codeSystem shall contain the OID " 2.16.840.1.113883.2.1.3.2.4.17.400 "
The XML attribute displayName shall carry the display name or description associated with the code in the alternative vocabulary

[0..1] preferenceInd (BL)

Model Attribute Description

A flag used to indicate if the language stated in languageCode is preferred by the patient.

Implementation in XML Instance

When sending a Boolean value, the XML attribute value of the XML element preferenceInd should carry true or false.

The XML element preferenceInd can carry an XML element nullFlavor instead of true or false to allow assertion of things like "patient was not asked".

The recommended values for the XML attribute nullFlavor are listed below

nullFlavor Definition

UNK Unknown - A proper value is applicable, but not known

ASKU Asked but unknown - Information was sought but not found (e.g., patient was asked but didn't know)

NAV Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.

NASK Not asked - This information has not been sought (e.g., patient was not asked)

MSK Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons.
There may be an alternate mechanism for gaining access to this information.

[0..1] proficiencyLevelCode (CE { CWE:LanguageAbilityProficiency } )

Model Attribute Description

The HL7 attribute proficiencyLevelCode uses a code taken from the HL7 LanguageAbilityProficiency vocabulary or an alternative vocabulary to describe the patient's proficiency to communicate in the mode stated in the HL7 attribute modeCode, for the language stated in the HL7 attribute languageCode.

Implementation in XML Instance

When the HL7 vocabulary LanguageAbilityProficiency is used then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element proficiencyLevelCode as follows:

The XML attribute code shall contain a code from the table below
The XML attribute codeSystem shall contain the OID " 2.16.840.1.113883.5.61 "
The XML attribute displayName shall carry the displayName associated with the code in the table below

Code	DisplayName
E	Excellent
F	Fair
G	Good
P	Poor

When an alternative vocabulary is used and an OID is available then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element proficiencyLevelCode as follows:

The XML attribute code shall contain a code from the alternative vocabulary

The XML attribute codeSystem shall contain the OID for the alternative vocabulary

The XML attribute displayName shall carry the display name or description associated with the code in the alternative vocabulary

When an alternative vocabulary is used and an OID is not available then:

The Coded Plain data type flavour of Coded with Equivalents (CE) shall be used to carry this information in the XML element proficiencyLevelCode as follows:

The XML attribute code shall contain a code from the alternative vocabulary

The XML attribute codeSystem shall contain the OID " 2.16.840.1.113883.2.1.3.2.4.17.401 "

The XML attribute displayName shall carry the display name or description associated with the code in the alternative vocabulary

[1..1] [M] templateId (II)
{ Fixed="COCD_TP145201GB01#languageCommunication" }

Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:

The XML root attribute is fixed to the OID " 2.16.840.1.113883.2.1.3.2.4.18.2 "
The XML extension attribute is fixed to " COCD_TP145201GB01#languageCommunication ".

[1..1] [M] classCode (CS { CNE: EntityClass } )
{ Fixed="ORG" }

Model Attribute Description

The HL7 attribute classCode describes this class as an organisation.

Implementation in XML Instance

The XML attribute classCode is fixed to " ORG ".

[1..1] [M] determinerCode (CS { CNE: EntityDeterminer } )
{ Fixed="INSTANCE" }

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of an organisation.

Implementation in XML Instance

The XML attribute determinerCode is fixed to " INSTANCE ".

[0..1] addr (AD)

Model Attribute Description

The HL7 attribute addr provides a contact address for the organisation.

The HL7 attribute addr allows structured and unstructured addresses to be carried in an instance. Only structured addresses are recommended to be used. There are a number of structured forms of addresses. The three shown here are the recommended formats for organisation addresses, they are listed in no particular order.

Implementation in XML Instance

When the structured address in the style of PDS is used then it shall contain five XML elements streetAddressLine:

The first XML element streetAddressLine should contain the premises name
The second XML element streetAddressLine should contain the number and thoroughfare
The third XML element streetAddressLine should contain the locality
The fourth XML element streetAddressLine should contain the post town
The fifth XML element streetAddressLine should contain the county

The first XML element streetAddressLine or second XML element streetAddressLine and the fourth XML element streetAddressLine are mandated to be populated.

The XML element postalCode may be used to carry a postcode
The XML element addressKey may be used to carry a PAF key

or the address may use the fully structured address:

The XML element houseNumber should contain the house/building number or name
The XML element streetName should contain contains the street name
The XML element city should contain the city name
The XML element county should contain the county
The XML element country should contain the country name
The XML element postalCode should contain the post code
The XML element addressKey should contain the address key

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included:

The first XML element streetAddressLine contains the first address line
The second XML element streetAddressLine contains the second address line
The third XML element streetAddressLine contains the third address line
and so on ....

The XML element addr allows an XML attribute use, this should be used to further define the organisation address when required. Only the use values listed below are recommended to be used for organisation addresses.

Code	Definition
WP	Work place - An office address. First choice for business related contacts during business hours.
TMP	Temporary address - may be good for visit or mailing.
PHYS	Physical visit address - Used primarily to visit an address.
PST	Postal address - Used to send mail.

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times:

A point in time when the contact address details are valid
A start and end time

Just including hours and minutes to indicate opening hours
Using dates for indicating a contact address is only for a certain period of time

A start time only to indicate when the contact address is valid from
An end time only to indicate that the contact address is only valid until a certain date

[1..1] [M] id (II)

Model Attribute Description

The HL7 attribute id uses an ODS code as an identifier that uniquely identifies the organisation which provides/provided care to the patient. The ODS code should identify the organisation at either the site level or organisation level. Where possible the organisation should be identified at the site level. ODS codes were formerly known as NACS codes.

Implementation in XML Instance

When ODS site code is used then the XML element id is populated in the following way:

The XML attribute root shall contain an OID with the value " 2.16.840.1.113883.2.1.3.2.4.19.2 "
The XML attribute extension shall contain the ODS site code.

When ODS organisation code is used then the XML element id is populated in the following way:

The XML attribute root shall contain an OID with the value " 2.16.840.1.113883.2.1.3.2.4.19.1 "
The XML attribute extension shall contain the ODS organisation code.

[1..1] [M] name (ON)

Model Attribute Description

The HL7 attribute name uses the description of the organisation associated with the ODS code.

Implementation in XML Instance

The XML element name will carry the description associated with the ODS code carried in the XML attribute extension of the XML element id.

[1..1] [M] standardIndustryClassCode (CV { CNE:CDAOrganizationProviderType } )

Model Attribute Description

The HL7 attribute standardIndustryClassCode uses a code taken from the CDAOrganizationProviderType vocabulary to indicate the type of care provider.

The only use currently for this attribute is to indicate that the organisation is the patient's registered GP practice.

Implementation in XML Instance

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element standardIndustryClassCode as follows:

The XML attribute code shall contain a code from the CDAOrganizationProviderType vocabulary
The XML attribute codeSystem shall contain the OID " 2.16.840.1.113883.2.1.3.2.4.17.289 "
The XML attribute displayName shall carry the description associated with the code in the CDAOrganizationProviderType vocabulary.

[0..*] telecom (SET<TEL>)

Model Attribute Description

The HL7 attribute telecom provides contact details for the organisation in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

This XML element telecom should be populated as below:

The XML attribute value of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

For a telephone number the actual telephone number would be prefixed with tel:
For a fax number the actual fax number would be prefixed with fax:
For an email address the actual email address would be prefixed with mailto:

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended for an organisation's contact details:

Code	Definition
AS	Answering service - an automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.
EC	Emergency contact - A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.

The XML element useablePeriod of XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

A point in time when the contact details are valid
A start and end time

Just including hours and minutes to indicate opening hours
Using dates for indicating a contact is only for a certain period of time

A start time only to indicate when the contact details are valid from
An end time only to indicate that the contact details are only valid until a certain date

[1..1] [M] templateId (II)
{ Fixed="COCD_TP145201GB01#providerOrganization" }

Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:

The XML attribute root is fixed to the OID " 2.16.840.1.113883.2.1.3.2.4.18.2 "
The XML attribute extension is fixed to " COCD_TP145201GB01#providerOrganization ".

NHS 111
Domain Message Specification

PatientUniversal Tabular View

NHS 111Domain Message Specification

PatientUniversal Tabular View

NHS 111
Domain Message Specification