Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
subject	S	1..1	Reference(Patient)	Focus of message
identifier	S	0..1	Identifier	NHS Number used to identify the patient
system		0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Open by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
authoredOn	S	0..1	dateTime	When the request was authored
requester	S	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	S	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
subject	S	1..1	Reference(Patient)	Focus of message
identifier	SΣ	0..1	Identifier	NHS Number used to identify the patient
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
authoredOn	SΣ	0..1	dateTime	When the request was authored
requester	SΣ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	SΣ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CommunicationRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 From the FHIR Standard
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category
CommunicationRequest.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CommunicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CommunicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CommunicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
basedOn	Σ	0..*	Reference(Resource)	Fulfills plan or proposal
replaces	Σ	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
statusReason		0..1	CodeableConcept	Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	S	1..1	Reference(Patient)	Focus of message
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	NHS Number used to identify the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
about		0..*	Reference(Resource)	Resources that pertain to this communication request
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
occurrence[x]	Σ	0..1		When scheduled
occurrenceDateTime			dateTime
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	When the request was authored
requester	SΣ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	SΣ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
reasonCode	Σ	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
note		0..*	Annotation	Comments made about communication request
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CommunicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
CommunicationRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 From the FHIR Standard
CommunicationRequest.statusReason	example
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category
CommunicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
CommunicationRequest.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
CommunicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
CommunicationRequest.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
CommunicationRequest.subject.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
CommunicationRequest.reasonCode	example	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CommunicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CommunicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CommunicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 5 elements
Must-Support: 10 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• Letter PDF Document (https://nhsdigital.github.io/nhs-notify-standards/fhir/docs/StructureDefinition/nhsnotify-letter-documentreference)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of CommunicationRequest.payload.content[x]

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
subject	S	1..1	Reference(Patient)	Focus of message
identifier	S	0..1	Identifier	NHS Number used to identify the patient
system		0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Open by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
authoredOn	S	0..1	dateTime	When the request was authored
requester	S	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	S	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
subject	S	1..1	Reference(Patient)	Focus of message
identifier	SΣ	0..1	Identifier	NHS Number used to identify the patient
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
authoredOn	SΣ	0..1	dateTime	When the request was authored
requester	SΣ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	SΣ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CommunicationRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 From the FHIR Standard
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category
CommunicationRequest.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CommunicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CommunicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CommunicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
basedOn	Σ	0..*	Reference(Resource)	Fulfills plan or proposal
replaces	Σ	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
statusReason		0..1	CodeableConcept	Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
category	S	0..*	CodeableConcept	Message category Binding: https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category (example)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	S	1..1	Reference(Patient)	Focus of message
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	NHS Number used to identify the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/nhs-number
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
about		0..*	Reference(Resource)	Resources that pertain to this communication request
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
payload	S	1..*	BackboneElement	At least one letter payload (PDF metadata via DocumentReference)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	Reference(Resource)	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentReference	S	1..1	Reference(Letter PDF Document)	DocumentReference wrapping the PDF binary
occurrence[x]	Σ	0..1		When scheduled
occurrenceDateTime			dateTime
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	When the request was authored
requester	SΣ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Submitting system or responsible party
recipient	S	1..*	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)	Intended recipient entity (e.g. print fulfilment endpoint)
sender	SΣ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Source organization (ODS code)
reasonCode	Σ	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
note		0..*	Annotation	Comments made about communication request
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CommunicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
CommunicationRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 From the FHIR Standard
CommunicationRequest.statusReason	example
CommunicationRequest.category	example	https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category https://nhsdigital.github.io/nhs-notify-standards/fhir/ValueSet/nhsnotify-letter-category
CommunicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
CommunicationRequest.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
CommunicationRequest.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
CommunicationRequest.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
CommunicationRequest.subject.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
CommunicationRequest.reasonCode	example	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CommunicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CommunicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CommunicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CommunicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 5 elements
Must-Support: 10 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• Letter PDF Document (https://nhsdigital.github.io/nhs-notify-standards/fhir/docs/StructureDefinition/nhsnotify-letter-documentreference)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of CommunicationRequest.payload.content[x]