Status: Active: Approved (STU)

Definition: The social care needs an adult/carer has as defined within The Care and Support (Eligibility Criteria) Regulations 2015 and identified as part of the Care Eligibility Assessment.

Introduction

This profile sets minimum expectations for the Social Care Support Need resource which is modelled using the FHIR Condition resource. The FHIR Condition resource was chosen to model the as it was the most akin in terms of logic and structure. Many of the irrelevant health fields have been stripped from this resource which has created a clear and concise model for population. We will simply refer to this resource as a Support Need throughout the remainder of the notes section.

Coverage and references

• A Data Provider MUST offer FHIR resources to represent its own service users’ support needs.

  • Needs that are being recorded and supported by other orgs – If the needs are not recorded within the system, then the organization would not be able to share it, that is not something specific to this particular resource, but would be universal to all resources.
  • If those needs are recorded in the system then it should be shared (may be with a comment to say this is manged by external org – this is just one possible solution and may not be achievable, however depending on the use case we can discuss the specific scenarios with the data provider and come up with some options).

Support Need Period

The Support Need Period is the duration of the identified need. The Condition resource offered two date fields which seemed to be suitable candidates for holding this data these being ‘onset’ and ‘abatement’. However, the description of these fields, and rules which needed to be applied during their usage in order to be FHIR compliant, made using them unnecessarily complicated. Therefore, we have chosen to remove both date fields, and create our own extension, SupportNeedPeriod, to house this data.

Mandatory fields

The following fields are mandatory:

• clinicalStatus – A mandatory flag to indicate whether the support need is active or not. We limit the valueset to the following values; active

  inactive

• category – This provides a level of categorisation i.e. if the need relates to an adult or a carer. We extend the care connect valueset to include a defined a list of codes derived based on The Care and Support (Eligibility Criteria) Regulations 2015.

• code – code is used to house the ‘type’ of support need. This should always be known, and vital for meaningful display purposes. We have defined a list of specified outcomes in The Care and Support (Eligibility Criteria) Regulations 2015 with Light touch to Adult Social Care Record (MODS) standard to define codes.

• subject.patient – The person which is the subject of the support need.

• assertedDate – The date that the support need was identified as part of an assessment.

Optional fields

Other fields are optional and may be populated if known – on the understanding that not all data consumers will necessarily make use of them. Optional fields to note include:

• partOfAssessment – An extension has been created which will allow an optional link to the assessment in which this particular need was identified.

• identifier:localIdentifier – As with most other resources, there is the option to include a local identifier which may help to identify the record at a local level.

• note – use note to enter further detail on the support need.

• asserter – The source of the information about the identified need. This can be a reference to a practitioner.

• supportNeedPeriod – Should be populated with the start and end date of the need as identified as part of an assessment

Discouraged or Removed fields

• context – This field is deprecated in R4 and has been removed from our specification.
• abatement and onSet – Removed to avoid confusion when supplying the Support Reason Period (See mandatory notes section above).
• code(SNOMEDCT) – This slice created by Care Connect has been removed to avoid confusion with the list of support need types generated by the Social Care Data Standards working group.
• ConditionEpisode-1 A Care connect extension which is not relevant here.

The following fields have been removed as they capture Health Care related data which is not relevant in Social Care:

• severity
• bodySite
• stage
• evidence

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CareConnect-Condition-1

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:episodisity		0..0
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:localIdentifier		0..1	Identifier	External Ids for this condition
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	S	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
clinicalStatus	S	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
severity		0..0
code	S	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
coding		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
coding:snomedCT		0..0
bodySite		0..0
subject	S	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
context		0..0
onset[x]		0..0
abatement[x]		0..0
assertedDate	S	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter		0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
stage		0..0
evidence		0..0
note		0..*	Annotation	Can be used to provide further information to describe the support Need
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	Σ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	SΣ	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
clinicalStatus	?!SΣC	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
code	SΣ	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter	Σ	0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
note		0..*	Annotation	Can be used to provide further information to describe the support Need
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site

Constraints

Id	Grade	Path(s)	Details	Requirements
con-3	error	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error : verificationStatus='entered-in-error' or clinicalStatus.exists()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
dom-1	error	Condition	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Condition	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()

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	Σ	0..1	Identifier	External Ids for this condition
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	SΣ	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter	Σ	0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
note		0..*	Annotation	Can be used to provide further information to describe the support Need
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnect-Practitioner-1 | CareConnectPatient1)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier.type	extensible	Identifier Type Codes
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	example	Condition Stage
Condition.evidence.code	example	Manifestation and Symptom Codes

Differential View

This structure is derived from CareConnect-Condition-1

Name	Flags	Card.	Type	Description & Constraints
Condition		0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:episodisity		0..0
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
Slices for identifier		0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:localIdentifier		0..1	Identifier	External Ids for this condition
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	S	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
clinicalStatus	S	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
severity		0..0
code	S	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
coding		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
coding:snomedCT		0..0
bodySite		0..0
subject	S	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
context		0..0
onset[x]		0..0
abatement[x]		0..0
assertedDate	S	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter		0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
stage		0..0
evidence		0..0
note		0..*	Annotation	Can be used to provide further information to describe the support Need
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	Σ	0..1	Identifier	External Ids for this condition
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	SΣ	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
clinicalStatus	?!SΣC	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
code	SΣ	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter	Σ	0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
note		0..*	Annotation	Can be used to provide further information to describe the support Need
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site

Constraints

Id	Grade	Path(s)	Details	Requirements
con-3	error	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error : verificationStatus='entered-in-error' or clinicalStatus.exists()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission : abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
dom-1	error	Condition	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Condition	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	CareConnect-Condition-1	Detailed information about conditions, problems or diagnoses
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
supportNeedPeriod		0..1	Period	The period during which the person's needs were identified for support. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
partOfAssessment		0..1	Reference(InterweaveSocialCareAssessment)	Reference to an assessment in which this particular need has been identified. URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this condition Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..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(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	Σ	0..1	Identifier	External Ids for this condition
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (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	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-socialcaresupportneed-identifier
value	SΣ	1..1	string	The Local socialcaresupportneed Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	1..1	code	A mandatory flag to indicate whether the support Need is active or not. Valueset restricted to active and inactive only. Binding: Interweave Social Care Support Need Clinical Status (required)
category	S	1..1	CodeableConcept	A categorisation of the Need why a person is receiving support. Binding: Interweave Social Care Support Need Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	The type of support Need. Binding: Interweave Social Care Support Need (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(CareConnectPatient1)	The person which is subject of the support Need.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
assertedDate	SΣ	1..1	dateTime	Date record was believed accurate / the need was recorded.
asserter	Σ	0..1	Reference(CareConnect-Practitioner-1)	Optionally provide the practitioner who asserted the support Need
note		0..*	Annotation	Can be used to provide further information to describe the support Need
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(RelatedPerson | CareConnect-Practitioner-1 | CareConnectPatient1)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text		1..1	string	The annotation - text content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Condition.meta.security	extensible	All Security Labels
Condition.meta.tag	example	Common Tags
Condition.meta.tag:Source	example	Common Tags
Condition.meta.tag:Provenance	example	Common Tags
Condition.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Condition.identifier.use	required	IdentifierUse
Condition.identifier.type	extensible	Identifier Type Codes
Condition.identifier:localIdentifier.use	required	IdentifierUse
Condition.identifier:localIdentifier.type	extensible	Identifier Type Codes
Condition.clinicalStatus	required	Interweave Social Care Support Need Clinical Status
Condition.category	required	Interweave Social Care Support Need Category (a valid code from InterweaveSocialCareSupportNeedCategory)
Condition.code	required	Interweave Social Care Support Need (a valid code from InterweaveSocialCareSupportNeed)
Condition.bodySite.coding:snomedCT	required	Care Connect Body Site
Condition.stage.summary	example	Condition Stage
Condition.evidence.code	example	Manifestation and Symptom Codes

This structure is derived from CareConnect-Condition-1

Summary

Mandatory: 6 elements (9 nested mandatory elements)
Must-Support: 17 elements
Fixed Value: 3 elements
Prohibited: 10 elements

Structures

This structure refers to these other structures:

• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)
• CareConnect-Practitioner-1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1)

Extensions

This structure refers to these extensions:

• https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareSupportNeedPeriod
• https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SocialCareServicePartofAssessment

Slices

This structure defines the following Slices:

• The element Condition.meta.tag is sliced based on the value of value:system
• The element Condition.identifier is sliced based on the value of value:system