Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave appointment resource. We use the UKCore-Appointment structure definition as a base to this profile.

This Resource will give the consumer the ability to see information of a booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time.

Note that it is necessary to consider the different purposes for which appointment data may be shared in a regional care record – as this has a bearing on how the fields are populated:

• Historical – this overlaps with the "Encounter" to a large extent, but may still be useful to build the picture of where someone has been, who they have seen and why. However the precise details of time and location are less likely to be important.

• Future – this a key use, to see what is upcoming. For example to build a picture of ongoing care, as well as to see what other practitioners are involved, and also to coordinate care – for example to arrange other interventions at the same time / place.

• Patient – there is a further use-case where appointments are viewed by the patient themselves – for example in an “app” which reminds them where and when to go. In this case the precise time and location are clearly vital.

• Scheduling – appointment data may potentially be used for scheduling – for example to match required appointments with available time slots and practitioners with appropriate skills. It is assumed however that this will be a feature of local systems and NOT a primary use-case at present for regional sharing.

Mandatory fields

The following mandatory fields are defined:

1. Status - this is already mandatory in FHIR. Note that for future appointments it will be important to keep this status up-to-date.

2. Service Type - The specific service that is to be performed during this appointment. It is based on SNOMED refset 1127531000000102: Services Simple Reference Set and also covers social care.

3. Participant: Subject - rather unusually, the FHIR Appointment does not actually have a "subject" field, but instead a multi-purpose "participant" field. It is therefore mandatory to have exactly one "participant" of type "subject" to identify the Patient involved.

Must Support fields

In addition the following fields are "Must Support" – i.e., they must be populated if relevant and known.

1. Identifier - A Local Id should be provided, such that could be quoted if manually getting in touch to find out more

2. Start - The date/time that an appointment is to take place. (Note that FHIR requires this field to be populated for appointments that are not at status “proposed” or “cancelled”)

3. Appointment Type - A simple list of codes eg "routine", "emergency" etc. We add a value for "urgent" to cover scheduled but urgent appointments.

4. Description - Any other title or text to further describe the appointment

5. Participant: Primary Performer - a reference to the main practitioner involved, once they have been allocated.

6. Participant: Location - again, rather unusually, the location is considered as another "participant" in the FHIR Appointment. A reference to the location is therefore required, once this has been allocated.
   • Note that a location that is as granular as possible should be provided, although what this means may vary by Data Provider. Some may be able to allocate locations down to the "room" level - with this obviously being essential if the aim is to guide the patient directly to the right place. Others may allocate only at a "ward" or even "site" level - with the patient having to ask for further directions on arrival.

7. Reason: A long list of SNOMED codes to describe different reasons which have led to the Appointment.

   We pre-adopt the value set used in R4. This builds on the existing STU3 list covering SNOMED codes for "Clinical Finding" and "Procedure", and adds codes for "Context-dependent categories" (Social Care) and "Events" (A&E)

8. Delivery Channel (Extension) - simple and useful field to indicate whether in-person, telephone, or video

9. Cancellation Reason - obviously only relevant and useful if the appointment is cancelled.

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.

Discouraged or Removed fields

• Booking Organisation (Care Connect Extension) - Proposed that this can instead be covered by other fields. For the organisation making the booking then see "basedOn". For the organisation taking the booking then see provenance tags in the "meta" section.

• Supporting Information - A pointer to potentially any other FHIR Resource. Should not be used as potentially difficult for a Data Consumer to know how to handle.

• Comment - To be used only with great care. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. For any patient specific information uses see "Patient Instruction" element.

• Priority and Requested Period - more relevant for local use in a scheduling system, rather than a regional shared record.

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

This structure is derived from UKCoreAppointment

Name	Flags	Card.	Type	Description & Constraints
Appointment		0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
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..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
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
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
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
Slices for extension				Content/Rules for all slices
extension:bookingOrganization		0..1	ExtensionUKCoreBookingOrganization	DISCOURAGED - use basedOn or provenance tags instead
Slices for identifier		0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	External Ids for this item
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	S	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
cancelationReason	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory		0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	S	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
coding
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
appointmentType		0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
coding
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
reasonReference		0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
basedOn		0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant		1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
type	S	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
coding
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
actor	S	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	S	1..1	code	accepted | declined | tentative | needs-action
participant:subject	S	1..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: SBJ
display		0..1	string	Representation defined by the system Fixed Value: subject
actor		0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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
participant:location	S	0..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: LOC
display		0..1	string	Representation defined by the system Fixed Value: location
actor		0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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
participant:primaryPerformer	S	0..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: PPRF
display		0..1	string	Representation defined by the system Fixed Value: primary performer
actor		0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) app-2: Either start and end are specified, or neither app-3: Only proposed or cancelled appointments can be missing start/end dates app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show
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..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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: CommonTags (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: CommonTags (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://fhir.interweavedigital.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: CommonTags (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://fhir.interweavedigital.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: CommonLanguages (preferred): 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
Slices for extension				Content/Rules for all slices
bookingOrganization		0..1	Reference(Organization)	DISCOURAGED - use basedOn or provenance tags instead URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BookingOrganization
deliveryChannel		0..1	CodeableConcept	Defines the delivery channel of a scheduled appointment. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Binding: UK Core Delivery Channel (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this item
use	?!Σ	0..1	code	usual | official | temp | secondary | old (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.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	SΣ	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	The overall status of the appointment. Binding: AppointmentStatus (required): The free/busy status of an appointment.
cancelationReason	SΣ	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory	Σ	0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
specialty	SΣ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment. Binding: UK Core Practice Setting Code (extensible)
appointmentType	SΣ	0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
reasonCode	SΣ	0..*	CodeableConcept	The reason for the appointment. Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
reasonReference	S	0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
start	SΣ	0..1	instant	The start time of the appointment.
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
basedOn	S	0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant	SC	1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code app-1: Either the type or actor on the participant SHALL be specified
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
actor	SΣ	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	SΣ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Appointment.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Appointment.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Appointment.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.status	required	AppointmentStatus http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1 from the FHIR Standard
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.specialty	extensible	UKCorePracticeSettingCode (a valid code from UKCore Practice Setting Code) https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG
Appointment.participant.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:subject.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:location.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
app-1	error	Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	Either the type or actor on the participant SHALL be specified : type.exists() or actor.exists()
app-2	error	Appointment	Either start and end are specified, or neither : start.exists() = end.exists()
app-3	error	Appointment	Only proposed or cancelled appointments can be missing start/end dates : (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4	error	Appointment	Cancelation reason is only used for appointments that have been cancelled, or no-show : Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Appointment	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	Appointment	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	Appointment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Appointment	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
Appointment	C	0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) app-2: Either start and end are specified, or neither app-3: Only proposed or cancelled appointments can be missing start/end dates app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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: CommonTags (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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.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
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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.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
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: CommonLanguages (preferred): 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
bookingOrganization		0..1	Reference(Organization)	DISCOURAGED - use basedOn or provenance tags instead URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BookingOrganization
deliveryChannel		0..1	CodeableConcept	Defines the delivery channel of a scheduled appointment. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Binding: UK Core Delivery Channel (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
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 Example General: http://www.acme.com/identifiers/patient
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(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this item
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	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	SΣ	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	The overall status of the appointment. Binding: AppointmentStatus (required): The free/busy status of an appointment.
cancelationReason	SΣ	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory	Σ	0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
specialty	SΣ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment. Binding: UK Core Practice Setting Code (extensible)
appointmentType	SΣ	0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
reasonCode	SΣ	0..*	CodeableConcept	The reason for the appointment. Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
reasonReference	S	0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
start	SΣ	0..1	instant	The start time of the appointment.
end	Σ	0..1	instant	When appointment is to conclude
minutesDuration		0..1	positiveInt	Can be less than start/end (e.g. estimate)
slot		0..*	Reference(Slot)	The slots that this appointment is filling
created		0..1	dateTime	The date that this appointment was initially created
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
patientInstruction		0..1	string	Detailed information and instructions for the patient
basedOn	S	0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant	SC	1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code app-1: Either the type or actor on the participant SHALL be specified
participant:All Slices				Content/Rules for all slices
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
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
actor	SΣ	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	SΣ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:subject	SC	1..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: SBJ
display	Σ	0..1	string	Representation defined by the system Fixed Value: subject
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
actor	Σ	0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:location	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: LOC
display	Σ	0..1	string	Representation defined by the system Fixed Value: location
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
actor	Σ	0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:primaryPerformer	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: PPRF
display	Σ	0..1	string	Representation defined by the system Fixed Value: primary performer
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
actor	Σ	0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Appointment.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Appointment.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Appointment.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Appointment.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Appointment.status	required	AppointmentStatus http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1 from the FHIR Standard
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.specialty	extensible	UKCorePracticeSettingCode (a valid code from UKCore Practice Setting Code) https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG
Appointment.participant.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:subject.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:subject.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:subject.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:subject.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:location.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:location.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:location.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:location.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:primaryPerformer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:primaryPerformer.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
app-1	error	Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	Either the type or actor on the participant SHALL be specified : type.exists() or actor.exists()
app-2	error	Appointment	Either start and end are specified, or neither : start.exists() = end.exists()
app-3	error	Appointment	Only proposed or cancelled appointments can be missing start/end dates : (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4	error	Appointment	Cancelation reason is only used for appointments that have been cancelled, or no-show : Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Appointment	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	Appointment	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	Appointment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Appointment	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()

Differential View

This structure is derived from UKCoreAppointment

Name	Flags	Card.	Type	Description & Constraints
Appointment		0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
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..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
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
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
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
Slices for extension				Content/Rules for all slices
extension:bookingOrganization		0..1	ExtensionUKCoreBookingOrganization	DISCOURAGED - use basedOn or provenance tags instead
Slices for identifier		0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	External Ids for this item
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	S	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
cancelationReason	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory		0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	S	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
coding
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
appointmentType		0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
coding
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
reasonReference		0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
basedOn		0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant		1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
type	S	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
coding
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
actor	S	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	S	1..1	code	accepted | declined | tentative | needs-action
participant:subject	S	1..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: SBJ
display		0..1	string	Representation defined by the system Fixed Value: subject
actor		0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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
participant:location	S	0..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: LOC
display		0..1	string	Representation defined by the system Fixed Value: location
actor		0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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
participant:primaryPerformer	S	0..1	BackboneElement	A list of participants involved in the appointment.
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		0..1	code	Symbol in syntax defined by the system Fixed Value: PPRF
display		0..1	string	Representation defined by the system Fixed Value: primary performer
actor		0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) app-2: Either start and end are specified, or neither app-3: Only proposed or cancelled appointments can be missing start/end dates app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show
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..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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: CommonTags (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: CommonTags (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://fhir.interweavedigital.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: CommonTags (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://fhir.interweavedigital.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: CommonLanguages (preferred): 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
Slices for extension				Content/Rules for all slices
bookingOrganization		0..1	Reference(Organization)	DISCOURAGED - use basedOn or provenance tags instead URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BookingOrganization
deliveryChannel		0..1	CodeableConcept	Defines the delivery channel of a scheduled appointment. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Binding: UK Core Delivery Channel (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this item
use	?!Σ	0..1	code	usual | official | temp | secondary | old (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.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	SΣ	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	The overall status of the appointment. Binding: AppointmentStatus (required): The free/busy status of an appointment.
cancelationReason	SΣ	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory	Σ	0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
specialty	SΣ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment. Binding: UK Core Practice Setting Code (extensible)
appointmentType	SΣ	0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
reasonCode	SΣ	0..*	CodeableConcept	The reason for the appointment. Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
reasonReference	S	0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
start	SΣ	0..1	instant	The start time of the appointment.
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
basedOn	S	0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant	SC	1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code app-1: Either the type or actor on the participant SHALL be specified
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
actor	SΣ	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	SΣ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Appointment.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Appointment.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Appointment.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.status	required	AppointmentStatus http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1 from the FHIR Standard
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.specialty	extensible	UKCorePracticeSettingCode (a valid code from UKCore Practice Setting Code) https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG
Appointment.participant.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:subject.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:location.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
app-1	error	Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	Either the type or actor on the participant SHALL be specified : type.exists() or actor.exists()
app-2	error	Appointment	Either start and end are specified, or neither : start.exists() = end.exists()
app-3	error	Appointment	Only proposed or cancelled appointments can be missing start/end dates : (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4	error	Appointment	Cancelation reason is only used for appointments that have been cancelled, or no-show : Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Appointment	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	Appointment	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	Appointment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Appointment	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	UKCoreAppointment	A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) app-2: Either start and end are specified, or neither app-3: Only proposed or cancelled appointments can be missing start/end dates app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
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: CommonTags (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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.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
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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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://fhir.interweavedigital.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
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: CommonLanguages (preferred): 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
bookingOrganization		0..1	Reference(Organization)	DISCOURAGED - use basedOn or provenance tags instead URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BookingOrganization
deliveryChannel		0..1	CodeableConcept	Defines the delivery channel of a scheduled appointment. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Binding: UK Core Delivery Channel (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	External Ids for this item Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
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 Example General: http://www.acme.com/identifiers/patient
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(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	External Ids for this item
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	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-appointment-identifier
value	SΣ	1..1	string	The Local appointment Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	The overall status of the appointment. Binding: AppointmentStatus (required): The free/busy status of an appointment.
cancelationReason	SΣ	0..1	CodeableConcept	The coded reason for the appointment being cancelled Binding: AppointmentCancellationReason (preferred)
serviceCategory	Σ	0..*	CodeableConcept	A general description under broad categorisation of the types of services that is to be performed during this appointment. Binding: ServiceCategory (preferred)
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: UK Core Care Setting Type (preferred)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
specialty	SΣ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment. Binding: UK Core Practice Setting Code (extensible)
appointmentType	SΣ	0..1	CodeableConcept	The type of appointment or patient that has been booked in the slot. Binding: InterweaveAppointmentType (required)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
reasonCode	SΣ	0..*	CodeableConcept	The reason for the appointment. Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
reasonReference	S	0..*	Reference(Condition | Procedure | Observation)	A reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
priority		0..1	unsignedInt	DISCOURAGED - More applicable to internal scheduling
description	S	0..1	string	Shown on a subject line in a meeting request, or appointment list
supportingInformation		0..*	Reference(Resource)	DISCOURAGED - very broad, and so difficult for a consumer to handle
start	SΣ	0..1	instant	The start time of the appointment.
end	Σ	0..1	instant	When appointment is to conclude
minutesDuration		0..1	positiveInt	Can be less than start/end (e.g. estimate)
slot		0..*	Reference(Slot)	The slots that this appointment is filling
created		0..1	dateTime	The date that this appointment was initially created
comment		0..1	string	DISCOURAGED. It must be assumed that this comment will be widely viewed across the region, including by the patient themselves. See also / instead the 'patientInstruction' field
patientInstruction		0..1	string	Detailed information and instructions for the patient
basedOn	S	0..*	Reference(InterweaveServiceRequest)	The service request this appointment is allocated to assess.
Slices for participant	SC	1..*	BackboneElement	A list of participants involved in the appointment. Slice: Unordered, Open by value:type.coding.code app-1: Either the type or actor on the participant SHALL be specified
participant:All Slices				Content/Rules for all slices
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
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
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
actor	SΣ	1..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	SΣ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:subject	SC	1..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: SBJ
display	Σ	0..1	string	Representation defined by the system Fixed Value: subject
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
actor	Σ	0..1	Reference(InterweavePatient)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:location	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: LOC
display	Σ	0..1	string	Representation defined by the system Fixed Value: location
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
actor	Σ	0..1	Reference(InterweaveLocation)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
participant:primaryPerformer	SC	0..1	BackboneElement	A list of participants involved in the appointment. app-1: Either the type or actor on the participant SHALL be specified
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
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	Unique id for inter-element referencing
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	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: PPRF
display	Σ	0..1	string	Representation defined by the system Fixed Value: primary performer
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
actor	Σ	0..1	Reference(InterweavePractitioner)	Person, Location/HealthcareService or Device
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	1..1	string	Reference to a resource (could be Contained)
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	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status	Σ	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
period		0..1	Period	Participation period of the actor
requestedPeriod		0..*	Period	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Appointment.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Appointment.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Appointment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Appointment.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Appointment.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Appointment.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Appointment.status	required	AppointmentStatus http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1 from the FHIR Standard
Appointment.cancelationReason	preferred	AppointmentCancellationReason http://hl7.org/fhir/ValueSet/appointment-cancellation-reason from the FHIR Standard
Appointment.serviceCategory	preferred	ServiceCategory http://hl7.org/fhir/ValueSet/service-category from the FHIR Standard
Appointment.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Appointment.specialty	extensible	UKCorePracticeSettingCode (a valid code from UKCore Practice Setting Code) https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode from this IG
Appointment.appointmentType	required	InterweaveAppointmentType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentType from this IG
Appointment.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Appointment.participant.type	required	InterweaveAppointmentParticipantType https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AppointmentParticipationType from this IG
Appointment.participant.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:subject.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:subject.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:subject.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:subject.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:location.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:location.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:location.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:location.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Appointment.participant:primaryPerformer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Appointment.participant:primaryPerformer.required	required	ParticipantRequired http://hl7.org/fhir/ValueSet/participantrequired|4.0.1 from the FHIR Standard
Appointment.participant:primaryPerformer.status	required	ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
app-1	error	Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	Either the type or actor on the participant SHALL be specified : type.exists() or actor.exists()
app-2	error	Appointment	Either start and end are specified, or neither : start.exists() = end.exists()
app-3	error	Appointment	Only proposed or cancelled appointments can be missing start/end dates : (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4	error	Appointment	Cancelation reason is only used for appointments that have been cancelled, or no-show : Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Appointment	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	Appointment	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	Appointment	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Appointment	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()

This structure is derived from UKCoreAppointment

Summary

Mandatory: 4 elements(23 nested mandatory elements)
Must-Support: 22 elements
Fixed: 12 elements
Prohibited: 6 elements

Structures

This structure refers to these other structures:

• InterweaveOrganization (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Organization)
• InterweaveServiceRequest (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-ServiceRequest)
• InterweavePatient (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Patient)
• InterweaveLocation (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Location)
• InterweavePractitioner (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Practitioner)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Appointment.meta.tag
• The element 1 is sliced based on the value of Appointment.identifier
• The element 1 is sliced based on the value of Appointment.participant