Status: Active: Approved (STU)

Introduction

This profile sets minimum expectations for the Appointment resource.

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 - to describe the type of appointment and/or clinic. We pre-adopt the UKCore value set (based on SNOMED refset 1127531000000102: Services Simple Reference Set) - for consistency with the Encounter, and because it is more relevant than the default FHIR example 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” - ie 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 (Care Connect Extension) - simple and useful field to indicate whether in-person, telephone, or video

9. Appointment Cancellation Reason (Extension, from R4) - obviously only relevant if the appointment is cancelled, but then useful to populate. (CareConnect offers a free-text extension - however we replace this by pre-adopting the field from R4 which offers a better coded list).

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. Points of note include:

• Specialty - further information which may be useful about the type of specialty required. Knowing the Service Type is probably sufficient for a shared care record, with the Specialty being more relevant to resourcing the correct staff member in a scheduling system. However obviously useful additional information if available. We replace the default FHIR valueset with the list of SDS Job Roles - which appears to be more complete and relevant to the UK, and which offers better coverage of Social Care.

• Indication - opportunity to provide additional “clinical” background to the appointment. Noting that this includes references to other FHIR resources (Condition, Procedure) which can obviously only be populated once actually implemented.

• Patient Instruction (Extension) - this is a useful field added in FHIR R4, and pre-adopted by us here as an extension. It provides a more specific alternative to the “comment” field for any notes specifically intended for the patient. It might be used, for example, by an appointment reminders app to provide instructions such as “Please arrive at least 10 minutes beforehand, and go to the room at the end of the corridor”

• Additional Participants - other participant type codes in the list may optionally be used to reference other FHIR Resource types ie RelatedPerson, Device, Healthcare Service. However it must not be assumed that a data consumer will have the ability to display anything more than the provided “display” text associated with a reference to these resources.

• Incoming Referral: Link to the originating Referral, if relevant and implemented. This could be very useful information. However FHIR makes significant changes from the STU3 “ReferralRequest” to the R4 “ServiceRequest”, and so we are reluctant to mandate implementation at this stageu

• End - the end date/time has been marked as optional as providers and consumers indicated that this is not an important field, with most people only being interested in the start date/time.

• Minutes Duration - can optionally be used to indicate at-a-glance how long the appointment is. May also be useful to indicate the anticipated duration within a longer overall timeslot.

Discouraged or Removed fields

• 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 many uses see instead “Patient Instruction” above.

• Service Category - unfortunately Care Connect has made a choice of mandating a code list based on SDS Job Roles. In our opinion this is not the intended use of this field, and so negates its use. (Encouragingly, drafts of the future UKCore specification revert to the standard FHIR list of simple appointment category codes - so this situation may change in future)

• Booking Organisation (Care Connect Extension) - Proposed that this can instead be covered by other fields. For the organisation making the booking then see “incomingReferral”. 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. .
• Priority, Slot, 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 CareConnect-Appointment-1

Name	Flags	Card.	Type	Description & Constraints
Appointment		0..*	CareConnect-Appointment-1	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
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:deliveryChannel	S	0..1	Extension-CareConnect-DeliveryChannel-1	An extension to record the delivery channel of a scheduled Appointment
extension:appointmentCancellationReason		0..0
extension:bookingOrganisation		0..1	Extension-CareConnect-BookingOrganisation-1	DISCOURAGED - use referral, or provenance tags instead
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
Slices for identifier		0..*	Identifier	External Ids for this item. Slice: Unordered, Open by value:system
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.yhcr.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
status	S	1..1	code	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
serviceCategory		0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use.
serviceType	S	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore 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
specialty		0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (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	S	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) 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
reason	S	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (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
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	S	0..1	instant	When appointment is to take place
slot		0..*	Reference(Slot)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
incomingReferral
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		0..1	string	If relevant, description of the referenced resource
Slices for participant	S	1..*	BackboneElement	Participants involved in 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 | 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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Patient)	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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Location)	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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Practitioner)	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
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	CareConnect-Appointment-1	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	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
deliveryChannel	S	0..1	code	An extension to record the delivery channel of a scheduled Appointment URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeliveryChannel-1 Binding: CareConnect-DeliveryChannel-1 (extensible): A ValueSet that identifies the delivery channel of an Appointment.
bookingOrganisation		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED - use referral, or provenance tags instead URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-BookingOrganisation-1
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
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:localIdentifier	SΣ	0..1	Identifier	External Ids for this item.
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-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	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error Binding: AppointmentStatus (required): The free/busy status of an appointment.
serviceCategory	Σ	0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use. Binding: Care Connect SDS Job Role Name (extensible): A ValueSet that contains a set of codes that identify the Practitioner of a scheduled Appointment.
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore Care Setting Type (preferred)
specialty	Σ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (preferred)
appointmentType	SΣ	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) Binding: InterweaveAppointmentType (required)
reason	SΣ	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (preferred)
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	When appointment is to take place
slot		0..*	Reference(Slot)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
Slices for participant	SC	1..*	BackboneElement	Participants involved in appointment Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
actor	SΣ	1..1	Reference(Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	S	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Patient)	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		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Location)	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		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Practitioner)	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		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
Appointment.meta.security	extensible	All Security Labels
Appointment.meta.tag	example	Common Tags
Appointment.meta.tag:Source	example	Common Tags
Appointment.meta.tag:Provenance	example	Common Tags
Appointment.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Appointment.identifier:localIdentifier.use	required	IdentifierUse
Appointment.status	required	AppointmentStatus
Appointment.serviceCategory	extensible	Care Connect SDS Job Role Name
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType
Appointment.participant.status	required	ParticipationStatus
Appointment.participant:subject.status	required	ParticipationStatus
Appointment.participant:location.status	required	ParticipationStatus
Appointment.participant:primaryPerformer.status	required	ParticipationStatus

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.empty() xor 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'))
dom-1	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation, Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	CareConnect-Appointment-1	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	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deliveryChannel	S	0..1	code	An extension to record the delivery channel of a scheduled Appointment URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeliveryChannel-1 Binding: CareConnect-DeliveryChannel-1 (extensible): A ValueSet that identifies the delivery channel of an Appointment.
bookingOrganisation		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED - use referral, or provenance tags instead URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-BookingOrganisation-1
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
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:localIdentifier	SΣ	0..1	Identifier	External Ids for this item.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-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	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error Binding: AppointmentStatus (required): The free/busy status of an appointment.
serviceCategory	Σ	0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use. Binding: Care Connect SDS Job Role Name (extensible): A ValueSet that contains a set of codes that identify the Practitioner of a scheduled Appointment.
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore Care Setting Type (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
specialty	Σ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
appointmentType	SΣ	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) Binding: InterweaveAppointmentType (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reason	SΣ	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
indication		0..*	Reference(Condition | Procedure)	Reason the appointment is to takes place (resource)
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	When appointment is to take place
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)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
incomingReferral		0..*	Reference(ReferralRequest)	The ReferralRequest provided as information to allocate to the Encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
Slices for participant	SC	1..*	BackboneElement	Participants involved in appointment Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
actor	SΣ	1..1	Reference(Patient | Practitioner | 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	S	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Patient)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Location)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Practitioner)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		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
Appointment.meta.security	extensible	All Security Labels
Appointment.meta.tag	example	Common Tags
Appointment.meta.tag:Source	example	Common Tags
Appointment.meta.tag:Provenance	example	Common Tags
Appointment.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Appointment.identifier:localIdentifier.use	required	IdentifierUse
Appointment.identifier:localIdentifier.type	extensible	Identifier Type Codes
Appointment.status	required	AppointmentStatus
Appointment.serviceCategory	extensible	Care Connect SDS Job Role Name
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType
Appointment.participant.required	required	ParticipantRequired
Appointment.participant.status	required	ParticipationStatus
Appointment.participant:subject.type	extensible	ParticipantType
Appointment.participant:subject.required	required	ParticipantRequired
Appointment.participant:subject.status	required	ParticipationStatus
Appointment.participant:location.type	extensible	ParticipantType
Appointment.participant:location.required	required	ParticipantRequired
Appointment.participant:location.status	required	ParticipationStatus
Appointment.participant:primaryPerformer.type	extensible	ParticipantType
Appointment.participant:primaryPerformer.required	required	ParticipantRequired
Appointment.participant:primaryPerformer.status	required	ParticipationStatus

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()
ele-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation, Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from CareConnect-Appointment-1

Name	Flags	Card.	Type	Description & Constraints
Appointment		0..*	CareConnect-Appointment-1	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
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:deliveryChannel	S	0..1	Extension-CareConnect-DeliveryChannel-1	An extension to record the delivery channel of a scheduled Appointment
extension:appointmentCancellationReason		0..0
extension:bookingOrganisation		0..1	Extension-CareConnect-BookingOrganisation-1	DISCOURAGED - use referral, or provenance tags instead
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
Slices for identifier		0..*	Identifier	External Ids for this item. Slice: Unordered, Open by value:system
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.yhcr.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
status	S	1..1	code	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
serviceCategory		0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use.
serviceType	S	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore 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
specialty		0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (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	S	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) 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
reason	S	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (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
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	S	0..1	instant	When appointment is to take place
slot		0..*	Reference(Slot)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
incomingReferral
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		0..1	string	If relevant, description of the referenced resource
Slices for participant	S	1..*	BackboneElement	Participants involved in 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 | 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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Patient)	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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Location)	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	Participants involved in appointment
type
coding
system		0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Practitioner)	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
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	CareConnect-Appointment-1	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	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
deliveryChannel	S	0..1	code	An extension to record the delivery channel of a scheduled Appointment URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeliveryChannel-1 Binding: CareConnect-DeliveryChannel-1 (extensible): A ValueSet that identifies the delivery channel of an Appointment.
bookingOrganisation		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED - use referral, or provenance tags instead URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-BookingOrganisation-1
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
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:localIdentifier	SΣ	0..1	Identifier	External Ids for this item.
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-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	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error Binding: AppointmentStatus (required): The free/busy status of an appointment.
serviceCategory	Σ	0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use. Binding: Care Connect SDS Job Role Name (extensible): A ValueSet that contains a set of codes that identify the Practitioner of a scheduled Appointment.
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore Care Setting Type (preferred)
specialty	Σ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (preferred)
appointmentType	SΣ	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) Binding: InterweaveAppointmentType (required)
reason	SΣ	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (preferred)
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	When appointment is to take place
slot		0..*	Reference(Slot)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
Slices for participant	SC	1..*	BackboneElement	Participants involved in appointment Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
actor	SΣ	1..1	Reference(Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location)	Person, Location/HealthcareService or Device
status	S	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Patient)	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		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Location)	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		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	Participants involved in appointment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
actor	Σ	0..1	Reference(Practitioner)	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		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
Appointment.meta.security	extensible	All Security Labels
Appointment.meta.tag	example	Common Tags
Appointment.meta.tag:Source	example	Common Tags
Appointment.meta.tag:Provenance	example	Common Tags
Appointment.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Appointment.identifier:localIdentifier.use	required	IdentifierUse
Appointment.status	required	AppointmentStatus
Appointment.serviceCategory	extensible	Care Connect SDS Job Role Name
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType
Appointment.participant.status	required	ParticipationStatus
Appointment.participant:subject.status	required	ParticipationStatus
Appointment.participant:location.status	required	ParticipationStatus
Appointment.participant:primaryPerformer.status	required	ParticipationStatus

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.empty() xor 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'))
dom-1	error	Appointment	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation, Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Appointment	C	0..*	CareConnect-Appointment-1	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	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deliveryChannel	S	0..1	code	An extension to record the delivery channel of a scheduled Appointment URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeliveryChannel-1 Binding: CareConnect-DeliveryChannel-1 (extensible): A ValueSet that identifies the delivery channel of an Appointment.
bookingOrganisation		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED - use referral, or provenance tags instead URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-BookingOrganisation-1
appointmentCancellationReasonR4	S	0..1	CodeableConcept	The coded reason for the appointment being cancelled (pre-adopted from R4) URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason Binding: Interweave R4 Appointment Cancellation Reason (required)
patientInstruction		0..1	string	Detailed information and instructions for the patient URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction
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:localIdentifier	SΣ	0..1	Identifier	External Ids for this item.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-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	proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error Binding: AppointmentStatus (required): The free/busy status of an appointment.
serviceCategory	Σ	0..1	CodeableConcept	DISCOURAGED - Unfortunately CareConnect has prescribed an inappropriate valueset for this field, which negates its use. Binding: Care Connect SDS Job Role Name (extensible): A ValueSet that contains a set of codes that identify the Practitioner of a scheduled Appointment.
serviceType	SΣ	1..*	CodeableConcept	The specific service that is to be performed during this appointment Binding: Interweave UkCore Care Setting Type (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
specialty	Σ	0..*	CodeableConcept	The specialty of a practitioner that would be required to perform the service requested in this appointment Binding: Care Connect SDS Job Role Name (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
appointmentType	SΣ	0..1	CodeableConcept	The style of appointment or patient that has been booked in the slot (not service type) Binding: InterweaveAppointmentType (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reason	SΣ	0..*	CodeableConcept	Reason this appointment is scheduled Binding: Interweave R4 Encounter Reason (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
indication		0..*	Reference(Condition | Procedure)	Reason the appointment is to takes place (resource)
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	When appointment is to take place
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)	DISCOURAGED - Relevant to a scheduling system, but less so to a regional shared record
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
incomingReferral		0..*	Reference(ReferralRequest)	The ReferralRequest provided as information to allocate to the Encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	0..1	string	If relevant, description of the referenced resource
Slices for participant	SC	1..*	BackboneElement	Participants involved in appointment Slice: Unordered, Open by value:type.coding.code
participant:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Role of participant in the appointment Binding: InterweaveAppointmentParticipantType (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
actor	SΣ	1..1	Reference(Patient | Practitioner | 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	S	1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:subject	SC	1..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Patient)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:location	SC	0..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Location)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		1..1	code	accepted | declined | tentative | needs-action Binding: ParticipationStatus (required): The Participation status of an appointment.
participant:primaryPerformer	SC	0..1	BackboneElement	Participants involved in appointment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	0..*	CodeableConcept	Role of participant in the appointment Binding: ParticipantType (extensible): Role of participant in encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/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(Practitioner)	Person, Location/HealthcareService or Device
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
required	Σ	0..1	code	required | optional | information-only Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
status		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
Appointment.meta.security	extensible	All Security Labels
Appointment.meta.tag	example	Common Tags
Appointment.meta.tag:Source	example	Common Tags
Appointment.meta.tag:Provenance	example	Common Tags
Appointment.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Appointment.identifier:localIdentifier.use	required	IdentifierUse
Appointment.identifier:localIdentifier.type	extensible	Identifier Type Codes
Appointment.status	required	AppointmentStatus
Appointment.serviceCategory	extensible	Care Connect SDS Job Role Name
Appointment.serviceType	preferred	Interweave UkCore Care Setting Type
Appointment.specialty	preferred	Care Connect SDS Job Role Name
Appointment.appointmentType	required	InterweaveAppointmentType
Appointment.reason	preferred	Interweave R4 Encounter Reason
Appointment.participant.type	required	InterweaveAppointmentParticipantType
Appointment.participant.required	required	ParticipantRequired
Appointment.participant.status	required	ParticipationStatus
Appointment.participant:subject.type	extensible	ParticipantType
Appointment.participant:subject.required	required	ParticipantRequired
Appointment.participant:subject.status	required	ParticipationStatus
Appointment.participant:location.type	extensible	ParticipantType
Appointment.participant:location.required	required	ParticipantRequired
Appointment.participant:location.status	required	ParticipationStatus
Appointment.participant:primaryPerformer.type	extensible	ParticipantType
Appointment.participant:primaryPerformer.required	required	ParticipantRequired
Appointment.participant:primaryPerformer.status	required	ParticipationStatus

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()
ele-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation, Appointment.participant, Appointment.participant:subject, Appointment.participant:location, Appointment.participant:primaryPerformer	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Appointment.extension:deliveryChannel, Appointment.extension:bookingOrganisation	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CareConnect-Appointment-1

Summary

Mandatory: 4 elements (30 nested mandatory elements)
Must-Support: 28 elements
Fixed Value: 12 elements
Prohibited: 2 elements

Extensions

This structure refers to these extensions:

• https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4AppointmentCancellationReason
• https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-R4PatientInstruction

Slices

This structure defines the following Slices:

• The element Appointment.meta.tag is sliced based on the value of value:system
• The element Appointment.identifier is sliced based on the value of value:system
• The element Appointment.participant is sliced based on the value of value:type.coding.code