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Original file line number Diff line number Diff line change
Expand Up @@ -31,18 +31,23 @@ topic: Application8

This application supports the use of the following use cases:

| Use Case | Name | Code |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------|-------|
| Referrals from A&G into eRS | A&G to eRS | a8t1 |
|Use case | Name | Code|
|--------------------------------------------------------------------------------|------|------|
| Improved Advice and Guidance to electronic-Referral Service (e-RS)| IAG to e-RS | A8T1 |
| 111Online to electronic-Referral Service (e-RS)| 111online to e-RS | A8T2 |
| NHS.UK to electronic-Referral Service (e-RS)| nhs.uk to e-RS | A8T3 |


## Introduction

### Overview

This page provides guidance for implementing the Referral Standard (BaRS) specifically for the use cases listed above. It should be used alongside the {{pagelink:design-core-1.0.7, text:BaRS Core implementation guide}} and API Specification when developing to the standard.
This page provides guidance for implementing the Referral Standard (BaRS) specifically for the use cases listed above. It should be used alongside the {{pagelink:design-core-1.3.1, text:BaRS Core implementation guide}} and API Specification when developing to the standard.

### Data model endorsements

TBC
NHS England teams within Referrals and Appointments, Digitial Urgent and Emergency Care and the National Pathway for Self-Referrals have co-produced the Application 8 standard to facilitate interoperability between existing systems for referral pathways.

This page provides guidance for implementing the Referral Standard (BaRS) specifically for the use cases listed above. It should be used alongside the {{pagelink:design-core-1.3.1, text:BaRS Core implementation guide}} and Payload Definitions when developing to the standard.

<hr />
Original file line number Diff line number Diff line change
Expand Up @@ -6,49 +6,65 @@ TOPIC: APP8-ScopeAndRequirements

### Scope Overview
This BaRS Application (Referrals from Advice and Guidance to eRS broker, Application 8) supports the following use case(s) ONLY:
- Advice and Guidance referring into eRS
* Improved Advice and Guidance to electronic-Referral Service (e-RS)
* 111Online to electronic-Referral Service (e-RS)
* NHS.UK to electronic-Referral Service (e-RS)

The payload and workflow have been designed to support this service. Other {{pagelink:applications, text:BaRS Applications}} offer scope for alternative use cases.


The payload and workflow have been designed to support these services. Other {{pagelink:applications, text:BaRS Applications}} offer scope for alternative use cases.

### Functional Scope
**Directing the referral (without Service Discovery)**
- Direct to eRS static value

**Service Discovery**
- Establishing a service, or service shortlist, for onward care is a mandatory step in the workflow


**Directing the referral (independent of Service Discovery)**
- Direct to predefined value representing the broker

**Referral**
- A referral in this Application is a request for care, on behalf of an individual, from a sending service to a broker
- The referral can be sent without having to establish the capacity of the receiving service
- The referral will contain primarily clinical information, indicating the need of the individual and **must** state the anticipated action required by the receiving service (see Task FHIR resource)
- A list of healthcare services which can support the patient/client need are offered to the broker to direct the next step in care
* Supporting information, other than the assessment, is expected to be included in a referral, if collected, including:
* new or existing safeguarding concerns
* locally held Special Patient Notes
* external information sources used during initial assessment prior to referral
* timing information to support the timely delivery of care and reporting


**API-M**
- All requests and responses associated with BaRS must occur through the BaRS API Proxy

**Constraints**
- No guidance is provided on the display of referral information beyond the {{pagelink:principles_prerequesites, text:Principles for rendering BaRS Payload}}
- Consent within BaRS will be for Direct-Care only
- BaRS currently supports the communication of consent for direct care only
- Certificates for Receiving messages to use nhs.uk domains only
- Receiving endpoints are to be internet facing
- Clincial Constraints exist - See Hazard Log
- No element level 'updates' to requests are supported. A new request must be generated to change information in the referral request
- No digital support to remove or cancel a referral are offered (this would need to be achieved manually)
- Where an Online Consultation or other self assessment tool is used to refer, the referral must be verified by a human representative of the sending organisation before the request is made
- The service discovery tool for establishing services for onward care must be the [e-RS Service Search API A010](https://digital.nhs.uk/developer/api-catalogue/e-referral-service-fhir#post-/STU3/HealthcareService/$ers.searchHealthcareServicesForPatient)

### Requirements

**Directing a referral**
- The service **must** support a unique identifier which the Sender is configured with to engage in the BaRS referral workflow
**Service Discovery**
- Where more than one service is shortlisted, the maximum number of services allowed on a given shortlist is 20.

**Referral**
- TBC

**Contacts**
- A minimum of one contact (patient or third party) with a contact method (phone, email, etc.) of <ins>phone</ins> **must** be provided in referral requests
- All contacts **must** have a rank associated with them
- There **must** be only one contact with a rank of 1
- All contacts **must** have at least one contact method (phone, email, etc.)
- All contact methods **must** have a rank
- There **must** be only one contact method with a rank of 1
- The contact ranked 1 and the contact method ranked 1 **must** be the primary callback for the request
**Referral**
- The referral Receiver **must** accept the referral request regardless of whether the patient is known to the service provider
- The referral Receiver **must** only accept potential patients who do **<ins>have</ins>** a national validated identifier e.g. NHS Number
- The national identifier **must** have a [verification status](https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-nhsnumberverificationstatus) of 'Number present and verified' otherwise, the referral Sender **must <ins>not</ins>** include it in the request
- Any new or existing safeguarding concern, recorded as part of the assessment, **must** be included in the referral Sender's request
- The referral Receiver **must** clearly identify any included safeguarding concern to the end user
- The referral Receiver **must** accurately represent information made by the Sender to the end user.
- The referral Sender **must** make available the human readable identifier for the referral, included in the HTTP synchronous response, to the end user
- Where the referral was <ins>not</ins> successful, the Receiver **must** send an appropriate response. See {{pagelink:core-failure_scenarios-1.3.1, text:failure scenarios}} for more detail
- Where the referral was <ins>not</ins> successful, the Sender **must** present an appropriate message to the end user. See {{pagelink:core-failure_scenarios-1.3.1, text:failure scenarios}} for more detail
- The referral Sender **must** indicate consent to share (for Direct Care) to the Receiver
- The referral Sender **must** indicate the urgency (using the agreed codeset) of the request to the Receiver


### Audit
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