Introduction

NHS 111 is a free 24/7/365 call centre service for patients with urgent medical concerns.  The service is provisioned on a regional basis and run by several different organisations nationally. 

111 call handling services use specific software systems that are outside the scope of the GP IT Futures framework.

A call to 111 may result in an ambulance call out, or a referral to one of several care settings:

• a local emergency department
• an Out of Hours (OOH) service
• the patient's registered GP

All of these will result in a 111 report message (Post Event Message) being sent to the patient's GP Practice.  A referral to the GP will additionally trigger a 111 referral message (also known as a Transfer of Care) sent to the GP practice.

The current interoperability requirement for GP IT Solution providers is to receive and ingest NHS 111 CDA messages sent by 111 provider systems.

In future, direct Appointment Bookings into GP Practices will be made from 111 providers using GP Connect. 

Compliance, Assurance and Testing 

The content for this is currently under development on the NHS Developer Website and will be published in due course. In the meantime, if you have any queries please contact uecintegration@nhs.net and/or itkconformance@nhs.net. 

Requirements

These requirements cover the ingestion of NHS111 CDA messages from 111 providers.  

Note that the interoperability requirements for direct Appointment Booking into GP Practices are covered by GP Connect, therefore are not detailed here.

Documentation

The documentation on this page is to provide an overview.  For details please refer to the websites and documents linked here.

Urgent and Emergency Care Technical and Interop Standards

The sections applicable to GP IT Solutions are:

• Post Event Messaging
• Referrals/Transfer of Care (suppliers should note that CDA for Transfer of Care messaging has been deprecated, and the new ITK3 + FHIR standards should be targeted)

Note this website is a work in progress and there may still be a need to refer to the older NHS England PDF documentation:

NHS England Integrated Urgent Care Service Specification

Particularly:

• Section 5.9 Interoperability
• Section 5.15 Post Event Messages (PEM)

NHS England Urgent Care Technical and Interoperability Standards

Overview

Dashed red boxes indicate scope of GP IT 111 Messaging.

NB the interaction between OOH Services is out of scope of the 111 interoperability and as such is not defined here

Integration Pattern

A synchronous point to point web services call from 111 Triage System to GP system.

Message Transport

Interoperability Toolkit (ITK) WS-SOAP Web Services.

Endpoint Discovery

111 Triage systems obtain endpoint URLs of target GP systems from their local Directory of Services.  The URL of the GP system's SOAP endpoint that handles 111 messages must be registered in the appropriate DoS of the locality. 

Message Specification

Both types of interaction use the NHS111 CDA Domain Message Specification (DMS) version 2.0 message.  The Interaction ID determines the type of interaction:

• NHS 111 Report when patient referred to GP: urn:nhs-itk:interaction:primaryGeneralPractitionerRecipientNHS111CDADocument-v2-0
• NHS 111 Copy Report when patient referred to another care setting: urn:nhs-itk:interaction:copyRecipientNHS111CDADocument-v2-0

Note the ITK CDA documentation refers to generic CDA messages, but for 111 interactions the specific 111-flavour of CDA is required.  

Message Recipient Behaviour

See Clinical Document Architecture (CDA)  for behaviours defined in the ITK.

Dependencies

Creating a compliant implementation requires implementing the following dependent interface standards:

• Interoperability Toolkit (ITK)
• Clinical Document Architecture (CDA)

Roadmap