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draft Scenario E-discharge summary 2.16.840.1.113883.3.1937.777.28.3.1

Name Details [‑]
draft E-discharge summary
prsb03-scenario-1
Version / effective date 3.0 - 2018‑10‑31
Description eDischarge summary 3.0
 - Updates as part of maintenance release Apr 21

eDischarge summary 2.1
 - Updated meds
draft doublearrow E-discharge summary
prsb03-transaction-10link
Version / effective date 3.0 - 2018‑10‑31    
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Description E-discharge summary
draft rotate E-discharge summary
prsb03-transaction-100link
Version / effective date 3.0 - 2018‑10‑31    
Label sc-1
Description E-discharge summary
Actor
Sender (organization) General practitioner
Associations
Contained concepts
Concept Card/Conf Id
folder Person demographics
1 … 1 Mandatory
prsb03-dataelement-10868link
The person's details and contact information.
treetree folder Person name
1 … 1 Mandatory
prsb03-dataelement-10869link
Details of the person's name
treeblank treetree draft  Person first name
1 … * Mandatory
prsb03-dataelement-13799link
The first name(s) of the person. This includes middle names.NHS data dictionary :- Person given name
treeblank treetree draft  Person family name
1 … * Mandatory
prsb03-dataelement-13800link
The family name or surname of the personNHS data dictionary : - Person family name
treeblank treetree draft  Person preferred name
0 … 1
prsb03-dataelement-10870link
The name by which a person wishes to be addressed. The preferred name volunteered by the person or a preferred name given by PDS that the person has asked to be called by.NHS data dictionary: - Person full name
treeblank treetree draft  Title
0 … 1
prsb03-dataelement-13089link
Person's titleNHS data dictionary: - Person title
treeblank treetree draft  Person name suffix
0 … *
prsb03-dataelement-13798link
A textual suffix that may be added to the end of a PERSON's name, for example, OBE, MBE, BSc, JP, GMNHS data dictionary: - Person suffix
treeblank treetree draft  Person full name
0 … 1
prsb03-dataelement-13801link
The full name of the person in text representation.NHS data dictionary :- Patient full name
treetree draft  Date of birth
1 … 1 Mandatory
prsb03-dataelement-10871link
The date of birth of the person.NHS data dictionary:- Person birth date
treetree draft  Gender
0 … 1
prsb03-dataelement-10872link
The person's stated gender.NHS data dictionary :- Person stated gender code
treetree draft  NHS number
0 … 1
prsb03-dataelement-10879link
The unique identifier for a person within the NHS in England and Wales.NHS data dictionary:- NHS number
treetree draft  NHS number status indicator
0 … 1
prsb03-dataelement-13297link
Provides an indication of the reliability of an NHS Number.NHS data dictionary :- NHS number status indicator
treetree draft  Other identifier
0 … *
prsb03-dataelement-10880link
Country specific or local identifier, e.g. Community Health Index (CHI) in Scotland. NHS data dictionary: - Local patient identifier(extended), Health and care number (NI only), Community health index number (Scotland only)
treetree folder Person's address
1 … * Mandatory
prsb03-dataelement-10881link
Person’s usual place of residence, and where relevant temporary and correspondence addresses.
treeblank treetree draft  Address line 1
1 … 1 Mandatory
prsb03-dataelement-13082link
Person's first line of address. NHS data dictionary :-  Address line 1
treeblank treetree draft  Address line 2
0 … 1
prsb03-dataelement-13083link
Person's second line of address. NHS data dictionary :- Address line 2
treeblank treetree draft  Address line 3
0 … 1
prsb03-dataelement-13084link
Person's third line of address. NHS data dictionary : - Address line 3
treeblank treetree draft  Address line 4
0 … 1
prsb03-dataelement-13085link
Person's fourth line of address. NHS data dictionary : - Address line 4
treeblank treetree draft  Address line 5
0 … 1
prsb03-dataelement-13086link
Person's fifth line of address.NHS data dictionary : - Address line 5
treeblank treetree draft  Postcode
0 … 1
prsb03-dataelement-13087link
The person's postcode.NHS data dictionary :- Postcode of usual address
treeblank treetree draft  Address type
0 … 1
prsb03-dataelement-13221link
The type of address e.g. Main address, Temp addressNHS data dictionary : - Address association type
treetree folder Person's contact details
0 … 1
prsb03-dataelement-13804link
Details of the person's contact information.
treeblank treetree draft  Preferred contact method
0 … 1
prsb03-dataelement-10886link
Preferred contact method, e.g. email, letter, phone, text message etc.NHS data dictionary :- Communication contact method
treeblank treetree folder Person's telephone number details
0 … *
prsb03-dataelement-10883link
The person's telephone number details
treeblank treeblank treetree draft  Person's telephone number
0 … 1
prsb03-dataelement-13808link
The person's telephone numberNHS data dictionary : - UK telephone number
treeblank treeblank treetree draft  Person's telephone number type
0 … 1
prsb03-dataelement-13805link
The contact type e.g. home, mobileFHIR value set: - Contact point use
treeblank treeblank treetree draft  Preference of telephone number
0 … 1
prsb03-dataelement-13809link
The preferred order of use for the telephone numberPreference of use 1-5, 1 being the highest.
treeblank treetree folder Person's email address details
0 … *
prsb03-dataelement-13807link
Details of the person's email address
treeblank treeblank treetree draft  Person's email address
0 … 1
prsb03-dataelement-10882link
Email address of the person.NHS data dictionary :- Contact email address
treeblank treeblank treetree draft  Person's email address type
0 … 1
prsb03-dataelement-13811link
The type of email address, home, workFHIR value set: - Contact point use
treeblank treeblank treetree draft  Preference of email address
0 … 1
prsb03-dataelement-13810link
The preferred order of use of email addressPreference of use 1-5, 1 being the highest.
treeblank treetree draft  Other contact information
0 … 1
prsb03-dataelement-13806link
Contact details via fax, sms, urlNHS data dictionary:- Communication contact string
treetree draft  Organ and tissue donation
0 … 1
prsb03-dataelement-13847link
Whether the person has given consent for organ and/or tissue donation or opted out of automatic donation where applicable. This is information provided by the national register.Flag: - Yes or No
folder GP practice
1 … 1 Mandatory
prsb03-dataelement-101link
Details of the person's GP practice.
treetree folder GP practice record entry
1 … * Mandatory
prsb03-dataelement-10643link
This is an GP practice record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items
treeblank treetree draft  GP name
0 … 1
prsb03-dataelement-10003link
The name of the person's GP. If the person is registered with a GP practice, their usual GP name will be something volunteered by the person or their representative.Free text
treeblank treetree draft  GP practice details
0 … 1
prsb03-dataelement-10002link
Name and address of the person's registered GP practice Registered GP practice details are available from the Person Demographics Service (PDS), or volunteered from the person or their representative. Include details of the practice name and address.Free text
treeblank treetree draft  GP practice identifier
1 … 1 Mandatory
prsb03-dataelement-10001link
The identifier of the registered GP practice. NHS data dictionary : - General medical practice code (patient registration)
folder About me
0 … 1
prsb03-dataelement-466link
About me
treetree folder About me
0 … *
prsb03-dataelement-10366link
This is a record of the things that a person feels it is important to communicate about their needs, strengths, values, concerns and preferences to others providing support and care.
treeblank treetree draft  What is most important to me
0 … 1
prsb03-dataelement-12964link
A description of what is most important to you
Emergency Information : - Include any essential information that any professional in health and social care should know about the you in any situation, including emergencies.
Other Information : -This could include : - Values, Spirituality/religion, Ethnicity, Culture, Pets, Goals and aspirations, Meaningful activities including leisure activities, visiting places, sport and exercise, listening to music, employment, education, volunteeringFree text or multimedia file
treeblank treetree draft  People who are important to me
0 … 1
prsb03-dataelement-13009link
 Details of who is important to you and why. They could be family members, carers, friends, members of staff etc. Include how you want the people important to you to be engaged and involved in your care and support in both emergency and normal situations. Include how you stay connected to the people important to you. Who should not be contacted or consulted about your care and support and why, if you wish to sayFree text or multimedia file
treeblank treetree draft  How I communicate and how to communicate with me
0 … 1
prsb03-dataelement-13006link

A description of how you communicate normally including any communication aids you use, for example a hearing aid.

  • Include your preferred language of communication, if your first language is not English.
  • Include how you would communicate when you are in pain or distress.
  • Include how you communicate choices.
  • Include how you give feedback or raise a concern.
  • Include how you like to receive information

Describe how you would like others to engage and communicate with you, including how you would like to be addressed.

Free text or multimedia file
treeblank treetree draft  My wellness
0 … 1
prsb03-dataelement-13005link

A description covering what you are able to do, how you engage with others and how you feel on a typical day through to on a day when you are unwell or really unwell.

  • Include any causes that might result in you becoming unwell and strategies for avoiding or addressing the causes. For example, not drinking enough water could cause constipation.
  • Include any signs that indicate you might be becoming unwell.
  • On a bad day describe what is different about what you are able to do, how you engage with others and how you feel.
  • Include how your everyday life is affected by any medical conditions e.g. dementia and any symptoms e.g. itchiness, cough, pain and how you manage those conditions.
  • Include past health issues or experiences that need to be considered
  • Include your wellbeing and lifestyle goals and aspirations
Free text or multimedia file
treeblank treetree draft  Please do and please don't
0 … 1
prsb03-dataelement-13008link

A description of things you want someone supporting you to do or not to do.

For example, this might include: - Talk to me not to my carer, remind me to take my medication, encourage me to wash my hands regularly, explain to me what is happening and why, respond to my communication.

A description of things you do not want someone supporting for you to do. For example, this might include: - Discussing or asking questions about certain topics, making assumptions about something, providing support when it is not wanted, talking to you in a certain way.

Free text or multimedia file
treeblank treetree draft  How and when to support me
0 … 1
prsb03-dataelement-13007link

A description of how and when you want someone caring for you to support you.

This could include support needs in an emergency situation (for example taking blood)

This could include support you need to maintain important routines or to carry out particular activities, for example: - Personal care routines, Eating and drinking, Bedtime routines, Taking medications, Moving and transitioning

This could also include support needed with:- wearing glasses/hearing aids/false teeth etc, making informed choices or understanding dangers and risks, managing your emotions, moods and behaviours, memory or confusion.

Include how your support needs change in different environments. Include any triggers that might result in you needing further support and strategies for avoiding or addressing the triggers. Include how you want the support to be provided.

Free text or multimedia file
treeblank treetree draft  Also worth knowing about me
0 … 1
prsb03-dataelement-13094link

A description of what is also worth knowing about you for people caring or supporting you.

This could include a short history of your life (where you have worked, where you lived, important events in your life, important people in your past life).

This could include a short profile of your current life:- your work / study, your aspirations, your skills, your networks, things you like e.g. particular foods, places, a football team and things you like to talk about, things you dislike

This could also include any care and support preferences that have not been included elsewhere.

Free text or multimedia file
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10367link
This is a record of the date that this information was last updated.Date and Time
treeblank treetree draft  Supported to write this by
0 … 1
prsb03-dataelement-10368link
Where relevant, this is a record of name, relationship/role and contact details of the individual who supported the person to write this section e.g. carer, family member, advocate, professional.Free text
folder Individual requirements
0 … 1
prsb03-dataelement-160link
The individual requirements of the person.
treetree folder Reasonable adjustment
0 … 1
prsb03-dataelement-12991link
A record of reasonable adjustments that must be provided by the service to comply with the Equality Act 2010.
treeblank treetree folder Reasonable adjustment record entry
0 … 1
prsb03-dataelement-13061link
This is a reasonable adjustment record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items
treeblank treeblank treetree folder Location
0 … 1
prsb03-dataelement-13098link
The location where the reasonable adjustment was identified.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13357link
The coded value for location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13358link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Reasonable adjustment
0 … 1
prsb03-dataelement-13017link
The reasonable adjustment required e.g. requires specific contact method, requires communication professional
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13505link
The coded value for reasonable adjustmentSNOMED CT : - Accessible information standard^999002121000000109 |Accessible information - communication support simple reference set (foundation metadata concept)|^999002151000000104 |Accessible information - requires communication professional simple reference set (foundation metadata concept)|^999002131000000106 |Accessible information - requires specific contact method simple reference set (foundation metadata concept)|^999002141000000102 |Accessible information - requires specific information format simple reference set (foundation metadata concept)|Refsets for other categories in development
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13506link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Reasonable adjustment additional detail
0 … 1
prsb03-dataelement-13018link
Further detail about the support required and the consequence of not providing it.Free text
treeblank treeblank treetree draft  Date
0 … 1
prsb03-dataelement-13020link
The date the reasonable adjustment was identified.Date and time
treeblank treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-13027link
The professional who confirmed the need for the reasonable adjustment.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13028link
The name of the professional.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13029link
The role the professional has in relation to the person.FHIR value set : - sdsjobrole
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13030link
The grade of the professional.Free text
treeblank treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-13031link
The specialty of the professional.NHS data dictionary - Main specialty code
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13032link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13033link
The name of the organisation the professional works for.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13034link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-13035link
A record of the details of the person that entered the reasonable adjustment and the date on which it was entered.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13036link
The name of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13037link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13038link
The grade of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-13039link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13040link
The organisation the person completing the record works for.
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13041link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-13042link
The date and time the record was completed.Date and time.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13043link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Impairment
0 … 1
prsb03-dataelement-13001link
A record of any impairments for the person relating to reasonable adjustments.
treeblank treetree folder Impairment record entry
0 … 1
prsb03-dataelement-13062link
This is an impairment record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items
treeblank treeblank treetree folder Location
0 … 1
prsb03-dataelement-13099link
The location where the impairment was identified.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13429link
The coded value for location.NHS data dictionary: - Organisation code service
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13430link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Impairment category
0 … 1
prsb03-dataelement-13022link
The category of the impairment e.g. Autism, Dementia, Physical disability, Sensory disability - such as sight or hearing, Long-term condition
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13507link
The coded value for impairment.SNOMED CT
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13508link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Impairment additional detail
0 … 1
prsb03-dataelement-13023link

Description of what the person can do with the impairment, what they want to be able to do and how they should be supported to do it and what the consequences are of not providing the support.
Where there is a sensory disability include sensory processing difficulties (e.g. affects to balance and movement, oversensitive, under-sensitive).
Free text
treeblank treeblank treetree draft  Date
0 … 1
prsb03-dataelement-13024link
The date the impairment was identified.Date and time
treeblank treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-13044link
The professional who confirmed the impairment.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13045link
The name of the professional.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13046link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13047link
The grade of the professional.Free text
treeblank treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-13048link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13049link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13050link
The name of the organisation the professional works for.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13051link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-13052link

A record of the details of the person that entered the impairment and the date on which it was entered.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13053link
The name of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13054link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13055link
The grade of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-13056link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13057link
The organisation the person completing the record works for.
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13058link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-13059link
The date and time the record was completed.Date and time.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13060link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Cognition
0 … *
prsb03-dataelement-10066link
Details of the persons cognitive impairment.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11705link
The date when the cognitive impairment was identified.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11706link
The location where the cognitive impairment was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13431link
The coded value for location.NHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13432link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Cognition
0 … 1
prsb03-dataelement-13669link
The cognitive impairment to be considered when communicating with the person, child or their primary carer.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11470link
The professional who identified the cognitive impairment.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11471link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11472link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11473link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11474link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11475link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11476link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11477link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11478link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11479link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11480link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11481link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11482link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11483link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11484link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11485link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11486link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Mobility
0 … *
prsb03-dataelement-10067link
Details of the person's mobility needs.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11707link
The date when the mobility needs were identified.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11710link
The location where the mobility needs were identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13433link
The coded value for location.NHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13434link
Free text field to be used if no coded text available
treeblank treetree folder Mobility needs
0 … 1
prsb03-dataelement-13670link
The mobility needs of the person that allows movement between two spaces and achieves participation and a degree of independence.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13671link
The coded value for mobility needsSNOMED CT: - ^999002551000000108 |Mobility findings simple reference set (foundation metadata concept)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13672link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11487link
The professional who identified the mobility needs.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11488link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11489link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11490link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11491link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11492link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11493link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11494link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11495link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11496link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11497link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11498link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11499link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11500link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11501link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11502link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11503link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Other individual requirements
0 … *
prsb03-dataelement-10835link
Details of any other individual requirements the person may have
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11711link
The date when the other individual requirements were identified.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11712link
The location where the other individual requirements were identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13435link
The coded value for location.NHS data dictionary : - Organisation service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13436link
Free text field to be used if no coded text available
treeblank treetree draft  Other individual requirement
0 … 1
prsb03-dataelement-13673link
Other individual requirements that a person may have.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11504link
The professional who identified the other individual requirements.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11505link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11506link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11507link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11508link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11509link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11510link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11511link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11512link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11513link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11514link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11515link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11516link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11517link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11518link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11519link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … *
prsb03-dataelement-11520link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Legal information
0 … 1
prsb03-dataelement-520link
The legal information relating to the person.
treetree folder Consent for information sharing
0 … 1
prsb03-dataelement-10421link
Details of the person's consent for information sharing
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11713link
The date when the consent was givenDate and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11714link
The location where the consent was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13451link
The coded value for location.NHS data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13452link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Consent for information sharing
0 … 1
prsb03-dataelement-13575link
This is a record of consent for information sharing under the common law duty of confidentiality. Where consent has not been obtained or sought, the reason why should be provided. Include best interests decision where person lacks capacity. This is a placeholder until the national guidance is published.Free text
treeblank treetree draft  Reason for consent not given
0 … 1
prsb03-dataelement-13778link
Reason not given for consentFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11715link
The professional who took the consent for information sharing
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11716link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11717link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11718link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11719link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11720link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11721link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11722link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11723link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11724link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11725link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11726link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11727link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11728link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11729link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11730link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11731link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Consent relating to child
0 … *
prsb03-dataelement-10422link
Details of the person's consent relating to child
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11732link
The date when the person with responsibility for the child was identified.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11733link
The location where the person with responsibility for the child was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13674link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13675link
Free text field to be used if no coded text available
treeblank treetree draft  Consent relating to child
0 … 1
prsb03-dataelement-13576link
The person with parental responsibility or appointed guardian where a child lacks competency. Consideration of age and competency, applying Gillick competency or Fraser guidelines.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11734link
The professional who identified the person responsible for the child.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11735link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11736link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11737link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11738link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11739link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11740link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11741link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11742link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11743link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11744link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11745link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11746link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11747link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11748link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11749link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11750link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Mental capacity assessment
0 … *
prsb03-dataelement-10424link
Details of the persons mental capacity assessment
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11688link
The date when the mental capacity assessment was made.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11689link
The location where the mental capacity assessment was made.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13449link
The coded value for location NHS data dictionary : - Organisation code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13450link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Mental capacity assessment
0 … 1
prsb03-dataelement-13724link
Whether an assessment of the mental capacity of the (adult) person has been undertaken, if so, what capacity the decision relates to and the outcome of the assessment. Also record best interests decision if person lacks capacity.Free text
treeblank treetree draft  Location of document
0 … 1
prsb03-dataelement-13779link
The location of the mental capacity assessment information.Free text or URL
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11281link
The professional who made the mental capacity assessment.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11282link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11283link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11288link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11284link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11285link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11286link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11287link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11289link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11290link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11291link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11292link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11293link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11294link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11295link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11296link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11297link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Lasting power of attorney for personal welfare or court-appointed deputy (or equivalent)
0 … 1
prsb03-dataelement-10425link
Details of the person's LPA record or equivalent
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-13630link
The date the LPA was recordedDate and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-13631link
The location where the LPA was given
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13632link
The coded value for locationNHS data dictionary : - Organisation code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13633link
Free text field to be used if no code is availableFree text
treeblank treetree folder Lasting power of attorney for personal welfare or court appointed deputy (or equivalent)
0 … 1
prsb03-dataelement-13634link
Record of one or more people who have been given power (LPA) by the person when they had capacity to make decisions about their health and welfare should they lose capacity to make those decisions. To be valid, an LPA must have been registered with the Court of Protection. If life-sustaining treatment is being considered the LPA document must state specifically that the attorney has been given power to consent to or refuse life-sustaining treatment. Details of any person (deputy) appointed by the court to make decisions about the person’s health and welfare. A deputy does not have the power to refuse life-sustaining treatment.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13636link
The coded value for the LPASNOMED CT: - ^999001951000000107 |Personal welfare lasting power of attorney findings simple reference set (foundation metadata concept)|
treeblank treeblank treetree draft  Location of document
0 … 1
prsb03-dataelement-13776link
The location of the LPA informationFree text or URL
treeblank treeblank treetree draft  Name of LPA
0 … 1
prsb03-dataelement-13635link
The names of any appointed people or deputiesFree text
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13637link
The contact details of the LPANHS data dictionary:- UK telephone number
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-13638link
The professional who took the details of the LPA or equivalent
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13639link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13640link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13641link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-13642link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13643link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13644link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13645link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-13646link
Details of the person who took the LPA.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13647link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13648link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13649link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-13650link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13651link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13652link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-13653link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13654link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Mental health act or equivalent status
0 … *
prsb03-dataelement-10427link
Details of the persons mental health act record
treeblank treetree draft  Section start date
0 … 1
prsb03-dataelement-10920link
The date the person was detained.Date and time
treeblank treetree draft  Section end date
0 … 1
prsb03-dataelement-10921link
The date the person was no longer detained.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11692link
The location where the decision to detain the person was made under the mental health act.
treeblank treetree folder Mental health act or equivalent status
0 … 1
prsb03-dataelement-13627link
Record where a person diagnosed with a mental disorder is formally detained under the Mental health act or equivalent, including the section number. If person subject to Community Treatment Order or Conditional Discharge (or equivalent) record here.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13628link
The coded value for mental health actNHS data dictionary: - Mental health act legal status classification code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13629link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Supporting information
0 … 1
prsb03-dataelement-13755link
If person subject to Community Treatment Order or Conditional Discharge (or equivalent) record here.NHS data dictionary : - Community treatment order
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11315link
The professional who made the decision to detain the person under the mental health act.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11316link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11317link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11318link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11319link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11320link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11321link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11322link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11323link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11324link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11325link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11326link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11327link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11328link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11329link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11330link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11331link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Advance decision to refuse treatment (ADRT)
0 … 1
prsb03-dataelement-10428link
Details of the person's ADRT status.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-13479link
The date the ADRT was recorded.Date
treeblank treetree folder Location
0 … 1
prsb03-dataelement-13480link
The location where the ADRT was recorded.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13481link
The coded value of locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13482link
Free text field to be used if no coded text available
treeblank treetree folder Advance decision to refuse treatment
0 … 1
prsb03-dataelement-13502link
A record of an advance decision to refuse one or more specific types of future treatment, made by a person who had capacity at the time of recording the decision. The decision only applies when the person no longer has the capacity to consent to or refuse the specific treatment being considered. An ADRT must be in writing, signed and witnessed. If the ADRT is refusing life-sustaining treatment it must state specifically that the treatment is refused even if the person’s life is at risk.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13503link
The coded value for advance decision to refuse treatment.SNOMED CT:- ^999002181000000105 |Advance decision to refuse treatment preference findings simple reference set (foundation metadata concept)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13504link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-13484link
The professional who recorded the ADRT
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13485link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13486link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13487link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-13488link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13489link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13490link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13491link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-13492link
Details of the person who recorded the ADRT.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-13493link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-13494link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-13495link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-13496link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-13497link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-13498link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-13499link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-13500link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Safeguarding
0 … 1
prsb03-dataelement-271link
The safeguarding details of the person.
treetree folder Safeguarding concerns
0 … 1
prsb03-dataelement-10821link
Details of safeguarding concerns
treeblank treetree draft  Safeguarding indicator
0 … 1
prsb03-dataelement-13428link
Indicates whether or not the hospital considers that there are safeguarding issues associated with the patient.Flag: No =N: Yes = Y
treeblank treetree draft  Safeguarding concerns date
0 … 1
prsb03-dataelement-10172link
The date the safeguarding concerns were identified.Date and time
treeblank treetree draft  Safeguarding concerns end date
0 … 1
prsb03-dataelement-10766link
The date safeguarding concerns ended.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-10173link
The location where the safeguarding concerns were identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13437link
The coded value of locationNHS data dictionary : - Organisation code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13438link
Free text field to be used if no code is availableFree text
treeblank treetree folder Safeguarding concerns
0 … 1
prsb03-dataelement-10171link
Identified safeguarding concerns.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13756link
The coded value for safeguarding concernsSNOMED CT : - 999002381000000108 | Safeguarding issues simple reference set (foundation metadata concept) |
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13757link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11358link
The professional who identified the safeguarding concerns.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11359link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11360link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11361link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11362link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11363link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11364link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11365link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11366link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11367link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11368link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11369link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11370link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11371link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11372link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11373link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11374link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-10175link
Further details on safeguarding concerns.Free text
folder Professional contacts
0 … 1
prsb03-dataelement-452link
The details of the person’s professional contacts.
treetree folder Professional contacts record entry
0 … *
prsb03-dataelement-10767link
This is a professional contacts record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10352link
The name of the professional with responsibility for the care of the person.Free text
treeblank treetree draft  Role
0 … 1
prsb03-dataelement-10353link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker, key worker, care home manager, care coordinator, LA hospital liaison person, care home contact, hospital clinician, Independent Mental Capacity Advocate (IMCA) etcFHIR value set : - SDSjobrole
treeblank treetree draft  Key worker
0 … 1
prsb03-dataelement-12973link
A flag that identifies the personal contact is the key worker assigned to the person.Flag : - Yes or No
treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-10354link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary : - Activity treatment function code
treeblank treetree draft  Team
0 … 1
prsb03-dataelement-10355link
The name of the team.Free text
treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-10356link
The name of the organisation.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13564link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13565link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-10357link
Contact details of the professional (e.g. telephone number, email address etc.).Free text
treeblank treetree draft  Start date
0 … 1
prsb03-dataelement-10358link
The start date of the professional relationship with the person.Date and time
treeblank treetree draft  End date
0 … 1
prsb03-dataelement-10359link
The end date of the professional relationship with the person.Date and time
folder Personal contacts
0 … 1
prsb03-dataelement-445link
The details of the individual's personal contacts.
treetree folder Personal contacts record entry
0 … *
prsb03-dataelement-10768link
This is personal contacts record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10345link
The name of the personal contact.Free text
treeblank treetree draft  Relationship
0 … 1
prsb03-dataelement-10346link
The relationship the personal contact has to the person, e.g. father, grandmother, family friend etc.FHIR value set : - Related person
treeblank treetree draft  Relationship type
0 … 1
prsb03-dataelement-12968link
Additional roles the person performs on behalf of the other (e.g. Carer, Next of Kin, Emergency Contact, Dependent, etc.)Free text
treeblank treetree draft  Parental Responsibility
0 … 1
prsb03-dataelement-10347link
Flag to indicate whether the personal contact has parental responsibilityFlag ; - Yes or No
treeblank treetree draft  Household member
0 … 1
prsb03-dataelement-10348link
Status identifying whether the personal contact is a member of the same householdFlag : - Yes or No
treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-10350link
Contact details of the personal contact (e.g. telephone number, email address etc.)Free Text
treeblank treetree draft  Comments
0 … 1
prsb03-dataelement-10937link
Notes on the significance of the personal contact to the person.Free text
folder Participation in research
0 … 1
prsb03-dataelement-168link
Participation in research
treetree folder Participation in research record entry
0 … *
prsb03-dataelement-10646link
This is a Participation in research record entry. There may be 0 to many record entry/entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Name of research study
0 … 1
prsb03-dataelement-10068link
Name and details of the research study/trial and/or drug/interventionFree text or URL
treeblank treetree draft  Identification code
0 … 1
prsb03-dataelement-10739link
Identification code of research studyNHS data dictionary :- Clinical trial identifier
folder Referral details
0 … 1
prsb03-dataelement-105link
The details of the referral.
treetree folder Referral details record entry
0 … *
prsb03-dataelement-10917link
This is the referral details record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10006link
The date of referralDate and time
treeblank treetree folder Referrer details
0 … 1
prsb03-dataelement-10005link
The details of the referrer that is making the transfer.

This could be the person, GP surgery, department, specialty, sub-specialty, educational institution, mental health team, care home etc.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10971link
The name of the referrer.Free text
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-10972link
Role of the referrer.FHIR value set : - sdsjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-10973link
The grade of the referrer.Free text
treeblank treeblank treetree draft  Team
0 … 1
prsb03-dataelement-12409link
The team or department of the referrer.Free text
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12410link
The specialty of the referrer.NHS data dictionary - Activity treatment function code
treeblank treeblank treetree folder Service
0 … 1
prsb03-dataelement-12411link
The service of the referrer.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13397link
The coded value for serviceSNOMED CT: - 1127531000000102 |Services simple reference set (foundation metadata concept)|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13398link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-10974link
The organisation of the referrer.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13399link
The coded value for organisation codeNHS data dictionary : - Organisation data service
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13400link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-10975link
The contact details of the referrer.Free text
folder Admission details
0 … 1
prsb03-dataelement-181link
Admission details
treetree folder Admission details record entry
0 … *
prsb03-dataelement-10918link
This is the admission details record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date of admission
0 … 1
prsb03-dataelement-10085link
Date and time the person was admitted to hospital.Date and time
treeblank treetree folder Admitted to
0 … 1
prsb03-dataelement-10090link
The hospital the person was admitted to.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13380link
The coded value for admission toNHS data dictionary : - Organisations code of provider
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13381link
Free text field to be used if no code is availableFree text
treeblank treetree folder Responsible care professional
0 … 1
prsb03-dataelement-10087link
The care professional who has overall responsibility for the person (may not actually see the person)
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10992link
The name of the responsible care professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-10993link
The role of the responsible consultant.FHIR value set: - sdsjobrole
treeblank treetree folder Reason for admission
0 … 1
prsb03-dataelement-10081link
The health problems and issues experienced by the person that prompted the decision to admit to hospital e.g. chest pain, mental health crisis, blackout, fall, a specific procedure, intervention, investigation or treatment, non compliance with treatment.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13382link
The coded value for reason for admissionSNOMED CT: - ^1127581000000103 |Health issues simple reference set|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13384link
Free text field to be used if no code is availableFree text
treeblank treetree folder Admission method
0 … 1
prsb03-dataelement-10082link
How the person was admitted to hospital e.g. elective, emergency, maternity, transfer etc.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13385link
The coded value for admission methodNHS data dictionary : - Admission method
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13387link
Free text field to be used if no code is availableFree text
treeblank treetree folder Source of admission
0 … 1
prsb03-dataelement-10084link
Where the person was immediately prior to admission, e.g. usual place of residence, temporary place of residence, penal establishment.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13388link
The coded value of source of admissionNHS data dictionary :- Source of admission
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13389link
Free text field to be used if no code is availableFree text
treeblank treetree folder Individual accompanying person
0 … 1
prsb03-dataelement-10088link
Details of the accompanying individual and the extent to which they have provided the information about the person.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10984link
Name of individual accompanying person.Free text
treeblank treeblank treetree cancelled  Role
0 … 1
prsb03-dataelement-10985link
Role of the individual accompanying the person.NHS data dictionary : - Care professional
treeblank treeblank treetree folder Relationship
0 … 1
prsb03-dataelement-10986link
Relationship of individual accompanying the person.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13517link
The coded value for relationship to person.FHIR value set: - Relationship type
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13518link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-12447link
Information about the extent to which the accompanying individual provided information about the person.Free text.
treeblank treetree folder Specialty
0 … 1
prsb03-dataelement-10089link
The specialty e.g. physiotherapy, oncology, mental health etc
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13390link
The coded value for specialtyNHS data dictionary :- Activity treatment function code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13391link
Free text field to be used if no code is availableFree text
folder Discharge details
0 … 1
prsb03-dataelement-191link
Discharge details
treetree folder Discharge details record entry
0 … *
prsb03-dataelement-10919link
This is the discharge details record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date of discharge
0 … 1
prsb03-dataelement-10096link
The date and time of dischargeDate and time
treeblank treetree draft  Discharge location
0 … 1
prsb03-dataelement-10095link
The hospital the person was discharged from.NHS data dictionary : - Organisation data service
treeblank treetree folder Discharging consultant
0 … 1
prsb03-dataelement-10093link
The consultant responsible for the person at time of discharge.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10994link
The name of the discharging consultantFree text
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-10995link
The role of the discharging consultantFHIR value set : - sdsjobrole
treeblank treetree folder Discharge method
0 … 1
prsb03-dataelement-10098link
The method of discharge from hospital e.g. person discharged on clinical advice or with clinical consent; person discharged him/herself or was discharged by a relative or advocate.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13393link
The coded value for discharge methodNHS data dictionary : - Discharge method
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13394link
Free text field to be used if no code is availableFree text
treeblank treetree folder Discharging specialty
0 … 1
prsb03-dataelement-10094link
The specialty of the consultant responsible for the person at the time of discharge.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13395link
The coded value for discharge specialityNHS data dictionary : - Activity treatment function code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13396link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Discharging department
0 … 1
prsb03-dataelement-10987link
The department from which the person is discharged.Free text
treeblank treetree folder Discharge destination
0 … 1
prsb03-dataelement-10099link
treeblank treeblank treetree draft  Discharge destination
0 … 1
prsb03-dataelement-10100link
The destination of the person on discharge from hospital e.g. usual place of residence, NHS run care home.NHS data dictionary - Discharge destination.
treeblank treeblank treetree draft  Discharge address
0 … 1
prsb03-dataelement-10101link
Address to which the person is discharged if not the usual place of residence.NHS data dictionary :- Address
folder Problem list
1 … 1 Mandatory
prsb03-dataelement-10927link
A summary of the problems that require investigation or treatment.
treetree folder Problem list record entry
0 … *
prsb03-dataelement-10928link
This is a problem list record entry.

There may be 0 to many record entries under problem list.

Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10929link
The date the problem was identified.Date and time
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12133link
The professional who identified the problem.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12134link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12135link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12136link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12137link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12138link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12139link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12140link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Location
0 … 1
prsb03-dataelement-10931link
The location the problem was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13242link
The coded value for location.NHS data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13243link
Free text field to be used if no code is availableFree text
treeblank treetree folder Problem
1 … 1 Mandatory
prsb03-dataelement-10932link
A condition which needs addressing and so is important for every professional to know about when seeing the person.

Problems may include diagnoses, symptoms, disabilities and social or behavioural issues, and comprise the ‘Problem list’
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13244link
The coded value for the problem list.SNOMED CT : - ^1127581000000103 |Health issues simple reference set|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13245link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Onset date
0 … 1
prsb03-dataelement-10933link
A date or estimated date that the problem beganDate and time
treeblank treetree draft  End Date
0 … 1
prsb03-dataelement-10934link
The date or estimated date the problem was resolved.Date and time.
treeblank treetree folder Problem on discharge
0 … 1
prsb03-dataelement-14262link
PLACEHOLDER: The main problem or diagnosis on discharge.

Problems may include diagnoses, symptoms, disabilities and social or behavioural issues, and comprise the ‘Problem list’
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-14263link
The coded value for the problem list.SNOMED CT : - ^1127581000000103 |Health issues simple reference set|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-14264link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Stage of disease
0 … 1
prsb03-dataelement-10935link
The stage of the disease where relevant.Free text
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12141link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12142link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12143link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12144link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12145link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12146link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12147link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12148link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12149link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treeblank treetree draft  Comment
0 … *
prsb03-dataelement-10936link
Supporting text may be given covering the problem.Free text
folder Procedures and therapies
0 … 1
prsb03-dataelement-238link
The details of any procedures performed. Includes both psychological and medical therapies and procedures (e.g. cognitive behaviour therapy, hip replacement)
treetree folder Procedure record entry
0 … *
prsb03-dataelement-10652link
This is a procedure record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10138link
The date the procedure was performed.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-13246link
The location the problem was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13247link
The coded value for location.NHS data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13248link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12150link
The professional who performed the procedure.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12151link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12152link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12153link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12154link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12155link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12156link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12157link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Procedure
1 … 1 Mandatory
prsb03-dataelement-10141link
The therapeutic or diagnostic procedure performed. Includes both psychological and medical therapies and procedures (e.g. cognitive behaviour therapy, or follow-up interventions as a result of physical health checks). Complementary or alternative procedures and therapies should be recorded here.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13249link
The procedure code.SNOMED CT : - <<71388002 |Procedure| OR <<129125009 |Procedure with explicit context|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13250link
Free text field to be used if no code is availableFree text
treeblank treetree folder Anatomical site
0 … 1
prsb03-dataelement-10142link
The body site of the procedure
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13251link
The coded value of the anatomical site.SNOMED CT :- <123037004 |Body structure (body structure)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13252link
Free text field to be used if no code is availableFree text
treeblank treetree folder Laterality
0 … 1
prsb03-dataelement-10143link
Laterality of the procedure
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13253link
The coded value for laterality.SNOMED CT:- <182353008 |Side (qualifier value)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13254link
Free text field to be used if no code is availableFree text
treeblank treetree folder Complications related to procedure
0 … 1
prsb03-dataelement-10144link
Details of any intra-operative complications encountered during the procedure, arising during the person’s stay in the recovery unit or directly attributable to the procedure.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13255link
The coded value for complications relating to procedure.SNOMED CT : - <404684003 |Clinical finding (finding)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13256link
Free text field to be used if no code is availableFree text
treeblank treetree folder Specific anesthesia issues
0 … 1
prsb03-dataelement-10145link
Details of any adverse reaction to any anesthetic agents including local anesthesia. Problematic intubation, transfusion reaction, etc.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13257link
The coded value for specific anesthesia issues.SNOMED CT
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13258link
Free text field to be used if no code is availableFree text
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12158link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12159link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12160link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12161link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12162link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12163link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12164link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12165link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12166link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-10146link
Any further textual comment to clarify such as statement that information is partial or incomplete. Also indicate the outcome of the procedure.Free text
folder Clinical Summary
1 … 1 Mandatory
prsb03-dataelement-247link
Clinical Summary
treetree draft  Clinical summary
1 … 1 Mandatory
prsb03-dataelement-10147link
Summary of the encounter. Where possible, very brief. This may include interpretation of findings and results; differential diagnoses, opinion and specific action(s). Planned actions will be recorded under ‘plan’.Free text
folder Social context
0 … 1
prsb03-dataelement-136link
The social setting in which the person lives, such as their household, occupational history, and lifestyle factors.
treetree folder Household composition
0 … 1
prsb03-dataelement-10036link
Details of the person's household composition.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11770link
The date when the household composition was taken.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-13271link
The location where the household composition was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13272link
The coded value for location.NHS data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13273link
Free text field to be used if no code is availableFree text
treeblank treetree folder Household composition
0 … 1
prsb03-dataelement-13261link
Description of the household composition e.g. lives alone, lives with family, lives with partner, etc.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13262link
The coded value of household compositionSNOMED CT: - 1027891000000106 | Household composition findings simple reference set (foundation metadata concept) |
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13263link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11648link
The professional who took the household composition.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11649link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11650link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11651link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11652link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11653link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11654link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11655link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11521link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11522link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11523link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11524link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11525link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11526link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11527link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11528link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11529link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Occupational history
0 … 1
prsb03-dataelement-10037link
The current and/or previous occupation(s) of the person.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11772link
The date when the occupational history was taken.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11773link
The location where the occupational history was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13274link
The coded value for the location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13275link
Free text field to be used if no code is availableFree text
treeblank treetree folder Occupational history
0 … 1
prsb03-dataelement-13264link
The current and/or previous occupation(s) of the person.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13265link
The coded value for occupational historySNOMED CT : - ^999001571000000109 | Occupation simple reference set (foundation metadata concept)
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13266link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11656link
The professional who took the occupational history.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11657link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11658link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11659link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11660link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11661link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11662link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11663link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11530link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11531link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11532link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11533link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11534link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11535link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11536link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11537link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11538link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Educational history
0 … 1
prsb03-dataelement-10038link
Details of the person's educational history.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11774link
The date when the educational history was taken.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11775link
The location where the education history was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13276link
The coded value for location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13277link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Educational history
0 … 1
prsb03-dataelement-13840link
The current and/or previous relevant educational history of the person.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11776link
The professional who took the educational history.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11777link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11778link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11779link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11780link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11781link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11782link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11783link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11539link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11540link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11541link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11542link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11543link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11544link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11545link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11546link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11547link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Lifestyle choices
0 … 1
prsb03-dataelement-10039link
The lifestyle choices made by the person which are pertinent to his or her health and well-being, e.g. physical activity level, pets, hobbies and sexual habits
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11784link
The date when the lifestyle choices were taken.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11785link
The location where the lifestyle choices were taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13278link
The coded value for location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13279link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Lifestyle choices
0 … 1
prsb03-dataelement-13841link
The lifestyle choices made by the person which are pertinent to his or her health and well-being, e.g. physical activity level, pets, hobbies and sexual preferences.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11786link
The professional who took the lifestyle choices.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11787link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11788link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11789link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11790link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11791link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11792link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11793link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11548link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11549link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11550link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11551link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11552link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11553link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11554link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11555link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11556link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Smoking status
0 … 1
prsb03-dataelement-10040link
Details of the person's smoking status.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11794link
The date when the smoking status was taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11795link
The location where the smoking status was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13281link
The coded value for locationNHS data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13282link
Free text field to be used if no code is availableFree text
treeblank treetree folder Smoking status
0 … 1
prsb03-dataelement-13283link
Record of any drug/substance use by the person.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13284link
The smoking status of the person.SNOMED CT:- ^999000891000000102 |Smoking simple reference set (foundation metadata concept)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13285link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Smoking status - details
0 … 1
prsb03-dataelement-13286link
Further details recorded about the smoking status of the personFree text
treeblank treetree folder Date stopped smoking
0 … 1
prsb03-dataelement-13287link
The date the person stopped smoking (if known)
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13288link
The coded value for date stopped smoking.SNOMED CT:- 160625004 |Date ceased smoking (observable entity)|
treeblank treeblank treetree draft  Date
0 … 1
prsb03-dataelement-13289link
The date the person stopped smoking.Date and time
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11796link
The professional who took the smoking status.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11797link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11798link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11799link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11800link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11801link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11802link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11803link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11557link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11558link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11559link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11560link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11561link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11562link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11563link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11564link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11565link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Alcohol intake
0 … 1
prsb03-dataelement-10041link
Details of the person's alcohol intake
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11804link
The date when the alcohol intake was noted.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11805link
The location where the alcohol intake was noted.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13332link
The coded value for location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13333link
Free text field to be used if no code is availableFree text
treeblank treetree folder Alcohol intake
0 … 1
prsb03-dataelement-13290link
Latest or current alcohol consumption.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13291link
The coded value of the person alcohol intakeSNOMED CT :- 219006 |Current drinker of alcohol (finding)| OR 105542008 |Current non-drinker of alcohol (finding)| OR 228274009 |Lifetime non-drinker (finding)| OR 1104551000000109 |Declined to provide information about alcohol use (situation)| OR 371434005 |History of alcohol abuse (situation)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13292link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11806link
The professional who noted the alcohol intake.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11807link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11808link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11809link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11810link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11811link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11812link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11813link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11566link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11567link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11568link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11569link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11570link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11571link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11572link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11573link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11574link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Drug/substance use
0 … 1
prsb03-dataelement-10042link
Details of the person's drug and substance use.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11814link
The date when the drug/substance use was noted.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11815link
The location where the drug/substance use was noted.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13334link
The coded value for location.NHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13335link
Free text field to be used if no code is availableFree text
treeblank treetree folder Drug/substance use
0 … 1
prsb03-dataelement-13336link
Latest or current drug/substance use.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13337link
The coded value for drug and substance misuse.SNOMED CT:- 361055000 |Misuses drugs (finding)| OR 371422002 |History of substance abuse (situation)| OR 228368007 |Has never misused drugs (situation)| OR 783241000000102 |Declined to give substance misuse history (finding)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13338link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11816link
The professional who noted the drug/substance use.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11817link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11818link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11819link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11820link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11821link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11822link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11823link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11575link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11576link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11577link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11578link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11579link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11580link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11581link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11582link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11583link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Social circumstances
0 … 1
prsb03-dataelement-10043link
Details of the persons social circumstances
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11824link
The date when the social circumstances were taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11825link
The location where the social circumstances were taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13339link
The coded value for the location
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13340link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Social circumstances
0 … 1
prsb03-dataelement-13341link
A person’s social background, network and personal circumstances, e.g. housing. This should include whether the person is a carer.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11826link
The professional who took the social circumstances.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11827link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11828link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11829link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11830link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11831link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11832link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11833link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11584link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11585link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11586link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11587link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11588link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11589link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11590link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11591link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11592link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Access
0 … 1
prsb03-dataelement-10045link
Details of access for the person.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11844link
The date when the special access requirements were taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11845link
The location where the special access requirements were taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13343link
The coded value for locationNHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13344link
Free text field to be used if no coded text available
treeblank treetree draft  Access
0 … 1
prsb03-dataelement-13342link
Special access requirements e.g. key safe, coded lock, which door to use, stretcher access, etc.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11846link
The professional who took the special access requirements.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11847link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11848link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11849link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11850link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11851link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11852link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11853link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11602link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11603link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11604link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11605link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11606link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11607link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11608link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11609link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11610link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Dependants
0 … 1
prsb03-dataelement-10046link
Details of any responsibility the person has for dependants.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11854link
The date when the dependents details were taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11855link
The location where the dependents details were taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13346link
The coded value for locationNHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13347link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Dependants
0 … 1
prsb03-dataelement-13345link
Provide details of any responsibility the person has for dependants. In the case of children provide date of birth of the child.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11856link
The professional who took the dependents details.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11857link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11858link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11859link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11860link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11861link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11862link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11863link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11611link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11612link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11613link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11614link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11615link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11616link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11617link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11618link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11619link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Accommodation status
0 … 1
prsb03-dataelement-10047link
Details of the type of accommodation where the person lives.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11864link
The date when the accommodation status was taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11865link
The location where the accommodation was taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13352link
The coded value of locationNHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13353link
Free text field to be used if no code is availableFree text
treeblank treetree folder Accommodation status
0 … 1
prsb03-dataelement-13348link
An indication of the type of accommodation where the person lives.

This should be based on the main or permanent residence.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13349link
The coded value for accommodation statusNHS data dictionary :- Accommodation status
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13350link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11866link
The professional who took the accommodation status.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11867link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11868link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11869link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11870link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11871link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11872link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11873link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11874link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11875link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11876link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11877link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11878link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11879link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11880link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11881link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11882link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Household environment
0 … 1
prsb03-dataelement-10051link
Details of the person's household environment.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-11883link
The date when the household environment details were taken.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11884link
The location where the household environment details were taken.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13351link
The coded value for locationNHS Data dictionary : - Organisation data service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13354link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Household environment
0 … 1
prsb03-dataelement-13842link
Factors in the household which impact the person's health and wellbeing, to include smoking in the home, alcohol/substance use etc.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11885link
The professional who took the household environment details.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11886link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11887link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11888link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11889link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11890link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11891link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11892link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11621link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11622link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11623link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11624link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11625link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11626link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11627link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11628link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11629link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Investigation results
0 … 1
prsb03-dataelement-257link
Investigation results
treetree folder Investigation results record entry
0 … *
prsb03-dataelement-10654link
This is a investigation result record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10157link
The date and time when the investigation was performedDate and time
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12099link
The professional who performed the investigation.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12100link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12101link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12102link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12103link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12104link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12105link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12106link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Location
0 … 1
prsb03-dataelement-10159link
The location where the investigation took place.
treeblank treeblank treetree draft  Coded location
0 … 1
prsb03-dataelement-13725link
The coded value for locationNHS data dictionary : Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13726link
Free text field to be used if no code is availableFree text
treeblank treetree folder Investigation
1 … 1 Mandatory
prsb03-dataelement-10160link
The investigation performed.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13525link
The coded value for investigationSNOMED CT: - <71388002 |Procedure (procedure)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13526link
Free text field to be used if no code is availableFree text
treeblank treetree folder Investigation result
0 … 1
prsb03-dataelement-10161link
For each investigation, the result of the investigation. This can include a report which may have results for multiple tests.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13527link
The coded value for investigation resultsSNOMED CT:- <404684003 |Clinical finding (finding)| OR <243796009 |Situation with explicit context (situation)|
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13528link
Free text field to be used if no code is availableFree text
treeblank treetree folder Structured investigation result
0 … 1
prsb03-dataelement-12415link
A structured set of information for each investigation result.
treeblank treeblank treetree draft  Value
0 … 1
prsb03-dataelement-12416link
The value of the investigation result.Numeric
treeblank treeblank treetree draft  Units of measure
0 … 1
prsb03-dataelement-12417link
The units of the investigation result.UCUM code
treeblank treeblank treetree draft  Reference ranges
0 … 1
prsb03-dataelement-12418link
The reference range for the investigation result.Free text
treeblank treeblank treetree draft  Abnormal indicator
0 … 1
prsb03-dataelement-12419link
Indicator if the investigation is abnormal.Abnormal or Normal
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12107link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12108link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12109link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12110link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12111link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12112link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12113link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12114link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12115link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Assessments
0 … 1
prsb03-dataelement-262link
Details of the person's assessments
treetree folder Assessments record entry
0 … *
prsb03-dataelement-11664link
This is the assessments record entry. There may be 0 to many record entry/entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10763link
The date the assessment was done.Date and time.
treeblank treetree folder Location
0 … 1
prsb03-dataelement-10764link
The location where the assessment was done.ODS code or free text.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13570link
The coded value for locationNHS data dictionary: - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13571link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Assessment type
0 … 1
prsb03-dataelement-10822link
The type of the assessment e.g. social care needs assessment.Free text
treeblank treetree draft  Assessment summary
0 … 1
prsb03-dataelement-10754link
The summary of the assessmentFree text
treeblank treetree folder Structured assessment
0 … 1
prsb03-dataelement-10655link
Details of the structured assessment.
treeblank treeblank treetree draft  Structured assessment name
0 … 1
prsb03-dataelement-11751link
Structured assessment name e.g. New York Heart Failure, Glasgow Coma scale, Activities of Daily Living (ADL) etc.SNOMED CT
treeblank treeblank treetree draft  Assessment score
0 … 1
prsb03-dataelement-10162link
The structured assessment score.Free text.
treeblank treeblank treetree draft  Assessment value
0 … 1
prsb03-dataelement-10163link
The structured assessment value.Numeric
treeblank treeblank treetree draft  Subscale score
0 … *
prsb03-dataelement-10169link
The subscale score of the structured assessment.Free text.
treeblank treeblank treetree draft  Subscale value
0 … *
prsb03-dataelement-10170link
The subscale value of the structured assessment.Numeric
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12382link
The professional who did the assessment.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12383link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12384link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12385link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12386link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12387link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12388link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12389link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11752link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11753link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11754link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11755link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11756link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11757link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11758link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11759link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11760link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-10164link
Supporting text may be given regarding the assessment.Free text
folder Risks
0 … 1
prsb03-dataelement-276link
Details of any risks related to the person.
treetree folder Risks to self
0 … *
prsb03-dataelement-10176link
Details of the persons risk to self
treeblank treetree draft  Start date of risk
0 … 1
prsb03-dataelement-11893link
The start date of the risk.Date and time
treeblank treetree draft  End date of risk
0 … 1
prsb03-dataelement-11894link
The date the risk ended.Date and time
treeblank treetree draft  Risk to self
0 … 1
prsb03-dataelement-13579link
Risks the person poses to themselves, e.g. suicide, overdose, self-harm, self-neglect.SNOMED CT: - <281694009 |Finding of at risk (finding)|
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11895link
The location where the risk was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13586link
The coded value for locationNHS data dictionary : - Organisation service code
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13587link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11896link
The professional who identified the risk.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11897link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11898link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11899link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11900link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11901link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11902link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11903link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11904link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11905link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11906link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11907link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11908link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11909link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11910link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11911link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11912link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Risks to others
0 … *
prsb03-dataelement-10177link
Details of the person's risk to others
treeblank treetree draft  Start date of risk
0 … 1
prsb03-dataelement-11913link
The start date of the risk.Date and time
treeblank treetree draft  End date of risk
0 … 1
prsb03-dataelement-11914link
The date the risk ended.Date and time
treeblank treetree draft  Risks to others
0 … 1
prsb03-dataelement-13580link
Risks to professionals or others.SNOMED CT: - <<391155006 |At risk of harming others (finding)|
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11915link
The location where the risk to others was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13588link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13589link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11916link
The professional who identifies the risk to others.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11917link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11918link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11919link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11920link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11921link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11922link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11923link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11924link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11925link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11926link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11927link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11928link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11929link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11930link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11931link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11932link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Risk from others
0 … *
prsb03-dataelement-10178link
Risks to the person from an identified individual e.g. family member etc.Free Text.
treeblank treetree draft  Start date of risk
0 … 1
prsb03-dataelement-11933link
The start date of the risk.Date and time
treeblank treetree draft  End date of risk
0 … 1
prsb03-dataelement-11934link
The date the risk ended.Date and time
treeblank treetree draft  Risk from others
0 … 1
prsb03-dataelement-13581link
Risks to the person from an identified individual e.g. family member etc.SNOMED CT: - <281694009 |Finding of at risk (finding)|
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11935link
The location where the risk from others was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13590link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13591link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11936link
The professional who identified the risk from others.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11937link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11938link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11939link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11940link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11941link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11942link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11943link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11944link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11945link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11946link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11947link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11948link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11949link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11950link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11951link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11952link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Risk of accidents
0 … *
prsb03-dataelement-10751link
Details of the risks the person poses to themselves from accidents.
treeblank treetree draft  Start date of risk
0 … 1
prsb03-dataelement-11953link
The start date of the risk.Date and time
treeblank treetree draft  End date of risk
0 … 1
prsb03-dataelement-11954link
The date the risk ended.Date and time
treeblank treetree draft  Risk of accidents
0 … 1
prsb03-dataelement-13582link
Risks the person poses to themselves from accidents.Free text
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11955link
The location where the risk of accidents was identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13592link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13593link
Free text field to be used if no coded text available
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11956link
The professional who identified the risk of accidents.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11957link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11958link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11959link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11960link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11961link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11962link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11963link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11964link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11965link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11966link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11967link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11968link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11969link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11970link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11971link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11972link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree folder Other risks
0 … *
prsb03-dataelement-10802link
Details of other risks, factors or behaviours relating to the person.
treeblank treetree draft  Start date of risk
0 … 1
prsb03-dataelement-11973link
The start date of the risk.Date and time
treeblank treetree draft  End date of risk
0 … 1
prsb03-dataelement-11974link
The date the risk ended.Date and time
treeblank treetree draft  Other risks
0 … 1
prsb03-dataelement-13583link
Other risks, factors or behaviours relating to the person.Free text
treeblank treetree folder Location
0 … 1
prsb03-dataelement-11975link
The location where the other risks were identified.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13594link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13595link
Free text field to be used if no code is availableFree text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-11976link
The professional who identified the other risks.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11977link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11978link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11979link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-11980link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11981link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11982link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11983link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11984link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11985link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11986link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11987link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11988link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11989link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11990link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-11991link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-11992link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Allergies and adverse reactions
0 … 1
prsb03-dataelement-282link
Allergies and adverse reactions
treetree folder Allergies and adverse reactions record entry
0 … *
prsb03-dataelement-10657link
This is a allergies and adverse reactions record entry. There may be 1 to many record entries under a section.

Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Type of reaction
0 … 1
prsb03-dataelement-10186link
The type of reaction experienced by the person (allergic, adverse, intolerance)FHIR value set :- Allergy, Intolerance
treeblank treetree folder Causative agent
1 … 1 Mandatory
prsb03-dataelement-10182link
The agent such as food, drug or substances that has caused or may cause an allergy, intolerance or adverse reaction in this person Or “No known drug allergies or adverse reactions” Or “Information not available”
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13441link
The coded value for causative agentSNOMED CT : - <105590001 |Substance OR <373873005 |Pharmaceutical / biologic product| OR <<716186003 |No known allergy| OR 196461000000101 |Transfer-degraded drug allergy| OR 196471000000108 |Transfer-degraded non-drug allergy)
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13442link
Free text field to be used if no code is availableFree text
treeblank treetree folder Reaction details cluster
0 … *
prsb03-dataelement-10658link
Details of the reaction.
treeblank treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10190link
The date that the reaction was identified.Date and time
treeblank treeblank treetree folder Location
0 … 1
prsb03-dataelement-10846link
Details of where the allergy was identified. Linked to the date of the diagnosis by the professional.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13439link
The coded value for location.NHS data dictionary : - Organisation data service
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13440link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Substance
0 … 1
prsb03-dataelement-11665link
The substance, or a class of substances, that is considered to be responsible for the adverse reaction.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13554link
The coded value for substanceSNOMED CT : - <105590001 | Substance (substance) | or <373873005 | Pharmaceutical / biologic product (product) |
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13555link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Description of reaction
0 … 1
prsb03-dataelement-10183link
A description of the manifestation of the allergic or adverse reaction experienced by the person. For example, skin rash.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13556link
The coded value for description of reaction.SNOMED CT: - ^1127581000000103 |Health issues simple reference set|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13557link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree draft  Onset date
0 … 1
prsb03-dataelement-13844link
Date and time when manifestations showed e.g could be at home a few days earlier than the contactDate and time
treeblank treeblank treetree folder Severity
0 … 1
prsb03-dataelement-10184link
A description of the severity of the reaction.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13558link
The coded value for severityFHIR value set : - Severity
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13559link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Certainty
0 … 1
prsb03-dataelement-10185link
A description of the certainty that the stated causative agent caused the allergic or adverse reaction.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13560link
The coded value for certainty.FHIR value set : - Certainty
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13561link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Route of exposure
0 … 1
prsb03-dataelement-13856link
The route the person was exposed to the substance
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13857link
The coded value for route of exposureSNOMED CT: - ^999000051000001100 |ePrescribing route of administration simple reference set|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13858link
Free text field to be used if no coded text available
treeblank treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-10189link
Any additional comment or clarification about the adverse reaction.Free text
treeblank treetree draft  Evidence
0 … 1
prsb03-dataelement-10187link
Results of investigations that confirmed the certainty of the diagnosis. Examples might include results of skin prick allergy testsFree text
treeblank treetree draft  Date first experienced
0 … 1
prsb03-dataelement-10188link
When the reaction was first experienced i.e this may not be the first this has happened. May be a date or partial date (e.g. year) or text (e.g. during childhood)Date and time
treeblank treetree draft  Allergy end date
0 … 1
prsb03-dataelement-14253link
The date the allergy was diagnosed as endedDate and time 
treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-14273link
Any further comments on the person's allergies or adverse reactions.Free text
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12010link
The professional who identified the reaction.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12011link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12012link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12013link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12014link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12015link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12016link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12017link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12018link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12019link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12020link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12021link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12022link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12023link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12024link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12025link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12026link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Medications and medical devices
0 … 1
prsb03-dataelement-636link
Medications and medical devices
treetree folder Medication item entry
0 … *
prsb03-dataelement-10663link
All medications and devices that can be prescribed to be entered via this Medication item entry. Handles details of continuation / addition / amendment of admission medications.
treeblank treetree folder Medication item cluster
0 … 1
prsb03-dataelement-10664link
Medication item cluster
treeblank treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10843link
The date on which the medication or medical device was prescribed.Date and time
treeblank treeblank treetree folder Location
0 … 1
prsb03-dataelement-10844link
The location where the medication or the medical device was prescribed.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13620link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13621link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12002link
The professional who prescribed the medication or medical device.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12003link
The name of the professional.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12004link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12005link
The grade of the professional.Free text
treeblank treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12006link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12007link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12008link
The name of the organisation the professional works for.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12009link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treeblank treetree folder Medication name
0 … 1
prsb03-dataelement-10536link
May be generic name or brand name.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13622link
The coded value for medication nameSNOMED CT: - ^999000581000001102 |National Health Service dictionary of medicines and devices virtual therapeutic moiety simple reference set (foundation metadata concept)| OR ^999000561000001109 |National Health Service dictionary of medicines and devices virtual medicinal product simple reference set (foundation metadata concept)| OR ^999000571000001104 |National Health Service dictionary of medicines and devices virtual medicinal product pack simple reference set (foundation metadata concept)| OR ^999000541000001108 |National Health Service dictionary of medicines and devices actual medicinal product simple reference set (foundation metadata concept)| OR ^999000551000001106 |National Health Service dictionary of medicines and devices actual medicinal product pack simple reference set (foundation metadata concept)|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13623link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Form
0 … 1
prsb03-dataelement-10537link
The form of the medication e.g. capsule, drops, tablet, lotion etc.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13624link
The coded value for form.SNOMED CT: - 421967003 | Drug dose form (qualifier value) |
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13625link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Route
0 … 1
prsb03-dataelement-10538link
The route by which the medication is administered e.g. oral, IM, IV
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13655link
The coded value for routeSNOMED CT: - 999000051000001100 |ePrescribing route of administration simple reference set (foundation metadata concept)|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13656link
Free text field to be used if no code is availableFree text
treeblank treeblank treetree folder Site
0 … 1
prsb03-dataelement-10540link
The anatomical site at which the medication is to be administered.
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13657link
The coded value for site SNOMED CT: - <442083009 | Anatomical or acquired body structure (body structure) |
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13658link
Amount of vaccine administered.Free text
treeblank treeblank treetree folder Method
0 … 1
prsb03-dataelement-10541link
The technique or method by which the medication is to be administered.
treeblank treeblank treetree draft  Over the counter medication flag
0 … 1
prsb03-dataelement-13379link
Indicates if the medication or device is acquired without a prescription i.e. got by the person over the counterFlag : - Yes or No
treeblank treeblank treetree draft  Dose directions description
0 … 1
prsb03-dataelement-10544link
Describes the entire medication dosage and administration directions including dose quantity and medication frequency and optionally duration e.g. “1 tablet at night" or “2mg at 10pm”.Free text
treeblank treeblank treetree folder Structured dose direction cluster
0 … 1
prsb03-dataelement-11639link
A structural representation of the elements carried by the dose syntax in 'parsable dose strength / timing' i.e. dose strength, dose timing, dose duration and maximum dose.
treeblank treeblank treeblank treetree draft  Structured dose amount
0 … 1
prsb03-dataelement-10554link
A structural representation of dose amount, e.g. 20mg or 2 tablets. This element will generally only be used when persisting data within systems with 'parsable dose directions' being used to exchange the same information between systems.As per FHIR Dose Syntax Implementation Guidance (NHS Digital):https://developer.nhs.uk/apis/dose-syntax-implementation-1-3-1-alpha/
treeblank treeblank treeblank treetree draft  Structured dose timing
0 … 1
prsb03-dataelement-10555link
A slot containing a structural, computable representation of dose timing and maximum dose. This element will generally only be used when persisting data within systems with 'parsable dose directions' being used to exchange the same information between systems.As per FHIR Dose Syntax Implementation Guidance (NHS Digital):https://developer.nhs.uk/apis/dose-syntax-implementation-1-3-1-alpha/
treeblank treeblank treeblank treetree draft  Dose direction duration
0 … 1
prsb03-dataelement-10548link
Recommendation of the time period for which the medication should be continued, including direction not to discontinue.As per FHIR Dose Syntax Implementation Guidance (NHS Digital):https://developer.nhs.uk/apis/dose-syntax-implementation-1-3-1-alpha/
treeblank treeblank treetree draft  Additional instructions
0 … 1
prsb03-dataelement-10545link
Allows for: requirements for adherence support, e.g. compliance aids, prompts and packaging requirements, additional information about specific medicines e.g. where specific brand required, person requirements, e.g. unable to swallow tablets.FHIR value set : - Additional instruction
treeblank treeblank treetree folder Course details cluster
0 … 1
prsb03-dataelement-10561link
Details of the overall course of medication.
treeblank treeblank treeblank treetree draft  Course status
0 … 1
prsb03-dataelement-10666link
The status of this prescription.FHIR value set : - Medication status
treeblank treeblank treeblank treetree draft  Indication
0 … 1
prsb03-dataelement-10546link
Reason for medication being prescribed, where known.Free text
treeblank treeblank treeblank treetree draft  Start date/time
0 … 1
prsb03-dataelement-10667link
The date and/or time that the medication course should begin.Date and time
treeblank treeblank treeblank treetree draft  End date/time
0 … 1
prsb03-dataelement-10557link
The date and/or time that the medication course should finish.Date and time
treeblank treeblank treeblank treetree draft  Link to indication record
0 … 1
prsb03-dataelement-10668link
A link to the record which contains the indication for this medication order.Free text with URL
treeblank treeblank treeblank treetree draft  Comment/recommendation
0 … 1
prsb03-dataelement-10547link
Suggestions about duration and/or review, ongoing monitoring requirements, advice on starting, discontinuing or changing medication. Additional comment or recommendation about the medication course e.g. 'Patient named supply', 'unlicensed medication', 'Foreign brand' or monitoring recommendationsFree text
treeblank treeblank treetree folder Medication change summary cluster
0 … 1
prsb03-dataelement-10568link
Records the changes made to medication.
treeblank treeblank treeblank treetree draft  Status
0 … 1
prsb03-dataelement-10669link
The nature of any change made to the medication.FHIR value set : Medication status
treeblank treeblank treeblank treetree draft  Indication
0 … 1
prsb03-dataelement-10670link
Reason for change in medication, e.g. sub-therapeutic dose, person intolerant.Free text
treeblank treeblank treeblank treetree draft  Date of change
0 … 1
prsb03-dataelement-10671link
The date of the change - addition, or amendmentDate and time
treeblank treeblank treeblank treetree draft  Description of amendment
0 … 1
prsb03-dataelement-10672link
Where a change is made to the medication i.e. one drug stopped and another started or eg dose, frequency or route is changed.Free text
treeblank treeblank treetree draft  Total dose daily quantity
0 … 1
prsb03-dataelement-10665link
The total daily dose of this medication. This is helpful for estimating optimal adherence to dosing guidance. It may be computed from product/dose strength and frequency or entered manually.Free text
treeblank treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-11993link
Details of the person completing the record.
treeblank treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-11994link
The name of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-11995link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-11996link
The grade of the person completing the record.Free text.
treeblank treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-11997link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-11998link
The organisation the person completing the record works for.
treeblank treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-11999link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12000link
The date and time the record was completed.Date and time.
treeblank treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12001link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treeblank treetree folder Medical devices entry
0 … *
prsb03-dataelement-10583link
Medical devices
treeblank treeblank treetree draft  Medical device
0 … 1
prsb03-dataelement-10673link
Any medical device that isn't prescribed.Free text
treeblank treeblank treetree draft  Comments
0 … 1
prsb03-dataelement-11280link
Any information regarding the medical device.Free text
treeblank treetree folder Medication discontinued entry
0 … *
prsb03-dataelement-10576link
Medication discontinued entry
treeblank treeblank treetree folder Name of discontinued medication
0 … 1
prsb03-dataelement-10577link
The name of the medication or medical device being discontinued
treeblank treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13659link
The coded value for medication name SNOMED CT: - ^999000581000001102 |National Health Service dictionary of medicines and devices virtual therapeutic moiety simple reference set (foundation metadata concept)| OR ^999000561000001109 |National Health Service dictionary of medicines and devices virtual medicinal product simple reference set (foundation metadata concept)| OR ^999000571000001104 |National Health Service dictionary of medicines and devices virtual medicinal product pack simple reference set (foundation metadata concept)| OR ^999000541000001108 |National Health Service dictionary of medicines and devices actual medicinal product simple reference set (foundation metadata concept)| OR ^999000551000001106 |National Health Service dictionary of medicines and devices actual medicinal product pack simple reference set (foundation metadata concept)|
treeblank treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13660link
Amount of vaccine administered.Free text
treeblank treeblank treetree draft  Status
0 … 1
prsb03-dataelement-12472link
The status of any change made to the medication. MUST CONTAIN STOPPED.FHIR value set: - Medication status
treeblank treeblank treetree draft  Indication
0 … 1
prsb03-dataelement-10579link
The clinical indication for any changes in medication statusFree text
treeblank treeblank treetree draft  Date of change
0 … 1
prsb03-dataelement-10580link
The date of the discontinuationDate and time
treeblank treeblank treetree draft  Comment
0 … 1
prsb03-dataelement-10582link
Any additional comment about the discontinuation or amendment.Free text
folder Information and advice given
0 … 1
prsb03-dataelement-315link
Information and advice given
treetree draft  Information and advice given
0 … 1
prsb03-dataelement-10215link

The oral or written information or advice given to the patient, carer, other authorised representative, care professional or other third party. May include advice about actions related to medicines or other ongoing care activities on an ‘information prescription'. State here if there are concerns about the extent to which the patient and/or carer understand the information provided about diagnosis, prognosis and treatment.

Free text
folder Distribution list
0 … 1
prsb03-dataelement-330link
Distribution list
treetree folder Distribution list record entry
0 … *
prsb03-dataelement-10660link
This is a Distribution list record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Name
0 … 1
prsb03-dataelement-10230link
The name of the person the communication is to be sent to, this can be a person or professional.Free text
treeblank treetree draft  Role
0 … 1
prsb03-dataelement-10231link
If the communication is being sent to either a named individual, or to a non-named person with a specific role, then this is the role of the recipient.

Role may be entered as the communication is being created, or sourced from the hospital system. This may be a role defined in the National Workforce data set (see the NHS Data Dictionary Job Role Code).FHIR value set : - SDSjobrole
treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-10232link
The grade of the recipient, if known by the sending institution, otherwise omitted.Free text
treeblank treetree draft  Organisation name
0 … 1
prsb03-dataelement-10233link
The name of the organisation the recipient is representing or the organisation named as the receiving organisation.

An identifier for the organisation will be sent alongside the name, but may not displayed on rendered document.

NHS data dictionary : - Organisation code
treeblank treetree draft  Team
0 … 1
prsb03-dataelement-10234link
Team that the recipient belongs to in the context of receiving this message, or the team acting as the recipient.Free text
treeblank treetree draft  Relationship
0 … 1
prsb03-dataelement-13793link
The relationship of the receiver to the person for example, carer or parentFHIR value set : - Related person
folder Plan and requested actions
0 … 1
prsb03-dataelement-535link
The details of planned investigations, procedures and treatment, and whether this plan has been agreed with the person or their legitimate representative.
treetree folder Plan and requested actions record entry
0 … *
prsb03-dataelement-10661link
This is a plan and requested actions record entry. There may be 0 to many record entries under a section. Each record entry is made up of a number of elements or data items.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-10445link
The date on which the plan and requested actions were prepared.Date and time
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12167link
The professional who prepared the plan and requested actions.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12168link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12169link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12170link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12171link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12172link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12173link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12174link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Location
0 … 1
prsb03-dataelement-10842link
The location where the plan and requested actions were prepared.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13684link
The coded value for locationNHS data dictionary : - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13685link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Actions for professionals
0 … 1
prsb03-dataelement-10436link
Including planned investigations, procedures and treatment for a person's identified conditions and priorities. For each action the following should be identified:outcome expectations, including the person’s expectations. A record of the planned and requested actions. May be structured (table), with actions, names, dates, status, location, strategies.Free text
treeblank treetree draft  Actions for person or their carer
0 … 1
prsb03-dataelement-10437link
For each action the following should be identified:outcome expectations, including person’s expectations. A record of the planned and requested actions. May be structured (table), with actions, names, dates, status, location, strategies.Free text
treeblank treetree draft  Agreed with the person or their legitimate representative
0 … 1
prsb03-dataelement-10438link
Indicates whether the person or their legitimate representative has agreed the entire plan or individual aspects of treatment, expected outcomes, risks and alternative treatments. A record of the agreement of the decisions made.Free text
treeblank treetree draft  Outcome of plan and requested actions
0 … *
prsb03-dataelement-10950link
The details of the outcome of the plan and requested actions.Free text.
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12175link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12176link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12177link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12178link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12179link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12180link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12181link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12182link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12183link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Person completing record
1 … 1 Mandatory
prsb03-dataelement-12605link
Details of the person completing the record.
treetree draft  Name
1 … 1 Mandatory
prsb03-dataelement-12606link
The name of the person completing the record.Free text.
treetree draft  Role
1 … 1 Mandatory
prsb03-dataelement-12607link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treetree draft  Grade
0 … 1
prsb03-dataelement-12608link
The grade of the person completing the record.Free text.
treetree draft  Specialty
0 … 1
prsb03-dataelement-12609link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treetree folder Organisation
1 … 1 Mandatory
prsb03-dataelement-12610link
The organisation the person completing the record works for.
treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12611link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treetree draft  Date completed
1 … 1 Mandatory
prsb03-dataelement-12612link
The date and time the record was completed.Date and time.
treetree draft  Contact details
0 … *
prsb03-dataelement-12613link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
folder Care and support plan
0 … 1
prsb03-dataelement-508link
This records the decisions reached during conversation between the individual and health and care professional about future plans and also records progress.
treetree draft  Strengths
0 … *
prsb03-dataelement-10419link
Any strengths and assets the person has relating to their goals and hopes about their health and well-being.Free text
treetree folder Needs, concerns or problems
0 … *
prsb03-dataelement-10414link
Needs, concerns or problems the person has that relating to their health and well-being. May be linked to the problem list from the person’s record to avoid duplication. May include biological, psychological and social needs, concerns or problems. May include (eg) financial concerns over debt.Free text
treeblank treetree folder Goals and hopes
0 … *
prsb03-dataelement-10413link
The overall goals, hopes, aims or targets that the person has. Including anything that the person wants to achieve that relates to their future health and wellbeing. Each goal may include a description of why it is important to the person. Goals may also be ranked in order of importance or priority to the person.Free text
treeblank treeblank treetree folder Actions and activities
0 … *
prsb03-dataelement-10408link
Actions or activities the person or others plan to take to achieve the person's goals and the resources required to do this.

treeblank treeblank treeblank treetree draft  Stage goal
0 … 1
prsb03-dataelement-10674link
A specific sub-goal that is related to the overall goal as agreed by the person in collaboration with a professional.Free text
treeblank treeblank treeblank treetree draft  What
0 … 1
prsb03-dataelement-10675link
What the action is and how it is to be carried out?Free text.
treeblank treeblank treeblank treetree draft  Who
0 … 1
prsb03-dataelement-10676link
Name and role (e.g. person, carer, GP, OT, etc.) of the person, or a team, carrying out the proposed action, and, if relevant where action should take place.Free text.
treeblank treeblank treeblank treetree draft  When
0 … 1
prsb03-dataelement-10677link
Planned date, time, or interval, as relevantDate and time
treeblank treeblank treeblank treetree draft  Suggested strategies
0 … 1
prsb03-dataelement-10678link
Suggested strategies for potential problems.Free text.
treeblank treeblank treeblank treetree draft  Status
0 … 1
prsb03-dataelement-10679link
The status of the action or activity e.g. started, not started, completed, not applicable.Free text.
treeblank treeblank treeblank treetree draft  Confidence
0 … 1
prsb03-dataelement-10680link
How confident the person feels to carry it outFree text.
treeblank treeblank treeblank treetree draft  Outcome
0 … 1
prsb03-dataelement-10681link
The outcome of the stage goalFree text.
treeblank treeblank treeblank treetree draft  Date last updated
0 … 1
prsb03-dataelement-10682link
Date when action/activity record was last updatedDate and time
treeblank treeblank treeblank treetree draft  Review date
0 … 1
prsb03-dataelement-10683link
When the stage goal and action need to be reviewed.Date and time.
treeblank treeblank treetree draft  Outcomes
0 … *
prsb03-dataelement-10416link
Outcomes of each of the person’s goals, aims and targets. Includes comments recorded by the person, date and status.Free text
treetree draft  Agreed with person or legitimate representative
0 … 1
prsb03-dataelement-10409link
Indicates whether the plan was discussed and agreed with the person or legitimate representative. A record of the agreement of the decisions made.Free text
treetree draft  Care funding source
0 … 1
prsb03-dataelement-10410link
A reference to the funding source and any conditions or limitations associated.Free text
treetree draft  Date this plan was last updated
0 … 1
prsb03-dataelement-10412link
This is a record of the date that this care and support plan was last updated.Date and time
treetree draft  Other care planning documents
0 … *
prsb03-dataelement-10415link
Reference other care planning documents, including the type, location and date.

This may include condition-specific plans, advance care plans, end of life care plan, etc.Free text.
treetree draft  Planned review date/interval
0 … 1
prsb03-dataelement-10417link
This is the date/interval when this information will next be reviewed.Date and time
treetree draft  Responsibility for review
0 … 1
prsb03-dataelement-10418link
This is a record of who has responsibility for arranging review of this information.

Should include their name, role and contact details.Free text.
treetree folder Location
0 … 1
prsb03-dataelement-12044link
The location where the care and support plan was prepared.
treetree folder Performing professional
0 … 1
prsb03-dataelement-12027link
The professional who prepared the care and support plan.
treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12028link
The name of the professional.Free text.
treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12029link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12030link
The grade of the professional.Free text
treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12031link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12032link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12033link
The name of the organisation the professional works for.
treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12034link
Contact details of the professionalNHS data dictionary - UK phone number
treetree folder Person completing record
0 … *
prsb03-dataelement-12035link
Details of the person completing the record.
folder Contingency plans
0 … 1
prsb03-dataelement-469link
These are the things to do and people to contact should an individual’s health or other circumstances get worse
treetree draft  Agreed with person or legitimate representative
0 … 1
prsb03-dataelement-10369link
Indicates whether the plan was discussed and agreed with the person or legitimate representative.Free text
treetree draft  Anticipatory medicines/equipment
0 … *
prsb03-dataelement-10370link
Medicines or equipment available that may be required in specific situations and their location. A statement regarding the availability or location of the anticipatory medicines/equipment.Free text
treetree folder Advance statement
0 … 1
prsb03-dataelement-10777link
Written requests and preferences made by a person with capacity conveying their wishes, beliefs and values for their future care should they lose capacity.
treeblank treetree draft  Date
0 … 1
prsb03-dataelement-12267link
The date when the advanced statements was made.Date and time
treeblank treetree folder Location
0 … 1
prsb03-dataelement-12268link
The location where the advanced statement was made.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13698link
The coded value for locationNHS data dictionary: - Organisation data service
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13699link
Free text field to be used if no code is availableFree text
treeblank treetree folder Advance statement
0 … 1
prsb03-dataelement-13695link
Does the person have an advance statement.
treeblank treeblank treetree draft  Coded value
0 … 1
prsb03-dataelement-13696link
The coded value for advance statementSNOMED CT: - 816281000000101 | Has advance statement (Mental Capacity Act 2005) (finding) |
treeblank treeblank treetree draft  Free text
0 … 1
prsb03-dataelement-13697link
Free text field to be used if no code is availableFree text
treeblank treetree draft  Location of document
0 … 1
prsb03-dataelement-13760link
The location of where the advanced statement is held.Free text or URL
treeblank treetree folder Performing professional
0 … 1
prsb03-dataelement-12269link
The professional who made the advance statement.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12270link
The name of the professional.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12271link
The role the professional has in relation to the person e.g. GP, physiotherapist, community nurse, social worker etcFHIR value set :- SDSjobroletype
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12272link
The grade of the professional.Free text
treeblank treeblank treetree draft  Speciality
0 … 1
prsb03-dataelement-12273link
The specialty of the professional e.g. physiotherapy, oncology, mental health etcNHS data dictionary - Activity treatment function code
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12274link
Professional identifier for the professional e.g. GMC number, HCPC number etc or the personal identifier used by the local organisation.NHS data dictionary : - Professional registration identifier
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12275link
The name of the organisation the professional works for.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12276link
Contact details of the professionalNHS data dictionary - UK phone number
treeblank treetree folder Person completing record
0 … 1
prsb03-dataelement-12277link
Details of the person completing the record.
treeblank treeblank treetree draft  Name
0 … 1
prsb03-dataelement-12278link
The name of the person completing the record.Free text.
treeblank treeblank treetree draft  Role
0 … 1
prsb03-dataelement-12279link
The organisational role of the person completing record.FHIR value set :- SDSjobrole
treeblank treeblank treetree draft  Grade
0 … 1
prsb03-dataelement-12280link
The grade of the person completing the record.Free text.
treeblank treeblank treetree draft  Specialty
0 … 1
prsb03-dataelement-12281link
The main specialty of the person completing the record.NHS data dictionary :- Activity treatment function code
treeblank treeblank treetree folder Organisation
0 … 1
prsb03-dataelement-12282link
The organisation the person completing the record works for.
treeblank treeblank treetree draft  Professional identifier
0 … 1
prsb03-dataelement-12283link
Professional identifier for the person completing the record e.g. GMC number, HCPC number etc, or the personal identifier used by the local organisation.NHS data dictionary :- Professional registration identifier
treeblank treeblank treetree draft  Date completed
0 … 1
prsb03-dataelement-12284link
The date and time the record was completed.Date and time.
treeblank treeblank treetree draft  Contact details
0 … 1
prsb03-dataelement-12285link
Contact details of the person completing the record.
NHS data dictionary : - UK telephone number
treetree draft  Contingency plan name
0 … 1
prsb03-dataelement-10371link
Name of the contingency plan – what condition or circumstances it is addressing.Free text
treetree draft  Date this plan was last updated
0 … 1
prsb03-dataelement-10372link
The date that this contingency plan was last updated.Date and time
treetree draft  Planned review date/interval
0 … 1
prsb03-dataelement-10373link
This is the date/interval when this contingency plan will next be reviewed.Date and time
treetree draft  Responsibility for review
0 … 1
prsb03-dataelement-10374link
This is who has responsibility for arranging review of this information.

Should include their name, role and contact details.Free text.
treetree draft  Trigger factors
0 … *
prsb03-dataelement-10375link
Signs to watch out for that may indicate a significant change in health or other circumstances. A statement of trigger factors.Free text
treetree folder Coping strategies
0 … *
prsb03-dataelement-13850link
Details of coping strategies used
treeblank treetree draft  Coping strategy
0 … 1
prsb03-dataelement-13851link
The coping strategies are defined as thoughts and behaviours that people use to manage the internal and external demands of situations that are appraised as stressful. This should also include a record of any tools used to carry out the coping strategy.Free text
treeblank treetree draft  Start date
0 … 1
prsb03-dataelement-13852link
The date when the coping strategy startedDate and time
treeblank treetree draft  End date
0 … 1
prsb03-dataelement-13853link
The date when the coping strategy endedDate and time
treetree draft  Relapse indicators / early warning signs
0 … *
prsb03-dataelement-13854link
Details of the relapse indicators for the person. These may also be called 'early warning signs'Free text
treetree draft  What should happen
0 … *
prsb03-dataelement-10376link
Guidance on specific actions or interventions that may be required or should be avoided in specific situations. This may include circumstances where action needs to be taken if a carer is unable to care for the person. A statement of suggested actions. Usually expressed as: in the event of X do Y.Free text
treetree draft  Who should be contacted
0 … *
prsb03-dataelement-10377link
Who should be contacted in the event of significant problems or deterioration in health or wellbeing. E.g. name, role and contact details.Free text
treetree folder Person completing record
0 … 1
prsb03-dataelement-12053link
Details of the person completing the record.
folder Additional support plans
0 … *
prsb03-dataelement-502link
Additional support plans
treetree draft  Additional support plan name
0 … 1
prsb03-dataelement-10402link
The name of the particular additional supporting plan, e.g. dieticians plan, wound management plan, discharge management plan and behaviour support plan.Free text
treetree draft  Additional support plan content
0 … 1
prsb03-dataelement-10403link
This is the content of any additional care and support plan which the person and/or care professional consider should be shared with others providing care and support. May be structured in different ways, e.g. tables, diagrams, images. This is the content of any additional care and support plan which the individual and/or care professional consider should be shared with others providing care and support. It should be structured as recommended for the care and support plan and if contains additional detail, it may be referenced here.Free text
treetree draft  Planned review date/interval
0 … 1
prsb03-dataelement-10405link
This is the date/interval when this information will next be reviewed.Date and time
treetree draft  Responsibility for review
0 … 1
prsb03-dataelement-10406link
This is a record of who has responsibility for arranging review of this information. Should include their name, role and contact details.Free text.
treetree draft  Date this plan was last updated
0 … 1
prsb03-dataelement-10407link
This is a record of the date that this information was last updated.Date and time
treetree folder Person completing record
0 … 1
prsb03-dataelement-12070link
Details of the person completing the record.