{
  "resourceType" : "Bundle",
  "id" : "ReferralOrderMessage",
  "meta" : {
    "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/BundleMessage"]
  },
  "language" : "en",
  "identifier" : {
    "system" : "https://fhir.example-practice.nhs.uk/Id/message",
    "value" : "MSG000124"
  },
  "type" : "message",
  "timestamp" : "2026-09-04T10:15:00+01:00",
  "entry" : [{
    "fullUrl" : "https://fhir.example.nhs.uk/R4/MessageHeader/ReferralOrderMessageHeader",
    "resource" : {
      "resourceType" : "MessageHeader",
      "id" : "ReferralOrderMessageHeader",
      "meta" : {
        "lastUpdated" : "2026-09-04T10:15:00+01:00",
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/MessageHeader"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_ReferralOrderMessageHeader\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader ReferralOrderMessageHeader</b></p><a name=\"ReferralOrderMessageHeader\"> </a><a name=\"hcReferralOrderMessageHeader\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2026-09-04 10:15:00+0100</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-MessageHeader.html\">Document Message (MessageHeader)</a></p></div><p><b>event</b>: <a href=\"http://terminology.hl7.org/7.5.0/CodeSystem-v2-0003.html#v2-0003-O19\">event: O19</a> (OMG - General clinical order)</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://fhir.mft.nhs.uk/R4/$process-message\">https://fhir.mft.nhs.uk/R4/$process-message</a></td><td>Identifier: <a href=\"NamingSystem-ods-organization-code-namingsystem.html\" title=\"The identifier system for an Organisation registered with the Organisation Data Service (ODS).\">ODS Organisation Code</a>/R0A</td></tr></table><p><b>sender</b>: Identifier: <a href=\"NamingSystem-ods-organization-code-namingsystem.html\" title=\"The identifier system for an Organisation registered with the Organisation Data Service (ODS).\">ODS Organisation Code</a>/P89020</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://fhir.example-practice.nhs.uk/R4\">https://fhir.example-practice.nhs.uk/R4</a></td></tr></table><p><b>focus</b>: <a href=\"ServiceRequest-CardiologyReferral.html\">ServiceRequest Referral to cardiology service</a></p><p><b>definition</b>: <a href=\"MessageDefinition-referral-order.html\">Referral Order (O19)</a></p></div>"
      },
      "eventCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0003",
        "code" : "O19"
      },
      "destination" : [{
        "endpoint" : "https://fhir.mft.nhs.uk/R4/$process-message",
        "receiver" : {
          "identifier" : {
            "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
            "value" : "R0A"
          }
        }
      }],
      "sender" : {
        "identifier" : {
          "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
          "value" : "P89020"
        }
      },
      "source" : {
        "endpoint" : "https://fhir.example-practice.nhs.uk/R4"
      },
      "focus" : [{
        "reference" : "ServiceRequest/CardiologyReferral"
      }],
      "definition" : "https://fhir.acmeexample.org.uk/PatientCareCoordination/MessageDefinition/referral-order"
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/ServiceRequest/CardiologyReferral",
    "resource" : {
      "resourceType" : "ServiceRequest",
      "id" : "CardiologyReferral",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/ReferralRequest"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_CardiologyReferral\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest CardiologyReferral</b></p><a name=\"CardiologyReferral\"> </a><a name=\"hcCardiologyReferral\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ReferralRequest.html\">Referral Request</a></p></div><p><b>identifier</b>: Placer Identifier/REF-2026-000123, <code>https://fhir.nhs.uk/Id/UBRN</code>/000049637246</p><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 3457005}\">Patient referral</span></p><p><b>priority</b>: Urgent</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 183519002}\">Referral to cardiology service</span></p><p><b>subject</b>: <a href=\"Patient-Patient-Tameside.html\">Hodor TAMESIDE  Male, DoB: 1960-07-27 ( National Health Plan Identifier: NHS Number#9737383397)</a></p><p><b>occurrence</b>: 2026-09-11</p><p><b>authoredOn</b>: 2026-09-04 10:15:00+0100</p><p><b>requester</b>: <a href=\"PractitionerRole-GPAllenRole.html\">Allen (https://fhir.hl7.org.uk/Id/gmp-number#GMP Number#G1234567): General practitioner at HT PRACTICE (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#P89020)</a></p><p><b>performer</b>: <a href=\"HealthcareService-CardiologyService.html\">General Cardiology Outpatients by Manchester University NHS Foundation Trust (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#R0A) (http://fhir.nhs.net/Id/ers-service#1234567)</a></p><p><b>reasonCode</b>: <span title=\"Codes:{http://snomed.info/sct 267036007}\">Dyspnea</span></p><p><b>reasonReference</b>: <a href=\"Condition-ConditionDyspnoea.html\">Condition Dyspnea</a></p><p><b>note</b>: </p><blockquote><div><p>Determine the origin of Mr Tameside's shortness of breath. BMI 30, non-smoker, no chest pain, family history of coronary artery disease.</p>\n</div></blockquote></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PLAC"
          }]
        },
        "system" : "https://fhir.example-practice.nhs.uk/Id/referral",
        "value" : "REF-2026-000123",
        "assigner" : {
          "identifier" : {
            "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
            "value" : "P89020"
          }
        }
      },
      {
        "system" : "https://fhir.nhs.uk/Id/UBRN",
        "value" : "000049637246"
      }],
      "status" : "active",
      "intent" : "order",
      "category" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "3457005",
          "display" : "Patient referral"
        }]
      }],
      "priority" : "urgent",
      "code" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "183519002",
          "display" : "Referral to cardiology service"
        }]
      },
      "subject" : {
        "reference" : "Patient/Patient-Tameside",
        "identifier" : {
          "type" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
              "code" : "NH"
            }]
          },
          "system" : "https://fhir.nhs.uk/Id/nhs-number",
          "value" : "9737383397"
        }
      },
      "occurrenceDateTime" : "2026-09-11",
      "authoredOn" : "2026-09-04T10:15:00+01:00",
      "requester" : {
        "reference" : "PractitionerRole/GPAllenRole"
      },
      "performer" : [{
        "reference" : "HealthcareService/CardiologyService"
      }],
      "reasonCode" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "267036007",
          "display" : "Dyspnea"
        }]
      }],
      "reasonReference" : [{
        "reference" : "Condition/ConditionDyspnoea"
      }],
      "note" : [{
        "text" : "Determine the origin of Mr Tameside's shortness of breath. BMI 30, non-smoker, no chest pain, family history of coronary artery disease."
      }]
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/Patient/Patient-Tameside",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "Patient-Tameside",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/Patient"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_Patient-Tameside\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient Patient-Tameside</b></p><a name=\"Patient-Tameside\"> </a><a name=\"hcPatient-Tameside\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Patient.html\">Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Hodor TAMESIDE  Male, DoB: 1960-07-27 ( National Health Plan Identifier: NHS Number#9737383397)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Medical record number/B6789012</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">Stockport Road Tameside OL7 0NS </td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>General Practitioner: HT PRACTICE (Identifier: <a href=\"NamingSystem-ods-organization-code-namingsystem.html\" title=\"The identifier system for an Organisation registered with the Organisation Data Service (ODS).\">ODS Organisation Code</a>/P89020)</li></ul></td></tr></table></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "NH"
          }]
        },
        "system" : "https://fhir.nhs.uk/Id/nhs-number",
        "value" : "9737383397"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR"
          }]
        },
        "system" : "https://fhir.mft.nhs.uk/Id/mrn",
        "value" : "B6789012",
        "assigner" : {
          "identifier" : {
            "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
            "value" : "R0A"
          }
        }
      }],
      "name" : [{
        "family" : "TAMESIDE",
        "given" : ["Hodor"]
      }],
      "gender" : "male",
      "birthDate" : "1960-07-27",
      "address" : [{
        "line" : ["Stockport Road"],
        "city" : "Tameside",
        "postalCode" : "OL7 0NS"
      }],
      "generalPractitioner" : [{
        "type" : "Organization",
        "identifier" : {
          "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
          "value" : "P89020"
        },
        "display" : "HT PRACTICE"
      }]
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/PractitionerRole/GPAllenRole",
    "resource" : {
      "resourceType" : "PractitionerRole",
      "id" : "GPAllenRole",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/PractitionerRole"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_GPAllenRole\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole GPAllenRole</b></p><a name=\"GPAllenRole\"> </a><a name=\"hcGPAllenRole\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-PractitionerRole.html\">PractitionerRole</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Allen (https://fhir.hl7.org.uk/Id/gmp-number#GMP Number#G1234567): General practitioner at HT PRACTICE (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#P89020)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"The practitioner who is able to provide the services in this role\">Practitioner:</td><td colspan=\"3\"><a href=\"Practitioner-GPAllen.html\">Allen (https://fhir.hl7.org.uk/Id/gmp-number#GMP Number#G1234567)</a></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The organization where the practitioner performs the roles\">Organization:</td><td colspan=\"3\"><a href=\"Organization-P89020.html\">HT PRACTICE (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#P89020)</a></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Roles which this practitioner is authorized to perform for the organization\">Role:</td><td colspan=\"3\"><span title=\"Codes:{http://snomed.info/sct 62247001}\">General practitioner</span></td></tr></table></div>"
      },
      "practitioner" : {
        "reference" : "Practitioner/GPAllen"
      },
      "organization" : {
        "reference" : "Organization/P89020",
        "identifier" : {
          "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
          "value" : "P89020"
        }
      },
      "code" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "62247001",
          "display" : "General practitioner"
        }]
      }]
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/Practitioner/GPAllen",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "GPAllen",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/Practitioner"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_GPAllen\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner GPAllen</b></p><a name=\"GPAllen\"> </a><a name=\"hcGPAllen\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner.html\">Practitioner</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Allen (https://fhir.hl7.org.uk/Id/gmp-number#GMP Number#G1234567)</p><hr/></div>"
      },
      "identifier" : [{
        "system" : "https://fhir.hl7.org.uk/Id/gmp-number",
        "value" : "G1234567"
      }],
      "name" : [{
        "family" : "Allen",
        "prefix" : ["Dr"]
      }]
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/Organization/P89020",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "P89020",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/Organization"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_P89020\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization P89020</b></p><a name=\"P89020\"> </a><a name=\"hcP89020\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Organization.html\">Organization</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">HT PRACTICE (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#P89020)</p><hr/></div>"
      },
      "identifier" : [{
        "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
        "value" : "P89020"
      }],
      "name" : "HT PRACTICE"
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/HealthcareService/CardiologyService",
    "resource" : {
      "resourceType" : "HealthcareService",
      "id" : "CardiologyService",
      "meta" : {
        "profile" : ["https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/HealthcareService"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"HealthcareService_CardiologyService\"> </a><p class=\"res-header-id\"><b>Generated Narrative: HealthcareService CardiologyService</b></p><a name=\"CardiologyService\"> </a><a name=\"hcCardiologyService\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-HealthcareService.html\">HealthcareService</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">General Cardiology Outpatients by Manchester University NHS Foundation Trust (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#R0A) (http://fhir.nhs.net/Id/ers-service#1234567)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"The organization that provides this service\">Provided By:</td><td colspan=\"3\"><a href=\"Organization-R0A.html\">Manchester University NHS Foundation Trust (https://fhir.nhs.uk/Id/ods-organization-code#ODS Organisation Code#R0A)</a></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The specialties of the services that are provided\">Specialty:</td><td colspan=\"3\"><span title=\"Codes:{http://snomed.info/sct 394579002}\">Cardiology</span></td></tr></table></div>"
      },
      "identifier" : [{
        "system" : "http://fhir.nhs.net/Id/ers-service",
        "value" : "1234567"
      }],
      "providedBy" : {
        "reference" : "Organization/R0A"
      },
      "specialty" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "394579002",
          "display" : "Cardiology"
        }]
      }],
      "name" : "General Cardiology Outpatients"
    }
  },
  {
    "fullUrl" : "https://fhir.example.nhs.uk/R4/Condition/ConditionDyspnoea",
    "resource" : {
      "resourceType" : "Condition",
      "id" : "ConditionDyspnoea",
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_ConditionDyspnoea\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition ConditionDyspnoea</b></p><a name=\"ConditionDyspnoea\"> </a><a name=\"hcConditionDyspnoea\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 267036007}\">Dyspnea</span></p><p><b>subject</b>: <a href=\"Patient-Patient-Tameside.html\">Hodor TAMESIDE  Male, DoB: 1960-07-27 ( National Health Plan Identifier: NHS Number#9737383397)</a></p><p><b>recordedDate</b>: 2026-09-04</p></div>"
      },
      "clinicalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
          "code" : "active"
        }]
      },
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
          "code" : "problem-list-item"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "267036007",
          "display" : "Dyspnea"
        }]
      },
      "subject" : {
        "reference" : "Patient/Patient-Tameside"
      },
      "recordedDate" : "2026-09-04"
    }
  }]
}