Care Coordination and 360 Referrals (Proof of Concept) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
PRSB Standards
Proof of concept. This implementation guide is a demonstration only. It is
not an authoritative source, is not endorsed by NHS England, IHE or HL7, and
must not be used for implementation or clinical purposes.
The Professional Record Standards Body (PRSB) publishes
the clinical content standards for records shared in the UK: what information a
referral, letter, discharge summary or care plan should contain, and how it is
headed. They are information requirements, not exchange formats. In the
NW GMSA terms they
feed the data model; this guide supplies the workflow (the PCC interactions) they are
carried in.
This page lists each PRSB standard (as published on 2026-11-01), the 360X interaction it
may apply to and where in the clinical process it may apply.
The mappings are indicative - PRSB does not define them. As with other national
standards, PRSB content is assessed against the general standards (HL7 Europe HDR, IPS,
FHIR / CDA Documents) rather than assumed to be complete.
References
How PRSB Standards Fit
flowchart LR
subgraph Content["Information requirements (PRSB)"]
REF[Referral standards]
LET[Letter and discharge standards]
PLAN[Care plan standards]
CORE[Core, About Me,<br/>Document Naming, Provenance]
end
subgraph Workflow["Workflow (this guide)"]
P55[PCC-55<br/>Referral Request]
P59[PCC-59<br/>Interim Consultation Note]
P57[PCC-57<br/>Referral Outcome]
DCP[DCP<br/>shared care plan]
end
REF --> P55
LET --> P59
LET --> P57
PLAN --> DCP
PLAN --> P57
CORE -.all documents.-> P55
CORE -.-> P57
| Kind of PRSB standard |
Carried as |
Profile in this guide |
| Referral |
ServiceRequest and its clinical information (supportingInfo: FHIR Document, letter, QuestionnaireResponse) |
Referral Request |
| Letter (outpatient) |
FHIR Document |
HDR section structure (HDR itself is inpatient only - Open) |
| Discharge |
FHIR Document |
HL7 Europe HDR |
| Care plan |
CarePlan, shared through DCP or sent in the outcome |
Care Plan, HDR CarePlan |
| Shared record view |
Health Data API (document or resource sharing) |
- |
| Cross-cutting |
Document metadata, sections, Provenance |
All documents |
Referral Standards
| PRSB standard |
Version |
PRSB description |
PCC interaction |
Clinical process |
| Clinical Referral Information Standard |
v1.0 |
"Improving the exchange of referral information from GPs to hospital consultants and other health care professionals providing outpatient services." |
PCC-55 - the referral content (reason, question, clinical information); the eRS referral letter |
Implement (GP); Assessment (recipient's triage) |
| 111 Referral Standard |
v1.0 |
"Supporting clear and concise information flows between the 111 referrer and the receiving services and professionals." |
PCC-55 (BaRS on some routes today - see the assessment); PCC-60 when 111 books |
Implement (111); Start for the receiving service - including a virtual ward step-up |
| Hospital Referral for Assessment for Community Care |
v1.1 |
"…the information required in respect of a person being referred for ongoing community assessment for social care and support after a hospital stay." |
PCC-55 from the ward to social care; PCC-57 back |
End (hospital discharge planning); Implement |
| Urgent Transfer of Care from Care Home to Hospital |
v1.3 |
"…the information required for the care and support of a person when they are admitted to hospital from a care home in an emergency." |
PCC-55 - a transfer rather than a referral (no accept / decline) |
Implement (care home); Start (hospital) |
| Ambulance Handover to Emergency Care |
v1.0 |
"…the information that is shared when care is transferred from ambulances to emergency departments." |
PCC-55 as a handover (no accept / decline) |
Start and Assessment (ED) |
| Social Prescribing Standard |
v1.1 |
"Sharing and recording of information for all models of social prescribing including those used in local authorities and voluntary organisations…" |
PCC-55 to a link worker or service; PCC-57 outcome |
Implement; Evaluate |
Letter and Discharge Standards
| PRSB standard |
Version |
PRSB description |
PCC interaction |
Clinical process |
| Outpatient Letter Standard |
v2.2 |
"…digital outpatient letters allow clinical information to be recorded, exchanged and accessed consistently across care settings. Best practice for most outpatient letters is writing directly to patients." |
PCC-59 (clinic letter during care); PCC-57 (discharge from outpatients) - outpatient letter (HDR section codes) |
End of each encounter; Evaluate (referrer) |
| Transfer of Care - Acute Inpatient Discharge Standard |
v2.1 |
"Enabling hospitals to safely transfer standardised clinical information which can be extracted directly into GP IT systems, when a patient is discharged." |
PCC-57 - HL7 Europe HDR; also a virtual ward discharge |
End; Evaluate (GP) |
| Emergency Care Discharge Standard |
v2.2 |
"Sharing discharge information between Emergency Care and GP practices is essential for ensuring patient safety and good ongoing treatment." |
PCC-57 for a referral to ED (e.g. from 111 or the GP) - HDR fit is Open (inpatient only) |
End; Evaluate |
| Mental Health Inpatient Discharge |
v2.1 |
"Standardising information shared so professionals can provide continuity of care when an adult is discharged from mental health services." |
PCC-57 - Discharge Report |
End; Evaluate |
| Community Pharmacy Standard |
v3.01.3 |
"Supporting information sharing between community pharmacists and GP practices." |
PCC-57 - pharmacy consultation back to the GP (GP Connect Update Record); PCC-55 for referrals to the pharmacy |
Implement (pharmacy); Evaluate (GP) |
Care Plan and Condition Standards
| PRSB standard |
Version |
PRSB description |
PCC interaction |
Clinical process |
| Personalised Care and Support Plan |
v2.0 |
"Allowing the sharing of care plans between patients, carers and all the health and care professionals involved in a person's care…" |
DCP (PCC-37 to PCC-41); PCC-57 outcome as a care plan (continued care) |
Plan; Evaluate |
| Palliative and End of Life Care Information Standard |
v1.11 |
"…the standardised recording of information related to palliative care and end of life forming the core content of information to be held in electronic palliative care co-ordination systems (EPaCCS)." |
DCP - EPaCCS as the Care Plan Service; PCC-55 supporting information |
Plan; read in every Assessment |
| Nursing Care Needs Standard |
v1.0 |
"…a new nursing standard for use across different health and social care settings." |
PCC-55 supporting information (e.g. referral to community nursing or a virtual ward); DCP |
Assessment; Plan |
| Wound Care Standard |
v1.0 |
"…the information record content for the management of wound care…" - assessment and treatment, treatment plan, supported self-care |
DCP; PCC-59 / PCC-57 from community nursing |
Assessment; Plan; Implement |
| Diabetes Standard |
v1.0 |
"…sharing diabetes information between people and professionals across all care settings, including self management data from digital apps and medical devices…" |
DCP; device data as in virtual ward monitoring; PCC-55 supporting information |
Assessment; Plan; Evaluate |
| Epilepsy Information Standard |
v1-build.0.12 |
"…a nationally agreed approach to recording and sharing epilepsy related information…" |
DCP; PCC-55 / PCC-57 content for neurology referrals |
Assessment; Diagnosis; Plan |
| Maternity Information Standard |
v2.1.2 |
- |
DCP (the DCP pregnancy use case); referrals within maternity care PCC-55 |
Plan; across encounters |
| Shared Decision Making Standard |
v1.0 |
"A collaborative process where clinicians and individuals consider treatment options together…" |
PCC-59 / PCC-57 plan of care section; DCP |
Plan |
| Obstetric Anaesthetic Standard |
v1.0.0 |
"…the minimum dataset needed to improve care and quality outcomes for obstetric anaesthetic services…" |
Not a referral standard - in-service recording |
Implement |
Screening and Prevention Standards
| PRSB standard |
Version |
PRSB description |
PCC interaction |
Clinical process |
| Healthy Child Record Standard |
Amd 56/2024 |
"…what information on screening tests, immunisations and developmental milestones should be accessible…" |
PCC-55 / PCC-57 for screening follow-up (the 360X newborn hearing use case); DCP |
Assessment; Plan |
| NHS Health Check Standard |
v1.3.0 |
"…a public health programme aimed at preventing non-communicable diseases (NCDs) among adults aged 40-74 in England." |
Results may trigger PCC-55; outcome to the GP PCC-57 if done outside the practice |
Assessment; Diagnosis |
Shared Record and Cross-cutting Standards
| PRSB standard |
Version |
PRSB description |
PCC interaction |
Clinical process |
| Core Information Standard |
v2.01 |
"…a set of information that can potentially be shared between systems in different sites and settings…" |
All documents - the headings behind the sections of the referral, outpatient letters (HDR section codes) and HL7 Europe HDR |
All - Subjective (view the record) in each encounter |
| About Me Standard |
v2.01 |
"The most important details that a person wants to share with professionals in health and social care." |
PCC-55 supporting information; shared record |
All - especially Assessment |
| Care Homes View of Shared Care Records |
v1.1 |
"Information that care home staff can see in a shared care record." |
Not a PCC interaction - Health Data API resource / document sharing (Reports) |
Assessment (Subjective) |
| Information Provided by Local Authorities in Shared Care Records |
v1.1 |
"The important details that the local authority holds about people that would be useful for health and care professionals…" |
Not a PCC interaction - shared record; read when triaging PCC-55 |
Assessment (Subjective) |
| Document Naming Standard |
v4.9 |
"Making sure that records are properly named and indexed, so they can be retrieved in order to provide ongoing care." |
Every document in PCC-55, PCC-57, PCC-59: DocumentReference.type / Composition.type (Referral Document Type) |
Evaluate (finding documents later) |
| Provenance Data Standard |
v1.2 |
"…who made the record entry or carried out the activity, where and when…" |
All interactions - author, requester, owner, Provenance |
All |
Summary by Interaction
| PCC interaction |
PRSB standards that may apply |
| Referral Request [PCC-55] |
Clinical Referral Information, 111 Referral, Hospital Referral for Assessment for Community Care, Urgent Transfer of Care from Care Home to Hospital, Ambulance Handover, Social Prescribing; supporting information from About Me, Nursing Care Needs, Palliative and End of Life Care and condition standards |
| Accept / Decline [PCC-55], [PCC-56], Cancellation [PCC-58] |
None - workflow status only (Provenance) |
| Interim Consultation Note [PCC-59] |
Outpatient Letter; Wound Care, Shared Decision Making and condition standards for content |
| Referral Outcome [PCC-57] |
Outpatient Letter, Acute Inpatient Discharge, Emergency Care Discharge, Mental Health Inpatient Discharge, Community Pharmacy; Personalised Care and Support Plan (continued care) |
| Appointment [PCC-60] / No-Show [PCC-61] |
None (111 Referral where 111 books) |
| Dynamic Care Planning |
Personalised Care and Support Plan, Palliative and End of Life Care, Maternity, Diabetes, Epilepsy, Wound Care, Nursing Care Needs, Healthy Child Record |
| All |
Core Information, Document Naming, Provenance, About Me |
Summary by Clinical Process
| Clinical process |
PRSB standards that may apply |
| Start |
Ambulance Handover, Urgent Transfer of Care from Care Home to Hospital, 111 Referral (receiving service) |
| Assessment |
Core Information, About Me, Care Homes View, Local Authority Information, Nursing Care Needs, NHS Health Check, Healthy Child Record, condition standards |
| Diagnosis |
Epilepsy, NHS Health Check |
| Plan |
Personalised Care and Support Plan, Palliative and End of Life Care, Shared Decision Making, Maternity, Diabetes, Wound Care |
| Implement |
Clinical Referral Information, 111 Referral, Social Prescribing, Hospital Referral for Assessment for Community Care, Community Pharmacy |
| Evaluate |
Outpatient Letter, discharge standards, Community Pharmacy, Document Naming |
| End |
Acute Inpatient Discharge, Emergency Care Discharge, Mental Health Inpatient Discharge, Outpatient Letter, Hospital Referral for Assessment for Community Care |
To confirm: PRSB headings to HL7 Europe HDR sections, and the Clinical Referral
Information Standard to the Referral logical model.
An indicative heading mapping for discharge is on
Referral Outcome Reports.
The sections these standards share (demographics, allergies, social context, plan and
requested actions and others) are listed as reusable templates on
Composition, Archetypes and Templates, with the forms (Questionnaires) built from them.
