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Composition, Archetypes and Templates

flowchart LR
    C[Composition<br/>CDA / FHIR Document] -- contains --> A[Archetypes<br/>e.g. AllergyIntolerance, Condition]
    C -- contains --> T[Templates<br/>e.g. Social Context, Vital Signs]
    T -- contains --> O[Observations<br/>also an archetype]

A Composition contains archetypes and templates; templates contain Observations (which are also archetypes).

Clinical information is built in these layers:

PRSB standards are built from the same sections used again and again - patient demographics, allergies, social context, plan and requested actions. Each section is a reusable template. Some map directly to FHIR resources; others are captured as forms. This page lists the repeating templates found in ten PRSB standards, the matching NHS FDP Canonical Data Model objects (the archetypes) and the forms in this guide.

Compositions: HDR and Patient Summary

The two documents (compositions) used in this guide show the layers. Each Composition has coded sections; each section's entry holds the archetypes (FHIR resources) and its text holds the narrative. Some sections are filled from a template captured as a form. The PRSB section is the matching heading in the PRSB standard for that document.

flowchart LR
    C[Composition<br/>HDR discharge report] --> S1[Section: Allergies<br/>48765-2]
    C --> S2[Section: Vital signs<br/>8716-3]
    C --> S3[Section: Plan of care<br/>18776-5]
    S1 -- entry --> A1[AllergyIntolerance<br/>archetype]
    S2 -- entry --> A2[Observation<br/>archetype]
    F[Vital Signs form<br/>template] -. extracted to .-> A2
    S3 -- entry --> A3[CarePlan<br/>archetype]

HL7 Europe Hospital Discharge Report

HL7 Europe HDR 1.0.0 composition-eu-hdr (document type LOINC 34105-7); all sections are optional. Outpatient letters use the same section codes on a plain Composition (see the Discharge Report model). PRSB: eDis = Transfer of Care - Acute Inpatient Discharge v2.1, OPL = Outpatient Letter v2.2.

Document header, not sections: Person completing record → Composition.author; Distribution list → informationRecipient extension; Patient demographics and GP practice → Composition.subject (Patient); Admission / attendance details → Composition.encounter. No HDR section: Social context, Individual requirements, Legal information, Participation in research, Person and carer concerns (narrative or the Patient Summary - To confirm).

HL7 Europe Patient Summary

HL7 Europe EPS follows the IPS sections; checked here against IPS 2.0.1 Composition-uv-ips (document type LOINC 60591-5) - EPS differences To confirm. Problems, allergies and medications are required (1..1). PRSB: CIS = Core Information Standard v2.01. See the Patient Summary model.

Document header, not sections: Person demographics and GP practice → Composition.subject (Patient). No EPS / IPS section: Individual requirements, Legal information (other than advance decisions), Professional and personal contacts, Participation in research, Family history, Risks, Services and care - To confirm.

Section codes and entry types are from the hl7.fhir.eu.hdr 1.0.0 and hl7.fhir.uv.ips 2.0.1 packages; PRSB and CDM mappings are indicative - To confirm.

References

Archetypes: NHS FDP Canonical Data Model v1.0.0 (Full Specification, 142 objects; NHS England - Canonical Data Model).

Checked 2026-11-02. Section names vary slightly between standards (for example "Patient demographics" and "Person demographics"); they are grouped below. The CIS defines almost all of them, so it is not counted.

Repeating Templates

Sections that appear in three or more of the nine other standards:

Less common: About me (HRAC, PCSP), contingency and additional support plans (HRAC, PCSP), professional and personal contacts (HRAC, PCSP), attendance details (OPL, ECD). Only in HRAC: care needs summary, assessed level of care, primary support reason - the care assessment. Only in PCSP: the care and support plan itself.

CDM objects are matched by name to the PRSB sections - To confirm against each object's properties. Version 1.0.0 has no medication object.

Templates or forms? A template whose content is a clinical fact with its own FHIR resource (an allergy, a medicine, a diagnosis) is exchanged as that resource, inside a document (HDR, EPS) or by API. A form is used where the content is a set of questions answered at one time - social context, vital signs, an assessment. The answers can then be extracted into resources (SDC extraction) where that is useful.

Canonical Data Model and This Guide's Models

The FDP CDM objects that correspond to this guide's logical models:

Mapping by object name only. For the profile and property level mapping, and the gaps found, see FDP Canonical Data Model Mapping.

Repeating Sub-templates

Inside the sections, the same groups of items repeat in every record entry, especially in HRAC and CP:

These are record metadata, not questions: in a form they are QuestionnaireResponse.author, authored and source, not items.

Forms in This Guide

Candidates for further forms: Individual requirements (as its own form), About Me (PRSB About Me), Legal information, and Person and carer concerns - Open.

Care Assessment and Care Plan

In the NHS a care assessment form is very often called a "care plan". They are different things:

In the FDP CDM the same split exists: Community Care Plan is "a record of planned treatment or healthcare for a patient in the community setting" (after the NHS Data Dictionary Care Plan), while assessments are Scored Assessment records.

Social care uses "care plan" in the FHIR sense; the confusion is mostly in the NHS, where a "care plan" received from another organisation (for example the BaRS CarePlan

• see the BaRS review) is often an assessment.

flowchart LR
    A[Care Assessment<br/>QuestionnaireResponse] -- "supportingInfo" --> P[Care Plan<br/>CarePlan]
    P -- "activity" --> R1[Referral<br/>ServiceRequest + Task]
    P -- "activity" --> R2[Visits, tasks<br/>Appointment, Task]
    R1 -- "outcome" --> D[Discharge Report / letter]
    D -. "reassess" .-> A

Example: the completed care assessment before discharge from the virtual ward, and the community care and support plan formed from it (CarePlan.supportingInfo references the assessment; its activities include a referral to pulmonary rehabilitation).