Welcome to the NHS booking standard website. On this site you will find guidance, specifications and background information for suppliers who are implementing this standard as well as providers and comissioners who are looking to procure and deploy solutions that comply with this standard.

This page is a Quick Start Guide for those wishing to engage and build to the standard.

This is an overview of the anticipated phases of engagement. Click on an area to explore further…

Context

The aim of this programme of work is to deliver a standard for direct bookings within the NHS, to improve the patient experience of services through connected care paths. The standard ensures suppliers build compatible systems to both provide slots for bookings and consume the advertised availability by requesting bookings.

Functionality

The functionality suppliers adopt is that of Consumer and/or Provider. The operations for each are different aspects of the same workflow, namely, providing available slots and managing bookings within those slots.

Provider

As a Provider, a supplier will perform the following:

  • Offer Slots to Consumers
  • Create Booking
  • Cancel Booking
  • Receive Referral

Consumer

As a Consumer, a supplier will perform the following:

  • Service discovery (DoS)
  • Endpoint discovery (SDS)
  • Request Slots
  • Request Booking
  • Cancel Booking
  • Within consultation
  • Outside consultation
  • Send Referral

Standard - Implementation Guide

The overall Standard covers the context in which the functionality is intended to be used, the scope of functionality and how a supplier is expected to engage to deliver a successfully assured solution for their customer base. It can be thought of as an implementation guide, covering every step a supplier can expect to traverse from analysis through to deployment.

Functional Scope

This Standard supports the implementation of bookings, which includes Slot Management, Appointment Management and Analytics & Reporting. Additionally, it provides guidance on how to interact with services (DoS, SDS & SSP) which are utilised in combination with booking operations - see Interactions section.

Capabilities

The Standard has core use cases which suppliers must satisfy for their solution to be successfully assured. The capabilities overlap for Providers and Consumers but both having distinct roles in the workflows.

Interactions

The Standard can only be fulfilled at present in conjunction with additional National and Spine services.

DoS - Directory of Services

The DoS is required to find the Provider services and, therefore, the slots they provide for the various schedules. The functionality of the DoS also enables support for Booking Only services which Consumer systems will need to adhere to.

SDS - Spine Directory Service

This LDAP service provides a directory of endpoints for Provider systems. The DoS will hold the require Accredited System IDdentifier (ASID) which can then be used to query SDS and retrieve the endpoint.

SSP – Spine Secure Proxy

This proxy controls all traffic between Consumers and Providers, handling both the auth-n and auth-z functions.

Referrals

The Standard supports the ability to include a reference to any referral documents which might be sent in conjunction with making the booking. In order to support a cross-reference, it is expected the Referral document will contain reference to the booking as well.

Reporting

There is a requirement to support reporting from both Consumer and Provider perspectives.

Specification

The Specification is a technical document which explicitly details the resources and structures provided, consumed and interchanged within workflows. The outline of the method operations for the resources is also explained with worked through examples.

Resources

FHIR NHS Booking API is based on STU3 FHIR Resources. The Structure Definitions for each resource can be found in the Specification along with an overview of the dependencies including those which are mandated. It should be noted, the Booking Standard is not exactly equal to the base FHIR Resources and care should be taken to review what is documented in the Specification to avoid any omissions. A key resource is the Appointment resource which differs slightly from other resources in that it can be constructed using contained resources.

Operations

The Specification explains the method operations expected to be performed against the resources, such as GET, PUT and POST. There are worked examples to guide development which describes the implementation of key capabilities and how the operations work from both Provider and Consumer perspectives. The guide specifies the explicit technical detail for making and consuming the various requests and responses including interactions with external services – SDS & SSP. For any developer involved in the project this will be a key resource.

Testing & Assurance

Testing is central to any development and there are a range of options to support you in this area, from sandboxed environments (INT Spine) to purpose built tools which can validate workflows. Assurance is another significant part of developing a booking solution. A supplier will not be able to move into a Production environment with their customer base until the assurance process is complete. The approach to assurance has been designed to be lightweight and driven by the supplier to help limit delays. The principle is for suppliers to self-assure and provide documentation to the NHS Digital Solution Assurance Team to review and verify. The key document in the process is the SCAL (Supplier Conformance Assessment List).

SCAL – Supplier Conformance Assessment List

The SCAL document is for a supplier to complete, stating they support the various documented capabilities. Alongside this document, is the requirement for evidence and supporting diagrams to be provided, enabling the Solution Assurance Team to understand the solution and ensure it meets the required standard. In addition, the supplier will demonstrate an end-to-end test of their solution functionality within the INT environment, following given test scripts.

Environments

There are numerous environments to assist with all levels of development maturity. There aren’t any documented barriers-to-entry for any of these environments but you will work closely with the Booking Team to establish when access is appropriate based on development progress.

OpenTest

The OpenTest environment is a standalone environment which has dedicated instances of the TKW Tools (see Tooling) and it can be configured to make requests to locally instances. To get connected to the OpenTest request a connection pack.

INT Spine

This sandbox environment is within HSCN with connectivity to like-live production services of DoS, SDS and SSP. It is more mature than OpenTest and would only expect to be accessed when a solution is nearing the first draft of completion and can work end-to-end.

In order to access it, you will be required to speak to a member of the Booking Team who can make the necessary arrangements for your system to engage with this environment. Any development must be tested within the INT environment before it could be assured and expect to move to Production with a customer.

Tooling

A suite of tools called TKW Simulators are available for development and assurance. These are Docker containers which simulate the various capabilities for Providers and Consumers, outputting evidence (which can be supplied as part of the SCAL) and providing detailed validation reports on where a solution meets the standard or not. These tools can be used during any stage of development for either set of capabilities – Provider or Consumer.

Deployment

The process of moving a solution into a Live environment involves developing maturity and satisfying a given level of assurance. If a supplier is completely new to NHS Spine services, there will be certain prerequisite services (HSCN connectivity, SDS) which they need to be compliant with before moving onto environments which support booking. This ensures they have what is termed Technical Accreditation.

Roles and Responsibilities

The testing phases require management and co-ordination of several actors (Suppliers, their customers, DoS Leads etc.). The NHS Digital Booking Team will orchestra the setup of tests, co-ordinating each of these stages, but there is an expectation suppliers and their customers will provide sufficient resource to support too. A supplier should expect to provide a degree of project management to co-ordinate their internal teams and the engagement of their customers to run the end-to-end tests.

INT Testing

The first like-live end-to-end test of a solution will be on the INT environment. This environment supports the various spine services (PDS, SDS, SSP) to allow this to take place. A test on this environment should be prepared for with the similar degree of management as a Live test. It will involve multiple suppliers, configuration of the DoS and a member of the Booking Team. The evidence required for the SCAL can be performed and collected during testing on INT. This will lead to Assurance being agreed and a Technical Conformance certificate being issued, which must be obtained before progressing to a live deployment.

Technical Live

The first live end-to-end test of the solution and the last stage the Booking Team will be involved before the supplier moves to a business-as-usual deployment model. Again, this is a full end-to-end test, using customers live environments and live Spine services, including the live DoS, and needs careful planning to ensure all parties are engaged and ready.

Communication

It is expected engagement with the Booking Team will be ongoing throughout the development process and to support this we offer a plan to support. Communication Plan -

  • Teams Channel – continuously monitored and updated
  • Weekly calls – to mark progress and allow discussion
  • Ad hoc calls – to be arranged if blockers occur

If you have any questions please contact the Booking team at: bookingandreferrals@nhs.net

References