Summary release notes of the versions released in Digital Medicines Implementation Guide


  • New MIRC MESH Id added
  • Corrections for section heading names and associated codes

  • Attendance details (1077881000000105) -> Contacts with professionals (|contacts-with-professionals)
  • Clinical narrative (1077901000000108) -> Clinical Summary (887181000000106)
  • Consent (61861000000100) -> Legal information (886961000000102)


  • Minor illness specification: added Safeguarding; Examination findings and Signpost details sections
  • Updated Minor illness example
  • Change Minor Illness medication and medical devices section to be same as Emergency Supply
  • Minor Illness presenting complaint or issues section, changed to use a SNOMED code & removed Symptom Duration
  • Minor Illness - remove Referrer details section


  • Referral details - Clarification that Referral Details are details on onward referral(s). Change to intro text; change to “Referral to” sub heading description; change to example from self-referral to a GP referral.
  • Attendance details - Change to example to include a Service example for Emergancy Supply. Removal of prefixes (e.g. “Name:”) from example. Tidy up example - for example changed some <p> tags for <br/>. Added Emergecy Supply to “Consultation method”. Added Consultation method to example. Change Location to Community pharmacy.
  • GP Practice - Removed label (“ODS Organization Code:”) from Practice identifier in example. Added GP Practice name and address in example
  • Patient demographics - removed prefixes (Name: etc.) from the example. Improved formatting of Address by changing <p> to <br/>. Name now appears in one line.
  • Change to menu structure - Moved Observations from Common Headings to Minor Illness Referral Consultation


Note: At the time of publication, FHIR profile development to support the Minor Illness Referral Consultation (MIRC) care communication has not been completed. This development is planned for the future and will include:

  • A new MessageDefinition FHIR profile for the Minor Illness Referral Consultation (MIRC) care communication, with StructureDefinition URL ‘’.
  • A new code and display ‘ITK013D - ITK Digital Medicine Minor Illness Referral Consultation’ to be added to the CodeSystem ITK-MessageEvent-2.
  • Changes to CareConnect-ITK-DM-DMIRS-Composition:
    • Add new Composition.section for ‘Referrer Details’ with SNOMED CT representation ‘1052891000000108 - Referrer details’
    • Add new Composition.section for ‘Observations’ with SNOMED CT representation ‘11102421000000108 - Observations’
    • Correction to Composition.section.title for ‘presentingComplaintOrIssues’, from ‘Presentin complaint or issues’ to ‘Presenting complaint or issues’.

Corrections to existing example scenarios - SNOMED CT representations in the following examples have been updated:


Note: These examples are for demonstrating FHIR representation only. They do not imply business requirements in terms of the ITK Wrapper population, or clinical requirements for SNOMED CT representations.



Examples - Banners added clarifying that examples are illustrative, and have not been formally clinically assured Examples aligned with specification to correctly show Composition.section.text content:

  • Location of event - FHIR Target changed to additional freetext added to Composition.section.text
  • Serialisation code - optional field. Removed from examples.
  • Vaccine procedure - examples changed to 955691000000108 | Seasonal influenza vaccination given by pharmacist
  • Vaccine product - examples changed to 35727111000001109 | Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Mylan)

diff vs. 1.2.1-Private-Beta


Replaced SNOMED code:
SNOMED CT Concept ID : 820261000000101
Synonym: Controlled drug dispensing record

With new SNOMED code:
SNOMED CT Concept ID :1218611000000102
Synonym : Urgent supply of prescription items by community pharmacy


Added four new areas to the Specification:

  • New Medicine Service
  • Medication Review
  • Digital Minor Illness Refferal Service (DMIRS)
  • Appliance Use Review

This produces four new compositions profiles, Messaging Architecture and Message Headings

  • Message Definitions section has been removed
  • All examples have the <xml> tag which was shown at the beginning and the end, now put into a comments wrapper
  • Added new section Design & Build > Document Replacement
  • Added new section Messaging Architecture>Document Profiles>Digital Medicines Document Profiles has been created and now encapsulates all information
  • Added new section Message Headings > Overview of Headings has been created and now encapsulates all information
  • A “FHIR Target” column has been added to every Message Heading page showing the FHIR mapping
  • An in-correct SNOMED code was used in the previous release.
    886721000000107 Referral details
    1052891000000108 Referrer details
  • All Optional elements have been highlighted in red within the Message Headings to avoid confusion when implementing


The two scenario examples contained errors which have now been fixed and run against the Test Harness. They should now correctly validate and help suppliers with more guidance.


A patch release to correct SNOMED codes for Consent and Eligibility Criteria from temp codes to actual provided values:

New codes added: 61871000000107 | Eligibility for treatment 886961000000102 | Consent

Profiles changed: Consent and Eligibility Criteria Section

Consent Section


  • All gist linked examples have now been embedded into the spec as inline coding
  • All gist linked Message Definition examples embedded into the spec as inline coding
  • “Assure” menu section has been removed
  • “Deploy” menu section has been removed
  • New section “Distribution list” added to the specification
  • Immunizations references renamed to Vaccinations to match PRSB headings
  • Referrer details renamed to Referral Details in all sections to match PRSB headings
  • Following sections updated and checked to match the PRSB headings following review (Click on the links to see a change comparison)


Alpha release supporting the following for Immunizations and Emergency Medication Supply:


This draft version includes implementation guidance to support the development of the Digital Medicines specification in preparation for an Alpha release, supporting the following for Immunizations and Emergency Medication Supply:

Tags: development