Cancel an appointment for a patient at an organisation

Use case

This API is used to cancel a patient’s future appointment, obtained via use of either Retrieve a Patient’s Appointments, or Read an Appointment APIs. Any appointment - that is, irrespective of booking organisation - can be cancelled by a consuming organisation participating with the appointment hosting organisation in a GP Connect deployment.

The typical flow to cancel an appointment is:

  1. Search by NHS Number for, or otherwise obtain, a Patient resource.
  2. Search for Appointment resources for the Patient resource.
  3. Choose an Appointment resource and cancel it by amending the status to cancelled.

Security

  • GP Connect utilises TLS Mutual Authentication for system level authorization
  • GP Connect utilises a JSON Web Tokens (JWT) to transmit clinical audit and provenance details

Prerequisites

Consumer

The consumer system:

API usage

The consumer system SHALL only use the cancel appointment capability to cancel future appointments where appointment start dateTime is after the current date and time. If the appointment start date is in the past the provider SHALL return an error.

Request operation

FHIR relative request

PUT /Appointment/[id]

FHIR absolute request

PUT https://[proxy_server]/https://[provider_server]/[fhir_base]/Appointment/[id]

Request headers

Consumers SHALL include the following additional HTTP request headers:

Header Value
Ssp-TraceID Consumer’s TraceID (that is, GUID/UUID)
Ssp-From Consumer’s ASID
Ssp-To Provider’s ASID
Ssp-InteractionID urn:nhs:names:services:gpconnect:fhir:rest:cancel:appointment-1
If-Match The Appointment’s current ETag, e.g. W/"23"

Payload request body

The request payload is a profiled version of the standard FHIR® Appointment resource. See the FHIR resources page for more details.

Consumer systems:

  • SHALL send an Appointment resource that conforms to the GPConnect-Appointment-1 profile.
  • SHALL include the URI of the GPConnect-Appointment-1 profile StructureDefinition in the Appointment.meta.profile element of the appointment resource.

Only the following data elements can be modified when performing an appointment cancellation:

  • the appointment status MUST be updated to “cancelled”
  • the appointment cancellation-reason extension SHALL be included with the cancellation reason details

On the wire, a JSON serialised request would look something like the following:

{
  "resourceType": "Appointment",
  "id": "9",
  "meta": {
    "versionId": "636068818095315079",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/GPConnect-Appointment-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Organization",
      "id": "1",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
        ]
      },
      "identifier": [
        {
          "system": "https://fhir.nhs.uk/Id/ods-organization-code",
          "value": "A00001"
        }
      ],
      "type": [
        {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/GPConnect-OrganisationType-1",
              "code": "gp-practice"
            }
          ]
        }
      ],
      "name": "Test Organization Name",
      "telecom": [
        {
          "system": "phone",
          "value": "0300 303 5678"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-BookingOrganisation-1",
      "valueReference": {
        "reference": "#1"
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1",
      "valueString": "Free text cancellation reason."
    }
  ],
  "status": "cancelled",
  "description": "Free text description updated.",
  "start": "2017-05-30T10:00:00+01:00",
  "end": "2017-05-30T10:25:00+01:00",
  "slot": [
    {
      "reference": "Slot/1",
      "display": "Slot 1"
    }
  ],
  "created": "2017-05-25T13:48:41+01:00",
  "comment": "Free text comment.",
  "participant": [
    {
      "actor": {
        "reference": "Patient/1",
        "display": "Mr. Mike Smith"
      },
      "status": "accepted"
    },
    {
      "actor": {
        "reference": "Location/32",
        "display": "Leeds GP Clinic"
      },
      "status": "accepted"
    }
  ]
}

Error handling

The provider system:

  • SHALL return a GPConnect-OperationOutcome-1 resource that provides additional details when one or more data fields are corrupt or a specific business rule/constraint is breached.
  • SHALL return an error if any appointment details other than the appointment status and cancellation-reason fields are attempted to be updated.
  • SHALL return an error if the appointment being cancelled is in the past (the appointment start dateTime is before the current date and time).
  • SHALL return an error if the version identifier in the If-Match header does not match the Appointment’s current version identifier. See Managing resource contention.

Refer to Development - FHIR API guidance - error handling for details of error codes.

Request response

Response headers

Provider systems are not expected to add any specific headers beyond that described in the HTTP and FHIR® standards.

Payload response body

Provider systems:

  • SHALL return a 200 OK HTTP status code on successful execution of the operation.
  • SHALL return an Appointment resource that conform to the GPConnect-Appointment-1 profile.
  • SHALL include the URI of the GPConnect-Appointment-1 profile StructureDefinition in the Appointment.meta.profile element of the returned appointment resource.
  • SHALL include the versionId of the current version of each appointment resource.
  • SHALL have updated the appointment status to “cancelled”.
  • SHALL have updated the appointment cancellation-reason in line with any details supplied in the request.

  • SHALL meet General FHIR resource population requirements populating all fields where data is available, excluding those listed below

  • SHALL NOT populate the following fields:
    • reason
    • specialty
{
  "resourceType": "Appointment",
  "id": "9",
  "meta": {
    "versionId": "636068818095315079",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/GPConnect-Appointment-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Organization",
      "id": "1",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
        ]
      },
      "identifier": [
        {
          "system": "https://fhir.nhs.uk/Id/ods-organization-code",
          "value": "A00001"
        }
      ],
      "type": [
        {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/GPConnect-OrganisationType-1",
              "code": "gp-practice"
            }
          ]
        }
      ],
      "name": "Test Organization Name",
      "telecom": [
        {
          "system": "phone",
          "value": "0300 303 5678"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-BookingOrganisation-1",
      "valueReference": {
        "reference": "#1"
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1",
      "valueString": "Free text cancellation reason."
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-PractitionerRole-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
            "code": "R0260",
            "display": "General Medical Practitioner"
          }
        ]
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-DeliveryChannel-2",
      "valueCode": "In-person"
    }
  ],
  "status": "cancelled",
  "description": "Free text description updated.",
  "start": "2017-05-30T10:00:00+01:00",
  "end": "2017-05-30T10:25:00+01:00",
  "slot": [
    {
      "reference": "Slot/1",
      "display": "Slot 1"
    }
  ],
  "created": "2017-05-25T13:48:41+01:00",
  "comment": "Free text comment.",
  "participant": [
    {
      "actor": {
        "reference": "Patient/1",
        "display": "Mr. Mike Smith"
      },
      "status": "accepted"
    },
    {
      "actor": {
        "reference": "Location/32",
        "display": "Leeds GP Clinic"
      },
      "status": "accepted"
    }
  ]
}

Examples

C#

var client = new FhirClient("http://gpconnect.aprovider.nhs.net/GP001/STU3/1");
client.PreferredFormat = ResourceFormat.Json;
var appointment = client.Read<Appointment>("Appointment/9");
// Cancel The Appointment
appointment.Status = Appointment.AppointmentStatus.Cancelled;
appointment.Extension.Add(new Extension("https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1",new FhirString("Free text cancellation reason.")));
var cancelledAppointment = client.Update<Appointment>(appointment);
FhirSerializer.SerializeResourceToJson(cancelledAppointment).Dump();

Java

// Read appointment to be updated
FhirContext ctx = FhirContext.forStu3();
IGenericClient client = ctx.newRestfulGenericClient("http://gpconnect.aprovider.nhs.net/GP001/STU3/1");
Appointment appointment = client.read().resource(Appointment.class).withId("9").execute();

// Amend appointment status and cancellation reason
appointment.setStatus(AppointmentStatusEnum.CANCELLED);
ExtensionDt extension = new ExtensionDt(false);
extension.setUrl("https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1");
extension.setValue(new StringDt("Free text cancellation reason."));
appointment.addUndeclaredExtension(extension);

// Cancel appointment
MethodOutcome response = client.update()
	.resource(appointment)
	.prefer(PreferReturnEnum.REPRESENTATION)
	.preferResponseType(Appointment.class)
	.execute();

System.out.println(fhirContext.newJsonParser().setPrettyPrint(true).encodeResourceToString(response.getResource()));
Tags: appointments