Key NHS APIs Using FHIR R4
| NHS API | Purpose | FHIR Resources | Auth Method |
|---|---|---|---|
| NHS Spine (PDS) | Patient Demographics Service — verify NHS numbers, patient details | Patient resource (UK Core) | NHS smartcard / API key + OAuth2 |
| GP Connect (Record Access) | Access GP clinical records for connected NHS services | Patient, Condition, Medication, Observation | NHS system OAuth2 + smartcard |
| GP Connect (Appointments) | Book/manage GP appointments digitally | Slot, Appointment, Schedule | NHS system OAuth2 |
| NHS Login | Patient identity verification — P5 (low) and P9 (high) assurance levels | OIDC/OAuth2 — not FHIR | NHS Digital OIDC client credentials |
| NHS 111 / UEC APIs | Urgent care referral and transfer | Encounter, ServiceRequest | NHS API management platform |
| Electronic Prescription Service (EPS) | Digital prescription creation and dispensing | MedicationRequest, MedicationDispense | NHS smartcard |
UK Core FHIR Profiles — Why They Matter
UK Core adds NHS-specific identifier systems (NHS Number, ODS codes, SNOMED CT UK edition)
UK Core constrains cardinality on clinical resources to match NHS data quality standards
UK Core adds UK-specific extensions for GP systems, consent models, and clinical coding
UK Core profiles are versioned — implementation must specify the version it supports
NHS Digital publish UK Core conformance resources (StructureDefinitions, ValueSets, CodeSystems) on the NHS Digital FHIR server
UK Core is the NHS England-mandated set of profiles and extensions that constrain and extend base FHIR R4 for UK use. Implementing generic FHIR R4 is not sufficient for NHS integration — you must implement UK Core profiles. Key differences:
NHS Login Integration — Patient Identity Verification
| Assurance Level | What's Verified | Use Case | Verification Method |
|---|---|---|---|
| P5 — Medium | Email + basic demographic match | Non-clinical, lower-risk services | Online ID document scan + demographic match |
| P9 — High | Full identity verification | Clinical services, prescription access | In-person ID verification or video ID proofing |
NHS Login integration requires: supplier agreement with NHS Digital, test environment onboarding (sandbox → integration → production pathway), implementation of OIDC authorisation code flow with PKCE, and privacy notice meeting NHS Login requirements.