{"openapi":"3.0.3","info":{"title":"Patient flags API","description":"## Overview\nUse this API to access and update patient flags and associated supporting resources.\n\nYou can access and update:\n\n- [Reasonable Adjustments (RA) Flag and associated impairments, adjustments and underlying conditions](https://digital.nhs.uk/services/reasonable-adjustment-flag#how-the-reasonable-adjustment-flag-works)\n- [Female Genital Mutilation (FGM) Flag](https://digital.nhs.uk/services/female-genital-mutilation-information-sharing#how-this-service-works)\n\nYou can access:\n- [Child Protection - Information Sharing (CP-IS) Flag and associated care team (for scheduled care)](https://digital.nhs.uk/services/child-protection-information-sharing-service#how-this-service-works)\n\nIn the coming months, the CP-IS Flag will be supported for unscheduled care in conjunction with the usage of the CP-IS unscheduled care encounter API\n\n### About flags\n\nEach flag consists of the flag itself, and any supporting resources to give context to the flag.\n\nEach flag has a different set of associated resources.\n - Reasonable Adjustment Flag consists of the flag itself that indicates the patient requires reasonable adjustments. Supporting resources are optionally included to provide details of adjustments, impairments and underlying conditions to be considered.\n\n - Female Genital Mutilation Flags consist of the flag itself.\n\n - Child Protection - Information Sharing Flag consists of the flag itself that indicates a child has a child protection plan. Supporting resources are details of the care team.\n\nYou can use the Patient Flag API to:\n- get all patient flags\n- get the flag and supporting resources for a specific flag\n- create a flag and supporting resources\n- delete a flag (which deletes all supporting resources)\n- create a supporting resource\n- delete a supporting resource\n\nYou can not update individual supporting resources. To change a resource, you must delete the resource first and then create the resource.\n\n## Who can use this API\nThis API can only be used where there is a legal basis to do so. Make sure you have a valid use case before you go too far with your development. You must demonstrate you have a valid use case as part of digital onboarding.\n\nYou must do this before you can go live (see 'Onboarding' below).\n\n## Related APIs\nTo use this API, you will need the patient's NHS number, which can be retrieved by using the following API:\n\n- [Personal Demographics Service (FHIR) API](https://digital.nhs.uk/developer/api-catalogue/personal-demographics-service-fhir) - use this API to search for patients and retrieve their details. This API can also be used to update their details in some cases.\n\nThe following API is related to Patient Flags Service - FHIR API:\n\n- [Multicast Notification Service API](https://digital.nhs.uk/developer/api-catalogue/multicast-notification-service) - use this API to receive automatic updates when Reasonable Adjustment data is changed.\n\n## API status and roadmap\nThis API is [Internal](https://digital.nhs.uk/developer/guides-and-documentation/reference-guide#statuses) and [Beta](https://digital.nhs.uk/developer/guides-and-documentation/reference-guide#statuses) - we do not expect further breaking changes.\n\nThe Reasonable Adjustment Flag and Female Genital Mutilation Flag via the Patient Flags API are available for testing via a sandbox service and an integration environment.\nThe Child Protection - Information Sharing Flag (read care plan for scheduled care) is available for testing for testing via a sandbox service and an integration environment. \n\nThe Reasonable Adjustment Flag via the Patient Flags API is in use by NCRS (National Care Record Service). It is currently going through first of type for integration with external third parties. \n\n## Technology\nThis API is [RESTful](/developer/guides-and-documentation/api-technologies-at-nhs-digital#basic-rest).\n\nIt conforms to the [FHIR (R4)](https://digital.nhs.uk/developer/guides-and-documentation/api-technologies-at-nhs-digital#fhir) global standard for health care data exchange, specifically to [FHIR Release 4](https://www.hl7.org/fhir/R4/) however it is not fully compliant.\n\nNon-compliance is related to using non-FHIR resources as part of the url.\n\nThe endpoint `/PatientFlag` is not valid in the FHIR R4 standard as there is no FHIR resource named \"PatientFlag\" within the standard.\n\nYou do not need to know much about FHIR to use this API - FHIR APIs are just RESTful APIs that follow specific rules. In particular:\n\n - resource names are capitalised and singular, for example /Patient not /patients\n - array names are singular, for example line not lines for address lines\n - data items that are country-specific and thus not included in the FHIR global base resources are usually wrapped in an extension object\n\nThere are [libraries and SDKs](https://digital.nhs.uk/developer/guides-and-documentation/our-api-technologies#fhir-libraries-and-sdks) available to help with FHIR API integration.\n\n## Network access\nThis API is available on the internet and, indirectly, on the [Health and Social Care Network (HSCN)](https://digital.nhs.uk/services/health-and-social-care-network).\n\nTo use this API with NHS smartcards, the end user needs an HSCN connection, although internet-facing alternatives to smartcards are available.\n\nFor more details see [Network access for APIs](https://digital.nhs.uk/developer/guides-and-documentation/network-access-for-apis).\n\n## Security and authorisation\nThis API supports two access modes:\n\n* [application-restricted access](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation#application-restricted-apis)\n\n* [user-restricted access](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation#user-restricted-apis)\n\nRecommended mode of access to interact with the API is user-restricted access mode. As part of the onboarding process, justification will be required for use of application-restricted access.\n\n### Application-restricted access\n\nThis access mode is [application-restricted](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation#application-restricted-apis), meaning we authenticate the calling application but not the end user.\n\nThe end user could be:\n\n* a healthcare worker - in which case you must ensure they are authenticated and suitably authorised locally\n* not present at all - for example as part of a back end process to bulk upload patient flags\n\nTo use this access mode, use the following security pattern:\n* [Application-restricted RESTful APIs - signed JWT authentication](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation/application-restricted-restful-apis-signed-jwt-authentication)\n\n### User-restricted access\n\nThis access mode is user-restricted, meaning an end user must be present, authenticated and authorised.\n\nThe end user must be:\n\n* a healthcare worker\n* strongly authenticated, using NHS Care Identity Service 2 (NHS CIS2)\n* authorised, using national role-based access control (RBAC)\n\nTo use this access mode, use one of the following security patterns:\n| Security Pattern | Technical details | Advantages | Disadvantages |\n| ---------------------------------------|---------------------------------------------|---------------------------------------| ---------------------------------------|\n| [User-restricted RESTful API - using NHS CIS2 - combined authentication and authorisation](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation/user-restricted-restful-apis-nhs-cis2-combined-authentication-and-authorisation) | OAuth 2.0 authorisation code flow with API key and secret |No need to integrate and onboard separately with NHS CIS2. |No access to user information. Not recommended for use in GP software. |\n| [User-restricted RESTful API - using NHS CIS2 - separate authentication and authorisation](https://digital.nhs.uk/developer/guides-and-documentation/security-and-authorisation/user-restricted-restful-apis-nhs-cis2-separate-authentication-and-authorisation) | OAuth 2.0 token exchange with signed JWT | Gives access to user information. Recommended for use in GP software. |Need to integrate and onboard separately with NHS CIS2. |\n\n## Errors\nWe use standard HTTP status codes to show whether an API request succeeded or not. They are usually in the range:\n\n* 200 to 299 if it succeeded, including code 202 if it was accepted by an API that needs to wait for further action\n* 400 to 499 if it failed because of a client error by your application\n* 500 to 599 if it failed because of an error on our server\n\nErrors specific to each API are shown in the Endpoints section, under Response. See our [reference guide](https://digital.nhs.uk/developer/guides-and-documentation/reference-guide#http-status-codes) for more on errors.\n\n\n## Open source\nYou might find the following [open source](https://digital.nhs.uk/developer/guides-and-documentation/reference-guide#open-source) resources useful:\n\n| Resource | Description | Links |\n| ---------------------------------------|---------------------------------------------|---------------------------------------|\n| Patient Flags API | Source code for the proxy, sandbox and backend |[GitHub repo](https://github.com/NHSDigital/patient-flags-api) |\n| FHIR libraries and SDKs | Various open source libraries for integrating with FHIR APIs | [FHIR libraries and SDKs](https://digital.nhs.uk/developer/guides-and-documentation/our-api-technologies#fhir-libraries-and-sdks) |\n\n\n## Environments and testing\n| Purpose | Base URL |\n| ---------------------------------------|------------------------------------------|\n| Sandbox | `https://sandbox.api.service.nhs.uk/patient-flags-api/FHIR/R4` |\n| Integration test | `https://int.api.service.nhs.uk/patient-flags-api/FHIR/R4` |\n| Production | `https://api.service.nhs.uk/patient-flags-api/FHIR/R4` |\n\n### Sandbox testing\nOur [sandbox environment](https://digital.nhs.uk/developer/guides-and-documentation/testing#sandbox-testing):\n- is for early developer testing\n- only covers a limited set of scenarios\n- is stateless, so it does not actually persist any updates\n- is open access, so does not allow you to test authorisation\n\nFor more details on sandbox testing, or to try out the sandbox using our \\\"Try this API\\\" feature, see the documentation for each endpoint.\n\n### Integration testing\nOur [integration test environment](https://digital.nhs.uk/developer/guides-and-documentation/testing#integration-testing):\n* is for formal integration testing\n* is stateful, so persists updates\n* includes authorisation, with options for app-restricted and user-restricted access (with or without [smartcards](https://digital.nhs.uk/services/registration-authorities-and-smartcards))\n\nTo test updating patient flags, you must set up your own test data.\n\nFor more details see [integration testing with our RESTful APIs](https://digital.nhs.uk/developer/guides-and-documentation/testing#integration-testing-with-our-restful-apis).\n\n## Onboarding\nAll suppliers should have registered interest in the Reasonable Adjustment Flag. Please use this [form](https://digital.nhs.uk/services/patient-flag-api-supplier-interest) if you have not already registered.\nThis form can be used to express your interest in all flags that are supported by the Patient Flags API. \n\n
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\n\nYou need to get your software approved by us before it can go live with this API. We call this onboarding. The onboarding process can sometimes be quite long, so it's worth planning well ahead.\n\nAs part of this process, you need to demonstrate that you can manage risks and that your software conforms technically with the requirements for this API.\n\nInformation on this page might impact the design of your software. For details, see [Onboarding support information](https://digital.nhs.uk/developer/api-catalogue/patient-flags-service---fhir-api/onboarding-support-information).\n\nTo understand how our online digital onboarding process works, see [digital onboarding](https://digital.nhs.uk/developer/guides-and-documentation/digital-onboarding).\n\n
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","contact":{"name":"API Management Support","email":"api.management@nhs.net"},"version":"4.1.6"},"servers":[{"url":"https://sandbox.api.service.nhs.uk/patient-flags-api/FHIR/R4","description":"Sandbox environment"}],"paths":{"/BulkUpload":{"post":{"summary":"Bulk upload patient flags","description":"## Overview\nUse this endpoint to bulk upload locally collected flags to the national service. The endpoint can be used to submit multiple flags of the same type in a single operation.\nThis bulk upload approach can be used for any flags that are supported by the Patient Flag API.\n\nThis endpoint currently supports bulk upload of the following flags\n* Reasonable Adjustment Flag\n\nReasonable Adjustment Flags have been collected locally as part of the Information Standard - Phase 1.\n\nSuppliers are expected to upload all locally collected Reasonable Adjustment Flags before they start to use the API.\n\n## Definitions\n\nBelow are valid values for each of the Reasonable Adjustment attributes.\n\n* [patient flag](https://github.com/NHSDigital/patient-flags-api/blob/main/lambdas/shared/fhir_codes/PatientFlag-Flag-1.json)\n\n* [impairments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-ConditionCode-1)\n\n* [adjustments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-AdjustmentCategory-1)\n\n* underlying condition codes - SNOMED codes and display values. These are not validated by the API, the SNOMED codes and display used in underlying conditions must be validated by the calling system before they are passed into the API.\n\n## Upload a reasonable adjustment record for a patient\n\nThe schema for each line in the bulk upload file can be found in the 'Request body schema' section below. The additional steps required to bulk upload the reasonable adjustments are documented below.\n\n## Generating the request body\nThe bulk upload file should be a .txt file.\nEach Reasonable Adjustment record should be a json string on a separate line. For example, [Example Reasonable Adjustment Bulk Upload File](https://github.com/NHSDigital/patient-flags-api/blob/main/lambdas/tests/data/bulk_upload/bulk_upload_all_correct.txt)\n\nThe file should then be Gzipped and base64 encoded.\n\nExample Python:\n\n```\nimport gzip\nimport base64\n\nwith open(\"file.txt\", \"r\") as _file:\n file_content = _file.read()\n bytes_content = file_content.encode()\n gzipped_content = gzip.compress(bytes_content)\n encoded_content = base64.b64encode(gzipped_content)\n\nrequests.post(\n ...\n data=encoded_content\n)\n```\n\n### ⚠️ Caution on Concurrent Bulk Uploads\n\nRequests made to the Bulk Upload endpoint may be executed in parallel if multiple concurrent requests are made.\n\nIn situations where records for a single patient (NHS number) are split across multiple files, no guarantee is made on which file is processed first. This may cause an unpredictable final data state if records in one file must be applied before reords in another.\n\nAPI Consumers must therefore either:\n* Ensure that where concurrent requests are made, all data for a given patient is contained within the same file.\n* Avoid concurrent requests to the Bulk Upload endpoint entirely.\n\n## Business logic\nNo identifiers are returned as part of the POST request.\n\nSuccessful lines/count will not be returned as part of the POST request.\n\nIf a POST request fails an error response will be returned. Any successful lines will remain committed. The entire file can be posted again and the API will ignore any duplicates.\n\nAll records in the bulk upload file must be validated and synchronised with [PDS](https://digital.nhs.uk/developer/api-catalogue/personal-demographics-service-fhir) before submission to the API to ensure that they have the correct patient identifier. The API will not perform any patient validation checks and will commit the changes submitted in the file.\n\nOnly one patient flag can exist per patient / type of flag. If a patient flag is posted for a patient that already has the flag,\nthe records are merged using the following logic:\n- any additional resources from the second post are added to the existing flag\n- notes from any identical resources are added to the same resource in the existing flag\n\n## Error scenarios\n\n### Failures of the request as a whole\n| Error scenario | Status | Error code | Diagnostics |\n|----------------------------|--------|---------------------------|--------------------------------------------------------------------------------------------------------|\n| Incorrect method (e.g. PUT)| 404 | None\t | This will be rejected at the APIM proxy layer which does not provide a response body for 404 responses |\n| Incorrect/missing header\t | 400 | MISSING_OR_INVALID_HEADER | '{header}' header missing or invalid |\n| No body\t | 400 | MISSING_REQUEST_BODY | Post method must include request body |\n| Incorrect base 64 encoding | 400 | INVALID_REQUEST_BODY | Unable to base64 decode request body |\n| Incorrect gzipping\t | 400 | INVALID_REQUEST_BODY | Successfully decoded base64 request body but unable to decompress the contents using gzip |\n| Empty file | 400 | INVALID_REQUEST_BODY | Successfully decoded and decompressed body but file is empty |\n\n### Server responses when the above checks have been satisfied\n\n| Error scenario | Status | Response body |\n|----------------------------|--------|---------------------------|\n| All lines have processed successfully\t| 201 |\tEmpty string |\n| All lines have failed processing\t | 400 | Base64 encoded, gzipped file containing the failing lines AND each line has an additional key of error which will provide the reason that the line failed |\n| Some lines have processed successfully, some have failed | \t207 |\tBase64 encoded, gzipped file containing the failing lines AND each line has an additional key of error which will provide the reason that the line failed |\n\n\n### Failures due to incorrect lines\nIf the server failed to process any lines, these will be returned as base64 encoded, gzipped file similar to [this one]( https://github.com/NHSDigital/patient-flags-api/blob/main/lambdas/tests/data/bulk_upload/bulk_upload_all_correct.txt)","operationId":"bulkUpload","parameters":[{"$ref":"#/components/parameters/TextContent"},{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"}],"requestBody":{"content":{"application/fhir+json":{"schema":{"type":"object","properties":{"code":{"type":"string"},"note":{"type":"object","properties":{"text":{"type":"string"},"author":{"type":"string"}}},"nhs_number":{"type":"string","example":"9449306753"},"conditions":{"type":"array","items":{"type":"object","properties":{"note":{"type":"object","properties":{"text":{"type":"string"},"author":{"type":"string"}}},"code":{"type":"string"},"display":{"type":"string"},"provenance":{"type":"object","properties":{"user_name":{"type":"string","example":"John Smith"},"user_org":{"type":"string","example":"Y12345"},"recorded":{"type":"string","example":"2021-03-17T15:52:14+00:00"}}}}}},"impairments":{"type":"array","items":{"type":"object","properties":{"note":{"type":"object","properties":{"text":{"type":"string"},"author":{"type":"string"}}},"code":{"type":"string"},"display":{"type":"string"},"provenance":{"type":"object","properties":{"user_name":{"type":"string","example":"John Smith"},"user_org":{"type":"string","example":"Y12345"},"recorded":{"type":"string","example":"2021-03-17T15:52:14+00:00"}}}}}},"adjustments":{"type":"array","items":{"type":"object","properties":{"note":{"type":"object","properties":{"text":{"type":"string"},"author":{"type":"string"}}},"code":{"type":"string"},"display":{"type":"string"},"category":{"type":"object","properties":{"code":{"type":"string"},"display":{"type":"string"}}},"provenance":{"type":"object","properties":{"user_name":{"type":"string","example":"John Smith"},"user_org":{"type":"string","example":"Y12345"},"recorded":{"type":"string","example":"2021-03-17T15:52:14+00:00"}}}}}}}},"examples":{"Example JSON of line with display values provided":{"summary":"Example JSON of line with display values provided","value":{"nhs_number":"9449306796","code":"NRAF","conditions":[{"code":"3","display":"Mobility (for example walking short distances or climbing stairs)","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}}],"adjustments":[{"code":"1325301000000104","display":"Uses emotional support animal","category":{"code":"007","display":"Adjustments for providing Additional Support to patients"},"provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}}],"impairments":[{"code":"7","display":"Mental health","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}}]}},"Example JSON of line with display values NOT provided":{"summary":"Example JSON of line with display values NOT provided","value":{"note":{"text":"This is a top level flag note","authorString":"authorString"},"nhs_number":"9449306753","code":"NRAF","conditions":[{"code":"3","display":"Mobility (for example walking short distances or climbing stairs)","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}}],"adjustments":[{"code":"966401000000100","category":{"code":"002"},"provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}},{"code":"719369003","category":{"code":"001"},"provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-22T10:05:33+00:00"},"status":"inactive"}],"impairments":[{"note":{"text":"This is an impairment note","authorString":"authorString"},"code":"2","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"}},{"code":"1","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-10T10:05:33+00:00"},"status":"inactive"}]}},"Example JSON of line with notes and best interest summary":{"summary":"Example JSON of line with notes","value":{"nhs_number":"9449306796","code":"NRAF","note":{"text":"This is a note for the Reasonable Adjustments flag as a whole","authorString":"authorString"},"conditions":[{"code":"3","display":"Mobility (for example walking short distances or climbing stairs)","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"},"note":{"text":"This is a note against the specific condition","authorString":"authorString"}}],"adjustments":[{"code":"1325371000000107","display":"Requires home visit appointments","category":{"code":"008","display":"Adjustments for Individual Care Requirements"},"provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"},"note":{"text":"This is a note against the specific adjustment","authorString":"authorString"}}],"impairments":[{"code":"3","display":"Mobility (for example walking short distances or climbing stairs)","provenance":{"user_name":"Some user","user_org":"Some Org","recorded":"2018-07-24T10:05:33+00:00"},"note":{"text":"This is a note against the specific impairment","authorString":"authorString"}}]}},"Example of Base64 encoded, Gzip compressed, multiple line file":{"summary":"Example of Base64 encoded, Gzip compressed, multiple line file","value":"H4sIAMBFnmYC/+1TTU/DMAy98yusnEAwKVu7j+62CzcYYtwQQmnrtYEmqZJ0bJr633E6waSKI9qpN9vPjf38+o5Ml+5dNypFy5bAkjhOIj6bTyN2BywzOYbq4/Pq/pRrh9pT6chqa/aHLvrp4jwOTbl0dSUCxNa+RAsVFtJLJTxCLbykB8BibTE8RfkOYUSADVlFiKtpikxlJf2BtfQgTdqhFjrDblzj0L5robqZG6MQQiVM7hBji19gTTHVLWbG5piH+oSPFyM+H03ilzFf8ukyim45BZy17YlhTsvSBtT8euYW9Zg9mNOCcL01FnAvVF0hfInqU+oCXGmsB2r3YWsH1JJVUqUd5oW07oZdktgb9Yr8o3Fe0ZV71GKezGYLzic9ik+l8aYuiajotCf9CmP7kie9r1bnMSA1yVmJcE7wBuhnANQ7aY0OOJgtZCT7ZTUOp5CqJg3+OMWiR2bjhZJaBP1Si8KXQUBKtsSpaPCyGrZXx8Gsg1kHsw5mHcw6mHUw6/+Z9RuPDwRyBgsAAA=="}}}},"required":true},"responses":{"201":{"description":"Success"},"400":{"description":"Request failed entirely"},"207":{"description":"Some lines were uploaded successfully"}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]}]}},"/PatientFlag":{"get":{"summary":"Get patient flags","description":"## Overview\n\nUse this endpoint to return all flags held against a patient. This endpoint supports retrieving the Reasonable Adjustment (RA) Flag, Female Genital Mutilation (FGM) Flag and the Child Protection - Information Sharing (CP-IS) Flag. Other flags will be introduced in the future.\n\nSuppliers are expected to use a verified NHS number as the unique identifier to call the Patient Flag API. [PDS FHIR API](https://digital.nhs.uk/developer/api-catalogue/personal-demographics-service-fhir) must be used to obtain the verified NHS number from Personal Demographic Service (PDS) to ensure they have correctly identified the patient.\n\nThere are two approaches available for retrieving flags.\n\n#### Approach 1 - Query for all flags associated with a patient\nThis will return only the flag indicators - supporting resources are not returned. For example, a request for all flags associated with a patient can return a response indicating that the patient has a Reasonable Adjustment Flag and a Female Genital Mutilation Flag.\n\nInclude the parameter:\n* 'patient' - patient's NHS number\n\n```\n/PatientFlag?patient=9449306753\n```\n\nThe response will be a bundle of flag resources without any of the supporting resources.\n\n#### Approach 2 - Query for a specific flag and supporting resources associated with a patient\nThis will return the flag indicator and all supporting resources. For example, a request for a Reasonable Adjustment Flag for a patient can return a response indicating that the patient does have a Reasonable Adjustment Flag together with details of their underlying conditions and impairments. A request for a Child Protection - Information Sharing Flag for a patient can return a response indicating that a Child Protection Plan is in place and the care team.\n\nInclude the parameters:\n* 'patient' - patient's NHS number\n* 'code' - [patient flag code](https://github.com/NHSDigital/patient-flags-api/blob/main/lambdas/shared/fhir_codes/PatientFlag-Flag-1.json)\n\n```\n/PatientFlag?patient=9449306753&code=NRAF (NRAF indicates the Reasonable Adjustment Flag)\n/PatientFlag?patient=9694201438&code=FGM (FGM indicates the Female Genital Mutilation Flag)\n/PatientFlag?patient=9449308853&code=CP-IS (CP-IS indicates the Child Protection Information Sharing Flag)\n```\nThe response will be a bundle of resources including the flag resource and any supporting resources.\n\n#### Recommended approach\nPatient Flag API will support more flags in the future.\n\nIf you plan to incorporate multiple flags into your solution, we recommend that you use Approach 1. Retrieve all flags first and then use this information to determine whether the flags exist, whether you need to query the specific flag for full details or whether you need create a new flag. This is the most efficient approach and will reduce the number of API calls made and reduce the volume of traffic.","operationId":"getFlag","parameters":[{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"},{"$ref":"#/components/parameters/Patient"},{"$ref":"#/components/parameters/Code"}],"responses":{"200":{"description":"Success","content":{"application/json":{"schema":{"type":"object","properties":{"resourceType":{"type":"string"},"id":{"type":"string"},"meta":{"type":"object","properties":{"lastUpdated":{"type":"string"}}},"type":{"type":"string"},"total":{"type":"number"},"link":{"type":"array","items":{"type":"object","properties":{"relation":{"type":"string"},"url":{"type":"string"}}}},"entry":{"type":"array","items":{"type":"object","properties":{"resource":{"type":"object","properties":{"resourceType":{"type":"string"},"id":{"type":"string"},"meta":{"type":"object","properties":{"lastUpdated":{"type":"string"}}},"status":{"type":"string"},"category":{"type":"array","items":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}}},"code":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}},"subject":{"type":"object","properties":{"reference":{"type":"string"}}},"contained":{"type":"array","items":{"type":"object","properties":{"resourceType":{"type":"string"},"target":{"type":"array","items":{"type":"object","properties":{"reference":{"type":"string"}}}},"recorded":{"type":"string"},"activity":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}},"agent":{"type":"array","items":{"type":"object","properties":{"who":{"type":"object","properties":{"display":{"type":"string"}}},"onBehalfOf":{"type":"object","properties":{"display":{"type":"string"}}}}}}}}},"extension":{"type":"array","items":{"type":"object"}},"period":{"type":"object","properties":{"start":{"type":"string"},"end":{"type":"object"}}}}}}}}}},"examples":{"All flags for a patient":{"summary":"All flags for a patient","value":{"resourceType":"Bundle","id":"f6fa9dcd-a495-492f-9e9a-ee1d7cff54c1","meta":{"lastUpdated":"2021-03-17T15:52:14+00:00"},"type":"searchset","total":2,"link":[{"relation":"self","url":"https://api.service.nhs.uk/patient-flags-api/FHIR/R4/PatientFlag?patient=9694201438"}],"entry":[{"resource":{"resourceType":"Flag","id":"f6fa9dcd-a495-492f-9e9a-ee1d7cff54c1","meta":{"lastUpdated":"2021-03-17T15:52:14+00:00"},"status":"active","category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"FGM","display":"Female Genital Mutilation Flag"}]}],"code":{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"FGM","display":"Female Genital Mutilation 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criteria","value":{"resourceType":"Bundle","id":"f6fa9dcd-a495-492f-9e9a-ee1d7cff54c1","meta":{"lastUpdated":"2021-03-17T15:52:14+00:00"},"type":"searchset","total":0,"link":[{"relation":"self","url":"https://api.service.nhs.uk/patient-flags-api/FHIR/R4/PatientFlag?patient=9449306796"}],"entry":[]}}}}}},"400":{"description":"Client error","content":{"application/json":{"examples":{"Patient parameter not included":{"summary":"Patient parameter not included","value":{"issue":[{"code":"invalid","details":{"coding":[{"code":"MISSING_QUERY_PARAMETER","display":"Missing Query Parameter","system":"https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1"}]},"diagnostics":"Required query string parameter missing - patient","severity":"error"}],"resourceType":"OperationOutcome"}}}}}}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]},{"nhs-login-p9":[]}]},"post":{"summary":"Create a patient flag","description":"## Overview\n\nUse this endpoint to create a flag for a patient including any supporting resources. The body of the request is a transaction bundle made up of\nthe patient flag resource and any other accepted FHIR resources to support that flag.\n\nFor example, for a Reasonable Adjustments Flag you would post a transaction containing:\n- patient flag resource (1 single resource)\n- underlying conditions (any number of resources)\n- impairments (any number of resources)\n- adjustments (any number of resources)\n\nUnderlying conditions, impairments and adjustments are optional FHIR resources.\n\n### Business logic\n\nOnly one patient flag can exist per patient / type of flag. If a patient flag is posted for a patient that already has the flag,\nthe records are merged using the following logic:\n- any additional resources from the second post are added to the existing flag\n- notes from any identical resources are added to the same resource in the existing flag\n- status of 201 is returned\n\nThis means the calling system should cater for the scenario where the response body of a post message contains additional resources /\nnotes to the request body.\n\nThe examples below contain valid request bodies for a Reasonable Adjustments Flag (RA) and a Female Genital Mutilation Flag (FGM).","operationId":"postFlag","parameters":[{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"}],"requestBody":{"content":{"application/fhir+json":{"schema":{"type":"object","properties":{"resourceType":{"type":"string"},"id":{"type":"string"},"type":{"type":"string"},"entry":{"type":"array","items":{"type":"object","properties":{"resource":{"type":"object","properties":{"resourceType":{"type":"string"},"contained":{"type":"array","items":{"type":"object","properties":{"resourceType":{"type":"string"},"target":{"type":"array","items":{"type":"object","properties":{"reference":{"type":"string"}}}},"recorded":{"type":"string"},"activity":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}},"agent":{"type":"array","items":{"type":"object","properties":{"who":{"type":"object","properties":{"display":{"type":"string"}}},"onBehalfOf":{"type":"object","properties":{"display":{"type":"string"}}}}}}}}},"category":{"type":"array","items":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}}},"subject":{"type":"object","properties":{"reference":{"type":"string"}}},"note":{"type":"array","items":{"type":"object","properties":{"text":{"type":"string"},"authorString":{"type":"string"}}}},"clinicalStatus":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"}}}}}},"code":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}}}},"request":{"type":"object","properties":{"method":{"type":"string"},"url":{"type":"string"},"ifNoneMatch":{"type":"string"},"ifModifiedSince":{"type":"string"},"ifMatch":{"type":"string"},"ifNoneExist":{"type":"string"}}}}}}}},"examples":{"Reasonable adjustments transaction bundle":{"summary":"Reasonable adjustments flag bundle (1 of each resource)","value":{"resourceType":"Bundle","id":"f6fa9dcd-a495-492f-9e9a-ee1d7cff54c1","type":"transaction","entry":[{"resource":{"resourceType":"Condition","contained":[{"resourceType":"Provenance","target":[{"reference":"#"}],"recorded":"2024-01-01T11:00:00+00:00","activity":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-DataOperation","code":"CREATE","display":"create"}]},"agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"note":[{"text":"This is a note about the Impairment","authorString":"authorString"}],"clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"active"}]},"code":{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/RA-ConditionCode","code":"7","display":"Mental health"}]}}},{"resource":{"resourceType":"Flag","status":"active","contained":[{"resourceType":"Provenance","target":[{"reference":"#"}],"recorded":"2024-01-01T11:00:00+00:00","activity":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-DataOperation","code":"CREATE","display":"create"}]},"agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"category":[{"coding":[{"code":"003","display":"Requires specific contact method","system":"https://fhir.nhs.uk/England/CodeSystem/RA-AdjustmentCategory"}]},{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"code":{"coding":[{"system":"https://snomed.info/sct","code":"719561001","display":"Requires contact via carer"}]},"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"extension":[{"url":"https://fhir.nhs.uk/England/StructureDefinition/Extension-FlagNotes","valueAnnotation":{"text":"A note about the adjustment","authorString":"authorString"}}]}},{"resource":{"resourceType":"Flag","status":"active","category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"code":{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]},"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"contained":[{"resourceType":"Provenance","target":[{"reference":"#"}],"recorded":"2024-01-01T11:00:00+00:00","activity":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-DataOperation","code":"CREATE","display":"create"}]},"agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}]}},{"resource":{"resourceType":"Condition","contained":[{"resourceType":"Provenance","target":[{"reference":"#"}],"recorded":"2024-01-01T11:00:00+00:00","activity":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-DataOperation","code":"CREATE","display":"create"}]},"agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"active"}]},"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"note":[{"text":"This is a note about the Underlying Condition","authorString":"authorString"}],"code":{"coding":[{"system":"https://snomed.info/sct","code":"new-code","display":"some snomed condition"}]}}}]}},"FGM transaction bundle":{"summary":"FGM bundle","value":{"id":"c14a96a0-4a93-45fb-bba8-90e0c20c4ad5","type":"transaction","resourceType":"Bundle","entry":[{"resource":{"resourceType":"Flag","status":"active","category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"FGM","display":"Female Genital Mutilation Flag"}]}],"code":{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"FGM","display":"Female Genital Mutilation Flag"}]},"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"period":{"start":"2021-03-17T15:52:14+00:00"},"extension":[{"url":"https://fhir.nhs.uk/England/StructureDefinition/Extension-FlagNotes","valueAnnotation":{"text":"A note about the FGM flag","authorString":"authorString"}}],"contained":[{"resourceType":"Provenance","target":[{"reference":"#"}],"recorded":"2024-01-01T11:00:00+00:00","activity":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-DataOperation","code":"CREATE","display":"create"}]},"agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}]}}]}}}}},"required":true},"responses":{"201":{"description":"Success"},"400":{"description":"Client error"},"422":{"description":"Business logic failure"}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]}]},"delete":{"summary":"Delete a patient flag","description":"## Overview\n\nUse this endpoint to delete a specific patient flag and supporting resources associated with that flag.\n\nInclude the parameters\n* 'patient' - patient's NHS number\n* 'code' - [patient flag code](https://github.com/NHSDigital/patient-flags-api/blob/main/lambdas/shared/fhir_codes/PatientFlag-Flag-1.json)\n* 'reason' - [reasonable adjustment removal reason codes](https://fhir.nhs.uk/STU3/ValueSet/RARecord-RemovalReason-1), [FGM-IS removal reason codes](https://simplifier.net/guide/nhs-england-implementation-guide-stu1/Home/Terminology/All-CodeSystems/CodeSystem-England-FGMRemovalReason?version=1.1.0)\n\nFor example, to delete a Reasonable Adjustment Flag\n```\n/PatientFlag?patient=9999999999&code=NRAF&reason=Error\n```\n\nThe response will be no content with HTTP response code 204.","operationId":"deleteFlag","parameters":[{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"},{"$ref":"#/components/parameters/RemovalReason"},{"$ref":"#/components/parameters/Patient"},{"$ref":"#/components/parameters/Code"}],"responses":{"204":{"description":"Success no content"},"400":{"description":"Client error"}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]}]}},"/{ResourceType}":{"post":{"summary":"Create a supporting resource","description":"## Overview\nUse this endpoint to add supporting resources to an existing patient flag. \n\n#### Reasonable Adjustments\nSupporting resources for the Reasonable Adjustments Flag can be underlying conditions, impairments or adjustments.\nBelow are valid values for each of the Reasonable Adjustment attributes:\n\n- [impairments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-ConditionCode-1) - impairment items coded to the harmonised impairment standard \n\n- [adjustments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-AdjustmentCategory-1) - SNOMED codes and display values\n\n- underlying condition codes - SNOMED codes and display values. These are not validated by the API, the SNOMED codes and display passed in the underlying conditions must be validated by the calling system before they are passed into the API.\n\nAdjustments are classified as 'Flag' FHIR resources. Impairments and underlying conditions are classified as 'Condition' FHIR resources.\n\nThe examples below demonstrate how to add supporting resources for the Reasonable Adjustment Flag.","operationId":"postResource","parameters":[{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"},{"$ref":"#/components/parameters/ResourceType"}],"requestBody":{"content":{"application/fhir+json":{"schema":{"type":"object","properties":{"resource":{"type":"object","properties":{"resourceType":{"type":"string"},"code":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}},"clinicalStatus":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"}}}}}},"category":{"type":"array","items":{"type":"object","properties":{"coding":{"type":"array","items":{"type":"object","properties":{"system":{"type":"string"},"code":{"type":"string"},"display":{"type":"string"}}}}}}},"subject":{"type":"object","properties":{"reference":{"type":"string"}}},"contained":{"type":"array","items":{"type":"object","properties":{"target":{"type":"array","items":{"type":"object","properties":{"reference":{"type":"string"}}}},"resourceType":{"type":"string"},"recorded":{"type":"string"},"agent":{"type":"array","items":{"type":"object","properties":{"who":{"type":"object","properties":{"display":{"type":"string"}}},"onBehalfOf":{"type":"object","properties":{"display":{"type":"string"}}}}}}}}},"note":{"type":"array","items":{"type":"object","properties":{"text":{"type":"string"},"authorString":{"type":"string"}}}}}},"request":{"type":"object","properties":{"method":{"type":"string"},"url":{"type":"string"},"ifNoneMatch":{"type":"string"},"ifModifiedSince":{"type":"string"},"ifMatch":{"type":"string"},"ifNoneExist":{"type":"string"}}}}},"examples":{"Post supporting underlying condition for NRAF Flag":{"summary":"Post supporting underlying condition for NRAF Flag","value":{"resource":{"resourceType":"Condition","code":{"coding":[{"system":"https://snomed.info/sct","code":"1234","display":"some snomed condition"}]},"clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"active"}]},"category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"contained":[{"target":[{"reference":"#"}],"resourceType":"Provenance","recorded":"2024-01-01T11:00:00+00:00","agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"note":[{"text":"This is a note about the Underlying Condition","authorString":"authorString"}]}}},"Post supporting adjustment for NRAF Flag":{"summary":"Post supporting adjustment for NRAF Flag","value":{"resource":{"category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]},{"coding":[{"code":"003","display":"Requires specific contact method","system":"https://fhir.nhs.uk/England/CodeSystem/RA-AdjustmentCategory"}]}],"status":"active","code":{"coding":[{"code":"936741000000100","display":"Requires contact by email","system":"http://snomed.info/sct"}]},"extension":[{"url":"https://fhir.nhs.uk/England/StructureDefinition/Extension-FlagNotes","valueAnnotation":{"text":"A note about the adjustment","authorString":"authorString"}}],"resourceType":"Flag","contained":[{"target":[{"reference":"#"}],"resourceType":"Provenance","recorded":"2024-01-01T11:00:00+00:00","agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"}}}},"Post supporting impairment for NRAF Flag":{"summary":"Post supporting impairment for NRAF Flag","value":{"resource":{"code":{"coding":[{"code":"9","display":"Social or behavioural (for example associated with autism spectrum disorder (ASD) which includes Asperger’s, or attention deficit hyperactivity disorder (ADHD))","system":"https://fhir.nhs.uk/England/CodeSystem/RA-ConditionCode"}]},"clinicalStatus":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"active"}]},"resourceType":"Condition","subject":{"reference":"https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449306753"},"category":[{"coding":[{"system":"https://fhir.nhs.uk/England/CodeSystem/PatientFlagCategory","code":"NRAF","display":"National Reasonable Adjustments Flag"}]}],"contained":[{"target":[{"reference":"#"}],"resourceType":"Provenance","recorded":"2024-01-01T11:00:00+00:00","agent":[{"who":{"display":"Dr. Someone"},"onBehalfOf":{"display":"Some GP Surgery"}}]}],"note":[{"text":"This is a note about the Impairment","authorString":"authorString"}]}}}}}},"required":true},"responses":{"200":{"description":"Success"},"400":{"description":"Client error"}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]}]}},"/{ResourceType}/{ResourceID}":{"delete":{"summary":"Delete a supporting resource","description":"## Overview\n\nUse this endpoint to delete a supporting resource from a specific patient flag.\nThe supporting resource is deleted by ID. \n\nA GET request must be made prior to deleting a flag to retrieve the supporting resource identifier and to check that the most up to date information is held for the flag. \n\n#### Reasonable Adjustments\nSupporting resources for Reasonable Adjustments Flag can be underlying conditions, impairments or adjustments.\nBelow are valid values for each of the Reasonable Adjustment attributes:\n\n- [impairments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-ConditionCode-1) - impairment items coded to the harmonised impairment standard \n\n- [adjustments](https://fhir.nhs.uk/STU3/CodeSystem/RARecord-AdjustmentCategory-1) - SNOMED codes and display values\n\n- underlying condition codes - SNOMED codes and display values. These are not validated by the API, the SNOMED codes and display passed in the underlying conditions must be validated by the calling system before they are passed into the API.\n\nAdjustments are classified as 'Flag' FHIR resources. Impairments and underlying conditions are classified as 'Condition' FHIR resources.\n\nInclude the parameter\n\n- 'reason' - [reasonable adjustment removal reason codes](https://fhir.nhs.uk/STU3/ValueSet/RARecord-RemovalReason-1)\n\n#### To delete an impairment or an underlying condition\n```\n/Condition/b8ab463d-f698-41a0-aae2-6d6163dd0825?reason=Error\n```\n\n#### To delete an adjustment\n```\n/Flag/b8ab463d-f698-41a0-aae2-6d6163dd0825?reason=DoesntApply\n```\n\nThe response will be no content with HTTP response code 204.\n\nThe examples below demonstrate how to delete supporting resources for the Reasonable Adjustment Flag.","operationId":"deleteResource","parameters":[{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"},{"$ref":"#/components/parameters/ResourceID"},{"$ref":"#/components/parameters/ResourceType"},{"$ref":"#/components/parameters/RemovalReason"}],"responses":{"204":{"description":"Success no content"},"400":{"description":"Client error","content":{"application/json":{"examples":{"Flag Id not included":{"summary":"Resource Id not included","value":{"issue":[{"severity":"error","code":"invalid","details":{"coding":[{"system":"https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1","code":"INVALID_REQUEST","display":"Invalid Request"}]},"diagnostics":"DELETE on endpoint=/Flag requires an ID"}],"resourceType":"OperationOutcome"}},"Flag Id included but not found":{"summary":"Resource Id included but not found","value":{"issue":[{"severity":"error","code":"invalid","details":{"coding":[{"system":"https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1","code":"RESOURCE_NOT_FOUND","display":"Resource Not Found"}]},"diagnostics":"Flag with given ID could not be found"}],"resourceType":"OperationOutcome"}}}}}}},"deprecated":false,"security":[{"app-level3":[]},{"nhs-cis2-aal3":[]},{"nhs-cis2-aal1":[]}]}},"/ReferenceData":{"get":{"summary":"Get reference data","description":"## Overview\nUse this endpoint to return all reference data for all flags supported by the Patient Flags API.\n\nFor example, the reference data will include resource codes for \n* impairments and adjustments for the Reasonable Adjustments Flag\n* protection plans for the Child Protection - Information Sharing Flag\n\nThis endpoint returns simple JSON and not FHIR JSON. \n\nNote: This endpoint is under active development and is subject to change.\n\nThe example below demonstrates how to return the reference data from the Patient Flags API.","operationId":"getReferenceData","parameters":[{"$ref":"#/components/parameters/TextContent"},{"$ref":"#/components/parameters/Authorization"},{"$ref":"#/components/parameters/RequestID"},{"$ref":"#/components/parameters/RoleID"},{"$ref":"#/components/parameters/RoleName"},{"$ref":"#/components/parameters/UserID"},{"$ref":"#/components/parameters/UserName"},{"$ref":"#/components/parameters/OrgCode"},{"$ref":"#/components/parameters/OrgName"}],"responses":{"200":{"description":"Success","content":{"application/json":{"schema":{"type":"object","properties":{"code":{"type":"object","properties":{"code":{"display":"string"}}}}},"examples":{"All reference data":{"summary":"Impairment codes reference data","value":{"NRAF":{"display":"National Reasonable Adjustments Flag","removalReason":{"Error":{"display":"The Reasonable Adjustment Flag was created in error"},"DoesntApply":{"display":"The Reasonable Adjustment Flag no longer applies to the patient"},"BestInterest":{"display":"A best interest decision was taken to remove the Reasonable Adjustments Flag"},"PatientObjection":{"display":"A patient objection has been upheld"},"ProxyObjection":{"display":"A patient representative objection has been upheld"}},"impairment":{"1":{"display":"Vision (for example blindness or partial sight)"},"2":{"display":"Hearing (for example deafness or partial hearing)"},"3":{"display":"Mobility (for example walking short distances or climbing stairs)"},"4":{"display":"Dexterity (for example lifting and carrying objects, using a keyboard)"},"5":{"display":"Learning or understanding or concentrating"},"6":{"display":"Memory"},"7":{"display":"Mental health"},"8":{"display":"Stamina or breathing or fatigue"},"9":{"display":"Social and / or communication differences (for example associated with Autism and Attention Deficit Hyperactivity Disorder - ADHD)"},"10":{"display":"Other (please specify)"},"12":{"display":"Patient would prefer not to say"}},"adjustmentCategory":{"001":{"display":"Communication support","adjustment":{"441092009":{"display":"Does lip read"},"719369003":{"display":"Does use communication device"},"285055002":{"display":"Does use hearing aid"},"520491000000109":{"display":"Preferred method of communication: written"},"225834007":{"display":"Uses a citizen advocate"},"225833001":{"display":"Uses a legal advocate"},"761541000000100":{"display":"Uses alternative communication skill"},"415803005":{"display":"Uses British sign language"},"445129003":{"display":"Uses cued speech transliterator"},"957031000000107":{"display":"Uses deafblind intervener"},"981781000000107":{"display":"Uses Deafblind Manual Alphabet"},"445121000":{"display":"Uses electronic note taker"},"445143008":{"display":"Uses lipspeaker"},"415805003":{"display":"Uses Makaton sign language"},"445076009":{"display":"Uses manual note taker"},"720462004":{"display":"Uses personal audio recording device to record information"},"837341000000108":{"display":"Uses Personal Communication Passport"},"404903008":{"display":"Uses sign language"},"445123002":{"display":"Uses speech to text reporter"},"445488003":{"display":"Uses telecommunications device for the deaf"},"288595009":{"display":"Uses a non-speech system for communication"},"1082531000000103":{"display":"Uses gestures for communication"},"719363002":{"display":"Uses high technology communication device"},"719364008":{"display":"Uses low technology communication device"},"719370002":{"display":"Uses non-powered communication device"},"1082541000000107":{"display":"Uses objects for communication"},"719373000":{"display":"Uses powered communication device"},"520471000000105":{"display":"Preferred method of communication: British Sign Language"},"1082671000000100":{"display":"Requires aphasia-friendly communication"},"1082691000000101":{"display":"Requires support for expressive communication needs"},"1082681000000103":{"display":"Requires support for receptive communication needs"},"198061000000105":{"display":"Uses hearing loop"}}},"002":{"display":"Requires communication professional","adjustment":{"204331000000107":{"display":"British Sign Language interpreter needed"},"945731000000104":{"display":"Hands-on signing interpreter needed"},"204341000000103":{"display":"Makaton Sign Language interpreter needed"},"225835008":{"display":"Needs an advocate"},"957071000000109":{"display":"Requires deafblind block alphabet interpreter"},"796201000000109":{"display":"Requires deafblind communicator guide"},"957111000000103":{"display":"Requires deafblind haptic communication interpreter"},"957051000000100":{"display":"Requires deafblind manual alphabet interpreter"},"945911000000109":{"display":"Requires lipspeaker"},"945891000000106":{"display":"Requires manual note taker"},"719563003":{"display":"Requires sighted guide"},"966401000000100":{"display":"Requires speech to text reporter"},"936761000000104":{"display":"Sign Supported English interpreter needed"},"945711000000107":{"display":"Visual frame sign language interpreter needed"},"1082661000000107":{"display":"Requires speech and language therapist support to communicate"}}},"003":{"display":"Requires specific contact method","adjustment":{"945931000000101":{"display":"Requires audible alert"},"936741000000100":{"display":"Requires contact by email"},"936721000000107":{"display":"Requires contact by letter"},"936701000000103":{"display":"Requires contact by short message service text message"},"795661000000104":{"display":"Requires contact by telephone"},"796081000000106":{"display":"Requires contact by text relay"},"719561001":{"display":"Requires contact via carer"},"945971000000104":{"display":"Requires tactile alert"},"945951000000108":{"display":"Requires visual alert"}}},"004":{"display":"Requires specific information format","adjustment":{"719758004":{"display":"Requires healthcare information recording on personal audio recording device"},"936581000000101":{"display":"Requires information by email"},"936661000000109":{"display":"Requires information in contracted (Grade 2) Braille"},"796161000000101":{"display":"Requires information in Easyread"},"936601000000105":{"display":"Requires information in electronic audio format"},"945751000000106":{"display":"Requires information in electronic downloadable format"},"936641000000108":{"display":"Requires information in Makaton"},"936621000000101":{"display":"Requires information in Moon alphabet"},"936681000000100":{"display":"Requires information in uncontracted (Grade 1) Braille"},"795801000000104":{"display":"Requires information on audio cassette tape"},"795731000000104":{"display":"Requires information on compact disc"},"795691000000105":{"display":"Requires information on digital versatile disc"},"945691000000105":{"display":"Requires information on universal serial bus mass storage device"},"367741000000102":{"display":"Requires information verbally"},"985021000000106":{"display":"Requires third party to read out written information"},"957331000000109":{"display":"Requires written information in at least 20 point sans serif font"},"957351000000102":{"display":"Requires written information in at least 24 point sans serif font"},"957371000000106":{"display":"Requires written information in at least 28 point sans serif font"},"1082551000000105":{"display":"Requires information in aphasia-accessible format"}}},"005":{"display":"Additional communication needs and support","adjustment":{"307089001":{"display":"Difficulty analysing information"},"955771000000100":{"display":"Uses apps on mobile device to support communication"},"936561000000105":{"display":"Uses Tadoma method for communication"},"954871000000106":{"display":"Uses switches for communication"},"311543001":{"display":"Difficulty processing information at normal speed"},"311540003":{"display":"Difficulty processing information accurately"},"737350008":{"display":"Needs assistance with communication"},"1108131000000104":{"display":"Requires appointment reminders"},"1108121000000101":{"display":"Has My Healthcare Passport"},"1108141000000108":{"display":"Expresses pain atypically"},"1108151000000106":{"display":"Requires carer to be present at encounters"},"1325291000000103":{"display":"Emergency contact details of specialist support team"},"1077121000000101":{"display":"Uses functional communication skills"},"288583009":{"display":"Uses non-verbal communication"},"288601001":{"display":"Uses verbal communication"}}},"006":{"display":"Community Language Support","adjustment":{"362721000000106":{"display":"Abkhazian language interpreter needed"},"362691000000102":{"display":"Afar language interpreter needed"},"362571000000102":{"display":"Afrikaans language interpreter needed"},"203281000000104":{"display":"Akan language interpreter needed"},"203291000000102":{"display":"Albanian language interpreter needed"},"203301000000103":{"display":"Amharic language interpreter needed"},"203311000000101":{"display":"Arabic language interpreter needed"},"972511000000109":{"display":"Aragonese interpreter needed"},"362261000000106":{"display":"Armenian language interpreter needed"},"362231000000101":{"display":"Assamese language interpreter needed"},"972521000000103":{"display":"Avaric interpreter needed"},"972531000000101":{"display":"Avestan interpreter needed"},"362541000000108":{"display":"Aymara language interpreter needed"},"362611000000106":{"display":"Azerbaijani language interpreter needed"},"972541000000105":{"display":"Bambara interpreter needed"},"972551000000108":{"display":"Bashkir interpreter needed"},"362641000000107":{"display":"Basque language interpreter needed"},"362071000000107":{"display":"Belarusian language interpreter needed"},"203321000000107":{"display":"Bengali language interpreter needed"},"362201000000107":{"display":"Bihari language interpreter needed"},"362171000000106":{"display":"Bislama language interpreter needed"},"972561000000106":{"display":"Bosnian interpreter needed"},"359821000000104":{"display":"Brawa language interpreter needed"},"362141000000100":{"display":"Breton language interpreter needed"},"353921000000107":{"display":"Bulgarian language interpreter needed"},"362371000000109":{"display":"Burmese language interpreter needed"},"203381000000108":{"display":"Cantonese language interpreter needed"},"362041000000101":{"display":"Catalan language interpreter needed"},"362331000000107":{"display":"Central Khmer language interpreter needed"},"972571000000104":{"display":"Chamorro interpreter needed"},"972581000000102":{"display":"Chechen interpreter needed"},"972591000000100":{"display":"Chinese interpreter needed"},"972601000000106":{"display":"Church Slavic interpreter needed"},"972611000000108":{"display":"Chuvash interpreter needed"},"972621000000102":{"display":"Cornish interpreter needed"},"361941000000107":{"display":"Corsican language interpreter needed"},"972631000000100":{"display":"Cree interpreter needed"},"203391000000105":{"display":"Croatian language interpreter needed"},"203401000000108":{"display":"Czech language interpreter needed"},"361971000000101":{"display":"Danish language interpreter needed"},"972641000000109":{"display":"Dhivehi interpreter needed"},"203411000000105":{"display":"Dutch language interpreter needed"},"362781000000107":{"display":"Dzongkha language interpreter needed"},"343671000000102":{"display":"English language interpreter needed"},"361881000000106":{"display":"Esperanto language interpreter needed"},"361911000000106":{"display":"Estonian language interpreter needed"},"359791000000109":{"display":"Ethiopian language interpreter needed"},"972651000000107":{"display":"Ewe interpreter needed"},"361791000000100":{"display":"Faroese language interpreter needed"},"203421000000104":{"display":"Farsi language interpreter needed"},"361821000000105":{"display":"Fijian language interpreter needed"},"343701000000103":{"display":"Finnish language interpreter needed"},"343711000000101":{"display":"Flemish language interpreter needed"},"203521000000103":{"display":"French Creole language interpreter needed"},"203441000000106":{"display":"French language interpreter needed"},"361501000000104":{"display":"Frisian language interpreter needed"},"972671000000103":{"display":"Fulah interpreter needed"},"343721000000107":{"display":"Gaelic language interpreter needed"},"361851000000100":{"display":"Galician language interpreter needed"},"203801000000105":{"display":"Ganda language interpreter needed"},"361471000000106":{"display":"Georgian language interpreter needed"},"203581000000102":{"display":"German language interpreter needed"},"203591000000100":{"display":"Greek language interpreter needed"},"361441000000100":{"display":"Guarani language interpreter needed"},"203601000000106":{"display":"Gujarati language interpreter needed"},"972681000000101":{"display":"Haitian interpreter needed"},"203611000000108":{"display":"Hakka language interpreter needed"},"203631000000100":{"display":"Hausa language interpreter needed"},"203641000000109":{"display":"Hebrew language interpreter needed"},"972691000000104":{"display":"Herero interpreter needed"},"203651000000107":{"display":"Hindi language interpreter needed"},"972701000000104":{"display":"Hiri Motu interpreter needed"},"360431000000104":{"display":"Hungarian language interpreter needed"},"359881000000103":{"display":"Iban language interpreter needed"},"360401000000105":{"display":"Icelandic language interpreter needed"},"972711000000102":{"display":"Ido interpreter needed"},"203531000000101":{"display":"Igbo language interpreter needed"},"362111000000101":{"display":"Indonesian language interpreter needed"},"972721000000108":{"display":"Interlingua interpreter needed"},"360341000000102":{"display":"Interlingue language interpreter needed"},"315594003":{"display":"Interpreter needed"},"360311000000103":{"display":"Inuktitut language interpreter needed"},"360251000000107":{"display":"Inupiaq language interpreter needed"},"972731000000105":{"display":"Irish interpreter needed"},"203371000000106":{"display":"Italian language interpreter needed"},"203681000000101":{"display":"Japanese language interpreter needed"},"360281000000101":{"display":"Javanese language interpreter needed"},"362011000000102":{"display":"Kalaallisut language interpreter needed"},"360101000000102":{"display":"Kannada language interpreter needed"},"972741000000101":{"display":"Kanuri interpreter needed"},"360191000000109":{"display":"Kashmiri language interpreter needed"},"360221000000102":{"display":"Kazakh language interpreter needed"},"972751000000103":{"display":"Kikuyu interpreter needed"},"360131000000108":{"display":"Kinyarwanda language interpreter 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