Understanding the NHSD architecture

Managing the data ingestion, data provision and maintenance in a comprehensive directory of healthcare services is a detailed end-to-end process. It begins with obtaining service data for collation and categorisation.

The NHSD architectural organisation structure example — NHSD high-level architecture, end-to-end

Once data is obtained, it is validated and organised into our data model to make it easily accessible to users. Data sources are engaged through formal relationships to provide regular updates and maintenance to support currency and accuracy of the directory.

NHSD FHIR entity relationships

The data model diagram below shows the NHSD FHIR entity relationships from the perspective of the Healthcare Service Resource and is followed with a description of each entity.

The NHSD architecture — NHSD FHIR entity data model

Organisation

An Organisation can be represented as a single practice or as a larger institution, agency or facility. The NHSD FHIR data model supports multi-level Organisation structures, which is often required for more complex organisations such as hospitals. An Organisation must have at least one Location, which provides address or coverage area information for the Healthcare Service/s provided.

Location

The Location provides address or coverage area information for the Healthcare Service. The Location also provides context for how the service is delivered, whether provided at a physical location, provided as a service in the home, or provided virtually. An Organisation must have at least one Location.

Healthcare Service

The Healthcare Service entity is at the core of the NHSD’s data architecture. Healthcare Services are delivered at a Location by an Organisation. In the NHSD model the Healthcare Service allows the association of secure messaging endpoints and thus a channel for delivery to that service.

Practitioner Role

A Healthcare Service is delivered by a Practitioner Role, which can be filled by a specific Practitioner who is working in that role at a point in time. The Practitioner provides details of an individual who delivers services in one or more Practitioner Roles.

Practitioner

A Practitioner is the individual person that is delivering the health-related service at a Healthcare Service under at least one Practitioner Role.

Endpoint

Endpoints ensure secure electronic messages, such as discharge summaries and referrals, are delivered to the correct services. A Healthcare Service or a Practitioner Role may have secure messaging endpoints.

In developing the FHIR model for the NHSD the following assumptions were made about the relationship between the FHIR Resources. It should be noted that the Healthcare Service is the core of the NHSD data.

An Organisation provides a Healthcare Service at a Location;
A Healthcare Service is provided by a Practitioner at a Location; and
The data model supports n-levels of organisational (part of) relationships.

For further information on our FHIR data model, download

An example of how organisations may be structured in the NHSD is represented in the diagram below.

NHSD Organisation structure example diagram — NHSD Organisation structure example