description: This profile defines the NHS England constraints and extensions on the International FHIR resource [MedicationDispense](https://hl7.org/fhir/R4/medicationdispense.html).
package_name: uk.nhsdigital.r4.test
derivation: constraint
name: NHSDigitalMedicationDispense
type: MedicationDispense
elements:
  category:
    elements:
      coding:
        elements:
          system: {index: 18}
          code: {index: 19}
        required: [system, code]
  whenHandedOver: {mustSupport: true, index: 50}
  whenPrepared: {mustSupport: true, index: 49}
  medicationCodeableConcept: {type: CodeableConcept, mustSupport: true, choiceOf: medication, index: 22}
  type:
    binding: {strength: required, valueSet: 'https://fhir.nhs.uk/ValueSet/DM-medicationdispense-type'}
    mustSupport: true
    index: 39
    elements:
      coding:
        elements:
          system: {index: 40}
          code: {index: 41}
        required: [system, code]
  statusReason:
    mustSupport: true
    choices: [statusReasonCodeableConcept]
    index: 9
  statusReasonCodeableConcept: {type: CodeableConcept, mustSupport: true, choiceOf: statusReason, index: 10}
  extension:
    type: Extension
    short: This is the non dispensing reason for the overall prescription
    mustSupport: true
    url: https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason
    index: 0
    slicing:
      slices:
        prescriptionNonDispensingReason:
          match: {}
          schema: {type: Extension, short: This is the non dispensing reason for the overall prescription, mustSupport: true, url: 'https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason', index: 0}
          max: 1
        prescriptionStatus:
          match: {}
          schema: {type: Extension, isModifier: false, url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus', index: 1}
        repeatInformation:
          match: {}
          schema: {type: Extension, short: Repeat Prescribing and Dispensing, mustSupport: true, url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation', index: 2}
          max: 1
        supplyHeaderIdentifier:
          match: {}
          schema: {type: Extension, short: Identifier for the SupplyHeader, mustSupport: true, url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-SupplyHeaderIdentifier', index: 3}
          max: 1
  status: {mustSupport: true, index: 7}
  statusReason[x]:
    elements:
      coding:
        index: 11
        elements:
          system: {index: 12}
          code: {index: 13}
        required: [system, code]
        slicing:
          rules: open
          discriminator:
          - {path: system, type: value}
          min: 1
          slices:
            notDispensedStatusReason:
              match: {system: 'https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason'}
              schema:
                binding: {strength: required, valueSet: 'https://fhir.nhs.uk/ValueSet/DM-medicationdispense-status-reason'}
                mustSupport: true
                index: 14
                elements:
                  system:
                    pattern: {type: Uri, value: 'https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason'}
                    index: 15
            amendmentStatusReason:
              match: {system: 'https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason'}
              schema:
                binding: {strength: required, valueSet: 'https://fhir.nhs.uk/ValueSet/DM-task-reason-code'}
                mustSupport: true
                index: 16
                elements:
                  system:
                    pattern: {type: Uri, value: 'https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason'}
                    index: 17
    required: [coding]
  dosageInstruction: {type: Dosage, mustSupport: true, index: 52}
  daysSupply: {mustSupport: true, index: 48}
  identifier:
    mustSupport: true
    index: 4
    elements:
      system: {index: 5}
      value: {index: 6}
    required: [value, system]
  context:
    type: Reference
    refers: ['https://fhir.hl7.org.uk/StructureDefinition/UKCore-EpisodeOfCare', 'https://fhir.nhs.uk/StructureDefinition/NHSDigital-Encounter']
    index: 27
  medicationReference:
    type: Reference
    mustSupport: true
    choiceOf: medication
    refers: ['https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense-Medication']
    index: 23
  quantity:
    mustSupport: true
    index: 42
    extensions:
      runningTotal: {url: 'https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal', max: 1, type: Extension, index: 43}
    elements:
      extension:
        type: Extension
        url: https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal
        index: 43
        slicing:
          slices:
            runningTotal:
              match: {}
              schema: {type: Extension, url: 'https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal', index: 43}
              max: 1
      value: {index: 44}
      unit: {index: 45}
      system: {index: 46}
      code: {index: 47}
    required: [value, unit, system, code]
  location:
    type: Reference
    refers: ['https://fhir.nhs.uk/StructureDefinition/NHSDigital-Location']
    index: 33
    elements:
      identifier:
        elements:
          system: {index: 34}
          value: {index: 35}
        required: [value, system]
      display: {index: 36}
    required: [display]
  authorizingPrescription:
    type: Reference
    mustSupport: true
    refers: ['https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest-Minimal']
    index: 37
    elements:
      reference: {index: 38}
    required: [reference]
  receiver: {index: 51}
  subject:
    type: Reference
    constraint:
      eps-2: {human: subject - An identifier reference or resource reference must be provided, severity: warning, expression: (reference.exists() or (identifier.exists()))}
      patient-nhs: {human: Length of the supplied NHS Number is wrong., severity: error, expression: 'identifier.where(system=''https://fhir.nhs.uk/Id/nhs-number'').exists().not() or (identifier.where(system=''https://fhir.nhs.uk/Id/nhs-number'').exists()  and identifier.where(system=''https://fhir.nhs.uk/Id/nhs-number'').value.matches(''^([0-9]{10})$''))'}
    mustSupport: true
    refers: ['https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient-PDS']
    index: 24
    elements:
      identifier:
        elements:
          system:
            pattern: {type: Uri, value: 'https://fhir.nhs.uk/Id/nhs-number'}
            index: 25
          value: {index: 26}
        required: [value, system]
  performer:
    mustSupport: true
    index: 28
    elements:
      actor:
        type: Reference
        constraint:
          performer: {human: An identifier reference or resource reference must be provided, severity: error, expression: (reference.exists() or identifier.exists())}
        refers: ['https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole-SDS']
        index: 29
        elements:
          reference: {index: 30}
          identifier:
            elements:
              system: {index: 31}
              value: {index: 32}
            required: [value, system]
        required: [reference]
  medication:
    mustSupport: true
    choices: [medicationCodeableConcept, medicationReference]
    index: 21
package_version: 2.16.0-prerelease
extensions:
  prescriptionNonDispensingReason: {url: 'https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason', max: 1, type: Extension, short: This is the non dispensing reason for the overall prescription, mustSupport: true, index: 0}
  prescriptionStatus: {url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus', type: Extension, isModifier: false, index: 1}
  repeatInformation: {url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation', max: 1, type: Extension, short: Repeat Prescribing and Dispensing, mustSupport: true, index: 2}
  supplyHeaderIdentifier: {url: 'https://fhir.nhs.uk/StructureDefinition/Extension-EPS-SupplyHeaderIdentifier', max: 1, type: Extension, short: Identifier for the SupplyHeader, mustSupport: true, index: 3}
class: profile
kind: resource
url: https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense
base: https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense
version: 1.0.2
required: [authorizingPrescription, quantity, subject, performer]