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Simplification in the UK

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Simplification of V3 and CDA in the UK: Background

The NHS have defined a number of Version 3 and CDA message exchanges and content, and published them in the Message Implementation Manual (MIM). Many of these are now in widespread use across the UK. Currently the NHS is defining the second release of its Integration Toolkit (ITK), to provide easly implementable standards for local integration, meeting the stated requirements of UK providers of health and social care. It is likely that the ITK will include CDA and V3 messages; for instance Release 1 of the ITK includes a CDA discharge sumnmary, which has been implemented by seversal suppliers; and Release 2 will include V3 messages for the national data spine.

NHS is considering whether to use message simplification techniques in ITK. It is in any case possible for suppliers and providers to use simplification as an implementation technique to read or write conformant full CDA and V3 messages, as defined by NHS, on the wire.

A project is under way to produce simplified forms of the CDA documents defined by NHS as part of the Common Assessment Framework (CAF) for health and social care. The intent of CAF is for caregivers in health and social care to be able to share assessments and care plans. The technical work of that simplification project is described below.

Outputs of the CAF Simplification Project

There are five CDA CAF documents which address the assessments of patients and citizens, and thier care plans. Some of these overlap strongly with the CDA discharge message defined in the MIM. The simplification project will produce the following outputs (for each CAF document, unless stated otherwise)

  • XML schema for the simplfied message
  • Example instances of the simplified message
  • Transforms in both directions between full and simplified messages (as XSLT, or via a Java transform engine)
  • Results of round-trip tests of the transforms (Full=>Simplified=>Full)


Simplification Inputs and Process