Cancel an appointment

Cancel an appointment for a patient at an organisation

Use case

This API is used to cancel a patient’s future appointment, obtained via use of either Retrieve a Patient’s Appointments, or Read an Appointment APIs.

Any future appointment, irrespective of booking organisation and irrespective of whether the appointment was booked via the GP Connect API, can be cancelled by a consuming organisation participating with the appointment hosting organisation in a GP Connect deployment. This however excludes visit appointments which cannot be cancelled using GP Connect.

The typical flow to cancel an appointment is:

Search by NHS Number for, or otherwise obtain, a Patient resource.
Search for Appointment resources for the Patient resource.
Choose an Appointment resource and cancel it by amending the status to cancelled.

Important: The Appointment Management capability pack is aimed at administration of a patient’s appointments. As a result of information governance (IG) requirements, the cancel appointments capability has been restricted to future appointments. More details are available on the Design decisions page.

Security

GP Connect utilises TLS Mutual Authentication for system level authorization
GP Connect utilises a JSON Web Tokens (JWT) to transmit clinical audit and provenance details

Prerequisites

Consumer

The consumer system:

SHALL have previously resolved the organisation’s FHIR® endpoint base URL through the Spine Directory Service
SHALL have previously traced the patient’s NHS Number using the Personal Demographics Service or an equivalent service.
SHALL have previously found the appointment ID using Retrieve a patient’s appointments.

API usage

The consumer system SHALL only use the cancel appointment interaction to cancel:

future appointments where appointment start date and time is after the current date and time. If the appointment start date and time is in the past the provider SHALL return an error.

Appointments for visits (where the delivery channel is set to ‘Visit’) cannot be cancelled using GP Connect. Providers SHALL return an error where a cancellation to a visit appointment is received.

Request operation

FHIR relative request

PUT /Appointment/[id]

FHIR absolute request

PUT https://[proxy_server]/https://[provider_server]/[fhir_base]/Appointment/[id]

Request headers

Consumers SHALL include the following additional HTTP request headers:

Header	Value
`Ssp-TraceID`	Consumer’s TraceID (that is, GUID/UUID)
`Ssp-From`	Consumer’s ASID
`Ssp-To`	Provider’s ASID
`Ssp-InteractionID`	`urn:nhs:names:services:gpconnect:fhir:rest:cancel:appointment-1`
`If-Match`	The Appointment’s current ETag, e.g. `W/"23"`

Payload request body

The request payload is a profiled version of the standard FHIR® Appointment resource. See the FHIR resources page for more details.

Consumer systems:

SHALL send an Appointment resource that conforms to the GPConnect-Appointment-1 profile.
SHALL include the URI of the GPConnect-Appointment-1 profile StructureDefinition in the Appointment.meta.profile element of the appointment resource.

Important: It is recommended that Consumers read the Appointment they wish to cancel (via Read an appointment or Retrieve a patient’s appointments), then update the fields allowed below in place. Attempting to recreate the Appointment resource from local transformed data formats/structures is not advised, and may result in the provider system rejecting the amendment due to an unintended change or missing field.

Only the following data elements can be modified when performing an appointment cancellation:

the appointment status MUST be updated to “cancelled”
the appointment cancellation-reason extension SHALL be included with the cancellation reason details

Important: If any content other than the appointment cancellation reason or appointment status is updated the server SHALL reject the amendment and return an error.

Note: GP Connect does not impose a character limit on the cancellation reason extension within the cancellation request, but due to differences in the provider system the cancellation reason may be truncated when stored in the provider system due to character limits.

On the wire, a JSON serialised request would look something like the following:

{
  "resourceType": "Appointment",
  "id": "9",
  "meta": {
    "versionId": "636068818095315079",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/GPConnect-Appointment-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Organization",
      "id": "1",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
        ]
      },
      "identifier": [
        {
          "system": "https://fhir.nhs.uk/Id/ods-organization-code",
          "value": "A00001"
        }
      ],
      "type": [
        {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/GPConnect-OrganisationType-1",
              "code": "gp-practice"
            }
          ]
        }
      ],
      "name": "Test Organization Name",
      "telecom": [
        {
          "system": "phone",
          "value": "0300 303 5678"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-BookingOrganisation-1",
      "valueReference": {
        "reference": "#1"
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1",
      "valueString": "Free text cancellation reason."
    }
  ],
  "status": "cancelled",
  "description": "Free text description updated.",
  "start": "2017-05-30T10:00:00+01:00",
  "end": "2017-05-30T10:25:00+01:00",
  "slot": [
    {
      "reference": "Slot/1"
    }
  ],
  "created": "2017-05-25T13:48:41+01:00",
  "comment": "Free text comment.",
  "participant": [
    {
      "actor": {
        "reference": "Patient/1"
      },
      "status": "accepted"
    },
    {
      "actor": {
        "reference": "Location/32"
      },
      "status": "accepted"
    }
  ]
}

Error handling

The provider system:

SHALL return a GPConnect-OperationOutcome-1 resource that provides additional details when one or more data fields are corrupt or a specific business rule/constraint is breached.
SHALL return an error if any appointment details other than the appointment status and cancellation-reason fields are attempted to be updated.
SHALL return an error if the appointment being cancelled is in the past (the appointment start date and time is before the current date and time).
SHALL return an error if the version identifier in the If-Match header does not match the Appointment’s current version identifier. See Managing resource contention.
SHALL return an error where the Appointment or referenced Slot(s) has a delivery channel of ‘Visit’

Refer to Development - FHIR API guidance - error handling for details of error codes.

Request response

Response headers

Provider systems are not expected to add any specific headers beyond that described in the HTTP and FHIR® standards.

Payload response body

Provider systems:

SHALL return a 200 OK HTTP status code on successful execution of the operation.
SHALL return an Appointment resource that conform to the GPConnect-Appointment-1 profile.
SHALL include the URI of the GPConnect-Appointment-1 profile StructureDefinition in the Appointment.meta.profile element of the returned appointment resource.
SHALL include the versionId of the current version of each appointment resource.
SHALL have updated the appointment status to “cancelled”.
SHALL have updated the appointment cancellation-reason in line with any details supplied in the request.
SHALL populate serviceType.text with the practice defined slot type description, and where available serviceCategory.text with a practice defined schedule type description (may be called session name or rota type).
SHALL meet General FHIR resource population requirements populating all fields where data is available, excluding those listed below
SHALL NOT populate the following fields:
- reason
- specialty

{
  "resourceType": "Appointment",
  "id": "9",
  "meta": {
    "versionId": "636068818095315079",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/GPConnect-Appointment-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Organization",
      "id": "1",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
        ]
      },
      "identifier": [
        {
          "system": "https://fhir.nhs.uk/Id/ods-organization-code",
          "value": "A00001"
        }
      ],
      "type": [
        {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/GPConnect-OrganisationType-1",
              "code": "gp-practice"
            }
          ]
        }
      ],
      "name": "Test Organization Name",
      "telecom": [
        {
          "system": "phone",
          "value": "0300 303 5678"
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-BookingOrganisation-1",
      "valueReference": {
        "reference": "#1"
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-AppointmentCancellationReason-1",
      "valueString": "Free text cancellation reason."
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-PractitionerRole-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
            "code": "R0260",
            "display": "General Medical Practitioner"
          }
        ]
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-GPConnect-DeliveryChannel-2",
      "valueCode": "In-person"
    }
  ],
  "status": "cancelled",
  "serviceCategory": {
    "text": "General GP Appointments"
  },
  "serviceType": [
    {
      "text": "General GP Appointment"
    }
  ],
  "description": "Free text description updated.",
  "start": "2017-05-30T10:00:00+01:00",
  "end": "2017-05-30T10:25:00+01:00",
  "slot": [
    {
      "reference": "Slot/1"
    }
  ],
  "created": "2017-05-25T13:48:41+01:00",
  "comment": "Free text comment.",
  "participant": [
    {
      "actor": {
        "reference": "Patient/1"
      },
      "status": "accepted"
    },
    {
      "actor": {
        "reference": "Location/32"
      },
      "status": "accepted"
    }
  ]
}

Important: A status response 200 OK implies that the state of any resources affected by the appointment cancellation (for example, the associated Slot) subsequently reflects the cancellation (for example, Appointment.status, Slot.status are updated in line with any internal integrity constraints).