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Implementation questions

Use these questions to establish what must be demonstrated before introducing NHS App services for Ministry of Defence (MOD)-registered patients. The Executive Summary sets out the R41 proposal: deliver existing NHS functions first and commission concept design for Defence Medical Information Capability Programme (DMICP) reminders. DMICP development, delivery and any pilot require further approval. MOD general practice (GP) record information exchange remains a separate later decision.

The programme owner, funding and initial providers remain unconfirmed. These are validation requirements, not evidence that access has been enabled, a provider has agreed to participate or expenditure has been authorised.

Initial NHS provider validation

Start with NHS hospital and specialist services in England that receive referrals for the proposed Defence Primary Healthcare (DPHC) patient groups. Select providers using actual referral patterns and patient need. Do not assume that national connectivity covers every hospital department, appointment type or patient. R41 paragraphs 4, 9 and 18–20 require tests of the services patients will use, with support and alternative channels available.

For each candidate, record the provider, service, intended patient group and precise function being assessed. Keep one dated result for each combination. Appointment display, referral status, a notification and an automated reminder are separate outcomes; evidence for one does not establish the others.

Requirement Evidence to obtain and acceptance question
Named provider and service Record the NHS trust or organisation, hospital or site, specialty, appointment types and referral path from DPHC. Obtain provider confirmation of which services and patient groups its NHS App connection covers, with exclusions and a confirmation date. Is this the service the intended patients actually attend?
Source and NHS App route Identify the authoritative booking system, supplier and active connection. Distinguish the NHS e-Referral Service (e-RS), Patient Care Aggregator / Wayfinder, a Patient Engagement Portal (PEP) and a portal used outside the App. Can the patient reach the expected information through the stated route, including any additional sign-in? A supplier's general capability is insufficient.
Access and patient matching Retain NHS England agreement on the MOD access arrangement before live patient testing. Establish the relevant Personal Demographics Service (PDS) registration, Organisation Data Service (ODS) practice identity and NHS-number matching. Test the intended registration, age and location groups through their own accounts. Do missing or mismatched details prevent inappropriate disclosure and lead to a usable correction route?
Appointment information and changes Follow an authorised test from referral or direct booking to the patient's view. Check the correct service, date, time, time zone, location or remote-attendance instructions and contact details against the source. Test changed, cancelled and duplicate appointments. Agree and measure acceptable update times; establish how stale or missing information is detected and corrected.
Notifications and reminders Identify which events produce referral notices, appointment notifications or timed reminders, and through which channel. Test settings enabled and disabled, failed delivery and the provider's existing alternative communication. Distinguish a message being sent, delivered and read. A referral acknowledgement or visible booking does not prove an appointment reminder.
Age and proxy access Confirm the service's age rules separately from general App eligibility. Test own-account and permitted family/carer access separately, including transitions relevant to the proposed group. Do not assume a proxy can manage hospital services or read messages in the cared-for profile. Record unsupported journeys and their alternatives; use the proxy access review.
Additional functions, if offered Record documents, results, questionnaires and appointment actions separately. Confirm release rules, permissions and the outcome in the provider's source system. A request to change an appointment is not a completed change. An existing NHS provider function does not establish a MOD GP-record connection or extend the DMICP design decision.
Safety, privacy and accessibility Obtain the applicable clinical-safety, data-protection, security and accessibility evidence for the named connection and proposed patient use. Check restricted records, incorrect recipients, shared devices and inaccessible information. Record defects, their patient impact and the evidence needed to resolve them before introduction.
Support and continuity Confirm how patients and staff report sign-in problems, missing or incorrect bookings, failed messages and urgent appointment changes. Demonstrate the hand-off between Defence, the provider, its supplier and NHS support where relevant. Keep existing telephone, text-message and other usable channels available. Operational responsibilities and service hours must be agreed before introduction; they are not assigned by this page.
Retained results and introduction decision Retain dated provider confirmation, controlled test references, expected and actual results, failures and retest evidence in an authorised location. Link only non-sensitive evidence summaries into this wiki. Record a decision for the exact provider, service, function and patient group tested, with exclusions, support and recheck triggers. Programme ownership and funding remain unconfirmed; service testing does not itself authorise delivery or expenditure.

Evidence boundary and completion

Use the existing NHS appointment routes and Patient Care Aggregator guidance to identify the route. The national coverage figures in SRC-132 describe April 2026; they do not select providers or prove current MOD patient access. General NHS eligibility still excludes Defence Medical Services (DMS) patients, as rechecked on 23 October 2026. Provider discussions and test planning can proceed, but live patient validation depends on the agreed access arrangement.

The NHS hospital-service guidance specifies access from age 16, with some trusts requiring age 18; notifications and messages are additional features. The NHS messaging guidance distinguishes e-RS processing and acceptance notices from booked appointments. Those notices do not cover referrals through other routes, direct hospital bookings or rejected referrals. These sources were rechecked on 23 October 2026; confirm the named provider's actual configuration before testing.

Mark each function as not yet tested, met, not met or not applicable with a reason. A successful result applies only to its recorded scope. Agree the test thresholds before execution and resolve failures affecting identity, information accuracy, safety or usable alternatives before introducing the affected service. Record the introduction decision, relevant approvals and outstanding limitations. Recheck when the route, provider configuration, patient group or service rules change.

Keep unresolved provider evidence in the existing Patient Care Aggregator / Wayfinder and PEP appointment items in the Evidence Validation Queue. Advice and self-service functions need their own checks and can progress independently of a hospital connection. This validation work does not require a new DMICP feed or approval of future GP integration.

Registration and identity

  • What does PDS show as the registered GP practice for each DPHC patient group?
  • For each registration transition, what request was accepted, did Primary Care Registration Management (PCRM) complete or raise an exception, what changed in PDS, did GP2GP or another record-transfer process complete, and what NHS App functions worked afterwards?
  • Which ODS codes represent DPHC practices and Defence Global Practice?
  • Does NHS account registration succeed for DPHC-registered patients?
  • What happens when a patient moves from NHS GP registration to DPHC registration?
  • Is the user seeking own NHS App access, or acting through a linked profile / proxy route?
  • For children, which age band applies: under 13, 13 to 15, or 16+?
  • For dependants, what is the dependant's own GP registration and NHS App account state, separate from the service person's registration?
  • For proxy access, are the proxy user and the person cared for registered at the same GP practice, and has the GP practice configured the linked profile and permitted services?

Feature mapping

  • Which NHS App features are needed: records, prescriptions, appointments, messages, referrals, linked profiles, or other services?
  • Which implementation phase is being assessed: initial provision, secondary healthcare (SHC) appointments, DMICP primary healthcare (PHC) appointment visibility, DMICP Primary healthcare (PHC) appointment management, clinical correspondence, test results, or later CORTISONE patient data?
  • For each feature, what is the source system and API route?
  • Is the route NHS App integration, GP Connect Appointment Management, GP Connect Patient Facing APIs, Interface Mechanism 1 (IM1), Spine Directory Service (SDS), Electronic Prescription Service (EPS), Patient Care Aggregator / Wayfinder, e-RS, PEP, NHS Notify, Message Exchange for Social Care and Health (MESH), or another service?
  • For appointments and referrals, is the feature DMICP PHC appointment visibility, DMICP PHC appointment management, GP appointment booking, e-RS, Patient Care Aggregator / Wayfinder, a PEP deep link, or a local provider portal?
  • For any PEP source, which route family is actually evidenced: PEP appointment or booking function, PEP document route, PEP results-release route, eForm/questionnaire route, PIFU route, or a general provider-portal capability?
  • For a PEP appointment or booking function, does the source prove appointment detail, booking, change, cancellation, or deep-link behaviour, and for which provider, product, patient cohort, age/proxy state, and NHS App connection?
  • For DMICP PHC appointment visibility, is there a documented DMICP appointment / diary feed, a CORTISONE / Health Connect or other transformation layer, and a validated NHS-facing display route such as direct NHS App web integration, a portal view, or NHS Notify for messages?
  • For DMICP PHC appointment management, is there a bidirectional route for booking, cancellation, rescheduling, slot search, appointment-change requests, and write-back to the authoritative DPHC appointment book?
  • For clinical correspondence, is the source an Secondary healthcare (SHC) provider document route, a PEP document route, a GP-filed document view, or another patient-facing document route?
  • For a PEP document route, what document types are included, how are they displayed or deep-linked from the NHS App, and what provider, authentication, age/proxy, and access-control rules apply?
  • For test results, is the source a GP-filed result view, a PEP results-release route, a provider results system, or a later CORTISONE patient-data route?
  • For a PEP results-release route, what result types are included, what clinical review / timing / suppression / override controls apply, and is the route PEP-only or NHS App-connected?
  • For GP-record evidence, is it a GP-filed document view or a GP-filed result view, and what filing state, release setting, GP clinical-system supplier, PDS/ODS state, practice capability, age/proxy rule, and DPHC practice-equivalence evidence exists?
  • For messages, is the sender using NHS Notify, NHS App Notifications and Messaging, Patient Care Aggregator appointment notifications, or a non-NHS App channel?
  • For every live-service route, what partner onboarding, connection agreement, clinical-safety, data-protection, technical-assurance, and information-security evidence exists?

DPHC and Programme Cortisone

Evidence required

Do not close this topic without direct evidence from MOD, Defence Medical Command (DMedC) / DPHC, NHS England, NHS England Digital, GP system supplier documentation, or implementation artefacts.