NHS Booking and Referral Standard

Important: This guide is currently under development

This is a preview of a developing guide for information only. It is not intended to be used until the completed v1.0.0 guide is released (around the end of March 2023)

If you are interested in developing a BaRS compliant solution right now, please use the contact form here and the team will be in touch

Reasonable Adjustment Codes BARS

CodeSystem

id : reasonable-adjustment-codes-bars

url : https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars

identifier

system : https://fhir.nhs.uk/identifier/CodeSystem

value : reasonable-adjustment-codes-bars

version : 1.0.0

name : reasonableadjustmentcodesbars

title : Reasonable Adjustment Codes BARS

status : active

date : 2022-03-11

publisher : NHS Digital

contact

name : NHS Digital

telecom

system : email

value : interoperabilityteam@nhs.net

use : work

description : Reasonable Adjustment Flag Reason Codes

caseSensitive : True

content : complete

concept

code : patientChoice

display : Patient Choice in Service Selection

concept

code : adjustcommunicationforhearingsensoryimpairment

display : Adjust communication for hearing / sensory impairment

concept

code : adjustforatypicalexpressionofpain

display : Adjust for atypical expression of pain

concept

code : adjustforuseofcommunicationbookaid

display : Adjust for use of communication book / aid

concept

code : advocatetobepresent

display : Advocate to be present

concept

code : carertobepresentforallcommunication

display : Carer to be present for all communication

concept

code : patientlikelytoalwaysrespondinthepositive

display : Patient likely to always respond in the positive

concept

code : provideappointmentreminders

display : Provide appointment reminders

concept

code : providewrittenremindersandadvice

display : Provide written reminders and advice

concept

code : reasonableadjustmentforcommunicationnodetailprovided

display : Reasonable adjustment for communication (no detail provided)

concept

code : reasonableadjustmentforcommunicationseedetailprovided

display : Reasonable adjustment for communication (see detail provided)

concept

code : patientnottobeleftalone

display : Patient not to be left alone

concept

code : adjusttoinvolvecarersinallaspectsofcare

display : Adjust to involve Carers in all aspects of care

concept

code : lastingpowerofattorney

display : Lasting Power of Attorney

concept

code : additionalsupportfordischarge

display : Additional support for discharge

concept

code : supportforvisualsensoryimpairment

display : Support for visual /sensory impairment

concept

code : reasonableadjustmentforadditionalsupportseedetailprovided

display : Reasonable adjustment for additional support (see detail provided)

concept

code : reasonableadjustmentforadditionalsupportnodetailprovided

display : Reasonable adjustment for additional support (no detail provided)

concept

code : adjustforneedlephobia

display : Adjust for needle phobia

concept

code : dislikesuniformswhitecoats

display : Dislikes uniforms / white coats

concept

code : respondstodistraction

display : Responds to distraction

concept

code : hasanticipatorycarecrisisplan

display : Has anticipatory care /crisis plan

concept

code : willonlytoleratemedicationsincertainformat

display : Will only tolerate medications in certain format

concept

code : maleorfemaleonlysupport

display : Male or Female only support

concept

code : reasonableadjustmenttopersonalisationseedetailprovided

display : Reasonable adjustment to personalisation (see detail provided)

concept

code : reasonableadjustmenttopersonalisationnodetailprovided

display : Reasonable adjustment to personalisation (no detail provided)

concept

code : adjustforlownoisestimulus

display : Adjust for low noise stimulus

concept

code : adjustforsingleroom

display : Adjust for single room

concept

code : wheelchairaccess

display : Wheelchair access

concept

code : adjustforspecialistequipment

display : Adjust for specialist equipment

concept

code : adjustforlowlightstimulus

display : Adjust for low light stimulus

concept

code : adjustminimisewaitingtimes

display : Adjust / minimise waiting times

concept

code : reasonableadjustmenttoenvironmentseedetailprovided

display : Reasonable adjustment to environment (see detail provided)

concept

code : reasonableadjustmenttoenvironmentnodetailprovided

display : Reasonable adjustment to environment (no detail provided)

concept

code : offerfirstorlastappointment

display : Offer first or last appointment

concept

code : considerhomevisits

display : Consider Home Visits

concept

code : providelongerappointment

display : Provide longer appointment

concept

code : provideadditionaltimefordecisionmakingprocessing

display : Provide additional time for decision making / processing

concept

code : adjustforhighlevelsofanxiety

display : Adjust for high levels of anxiety

concept

code : considerdesensitisationforanyprocedure

display : Consider desensitisation for any procedure

concept

code : considerpreoutpatientoradmissionvisit

display : Consider pre outpatient or admission visit

concept

code : reasonableadjustmenttoservicedeliveryseedetailprovided

display : Reasonable adjustment to service delivery (see detail provided)

concept

code : reasonableadjustmenttoservicedeliverynodetailprovided

display : Reasonable adjustment to service delivery (no detail provided)

concept

code : monitorforconstipation

display : Monitor for constipation

concept

code : monitorfordehydration

display : Monitor for dehydration

concept

code : monitornutrition

display : Monitor nutrition

concept

code : monitorforpressuresores

display : Monitor for pressure sores

concept

code : monitorfordysphagia

display : Monitor for Dysphagia

concept

code : monitorforself-harm

display : Monitor for self-harm

concept

code : monitorforepilepsy

display : Monitor for epilepsy

concept

code : reasonableadjustmentforspecificrisksseedetailprovided

display : Reasonable adjustment for specific risks (see detail provided)

concept

code : reasonableadjustmentforspecificrisksnodetailprovided

display : Reasonable adjustment for specific risks (no detail provided)

concept

code : reasonableadjustmentsforhealthandcareaccess

display : Reasonable adjustments for health and care access

concept

code : doeslipread

display : Does lip read

concept

code : doesusecommunicationdevice

display : Does use communication device

concept

code : doesusehearingaid

display : Does use hearing aid

concept

code : preferredmethodofcommunicationwritten

display : Preferred method of communication: written

concept

code : usesa citizenadvocate

display : Uses a citizen advocate

concept

code : usesa legaladvocate

display : Uses a legal advocate

concept

code : usesalternativecommunicationskill

display : Uses alternative communication skill

concept

code : usesbritishsignlanguage

display : Uses British sign language

concept

code : usescuedspeechtransliterator

display : Uses cued speech transliterator

concept

code : usesdeafblindintervener

display : Uses deafblind intervener

concept

code : usesdeafblindmanualalphabet

display : Uses Deafblind Manual Alphabet

concept

code : useselectronicnotetaker

display : Uses electronic note taker

concept

code : useslipspeaker

display : Uses lipspeaker

concept

code : usesmakatonsignlanguage

display : Uses Makaton sign language

concept

code : usesmanualnotetaker

display : Uses manual note taker

concept

code : usespersonalaudiorecordingdevicetorecordinformation

display : Uses personal audio recording device to record information

concept

code : usespersonalcommunicationpassport

display : Uses Personal Communication Passport

concept

code : usessignlanguage

display : Uses sign language

concept

code : usesspeechtotextreporter

display : Uses speech to text reporter

concept

code : usestelecommunicationsdeviceforthedeaf

display : Uses telecommunications device for the deaf

concept

code : britishsignlanguageinterpreterneeded

display : British Sign Language interpreter needed

concept

code : hands-onsigninginterpreterneeded

display : Hands-on signing interpreter needed

concept

code : makatonsignlanguageinterpreterneeded

display : Makaton Sign Language interpreter needed

concept

code : needsanadvocate

display : Needs an advocate

concept

code : requiresdeafblindblockalphabetinterpreter

display : Requires deafblind block alphabet interpreter

concept

code : requiresdeafblindcommunicatorguide

display : Requires deafblind communicator guide

concept

code : requiresdeafblindhapticcommunicationinterpreter

display : Requires deafblind haptic communication interpreter

concept

code : requiresdeafblindmanualalphabetinterpreter

display : Requires deafblind manual alphabet interpreter

concept

code : requireslipspeaker

display : Requires lipspeaker

concept

code : requiresmanualnotetaker

display : Requires manual note taker

concept

code : requiressightedguide

display : Requires sighted guide

concept

code : requiresspeechtotextreporter

display : Requires speech to text reporter

concept

code : signsupportedenglishinterpreterneeded

display : Sign Supported English interpreter needed

concept

code : visualframesignlanguageinterpreterneeded

display : Visual frame sign language interpreter needed

concept

code : requiresaudiblealert

display : Requires audible alert

concept

code : requirescontactbyemail

display : Requires contact by email

concept

code : requirescontactbyletter

display : Requires contact by letter

concept

code : requirescontactbyshortmessageservicetextmessage

display : Requires contact by short message service text message

concept

code : requirescontactbytelephone

display : Requires contact by telephone

concept

code : requirescontactbytextrelay

display : Requires contact by text relay

concept

code : requirescontactviacarer

display : Requires contact via carer

concept

code : requirestactilealert

display : Requires tactile alert

concept

code : requiresvisualalert

display : Requires visual alert

concept

code : requireshealthcareinformationrecordingonpersonalaudiorecordingdevice

display : Requires healthcare information recording on personal audio recording device

concept

code : requiresinformationbyemail

display : Requires information by email

concept

code : requiresinformationincontractedgrade2braille

display : Requires information in contracted (Grade 2) Braille

concept

code : requiresinformationineasyread

display : Requires information in Easyread

concept

code : requiresinformationinelectronicaudioformat

display : Requires information in electronic audio format

concept

code : requiresinformationinelectronicdownloadableformat

display : Requires information in electronic downloadable format

concept

code : requiresinformationinmakaton

display : Requires information in Makaton

concept

code : requiresinformationinmoonalphabet

display : Requires information in Moon alphabet

concept

code : requiresinformationinuncontractedgrade1braille

display : Requires information in uncontracted (Grade 1) Braille

concept

code : requiresinformationonaudiocassettetape

display : Requires information on audio cassette tape

concept

code : requiresinformationoncompactdisc

display : Requires information on compact disc

concept

code : requiresinformationondigitalversatiledisc

display : Requires information on digital versatile disc

concept

code : requiresinformationonuniversalserialbusmassstoragedevice

display : Requires information on universal serial bus mass storage device

concept

code : requiresinformationverbally

display : Requires information verbally

concept

code : requiresthirdpartytoreadoutwritteninformation

display : Requires third party to read out written information

concept

code : requireswritteninformationinatleast20pointsansseriffont

display : Requires written information in at least 20 point sans serif font

concept

code : requireswritteninformationinatleast24pointsansseriffont

display : Requires written information in at least 24 point sans serif font

concept

code : requireswritteninformationinatleast28pointsansseriffont

display : Requires written information in at least 28 point sans serif font

This code system https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars defines the following codes:

Code	Display
patientChoice	Patient Choice in Service Selection
adjustcommunicationforhearingsensoryimpairment	Adjust communication for hearing / sensory impairment
adjustforatypicalexpressionofpain	Adjust for atypical expression of pain
adjustforuseofcommunicationbookaid	Adjust for use of communication book / aid
advocatetobepresent	Advocate to be present
carertobepresentforallcommunication	Carer to be present for all communication
patientlikelytoalwaysrespondinthepositive	Patient likely to always respond in the positive
provideappointmentreminders	Provide appointment reminders
providewrittenremindersandadvice	Provide written reminders and advice
reasonableadjustmentforcommunicationnodetailprovided	Reasonable adjustment for communication (no detail provided)
reasonableadjustmentforcommunicationseedetailprovided	Reasonable adjustment for communication (see detail provided)
patientnottobeleftalone	Patient not to be left alone
adjusttoinvolvecarersinallaspectsofcare	Adjust to involve Carers in all aspects of care
lastingpowerofattorney	Lasting Power of Attorney
additionalsupportfordischarge	Additional support for discharge
supportforvisualsensoryimpairment	Support for visual /sensory impairment
reasonableadjustmentforadditionalsupportseedetailprovided	Reasonable adjustment for additional support (see detail provided)
reasonableadjustmentforadditionalsupportnodetailprovided	Reasonable adjustment for additional support (no detail provided)
adjustforneedlephobia	Adjust for needle phobia
dislikesuniformswhitecoats	Dislikes uniforms / white coats
respondstodistraction	Responds to distraction
hasanticipatorycarecrisisplan	Has anticipatory care /crisis plan
willonlytoleratemedicationsincertainformat	Will only tolerate medications in certain format
maleorfemaleonlysupport	Male or Female only support
reasonableadjustmenttopersonalisationseedetailprovided	Reasonable adjustment to personalisation (see detail provided)
reasonableadjustmenttopersonalisationnodetailprovided	Reasonable adjustment to personalisation (no detail provided)
adjustforlownoisestimulus	Adjust for low noise stimulus
adjustforsingleroom	Adjust for single room
wheelchairaccess	Wheelchair access
adjustforspecialistequipment	Adjust for specialist equipment
adjustforlowlightstimulus	Adjust for low light stimulus
adjustminimisewaitingtimes	Adjust / minimise waiting times
reasonableadjustmenttoenvironmentseedetailprovided	Reasonable adjustment to environment (see detail provided)
reasonableadjustmenttoenvironmentnodetailprovided	Reasonable adjustment to environment (no detail provided)
offerfirstorlastappointment	Offer first or last appointment
considerhomevisits	Consider Home Visits
providelongerappointment	Provide longer appointment
provideadditionaltimefordecisionmakingprocessing	Provide additional time for decision making / processing
adjustforhighlevelsofanxiety	Adjust for high levels of anxiety
considerdesensitisationforanyprocedure	Consider desensitisation for any procedure
considerpreoutpatientoradmissionvisit	Consider pre outpatient or admission visit
reasonableadjustmenttoservicedeliveryseedetailprovided	Reasonable adjustment to service delivery (see detail provided)
reasonableadjustmenttoservicedeliverynodetailprovided	Reasonable adjustment to service delivery (no detail provided)
monitorforconstipation	Monitor for constipation
monitorfordehydration	Monitor for dehydration
monitornutrition	Monitor nutrition
monitorforpressuresores	Monitor for pressure sores
monitorfordysphagia	Monitor for Dysphagia
monitorforself-harm	Monitor for self-harm
monitorforepilepsy	Monitor for epilepsy
reasonableadjustmentforspecificrisksseedetailprovided	Reasonable adjustment for specific risks (see detail provided)
reasonableadjustmentforspecificrisksnodetailprovided	Reasonable adjustment for specific risks (no detail provided)
reasonableadjustmentsforhealthandcareaccess	Reasonable adjustments for health and care access
doeslipread	Does lip read
doesusecommunicationdevice	Does use communication device
doesusehearingaid	Does use hearing aid
preferredmethodofcommunicationwritten	Preferred method of communication: written
usesa citizenadvocate	Uses a citizen advocate
usesa legaladvocate	Uses a legal advocate
usesalternativecommunicationskill	Uses alternative communication skill
usesbritishsignlanguage	Uses British sign language
usescuedspeechtransliterator	Uses cued speech transliterator
usesdeafblindintervener	Uses deafblind intervener
usesdeafblindmanualalphabet	Uses Deafblind Manual Alphabet
useselectronicnotetaker	Uses electronic note taker
useslipspeaker	Uses lipspeaker
usesmakatonsignlanguage	Uses Makaton sign language
usesmanualnotetaker	Uses manual note taker
usespersonalaudiorecordingdevicetorecordinformation	Uses personal audio recording device to record information
usespersonalcommunicationpassport	Uses Personal Communication Passport
usessignlanguage	Uses sign language
usesspeechtotextreporter	Uses speech to text reporter
usestelecommunicationsdeviceforthedeaf	Uses telecommunications device for the deaf
britishsignlanguageinterpreterneeded	British Sign Language interpreter needed
hands-onsigninginterpreterneeded	Hands-on signing interpreter needed
makatonsignlanguageinterpreterneeded	Makaton Sign Language interpreter needed
needsanadvocate	Needs an advocate
requiresdeafblindblockalphabetinterpreter	Requires deafblind block alphabet interpreter
requiresdeafblindcommunicatorguide	Requires deafblind communicator guide
requiresdeafblindhapticcommunicationinterpreter	Requires deafblind haptic communication interpreter
requiresdeafblindmanualalphabetinterpreter	Requires deafblind manual alphabet interpreter
requireslipspeaker	Requires lipspeaker
requiresmanualnotetaker	Requires manual note taker
requiressightedguide	Requires sighted guide
requiresspeechtotextreporter	Requires speech to text reporter
signsupportedenglishinterpreterneeded	Sign Supported English interpreter needed
visualframesignlanguageinterpreterneeded	Visual frame sign language interpreter needed
requiresaudiblealert	Requires audible alert
requirescontactbyemail	Requires contact by email
requirescontactbyletter	Requires contact by letter
requirescontactbyshortmessageservicetextmessage	Requires contact by short message service text message
requirescontactbytelephone	Requires contact by telephone
requirescontactbytextrelay	Requires contact by text relay
requirescontactviacarer	Requires contact via carer
requirestactilealert	Requires tactile alert
requiresvisualalert	Requires visual alert
requireshealthcareinformationrecordingonpersonalaudiorecordingdevice	Requires healthcare information recording on personal audio recording device
requiresinformationbyemail	Requires information by email
requiresinformationincontractedgrade2braille	Requires information in contracted (Grade 2) Braille
requiresinformationineasyread	Requires information in Easyread
requiresinformationinelectronicaudioformat	Requires information in electronic audio format
requiresinformationinelectronicdownloadableformat	Requires information in electronic downloadable format
requiresinformationinmakaton	Requires information in Makaton
requiresinformationinmoonalphabet	Requires information in Moon alphabet
requiresinformationinuncontractedgrade1braille	Requires information in uncontracted (Grade 1) Braille
requiresinformationonaudiocassettetape	Requires information on audio cassette tape
requiresinformationoncompactdisc	Requires information on compact disc
requiresinformationondigitalversatiledisc	Requires information on digital versatile disc
requiresinformationonuniversalserialbusmassstoragedevice	Requires information on universal serial bus mass storage device
requiresinformationverbally	Requires information verbally
requiresthirdpartytoreadoutwritteninformation	Requires third party to read out written information
requireswritteninformationinatleast20pointsansseriffont	Requires written information in at least 20 point sans serif font
requireswritteninformationinatleast24pointsansseriffont	Requires written information in at least 24 point sans serif font
requireswritteninformationinatleast28pointsansseriffont	Requires written information in at least 28 point sans serif font