Hello,
For context, this issue refers to a document processing platform that integrates into EMIS Web via the Partner API.
We’ve been dealing with an issue with adding attachments to the FileRecord call. For context, we file patient documents as attachments to a consultation block, which gets filed into the patient’s record.
The <Consultation> object looks a bit like this (I’ve omitted other <ConsultationElement>instances for brevity):
<Consultation>
<GUID>324c25c9-28c7-4598-8a2c-371e5628a423</GUID>
<AssignedDate>24/12/2025 00:00:00</AssignedDate>
<DatePart>4</DatePart>
<UserID>
<RefID>3797</RefID>
</UserID>
<LocationID>
<RefID>10</RefID>
</LocationID>
<LocationTypeID>
<RefID>1807271000006114</RefID>
</LocationTypeID>
<Duration>0</Duration>
<TravelTime>0</TravelTime>
<PolicyID>-1</PolicyID>
<OriginalAuthor>
<User>
<RefID>3797</RefID>
</User>
<SystemDate>24/12/2025</SystemDate>
</OriginalAuthor>
<ElementList>
<ConsultationElement>
<RefID>2</RefID>
<Header>
<Term>Document</Term>
</Header>
<Attachment>
<RefID>2</RefID>
<GUID>8b3fa060-3fed-4491-afcb-5f486d23d04c</GUID>
<AssignedDate>24/12/2025</AssignedDate>
<AuthorID>
<RefID>3797</RefID>
</AuthorID>
<OriginalAuthor>
<User>
<RefID>3797</RefID>
</User>
<SystemDate>24/12/2025</SystemDate>
</OriginalAuthor>
<DisplayTerm>Otorhinolaryngology service</DisplayTerm>
<DescriptiveText>Kings Hospital.pdf</DescriptiveText>
<PolicyID>-1</PolicyID>
<Code>
<Value>310149003</Value>
<Scheme>SNOMED</Scheme>
<Term>Otorhinolaryngology service</Term>
</Code>
<TermID>
<Value>310149003</Value>
<Scheme>SNOMED</Scheme>
<Term>Otorhinolaryngology service</Term>
</TermID>
<Title>Kings Hospital.pdf</Title>
<Address>C:\Users\imfarazmalik\medprompt\medprompt-emis\docs\FileRecordAttachment_NjBhNTc1MDQtMWFjMS00NmE4LTkzNGYtNjEyN2E4NTZhMzhh.pdf</Address>
<DDSIdentifier>028f459b-9d5f-4766-93d9-9a651ab3392e</DDSIdentifier>
</Attachment>
</ConsultationElement>
</ElementList>
</Consultation>
You can see that we try and pass the document directly, which encounters the 5MB file size limit on EMIS Web.
However, we recently became aware that other document processing platforms use a different strategy that bypasses this entirely – they send in the document to EMIS Web via NHS MESH first. We suspect the flow might look something like this:
What we’re thinking is that the <Attachment> element will reference a document already received and stored by EMIS Web, therefore no file bytes need to travel with the Partner API call. Could anyone shed light on this mechanism, specifically what the MESH ACK may look like and whether it carries the DDSIdentifier back to the sender?