NHS based Patient/ Appointment messaging - Prototyping

API Platform
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I’m a software developer working on the early stages of designing our integration capability for NHS-based systems as a prototyping.

Our initial focus is patient or appointment-related messaging (for example: New patient registration, booking, rescheduling, cancellation, notifications), with the intention of building this in a way that is future-proof, standards-based, and compliant with NHS expectations.

I’m reaching out to this community to learn from those who have already navigated this space and to ensure we start with the right architectural and integration decisions.

Specifically, I would really appreciate guidance or pointers on the following areas:

1. Integration & API Standards

  • What are the recommended NHS standards for appointment-related integrations today?

  • Is FHIR (R4) the preferred approach for appointments, or are there other patterns still commonly used?

  • Are there specific NHS APIs or services we should be designing around from day one?

2. Messaging & Eventing

  • For appointment events, is there a preferred messaging model (request/response vs event-driven)?

  • Are there commonly adopted messaging platforms or patterns (e.g. MESH, async messaging, webhooks)?

  • Any lessons learned when dealing with event ordering, retries, or idempotency in NHS integrations?

3. Data Formats & Interoperability

  • Recommended message formats and payload structures for appointment data?

  • Any common pitfalls when mapping internal models to NHS/FHIR resources?

4. Authentication & Security

  • What authentication mechanisms are typically expected (e.g. OAuth 2.0, NHS Identity, Spine-related auth)?

  • Any best practices around certificate management, environments, and access separation?

5. Compliance, Licensing & Assurance

  • What registrations, licences, or onboarding processes should we plan for early (e.g. NHS Digital, API subscriptions)?

  • How early should we be thinking about DSPT, DTAC, clinical safety (DCB0129/0160) in relation to integrations?

6. Developer Resources & Communities

  • Are there forums, Slack/Teams groups, GitHub repos, or documentation hubs you’d recommend?

  • Any real-world examples or reference implementations that helped you early on?

Our goal is to build something that aligns with NHS interoperability principles, avoids rework later, and respects both clinical safety and operational realities.

Any advice, links, war stories, or even “things you wish you’d known earlier” would be hugely appreciated.

Thank you in advance for your time, and I’m really looking forward to learning from the community.