Reasonable Adjustment - Maintaining Synchronicity

Requirement RAO009 of the Local Integration Requirement Specification relates to maintaining synchronicity between local and national RA records. Assuming the next point of reconciliation b/w local and national systems is a patient registration or booking event, how does NHS E want supplier systems to behave? Is the expectation the user in context is presented with a split screen highlighting differences between the local and national records and provide the user with options for reconciliation?

β€œAny Impairments, Adjustments, or Underlying Conditions and any associated free text added to a Reasonable Adjustment record (either as part of record creation or a subsequent update) MUST also be saved to the local patient record. This is to ensure that the local patient record, which is considered the master record, remains in sync with the Reasonable Adjustment record.”

With acceptance criteria that reads as follows
"1. When an impairment, adjustment, or underlying condition is added to the Reasonable Adjustment record (either as part of record creation or a subsequent update) the same MUST also be saved to the local patient record.

  1. This MUST include any free text which accompanies the impairment, adjustment, or underlying condition.

  2. When an impairment, adjustment, or underlying condition is removed from the Reasonable Adjustment record (either individually or as part of entire record removal) the system MUST ask the user whether they also want to remove the corresponding impairment or adjustment entry/entries from the local record.

  3. The user MUST be able to answer β€œNo” to this prompt thereby retaining the impairment or adjustment entry/entries in the local record.

  4. If the user deletes, marks in error, or otherwise removes a Snomed coded data item which has been added to the Reasonable Adjustment record (e.g. an underlying condition) from the local record, then the system MUST ask the user whether they also want to remove the corresponding data item from the Reasonable Adjustment record.

  5. The user MUST be able to answer β€œNo” to this prompt thereby retaining the data item in the Reasonable Adjustment record

7.If the user deletes, marks in error, or otherwise removes the Equality Act Disability Threshold Code from the local record then the system MUST ask the user whether they want to delete the entire Reasonable Adjustment record.

  1. The user MUST be able to answer β€œNo” to this prompt thereby retaining the Reasonable Adjustment record and the Equality Act Disability Threshold Code."
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Please can this question be reviewed?