It will be possible to send more than one Transfer of Care message for the same patient event.
The NHS Standard Contract (2017-2019) states that a discharge summary should be electronically issued to the Service User’s GP within 24 hours. If test results are not available to meet this deadline, then it should be issued to meet the deadline and a further “results letter” rather than a Transfer of Care discharge letter sent at a later point
The PRSB Outpatient Standard has not been ratified because the PRSB were waiting for the Royal College of Surgeons to nominate someone to provide an example letter. This is still the situation. NHS Digital have obtained reassurance from the PRSB that the Information Models associated with the Outpatient Use Case will not be impacted, and consequently this has not impeded the development of the FHIR bundles.
If the Community Mental Health service the patient is being discharged from is managed by the NHS Standard Contract 2017-2019 then it will require a Transfer of Care message. If the answer is no, then it does not
Section 3.1.2 http://prsb-dev.riviam.com/wp-content/uploads/2018/02/Implementation-Guidance-from-Discharge-Phase-2-To-be-read-with-Mental-Health-Report.pdf states “the practice of sending an initial brief summary and following up with a later more detailed letter should be deprecated”, i.e. the 24hr discharge becomes the full discharge summary
SC 11.7 of the NHS Standard Contract 2017/19 sets out:
There is implementation guidance and advice available on the PRSB website specifically relating to electronic discharge and clinic letters.
NHS organisations will be expected to have aligned their acute inpatient discharge, emergency care discharges, mental health discharges and outpatient letters with the nationally published specifications and have the capability to send by 1 October 2018. (Sending electronically (no paper or fax) was part of NHS Standard Contract 2015)