NHS North West Genomics
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Questionnaire: GMS WGS Cancer Ask At Order Entry Questions

Official URL: https://fhir.nwgenomics.nhs.uk/Questionnaire/GMSWGSCancerAskAtOrderEntry Version: 2.2.0
Unknown as of 2026-09-20 Computable Name:

For analysis purposes only - not an active or planned project.

Ask At Order Entry Questions for the NHS Genomic Medicine Service (GMS) Whole Genome Sequencing (WGS) Test Request - Cancer form (the national GMS-branded form, not NW GLH-specific), used alongside the common core order form - see Order Entry Questions. Like GMS WGS Rare Disease, this form has no Whole Genome Sequencing Test Category in the common core's Test Code branches, so its own Test Directory Clinical Indication item fills that gap directly.

This Questionnaire is compared against Genomic Test Order - see NW GLH Paper Test Request Forms - but does not yet declare derivedFrom/extends it: unlike the Ask At Order Entry Questionnaires that originated from an existing digital order-entry screen (see Order Entry Questions), this one hasn't yet been processed into the specific electronic Ask At Order Entry shape that relationship implies for use in an actual order. It structures the NHS Genomic Medicine Service (GMS) Whole Genome Sequencing (WGS) Test Request - Cancer form - the national GMS-branded form, distinct from the NW GLH-specific HRD and Tumour BRCA form (a different cancer test, not WGS) - see NW Genomics paper test request forms for how this compares to the other paper forms.

Source form: GMS WGS Test Request Form - Cancer, V1.22 July 2024 (PDF)

Summary

Item Paper Form Field FHIR
Patient first/last name Free text Patient.name
Ethnicity Coded Patient.extension:ethnicCategory
Date of birth dd/mm/yyyy Patient.birthDate
Hospital number Free text Patient.identifier:MedicalRecordNumber
Gender Male/Female/Other Patient.gender
Postcode Free text Patient.address.postalCode
NHS number Free text Patient.identifier:nhsNumber
Responsible consultant Name/Department address/Phone/Email PractitionerRole
Requesting organisation / GLH laboratory Two organisation fields PractitionerRole.organization / ServiceRequest.performer
Reason NHS Number not available Free text Patient.identifier:nhsNumber.extension
Presentation status First diagnosis/Recurrence/Relapse/Unknown Condition.clinicalStatus
Additional clinical information Free text ServiceRequest.note
Test Directory Clinical Indication & code Free text/code ServiceRequest.code
Tumour presentation type (solid tumour only) Primary/Metastatic/Unknown/Lymphoma Observation.valueCodeableConcept
Histopathology Lab ID (solid tumour only) Free text Specimen.accessionIdentifier.assigner.identifier.value
Tumour topography/morphology (solid tumour only) Free text Specimen.collection.bodySite / not yet mapped
Haemato-oncology liquid tumour type AML/ALL/Other Observation.valueCodeableConcept
SIHMDS Lab ID Free text Specimen.accessionIdentifier.assigner.identifier.value
% Malignant nuclei/blasts Numeric Observation.valueQuantity
Nucleated cell count Numeric (bone marrow/peripheral blood only) Not yet mapped
Record of Discussion Attached/to follow Observation.valueCodeableConcept
Main contact Name/department/phone/email, if different from responsible consultant Not yet mapped

Tumour and germline sample sections (sample type, sample ID, collection date/time, sample volume, comments) map directly onto the common core's own Specimen group and are not re-declared here. No Order Placer Number, Account Number/Hospital Spell Identifier, or clinician professional identifier (GMC/GMP) field is present on the paper form - the same universal gap as every other paper form compared on this page.

Profile: Questionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. **For analysis purposes only - not an active or planned project.** **Ask At Order Entry Questions** for the **NHS Genomic Medicine Service (GMS) Whole Genome Sequencing (WGS) Test Request - Cancer** form (the national GMS-branded form, not NW GLH-specific), used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions). Like [GMS WGS Rare Disease](Questionnaire-GMSWGSRareDisease.html), this form has no Whole Genome Sequencing Test Category in the common core's Test Code branches, so its own Test Directory Clinical Indication item fills that gap directly. Questionnaire https://fhir.nwgenomics.nhs.uk/Questionnaire/GMSWGSCancerAskAtOrderEntry#2.2.0
... Patient Patient 0..1 group Definition: Patient
Value Set:
.... LN/45392-8 Patient first name 0..1 string Definition: Patient.name.given
Value Set:
.... LN/45394-4 Patient last name 0..1 string Definition: Patient.name.family
Value Set:
.... LN/32624-9 Ethnicity 0..1 choice Definition: Patient.extension:ethnicCategory
Value Set: Ethnicity
.... LN/21112-8 Date of birth (dd/mm/yyyy) 0..1 date Definition: Patient.birthDate
Value Set:
.... LN/76435-7 Hospital number 0..1 string Definition: Patient.identifier:MedicalRecordNumber
Value Set:
.... LN/46098-0 Gender 0..1 choice Definition: Patient.gender
Value Set: AdministrativeGender
.... LN/45401-7 Postcode 0..1 string Definition: Patient.address.postalCode
Value Set:
.... LN/89061-6 NHS number 0..1 string Definition: Patient.identifier:nhsNumber
Value Set:
..... LN/89061-6-designNote See NOS/ReasonNHSNumberNotAvailable-cancer in Ask At Order Entry Questions below if not available. 0..1 display Value Set:
... HealthcareProfessional Responsible consultant 0..1 group Definition: PractitionerRole
Value Set:
.... LN/18705-4 Name 0..1 string Definition: PractitionerRole.practitioner.display
Value Set:
.... NOS/DepartmentAddress Department address 0..1 string Definition: PractitionerRole.organization.display
Value Set:
.... LN/81230-5 Phone 0..1 string Definition: PractitionerRole.telecom.value
Value Set:
.... LN/89058-2 Email 0..1 string Definition: PractitionerRole.telecom.value
Value Set:
... AskAtOrderEntry Ask At Order Entry Questions 0..1 group Value Set:
.... HL7/ORC-21-requesting-cancer Requesting organisation 0..1 string Definition: PractitionerRole.organization.identifier.value
Value Set:
..... HL7/ORC-21-requesting-cancer-designNote Same concept as the common core's own Referring Organisation ODS Code / Ordering Facility (HL7/ORC-21) - see GMS WGS Rare Disease's equivalent item for the same requester/performer split. 0..1 display Value Set:
.... NOS/GLHLaboratory GLH laboratory to receive sample 0..1 string Definition: ServiceRequest.performer
Value Set:
.... NOS/ReasonNHSNumberNotAvailable-cancer Reason NHS Number not available (e.g. patient not eligible, foreign national) 0..1 string Definition: Patient.identifier:nhsNumber.extension
Value Set:
.... NOS/PresentationStatus Presentation status 0..1 choice Definition: Condition.clinicalStatus
Value Set:
Options: 3 options
.... NOS/AdditionalClinicalInformation Additional clinical information (previous tumours, molecular testing, relevant treatment history) 0..1 string Definition: ServiceRequest.note
Value Set:
..... NOS/AdditionalClinicalInformation-designNote Same FHIR target as the common core's own Relevant clinical information and family history (HL7/NTE-1). 0..1 display Value Set:
.... NOS/TestDirectoryClinicalIndication-cancer Test Directory Clinical Indication & code (cancer type & sub-type) 1..1 choice Definition: ServiceRequest.code
Value Set: Genomic Test Codes
..... NOS/TestDirectoryClinicalIndication-cancer-designNote Same gap-fill as GMS WGS Rare Disease's own Test Code item - the common core's Cancer Test Code branch (HL7/OBR-4-c) is scoped to CancerTestCode, not Whole Genome Sequencing. 0..1 display Value Set:
.... SolidTumour Solid tumour requests only 0..1 group Value Set:
..... NOS/TumourPresentationType Tumour presentation type 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 4 options
..... NOS/HistopathologyLabID Histopathology Lab ID 0..1 string Definition: Specimen.accessionIdentifier.assigner.identifier.value
Value Set:
...... NOS/HistopathologyLabID-designNote Same underlying concept as the common core's own Pathology Laboratory Hospital/Trust ID (LN/80398-1-ODS). 0..1 display Value Set:
..... NOS/DateOfDiagnosis-solid Date of this diagnosis 0..1 date Definition: Condition.onsetDateTime
Value Set:
..... NOS/TumourTopography Tumour topography 0..1 string Definition: Specimen.collection.bodySite
Value Set:
...... NOS/TumourTopography-designNote Overlaps conceptually with the common core's own Tissue source/organ of origin (LN/39111-0). 0..1 display Value Set:
..... NOS/TumourMorphology-solid Tumour morphology 0..1 string Value Set:
...... NOS/TumourMorphology-solid-designNote No clean FHIR field identified for tumour morphology. 0..1 display Value Set:
..... NOS/AdditionalTumourInformation Additional tumour information (e.g. site of metastasis, unknown primary) 0..1 string Value Set:
.... HaemOncLiquidTumour Haemato-oncology liquid tumour requests only 0..1 group Value Set:
..... NOS/HaematoOncologyLiquidTumourType Haemato-oncology liquid tumour type 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
..... NOS/SIHMDSLabID SIHMDS Lab ID 0..1 string Definition: Specimen.accessionIdentifier.assigner.identifier.value
Value Set:
..... NOS/DateOfDiagnosis-haemonc Date of this diagnosis 0..1 date Definition: Condition.onsetDateTime
Value Set:
.... TumourSpecimen Tumour sample (being sent to GLH DNA extraction lab) 0..1 group Value Set:
..... TumourSpecimen-designNote Sample type (Fresh frozen tumour/Bone marrow/Blood EDTA/Other), Sample ID, Collection date/time and Sample volume map onto the common core's own Specimen group - not re-declared here. 0..1 display Value Set:
..... NOS/NeoplasticCellContent-gms % Malignant nuclei / blasts (or equivalent) 1..1 quantity Definition: Observation.valueQuantity
Value Set:
...... NOS/NeoplasticCellContent-gms-designNote Same underlying concept as WGS Local Test Order's Neoplastic cell content (NOS/NeoplasticCellContent-wgs) - reuses the same local code. 0..1 display Value Set:
..... NOS/NucleatedCellCount Nucleated cell count (if bone marrow/peripheral blood) 0..1 decimal Value Set:
.... GermlineSpecimen Germline sample (being sent to GLH DNA extraction lab) 0..1 group Value Set:
..... GermlineSpecimen-designNote Sample type (Blood EDTA/Saliva/Fibroblasts/Skin biopsy/Other), Sample ID, Collection date/time, Sample volume and Comments map onto the common core's own Specimen group - not re-declared here. 0..1 display Value Set:
.... NOS/RODToFollow-gms-cancer Record of Discussion (ROD) attached, or to follow 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... MainContact-cancer Main contact (if different from responsible consultant) 0..1 group Value Set:
..... MainContact-cancer-designNote Responsible consultant maps directly onto the common core's own Healthcare Professional group and is not re-declared here. Main Contact is the same genuinely-additional-person gap identified on GMS WGS Rare Disease and Genomic Test Order - Common Fields We May Have Missed (Copy Report To). 0..1 display Value Set:
..... NOS/MainContactName-cancer Name 0..1 string Value Set:
..... NOS/MainContactDepartmentAddress-cancer Department address 0..1 string Value Set:
..... NOS/MainContactPhone-cancer Phone 0..1 string Value Set:
..... NOS/MainContactEmail-cancer Email 0..1 string Value Set:

doco Documentation for this format

Options Sets

Answer options for NOS/PresentationStatus

  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#PresentationFirstDiagnosis
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#PresentationRecurrenceRelapse
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for NOS/TumourPresentationType

  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#TumourPresentationPrimary
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#TumourPresentationMetastatic
  • http://loinc.org#LA4489-6 ("Unknown")
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#TumourPresentationLymphoma

Answer options for NOS/HaematoOncologyLiquidTumourType

  • http://snomed.info/sct#91861009 ("Acute myeloid leukaemia (AML)")
  • http://snomed.info/sct#84228005 ("Acute lymphoblastic leukaemia (ALL)")

Answer options for NOS/RODToFollow-gms-cancer

  • http://loinc.org#LA33-6 ("Attached")
  • http://loinc.org#LA32-8 ("To follow")

Profile: Questionnaire

Patient

  • linkId: Patient
  • Definition:: Patient
  • Answers:

Patient first name

Patient last name

Ethnicity

Date of birth (dd/mm/yyyy)

Hospital number

Gender

Postcode

NHS number

See NOS/ReasonNHSNumberNotAvailable-cancer in Ask At Order Entry Questions below if not available.

  • linkId: LN/89061-6-designNote
  • Answers:

Responsible consultant

Name

Department address

Phone

Email

Ask At Order Entry Questions

  • linkId: AskAtOrderEntry
  • Answers:

Requesting organisation

Same concept as the common core's own Referring Organisation ODS Code / Ordering Facility (HL7/ORC-21) - see GMS WGS Rare Disease's equivalent item for the same requester/performer split.

  • linkId: HL7/ORC-21-requesting-cancer-designNote
  • Answers:

GLH laboratory to receive sample

Reason NHS Number not available (e.g. patient not eligible, foreign national)

Presentation status

Additional clinical information (previous tumours, molecular testing, relevant treatment history)

Same FHIR target as the common core's own Relevant clinical information and family history (HL7/NTE-1).

  • linkId: NOS/AdditionalClinicalInformation-designNote
  • Answers:

Test Directory Clinical Indication & code (cancer type & sub-type)*

Same gap-fill as GMS WGS Rare Disease's own Test Code item - the common core's Cancer Test Code branch (HL7/OBR-4-c) is scoped to CancerTestCode, not Whole Genome Sequencing.

  • linkId: NOS/TestDirectoryClinicalIndication-cancer-designNote
  • Answers:

Solid tumour requests only

  • linkId: SolidTumour
  • Answers:

Tumour presentation type

Histopathology Lab ID

Same underlying concept as the common core's own Pathology Laboratory Hospital/Trust ID (LN/80398-1-ODS).

  • linkId: NOS/HistopathologyLabID-designNote
  • Answers:

Date of this diagnosis

Tumour topography

Overlaps conceptually with the common core's own Tissue source/organ of origin (LN/39111-0).

  • linkId: NOS/TumourTopography-designNote
  • Answers:

Tumour morphology

  • linkId: NOS/TumourMorphology-solid
  • Answers:

No clean FHIR field identified for tumour morphology.

  • linkId: NOS/TumourMorphology-solid-designNote
  • Answers:

Additional tumour information (e.g. site of metastasis, unknown primary)

  • linkId: NOS/AdditionalTumourInformation
  • Answers:

Haemato-oncology liquid tumour requests only

  • linkId: HaemOncLiquidTumour
  • Answers:

Haemato-oncology liquid tumour type

SIHMDS Lab ID

Date of this diagnosis

Tumour sample (being sent to GLH DNA extraction lab)

  • linkId: TumourSpecimen
  • Answers:

Sample type (Fresh frozen tumour/Bone marrow/Blood EDTA/Other), Sample ID, Collection date/time and Sample volume map onto the common core's own Specimen group - not re-declared here.

  • linkId: TumourSpecimen-designNote
  • Answers:

% Malignant nuclei / blasts (or equivalent)*

Same underlying concept as WGS Local Test Order's Neoplastic cell content (NOS/NeoplasticCellContent-wgs) - reuses the same local code.

  • linkId: NOS/NeoplasticCellContent-gms-designNote
  • Answers:

Nucleated cell count (if bone marrow/peripheral blood)

  • linkId: NOS/NucleatedCellCount
  • Answers:

Germline sample (being sent to GLH DNA extraction lab)

  • linkId: GermlineSpecimen
  • Answers:

Sample type (Blood EDTA/Saliva/Fibroblasts/Skin biopsy/Other), Sample ID, Collection date/time, Sample volume and Comments map onto the common core's own Specimen group - not re-declared here.

  • linkId: GermlineSpecimen-designNote
  • Answers:

Record of Discussion (ROD) attached, or to follow

Main contact (if different from responsible consultant)

  • linkId: MainContact-cancer
  • Answers:

Responsible consultant maps directly onto the common core's own Healthcare Professional group and is not re-declared here. Main Contact is the same genuinely-additional-person gap identified on GMS WGS Rare Disease and Genomic Test Order - Common Fields We May Have Missed (Copy Report To).

  • linkId: MainContact-cancer-designNote
  • Answers:

Name

  • linkId: NOS/MainContactName-cancer
  • Answers:

Department address

  • linkId: NOS/MainContactDepartmentAddress-cancer
  • Answers:

Phone

  • linkId: NOS/MainContactPhone-cancer
  • Answers:

Email

  • linkId: NOS/MainContactEmail-cancer
  • Answers:

Profile: Questionnaire

LinkIDDescription & Constraintsdoco
.. Patient Definition: Patient
Value Set:
... LN/45392-8 Definition: Patient.name.given
Value Set:
... LN/45394-4 Definition: Patient.name.family
Value Set:
... LN/32624-9 Definition: Patient.extension:ethnicCategory
Value Set: Ethnicity
... LN/21112-8 Definition: Patient.birthDate
Value Set:
... LN/76435-7 Definition: Patient.identifier:MedicalRecordNumber
Value Set:
... LN/46098-0 Definition: Patient.gender
Value Set: AdministrativeGender
... LN/45401-7 Definition: Patient.address.postalCode
Value Set:
... LN/89061-6 Definition: Patient.identifier:nhsNumber
Value Set:
.... LN/89061-6-designNote Value Set:
.. HealthcareProfessional Definition: PractitionerRole
Value Set:
... LN/18705-4 Definition: PractitionerRole.practitioner.display
Value Set:
... NOS/DepartmentAddress Definition: PractitionerRole.organization.display
Value Set:
... LN/81230-5 Definition: PractitionerRole.telecom.value
Value Set:
... LN/89058-2 Definition: PractitionerRole.telecom.value
Value Set:
.. AskAtOrderEntry Value Set:
... HL7/ORC-21-requesting-cancer Definition: PractitionerRole.organization.identifier.value
Value Set:
.... HL7/ORC-21-requesting-cancer-designNote Value Set:
... NOS/GLHLaboratory Definition: ServiceRequest.performer
Value Set:
... NOS/ReasonNHSNumberNotAvailable-cancer Definition: Patient.identifier:nhsNumber.extension
Value Set:
... NOS/PresentationStatus Definition: Condition.clinicalStatus
Value Set:
Options: 3 options
... NOS/AdditionalClinicalInformation Definition: ServiceRequest.note
Value Set:
.... NOS/AdditionalClinicalInformation-designNote Value Set:
... NOS/TestDirectoryClinicalIndication-cancer Definition: ServiceRequest.code
Value Set: Genomic Test Codes
.... NOS/TestDirectoryClinicalIndication-cancer-designNote Value Set:
... SolidTumour Value Set:
.... NOS/TumourPresentationType Definition: Observation.valueCodeableConcept
Value Set:
Options: 4 options
.... NOS/HistopathologyLabID Definition: Specimen.accessionIdentifier.assigner.identifier.value
Value Set:
..... NOS/HistopathologyLabID-designNote Value Set:
.... NOS/DateOfDiagnosis-solid Definition: Condition.onsetDateTime
Value Set:
.... NOS/TumourTopography Definition: Specimen.collection.bodySite
Value Set:
..... NOS/TumourTopography-designNote Value Set:
.... NOS/TumourMorphology-solid Value Set:
..... NOS/TumourMorphology-solid-designNote Value Set:
.... NOS/AdditionalTumourInformation Value Set:
... HaemOncLiquidTumour Value Set:
.... NOS/HaematoOncologyLiquidTumourType Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... NOS/SIHMDSLabID Definition: Specimen.accessionIdentifier.assigner.identifier.value
Value Set:
.... NOS/DateOfDiagnosis-haemonc Definition: Condition.onsetDateTime
Value Set:
... TumourSpecimen Value Set:
.... TumourSpecimen-designNote Value Set:
.... NOS/NeoplasticCellContent-gms Definition: Observation.valueQuantity
Value Set:
..... NOS/NeoplasticCellContent-gms-designNote Value Set:
.... NOS/NucleatedCellCount Value Set:
... GermlineSpecimen Value Set:
.... GermlineSpecimen-designNote Value Set:
... NOS/RODToFollow-gms-cancer Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
... MainContact-cancer Value Set:
.... MainContact-cancer-designNote Value Set:
.... NOS/MainContactName-cancer Value Set:
.... NOS/MainContactDepartmentAddress-cancer Value Set:
.... NOS/MainContactPhone-cancer Value Set:
.... NOS/MainContactEmail-cancer Value Set:

doco Documentation for this format

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