NHS North West Genomics
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Questionnaire: WGS Local Test Order Ask At Order Entry Questions

Official URL: https://fhir.nwgenomics.nhs.uk/Questionnaire/WGSLocalTestOrderAskAtOrderEntry 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 NW GLH paper Genetic Testing Request Form - Whole Genome Sequencing (WGS) form, which accompanies samples sent directly to a NW GLH site, used alongside the common core order form - see Order Entry Questions.

Not to be confused with dWGS Sub-Order Manifest - that Questionnaire is the digital manifest for a distributed WGS sub-contracted order between GLHs (see dWGS); this one is the plain paper form used for a local WGS request, and does not by itself imply any sub-contracting.

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 NW GLH paper Genetic Testing Request Form - Whole Genome Sequencing (WGS) form, which accompanies samples sent to a NW GLH site - see NW Genomics paper test request forms for how this compares to the other paper forms.

Source form: NW GLH Form to accompany samples for Whole Genome Sequencing (WGS) Tests (PDF)

Summary

Item Paper Form Field FHIR
Surname/Forename Free text Patient.name
DoB Free text Patient.birthDate
Sex Free text Patient.gender
Address/Postcode Free text Patient.address
NHS No/Hospital No Free text Patient.identifier:nhsNumber / Patient.identifier:MedicalRecordNumber
Referring Clinician (Consultant, Hospital, Department, Tel, Email) Free text PractitionerRole
WGS test type Rare Disease (Proband/Family Member) or Cancer (Tumour/Germline sample) ServiceRequest.category
Proband Name/DOB of proband (Family Member pathway only) RelatedPerson (NK1-shaped, Role = Proband), repeating group
Neoplastic cell content % (Cancer tumour sample only) Observation.valueQuantity
NGIS Test Code Barcode/placeholder box, completed once the NGIS referral exists ServiceRequest.code (#choice, bound to NGIS Test Code)
High Infection Risk? Yes/No Observation.valueCodeableConcept
Consent Statement "A complete Patient Choice form must be received by the laboratory before WGS can be initiated" Observation.valueCodeableConcept (confirmation of receipt)

Like Prenatal Haemoglobinopathy, this form can name a second individual, and does so via the same NK1-shaped RelatedPerson group as WGS Test Additional Ask At Order Entry Questions - Related Individual (NK1) (NOS/Proband here, reusing that same group under its Proband role rather than Consultand) - but the roles are reversed here. In Genetic Clinical Referral/Prenatal Haemoglobinopathy/the Consultand role of that shared group, the base ServiceRequest's own Patient group is always the proband/primary patient, and the second individual is the RelatedPerson.patient-referencing relative. On the Family Member WGS pathway, it is the other way round: the common core's own Patient group is completed for the family member whose specimen this particular order carries, and the NOS/Proband group above names the already-referred proband instead, with NHS/hospital number (if known) enough to resolve it back to that proband's own existing Patient record rather than duplicating it. Take care not to assume the base Patient group is always the proband when reading this Questionnaire alongside the others. The paper form's own "NGIS/Barcode (Until NGIS Referral Received)" box is a placeholder used before the digital NGIS referral exists, not a distinct Order Placer Number - it converges on ServiceRequest.code once the NGIS referral is raised, and is bound to the same NGIS Test Code ValueSet (all codes from the Genomic Test Code CodeSystem) rather than free text. No Account Number/Hospital Spell Identifier or clinician professional identifier (GMC/GMP) field is present on the paper form. High Infection Risk (SNM/281269004) and a Consent Statement confirmation (SNM/74996004-patient-choice-form) - both present on the paper form itself - reuse the same shapes as NW Genomic General Ask At Order Questions's own equivalent items, since that Questionnaire isn't used alongside this one (this form has its own dedicated Ask At Order Entry Questionnaire, so Genomic General's fallback role doesn't apply here).

Relationship to GMS WGS Rare Disease

The Family Member pathway here is effectively a consultand test: the same real-world scenario as one repetition of GMS WGS Rare Disease's own repeating Family member(s) to be tested group - a relative tested alongside a proband, referenced back to them for interpretation. The two Questionnaires model it in opposite directions for the same reason described above (ServiceRequest.supportingInfo roles reversed): this form produces one order per specimen, so the family member is this order's own subject and the proband is the reference, whereas GMS WGS Rare Disease's composite form keeps the proband as the subject and lists family members as repeating RelatedPerson references instead - see GMS WGS Rare Disease - Practical Issues: One Form, Multiple Orders. This Questionnaire may therefore represent a ready-made way of resolving that composite-form problem, not just an analogy to it: decomposing GMS WGS Rare Disease's Family Members group into individual per-person orders could reuse this Family Member pathway's own shape directly - proband referenced back via NOS/Proband, the same NK1-shaped RelatedPerson group as each Family Members repetition on GMS WGS Rare Disease, both ultimately the same WGS Test Additional Ask At Order Entry Questions - Related Individual (NK1) group first generalised from Genetic Clinical Referral - Consultand - rather than needing a new decomposition pattern designed from scratch.

Profile: Questionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. **For analysis purposes only - not an active or planned project.** **Ask At Order Entry Questions** for the NW GLH paper **Genetic Testing Request Form - Whole Genome Sequencing (WGS)** form, which accompanies samples sent directly to a NW GLH site, used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions). **Not to be confused with** [dWGS Sub-Order Manifest](Questionnaire-dWGSSubOrder.html) - that Questionnaire is the digital manifest for a **distributed WGS sub-contracted order** between GLHs (see [dWGS](dWGS.html)); this one is the plain paper form used for a **local** WGS request, and does not by itself imply any sub-contracting. Questionnaire https://fhir.nwgenomics.nhs.uk/Questionnaire/WGSLocalTestOrderAskAtOrderEntry#2.2.0
... Patient Patient Details 0..1 group Definition: Patient
Value Set:
.... LN/45394-4 Surname 0..1 string Definition: Patient.name.family
Value Set:
.... LN/45392-8 Forename 0..1 string Definition: Patient.name.given
Value Set:
.... LN/21112-8 DoB 0..1 date Definition: Patient.birthDate
Value Set:
.... LN/46098-0 Sex 0..1 choice Definition: Patient.gender
Value Set: AdministrativeGender
.... LN/56799-0 Address 0..1 string Definition: Patient.address.line
Value Set:
.... LN/45401-7 Postcode 0..1 string Definition: Patient.address.postalCode
Value Set:
.... LN/89061-6-patient NHS No 0..1 string Definition: Patient.identifier:nhsNumber
Value Set:
..... LN/89061-6-patient-designNote Distinct linkId from NOS/Proband's own NHS Number (if known) item below (LN/89061-6) - that one is the Proband's, this is this order's own Patient (the family member, on the Family Member pathway). 0..1 display Value Set:
.... LN/76435-7-patient Hospital No 0..1 string Definition: Patient.identifier:MedicalRecordNumber
Value Set:
... HealthcareProfessional Referring Clinician 0..1 group Definition: PractitionerRole
Value Set:
.... LN/18705-4 Consultant (in full) 0..1 string Definition: PractitionerRole.practitioner.display
Value Set:
.... HL7/ORC-21 Hospital (in full) 0..1 string Definition: PractitionerRole.organization.identifier.value
Value Set:
.... NOS/DepartmentAddress Department 0..1 string Definition: PractitionerRole.organization.display
Value Set:
.... LN/81230-5 Tel 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:
.... NOS/WGSPathway WGS test type requested 1..1 choice Definition: ServiceRequest.category
Value Set:
Options: 4 options
.... NOS/Proband Proband (Family Member pathway only) 0..* group Definition: RelatedPerson
Enable When: NOS/WGSPathway = WGS pathway - Rare Disease, Family Member (NW GMSA Codes#WGSPathwayRareDiseaseFamilyMember)
Value Set:
..... NOS/Proband-designNote Same NK1-shaped RelatedPerson group as NW Genomic General Ask At Order Questions' own Related Individual (NK1) group (NOS/RelatedIndividual), used here under its Proband role rather than Consultand: the roles are reversed from Genetic Clinical Referral - Consultand, where the base ServiceRequest's own Patient is always the proband and the relative is the supportingInfo reference. Here, when the Family Member pathway is selected, this ServiceRequest's own common-core Patient group is completed for the FAMILY MEMBER whose specimen this particular order carries - it is this group, not the base Patient group, that names the proband. NHS/hospital number (if known) are enough to resolve this RelatedPerson to the proband's own, already-existing Patient record from their own separate WGS referral, without needing to duplicate it as a new Patient. This Family Member pathway is effectively a **consultand test**: the same real-world scenario as one repetition of GMS WGS Rare Disease's own repeating Family Members group (a relative tested alongside a proband for interpretation), just modelled the other way round because this form produces one order per specimen rather than a single composite family submission - see GMS WGS Rare Disease - Practical Issues: One Form, Multiple Orders. This Questionnaire may represent a ready-made way of resolving that composite-form problem, not just an analogy to it: decomposing a GMS WGS Rare Disease Family Members entry into an individual order could reuse this Family Member pathway's own shape directly - proband referenced back via NOS/Proband, the same way each Family Members repetition there references the proband via RelatedPerson - rather than needing a new decomposition pattern designed from scratch. 0..1 display Value Set:
..... NOS/RelatedIndividualRole Role 1..1 choice Value Set:
Options: 1 option
..... HL7/NK1-2 Name 1..1 string Definition: RelatedPerson.name
Value Set:
..... HL7/NK1-3 Relationship 1..1 choice Definition: RelatedPerson.relationship
Value Set: UK Core Person Relationship Type
..... HL7/NK1.15 Administrative Sex 0..1 choice Definition: RelatedPerson.gender
Value Set: AdministrativeGender
..... HL7/NK1-16 Date of Birth 0..1 date Definition: RelatedPerson.birthDate
Value Set:
..... LN/89061-6 NHS Number (if known) 0..1 string Definition: RelatedPerson.identifier:nhsNumber
Value Set:
..... LN/76435-7 Hospital Number (Medical Record Number), if known 0..1 string Definition: RelatedPerson.identifier:MedicalRecordNumber
Value Set:
..... NOS/RelatedIndividual-patient This order's own Patient (the family member) 1..1 reference Definition: RelatedPerson.patient
Value Set:
.... NOS/NGISTestCode National Genomic Informatics System (NGIS) Test Code 0..1 choice Definition: ServiceRequest.code
Value Set: NGIS Test Code
..... NOS/NGISTestCode-designNote The paper form's own 'NGIS/Barcode (Until NGIS Referral Received)' box is a placeholder used before the digital NGIS referral exists, rather than a distinct order identifier - it converges on the same ServiceRequest.code as the common core's Test Request group once the NGIS referral is created. 0..1 display Value Set:
.... SNM/281269004 High Infection Risk? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
..... SNM/281269004-designNote Present on the paper form's own Sample Information section (and echoed again in the NW GLH Laboratory use ONLY section) - same SNM/281269004 code and Yes/No shape as NW Genomic General Ask At Order Questions' own High Infection Risk item. 0..1 display Value Set:
.... NOS/InfectionRiskDetails High infection Risk Details 0..1 string Definition: Observation.valueString
Value Set:
.... SNM/74996004-patient-choice-form Confirm that a completed Patient Choice (consent) form has been received by the laboratory 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
..... SNM/74996004-patient-choice-form-designNote The paper form's own Referring Clinician section carries a Consent Statement: 'A complete Patient Choice form must be received by the laboratory before WGS can be initiated.' Modelled as a confirmation-of-receipt choice, the same #choice/confirmation-code shape as NW Genomic General Ask At Order Questions' own pathology-report confirmation item, rather than the Consent group's consent-for-testing/DNA-storage Y/N questions - the Patient Choice form is a separate, externally-referenced document this order depends on, not a question this order itself is asking. 0..1 display Value Set:

doco Documentation for this format

Options Sets

Answer options for NOS/WGSPathway

  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#WGSPathwayRareDiseaseProband
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#WGSPathwayRareDiseaseFamilyMember
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#WGSPathwayCancerTumour
  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#WGSPathwayCancerGermline

Answer options for NOS/RelatedIndividualRole

  • https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA#RoleProband

Answer options for SNM/281269004

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")

Answer options for SNM/74996004-patient-choice-form

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Profile: Questionnaire

Patient Details

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

Surname

Forename

DoB

Sex

Address

Postcode

NHS No

Distinct linkId from NOS/Proband's own NHS Number (if known) item below (LN/89061-6) - that one is the Proband's, this is this order's own Patient (the family member, on the Family Member pathway).

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

Hospital No

Referring Clinician

Consultant (in full)

Hospital (in full)

Department

Tel

Email

Ask At Order Entry Questions

  • linkId: AskAtOrderEntry
  • Answers:

WGS test type requested*

Proband (Family Member pathway only)

  • linkId: NOS/Proband
  • Definition:: RelatedPerson
  • Enable When: todo
  • Answers:

Same NK1-shaped RelatedPerson group as NW Genomic General Ask At Order Questions' own Related Individual (NK1) group (NOS/RelatedIndividual), used here under its Proband role rather than Consultand: the roles are reversed from Genetic Clinical Referral - Consultand, where the base ServiceRequest's own Patient is always the proband and the relative is the supportingInfo reference. Here, when the Family Member pathway is selected, this ServiceRequest's own common-core Patient group is completed for the FAMILY MEMBER whose specimen this particular order carries - it is this group, not the base Patient group, that names the proband. NHS/hospital number (if known) are enough to resolve this RelatedPerson to the proband's own, already-existing Patient record from their own separate WGS referral, without needing to duplicate it as a new Patient. This Family Member pathway is effectively a **consultand test**: the same real-world scenario as one repetition of GMS WGS Rare Disease's own repeating Family Members group (a relative tested alongside a proband for interpretation), just modelled the other way round because this form produces one order per specimen rather than a single composite family submission - see GMS WGS Rare Disease - Practical Issues: One Form, Multiple Orders. This Questionnaire may represent a ready-made way of resolving that composite-form problem, not just an analogy to it: decomposing a GMS WGS Rare Disease Family Members entry into an individual order could reuse this Family Member pathway's own shape directly - proband referenced back via NOS/Proband, the same way each Family Members repetition there references the proband via RelatedPerson - rather than needing a new decomposition pattern designed from scratch.

  • linkId: NOS/Proband-designNote
  • Answers:

Role*

Name*

Relationship*

Administrative Sex

Date of Birth

NHS Number (if known)

Hospital Number (Medical Record Number), if known

This order's own Patient (the family member)*

National Genomic Informatics System (NGIS) Test Code

The paper form's own 'NGIS/Barcode (Until NGIS Referral Received)' box is a placeholder used before the digital NGIS referral exists, rather than a distinct order identifier - it converges on the same ServiceRequest.code as the common core's Test Request group once the NGIS referral is created.

  • linkId: NOS/NGISTestCode-designNote
  • Answers:

High Infection Risk?

Present on the paper form's own Sample Information section (and echoed again in the NW GLH Laboratory use ONLY section) - same SNM/281269004 code and Yes/No shape as NW Genomic General Ask At Order Questions' own High Infection Risk item.

  • linkId: SNM/281269004-designNote
  • Answers:

High infection Risk Details

Confirm that a completed Patient Choice (consent) form has been received by the laboratory

The paper form's own Referring Clinician section carries a Consent Statement: 'A complete Patient Choice form must be received by the laboratory before WGS can be initiated.' Modelled as a confirmation-of-receipt choice, the same #choice/confirmation-code shape as NW Genomic General Ask At Order Questions' own pathology-report confirmation item, rather than the Consent group's consent-for-testing/DNA-storage Y/N questions - the Patient Choice form is a separate, externally-referenced document this order depends on, not a question this order itself is asking.

  • linkId: SNM/74996004-patient-choice-form-designNote
  • Answers:

Profile: Questionnaire

LinkIDDescription & Constraintsdoco
.. Patient Definition: Patient
Value Set:
... LN/45394-4 Definition: Patient.name.family
Value Set:
... LN/45392-8 Definition: Patient.name.given
Value Set:
... LN/21112-8 Definition: Patient.birthDate
Value Set:
... LN/46098-0 Definition: Patient.gender
Value Set: AdministrativeGender
... LN/56799-0 Definition: Patient.address.line
Value Set:
... LN/45401-7 Definition: Patient.address.postalCode
Value Set:
... LN/89061-6-patient Definition: Patient.identifier:nhsNumber
Value Set:
.... LN/89061-6-patient-designNote Value Set:
... LN/76435-7-patient Definition: Patient.identifier:MedicalRecordNumber
Value Set:
.. HealthcareProfessional Definition: PractitionerRole
Value Set:
... LN/18705-4 Definition: PractitionerRole.practitioner.display
Value Set:
... HL7/ORC-21 Definition: PractitionerRole.organization.identifier.value
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:
... NOS/WGSPathway Definition: ServiceRequest.category
Value Set:
Options: 4 options
... NOS/Proband Definition: RelatedPerson
Enable When: Not done yet
Value Set:
.... NOS/Proband-designNote Value Set:
.... NOS/RelatedIndividualRole Value Set:
Options: 1 option
.... HL7/NK1-2 Definition: RelatedPerson.name
Value Set:
.... HL7/NK1-3 Definition: RelatedPerson.relationship
Value Set: UK Core Person Relationship Type
.... HL7/NK1.15 Definition: RelatedPerson.gender
Value Set: AdministrativeGender
.... HL7/NK1-16 Definition: RelatedPerson.birthDate
Value Set:
.... LN/89061-6 Definition: RelatedPerson.identifier:nhsNumber
Value Set:
.... LN/76435-7 Definition: RelatedPerson.identifier:MedicalRecordNumber
Value Set:
.... NOS/RelatedIndividual-patient Definition: RelatedPerson.patient
Value Set:
... NOS/NGISTestCode Definition: ServiceRequest.code
Value Set: NGIS Test Code
.... NOS/NGISTestCode-designNote Value Set:
... SNM/281269004 Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... SNM/281269004-designNote Value Set:
... NOS/InfectionRiskDetails Definition: Observation.valueString
Value Set:
... SNM/74996004-patient-choice-form Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... SNM/74996004-patient-choice-form-designNote Value Set:

doco Documentation for this format

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Responses for this Questionnaire

There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.