Operating model and responsibilities
Proposed direction. Responsibilities, policy and workflows are part of the architecture. This table identifies roles to resolve during programme definition; it does not appoint bodies or confer legal authority.
| Role to establish | Accountability to define | Evidence of completion |
|---|---|---|
| Programme coalition | Agree the evolving problem, strategic direction, scope and investment decisions. | Decision record with clinical, operational, digital, governance and delivery participation. |
| Pathway/service owner | Define entry, triage, acceptance, escalation, continuity and closure, including external partners. | Approved pathway and cover arrangements with measurable outcomes. |
| Treating team and receiving team | Record care and explicitly hand over outstanding work. | Named work ownership, acceptance and exception records. |
| Record/content steward | Maintain provenance, quality, corrections, retention and reconciliation. | Content rules and traceable correction process. |
| Occupational assessor | Assess for the specified employment/readiness purpose and control disclosure. | Purpose-specific assessment and approved output definition. |
| Governance and legal roles | Resolve controller/processor responsibilities, confidentiality, rights and permitted use for each flow. | Applicable decision and agreements; no blanket Defence-wide inference. |
| Clinical safety, security and service operation | Assess hazards, operate controls, respond to incidents and manage change. | Setting-specific assurance, monitored service objectives and recovery evidence. |
| Patient/representative participation | Shape accessible pathways, transparency and correction mechanisms. | Tested patient journeys and appropriate representative authority. |
One referral, several responsibilities
A Defence primary-care clinician creates a referral with its question, relevant history, urgency and expected response. Delivery records the receiving route's acknowledgement. It does not record clinical acceptance. The receiving service triages, accepts or redirects the request with reasons. The pathway identifies who follows up while acceptance is unresolved.
The specialist retains its source assessment and sends relevant findings, treatment and follow-up to the PRC and other justified recipients. Shared access can expose permitted detail. Requested work has an accountable owner and closes only when the agreed outcome is recorded. A parallel occupational assessment uses its own purpose decision. Any command output is separately authorised and limited.
This is an illustrative future workflow. Clinical urgency may require direct communication alongside digital exchange. The information-flow reference distinguishes the existing public guidance from this proposed process.
Definition and transition
Agree the problem and strategic direction first. Then test representative pathways across all settings and nations, define responsibilities and evidence the benefits. Evaluate technical and organisational options together before selecting an investment or delivery sequence. Clinical coordination and occupational readiness have only a marginal initial emphasis.
A later migration plan must account for source history, open work, patient identity, corrections, care continuity, reconciliation, cutover and rollback. Existing commitments inform constraints but do not fix the target. Release of a component is separate from acceptance of the whole pathway.
The programme definition sets scope; the internal architecture sets capability boundaries. The governance reference and discovery register retain unresolved authority and implementation questions.