NHS England · Agentic Access
NHS England Agentic Access

x-agentic-access generated
NHS England exposes 70 API operations that an AI agent could call, of which 32 are state-changing ‘acting’ operations. This is a recommended x-agentic-access execution contract — the scope, audience, consequence tier, short-lived token constraints, and escalation each action should carry before it is handed to an autonomous agent.
By consequence: 38 read, 27 write, and 5 physical.
Contracts are classified heuristically from the provider’s OpenAPI and refresh on every APIs.io network build; audience is bound per deployment. The model follows Curity’s Access Intelligence (apidays Munich 2026). Browse every provider’s agent contracts at agentic-access.apis.io.
HealthcareUnited KingdomNational Health SystemFHIRHL7InteroperabilitySMART on FHIRHealth Datae-PrescribingEHR
Operations: 70 Acting: 32 Human-in-the-loop: 0 Method: generated
By consequence

read 38 write 27 physical 5
Highest-consequence actions

The physical and safety-critical operations an agent could invoke — the ones that most warrant scoped tokens, tight TTLs, and escalation. Full per-operation contracts are in the source below.
Method	Path	Consequence	Human-in-loop
POST	/STU3/CommunicationRequest/{ubrn}/$ers.sendCommunicationToRequester	physical	conditional
POST	/STU3/ReferralRequest/$ers.createReferralAndSendForTriage	physical	conditional
POST	/STU3/ReferralRequest/{ubrn}/$ers.changeShortlistAndSendForTriage	physical	conditional
POST	/communication/in-app/FHIR/R4/CommunicationRequest	physical	conditional
POST	/communication/notification/FHIR/R4/CommunicationRequest	physical	conditional
Source

Agentic Access

generated: '2026-07-24'
method: generated
source: openapi/nhs-app-openapi.yaml, openapi/nhs-booking-and-referral-fhir-openapi.yaml, openapi/nhs-communications-manager-openapi.yaml,
  openapi/nhs-e-referral-service-openapi.yaml, openapi/nhs-immunisation-history-openapi.yaml,
  openapi/nhs-organisation-data-service-fhir-r4-openapi.yaml, openapi/nhs-service-search-openapi.yaml
description: Recommended x-agentic-access execution contracts, classified heuristically from
  the OpenAPI. A governance starting point for exposing this API to AI agents — review and bind
  audience per deployment. See research/curity/agentic-governance/.
summary:
  operations: 70
  by_action_class:
    acting: 32
    connected: 38
  by_consequence:
    physical: 5
    read: 38
    write: 27
  human_in_the_loop_required: 0
operations:
- path: /communication/in-app/FHIR/R4/CommunicationRequest
  method: post
  operationId: create-in-app
  x-agentic-access:
    action-class: acting
    consequence: physical
    subject: required
    audience: null
    token:
      max-ttl: 300
      exchange: true
      purpose-required: true
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /communication/notification/FHIR/R4/CommunicationRequest
  method: post
  operationId: create-notification
  x-agentic-access:
    action-class: acting
    consequence: physical
    subject: required
    audience: null
    token:
      max-ttl: 300
      exchange: true
      purpose-required: true
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /communication/report/receipts/FHIR/R4/Task
  method: get
  operationId: get-receipt-report
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /communication/report/patients
  method: get
  operationId: get-patient-report
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /metadata
  method: get
  operationId: getMeta
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /MessageDefinition
  method: get
  operationId: getMessageDefinition
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /$process-message
  method: post
  operationId: processMessage
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /Slot
  method: get
  operationId: getSlots
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Appointment
  method: get
  operationId: getBookingByPatient
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Appointment/{id}
  method: get
  operationId: getBooking
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /ServiceRequest
  method: get
  operationId: getReferralByPatient
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /ServiceRequest/{id}
  method: get
  operationId: getReferral
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /v1/message-batches
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /v1/messages
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /v1/messages/{messageId}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /channels/nhsapp/accounts
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /{client-provided-message-status-URI}
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /{client-provided-channel-status-URI}
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /{client-provided-recipient-response-URI}
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/CodeSystem/{codeSystemType}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/ReferralRequest/$ers.fetchworklist
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Task
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/ReferralRequest/{ubrn}/_history/{version}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Binary/{attachmentLogicalID}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /R4/Binary/{id}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/ReferralRequest/{ubrn}/$ers.generateCRI
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/HealthcareService/$ers.searchHealthcareServicesForPatient
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/$ers.createReferral
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/$ers.createReferralAndSendForTriage
  method: post
  x-agentic-access:
    action-class: acting
    consequence: physical
    subject: required
    audience: null
    token:
      max-ttl: 300
      exchange: true
      purpose-required: true
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/Slot
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Appointment
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/Binary
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.maintainReferralLetter
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.acceptReferral
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.rejectReferral
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.generatePatientLetter
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.cancelAppointmentActionLater
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/CommunicationRequest/$ers.fetchworklist
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/CommunicationRequest/{ubrn}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/CommunicationRequest/{ubrn}/_history/{version}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Communication
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/CommunicationRequest/{ubrn}/$ers.sendCommunicationToRequester
  method: post
  x-agentic-access:
    action-class: acting
    consequence: physical
    subject: required
    audience: null
    token:
      max-ttl: 300
      exchange: true
      purpose-required: true
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/$ers.createFromCommunicationRequestActionLater
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.recordReviewOutcome
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /R4/PractitionerRole
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/ReferralRequest/{ubrn}/$ers.changeShortlist
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/ReferralRequest/{ubrn}/$ers.changeShortlistAndSendForTriage
  method: post
  x-agentic-access:
    action-class: acting
    consequence: physical
    subject: required
    audience: null
    token:
      max-ttl: 300
      exchange: true
      purpose-required: true
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /R4/HealthcareService/{id}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /R4/HealthcareService/{id}
  method: head
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Appointment/{id}
  method: put
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/Appointment/{id}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/Appointment/{id}/_history/{version}
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /R4/HealthcareService
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/ReferralRequest/{ubrn}/$ers.cancelReferral
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /R4/Practitioner
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /STU3/CommunicationRequest/{ubrn}/$ers.generateCRI
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /STU3/CommunicationRequest/$ers.createAdviceAndGuidance
  method: post
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /R4/ServiceRequest
  method: get
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Immunization
  method: get
  operationId: get-immunisation-history
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Organization
  method: get
  operationId: get-organization-resources
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Organizationaffiliation
  method: get
  operationId: get-organizationaffiliation-resources
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /Organization/{id}
  method: get
  operationId: get-single-organization
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /OrganizationAffiliation/{id}
  method: get
  operationId: get-single-organizationaffiliation
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /List{id}
  method: get
  operationId: get-deletion-notices
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /CodeSystem/
  method: get
  operationId: search-codesystem
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /ValueSet/
  method: post
  operationId: search-ods-organization-code
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required
- path: /metadata
  method: get
  operationId: get-capability-statement
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /
  method: get
  operationId: search-GET
  x-agentic-access:
    action-class: connected
    consequence: read
    subject: optional
    token:
      max-ttl: 3600
    audit: none
- path: /
  method: post
  operationId: search-POST
  x-agentic-access:
    action-class: acting
    consequence: write
    subject: required
    audience: null
    token:
      max-ttl: 900
    escalation:
      human-in-the-loop: conditional
      triggers:
      - abnormal
      - high-value
    audit: required