diff --git a/postman/validated_relationship_service.integration.postman_collection.json b/postman/validated_relationship_service.integration.postman_collection.json
index 1abfe654..8155564f 100644
--- a/postman/validated_relationship_service.integration.postman_collection.json
+++ b/postman/validated_relationship_service.integration.postman_collection.json
@@ -10050,4 +10050,4 @@
 			"value": ""
 		}
 	]
-}
\ No newline at end of file
+}
diff --git a/postman/validated_relationship_service.sandbox.postman_collection.json b/postman/validated_relationship_service.sandbox.postman_collection.json
index 03facbdb..2e586338 100644
--- a/postman/validated_relationship_service.sandbox.postman_collection.json
+++ b/postman/validated_relationship_service.sandbox.postman_collection.json
@@ -11554,4 +11554,4 @@
 			"value": "https://sandbox.api.service.nhs.uk/validated-relationships/FHIR/R4"
 		}
 	]
-}
\ No newline at end of file
+}
diff --git a/sandbox/api/post_consent.py b/sandbox/api/post_consent.py
index a44cbd41..0a8f220d 100644
--- a/sandbox/api/post_consent.py
+++ b/sandbox/api/post_consent.py
@@ -30,7 +30,8 @@ def post_consent_response() -> Union[dict, tuple]:
         logger.debug("Received request to POST consent")
         # Validate body - beyond the scope of sandbox - assume body is valid for scenario
         json = request.get_json()
-        patient_identifier = json["performer"][0]["identifier"]["value"]
+        grantee_ext = next(ext for ext in json["extension"] if "grantee" in ext["url"])
+        patient_identifier = grantee_ext["valueReference"]["identifier"]["value"]
         response = None
 
         # Successful parent-child proxy creation
diff --git a/sandbox/api/tests/test_post_consent.py b/sandbox/api/tests/test_post_consent.py
index 4978647a..1207cfd3 100644
--- a/sandbox/api/tests/test_post_consent.py
+++ b/sandbox/api/tests/test_post_consent.py
@@ -99,7 +99,14 @@ def test_post_consent_when_valid_returns_expected_response(
         content_type="application/json",
     )
     # Act
-    json = {"performer": [{"identifier": {"value": nhs_num}}]}
+    json = {
+        "extension": [
+            {
+                "url": "https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee",
+                "valueReference": {"identifier": {"value": nhs_num}},
+            }
+        ]
+    }
     response = client.post(CONSENT_API_ENDPOINT, json=json)
     # Assert
     if id is not None:
diff --git a/specification/examples/requests/PATCH_Consent/replace_legal_basis.yaml b/specification/examples/requests/PATCH_Consent/replace_legal_basis.yaml
deleted file mode 100644
index a08a4f72..00000000
--- a/specification/examples/requests/PATCH_Consent/replace_legal_basis.yaml
+++ /dev/null
@@ -1,17 +0,0 @@
-ReplaceLegalBasisRequest:
-  summary: Replace legal basis
-  description: payload used to add a new actor (legal basis) to the consent provision
-  value:
-    - op: replace
-      path: /provision/actor
-      value:
-        role:
-          coding:
-            - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
-              code: court-appointed-personal-welfare-deputy
-              display: Court appointed personal welfare deputy
-        reference:
-          type: RelatedPerson
-          identifier:
-            system: https://fhir.nhs.uk/Id/nhs-number
-            value: "9000000017"
diff --git a/specification/examples/requests/PATCH_Consent/replace_regulatory_basis.yaml b/specification/examples/requests/PATCH_Consent/replace_regulatory_basis.yaml
new file mode 100644
index 00000000..d86432d0
--- /dev/null
+++ b/specification/examples/requests/PATCH_Consent/replace_regulatory_basis.yaml
@@ -0,0 +1,13 @@
+ReplaceRegulatoryBasisRequest:
+  summary: Replace regulatory basis
+  description: payload used to add a new actor (regulatory basis) to the consent provision
+  value:
+    - op: add
+      path: /extension/-
+      value:
+      - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+        valueCodeableConcept:
+          coding:
+            - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+              code: court-appointed-personal-welfare-deputy
+              display: Court appointed personal welfare deputy
diff --git a/specification/examples/requests/POST_Consent/adult_to_adult_proxy_creation.yaml b/specification/examples/requests/POST_Consent/adult_to_adult_proxy_creation.yaml
index acbfb14b..45c443e9 100644
--- a/specification/examples/requests/POST_Consent/adult_to_adult_proxy_creation.yaml
+++ b/specification/examples/requests/POST_Consent/adult_to_adult_proxy_creation.yaml
@@ -24,24 +24,25 @@ ConsentAdultToAdultGuardianRequest:
       period:
         start: "2026-02-11T14:30:00Z"
       actor:
-        - role:
-            coding:
-              - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
-                code: court-appointed-personal-welfare-deputy
-                display: Court appointed personal welfare deputy
-          reference:
-            type: RelatedPerson
-            identifier:
-              system: https://fhir.nhs.uk/Id/nhs-number
-              value: "9000000017"
+          - reference:
+              type: RelatedPerson
+              identifier:
+                system: https://fhir.nhs.uk/Id/nhs-number
+                value: "9000000017"
     extension:
       - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
         valueCodeableConcept:
           coding:
             - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
               code: ROLE_CREATED
-              display: Role created
-      - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
+              display: Role created from scratch by GP
+      - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+        valueCodeableConcept:
+          coding:
+            - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+              code: "court-appointed-personal-welfare-deputy"
+              display: "Court Appointed Personal Welfare Deputy"
+      - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
         valueReference:
           identifier:
             system: https://fhir.nhs.uk/Id/nhs-number
diff --git a/specification/examples/requests/POST_Consent/parent_child_proxy_creation.yaml b/specification/examples/requests/POST_Consent/parent_child_proxy_creation.yaml
index df500ac1..35bd7667 100644
--- a/specification/examples/requests/POST_Consent/parent_child_proxy_creation.yaml
+++ b/specification/examples/requests/POST_Consent/parent_child_proxy_creation.yaml
@@ -25,28 +25,30 @@ ConsentParentChildProxyCreationRequest:
         start: "2025-02-11T14:30:00Z"
         end: "2029-02-11T14:30:00Z"
       actor:
-        - role:
-            coding:
-              - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
-                code: parental-responsibility
-                display: Parental responsibility
-          reference:
-            type: RelatedPerson
-            identifier:
-              system: https://fhir.nhs.uk/Id/nhs-number
-              value: "9000000009"
+          - reference:
+              type: RelatedPerson
+              identifier:
+                system: https://fhir.nhs.uk/Id/nhs-number
+                value: "9000000009"
     extension:
       - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
         valueCodeableConcept:
           coding:
             - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
               code: ROLE_CREATED
-              display: Role created
-      - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
+              display: Role created from scratch by GP
+      - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
         valueReference:
           identifier:
             system: https://fhir.nhs.uk/Id/nhs-number
             value: '9000000009'
+            display: Role created
+      - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+        valueCodeableConcept:
+          coding:
+            - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+              code: "parental-responsibility"
+              display: "Parental responsibility"
       - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantor
         valueReference:
           identifier:
diff --git a/specification/examples/responses/GET_Consent/filtered-relationships-status-active-include-details.yaml b/specification/examples/responses/GET_Consent/filtered-relationships-status-active-include-details.yaml
index 7a01311a..c4686c3f 100644
--- a/specification/examples/responses/GET_Consent/filtered-relationships-status-active-include-details.yaml
+++ b/specification/examples/responses/GET_Consent/filtered-relationships-status-active-include-details.yaml
@@ -96,11 +96,6 @@ ConsentMultipleRelationshipsStatusActiveIncludeDetailsBundle:
                 identifier:
                   system: "https://fhir.nhs.uk/Id/nhs-number"
                   value: "9000000017"
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: "Parental responsibility"
-                    system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -111,6 +106,12 @@ ConsentMultipleRelationshipsStatusActiveIncludeDetailsBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -200,30 +201,31 @@ ConsentMultipleRelationshipsStatusActiveIncludeDetailsBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: "9000000017"
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
           extension:
-          - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
-            valueCodeableConcept:
-              coding:
-                - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
-                  code: ROLE_CREATED
-                  display: Role created
-          - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
-            valueReference:
-              identifier:
-                system: https://fhir.nhs.uk/Id/nhs-number
-                value: '9000000017'
-          - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantor
-            valueReference:
-              identifier:
-                system: https://fhir.nhs.uk/Id/ods-organization-code
-                value: "G8101234"
+            - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
+              valueCodeableConcept:
+                coding:
+                  - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
+                    code: ROLE_CREATED
+                    display: Role created
+            - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+              valueCodeableConcept:
+                coding:
+                  - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                    code: "parental-responsibility"
+                    display: "Parental responsibility"
+            - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
+              valueReference:
+                identifier:
+                  system: https://fhir.nhs.uk/Id/nhs-number
+                  value: '9000000017'
+            - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantor
+              valueReference:
+                identifier:
+                  system: https://fhir.nhs.uk/Id/ods-organization-code
+                  value: "G8101234"
         search:
           mode: match
diff --git a/specification/examples/responses/GET_Consent/filtered-relationships-status-inactive.yaml b/specification/examples/responses/GET_Consent/filtered-relationships-status-inactive.yaml
index 12afd03f..aa4b1ea6 100644
--- a/specification/examples/responses/GET_Consent/filtered-relationships-status-inactive.yaml
+++ b/specification/examples/responses/GET_Consent/filtered-relationships-status-inactive.yaml
@@ -40,26 +40,27 @@ ConsentMultipleRelationshipsStatusInactiveBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000017'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
           extension:
-          - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
-            valueCodeableConcept:
-              coding:
-                - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
-                  code: ROLE_DEACTIVATED_END_DATE_REACHED
-                  display: End date reached
-          - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
-            valueReference:
-              identifier:
-                system: https://fhir.nhs.uk/Id/nhs-number
-                value: '9000000017'
+            - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
+              valueCodeableConcept:
+                coding:
+                  - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
+                    code: ROLE_DEACTIVATED_END_DATE_REACHED
+                    display: End date reached
+            - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+              valueCodeableConcept:
+                coding:
+                  - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                    code: "parental-responsibility"
+                    display: "Parental responsibility"
+            - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
+              valueReference:
+                identifier:
+                  system: https://fhir.nhs.uk/Id/nhs-number
+                  value: '9000000017'
         search:
           mode: match
       - fullUrl: https://api.service.nhs.uk/validated-relationships/FHIR/R4/Consent/ABCD12B3
@@ -88,30 +89,31 @@ ConsentMultipleRelationshipsStatusInactiveBundle:
           provision:
             type: permit
             actor:
-            - reference:
-                identifier:
-                  system: https://fhir.nhs.uk/Id/nhs-number
-                  value: '9000000017'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
+              - reference:
+                  identifier:
+                    system: https://fhir.nhs.uk/Id/nhs-number
+                    value: '9000000017'
             period:
               end: '2026-02-11'
               start: '2025-02-11'
           extension:
-          - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
-            valueCodeableConcept:
-              coding:
-                - system: http://terminology.hl7.org/CodeSystem/consent-reason
-                  code: OTHER
-                  display: Other reason
-              text: Patient would not respond to phone calls
-          - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
-            valueReference:
-              identifier:
-                system: https://fhir.nhs.uk/Id/nhs-number
-                value: '9000000017'
+            - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
+              valueCodeableConcept:
+                coding:
+                  - system: http://terminology.hl7.org/CodeSystem/consent-reason
+                    code: OTHER
+                    display: Other reason
+                text: Patient would not respond to phone calls
+            - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+              valueCodeableConcept:
+                coding:
+                  - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                    code: "parental-responsibility"
+                    display: "Parental responsibility"
+            - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
+              valueReference:
+                identifier:
+                  system: https://fhir.nhs.uk/Id/nhs-number
+                  value: '9000000017'
         search:
           mode: match
diff --git a/specification/examples/responses/GET_Consent/filtered-relationships-status-proposed-active.yaml b/specification/examples/responses/GET_Consent/filtered-relationships-status-proposed-active.yaml
index 348a7ff4..c925499c 100644
--- a/specification/examples/responses/GET_Consent/filtered-relationships-status-proposed-active.yaml
+++ b/specification/examples/responses/GET_Consent/filtered-relationships-status-proposed-active.yaml
@@ -40,11 +40,6 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000017'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -55,6 +50,12 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -98,11 +99,6 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000017'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -113,6 +109,12 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -156,11 +158,6 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000017'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -171,6 +168,12 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: APPLICATION_SUBMITTED
                   display: Application submitted online
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -214,11 +217,6 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000017'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -229,6 +227,12 @@ ConsentMultipleRelationshipsStatusProposedActiveBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: APPLICATION_SUBMITTED
                   display: Application submitted online
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml
index fa287995..6118be44 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml
@@ -72,11 +72,6 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -87,6 +82,12 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -158,11 +159,6 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -173,6 +169,12 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -244,11 +246,6 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -259,6 +256,12 @@ ConsentMultipleRelationshipsIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-include-performer-patient.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-include-performer-patient.yaml
index 559834de..55990492 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-include-performer-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-include-performer-patient.yaml
@@ -96,11 +96,6 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -111,6 +106,12 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -201,11 +202,6 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: best-interest
-                    display: Best Interest
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -216,6 +212,12 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "best-interest"
+                  display: "Best Interest"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -306,11 +308,6 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: best-interest
-                    display: Best Interest
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -321,6 +318,12 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "best-interest"
+                  display: "Best Interest"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-include-performer.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-include-performer.yaml
index cc813ede..48e91fba 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-include-performer.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-include-performer.yaml
@@ -65,11 +65,6 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                   identifier:
                     system: https://fhir.nhs.uk/Id/nhs-number
                     value: '9000000022'
-                role:
-                  coding:
-                    - code: parental-responsibility
-                      display: Parental responsibility
-                      system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -80,6 +75,12 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: parental-responsibility
+                  display: Parental responsibility
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -143,11 +144,6 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                   identifier:
                     system: https://fhir.nhs.uk/Id/nhs-number
                     value: '9000000022'
-                role:
-                  coding:
-                    - code: best-interest
-                      display: Best Interest
-                      system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -158,6 +154,12 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis
+            valueCodeableConcept:
+              coding:
+                - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
+                  code: best-interest
+                  display: Best interest
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -221,11 +223,6 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                   identifier:
                     system: https://fhir.nhs.uk/Id/nhs-number
                     value: '9000000022'
-                role:
-                  coding:
-                    - code: best-interest
-                      display: Best Interest
-                      system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -236,6 +233,12 @@ ConsentMultipleRelationshipsIncludePerformerBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis
+            valueCodeableConcept:
+              coding:
+                - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
+                  code: 'best-interest'
+                  display: 'Best interest'
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-patient.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-patient.yaml
index 21cd4169..4940c89a 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-patient.yaml
@@ -69,11 +69,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000020'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -84,6 +79,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -126,11 +127,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000021'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -141,6 +137,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -183,11 +185,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -198,6 +195,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer-patient.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer-patient.yaml
index a2f9a9ef..efc18a0a 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer-patient.yaml
@@ -91,11 +91,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000020'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -106,6 +101,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -166,11 +167,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000021'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -181,6 +177,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -241,11 +243,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2026-02-11"
               start: "2025-02-11"
@@ -256,6 +253,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer.yaml
index c2fc940d..593ebf55 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient-include-performer.yaml
@@ -62,11 +62,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000020'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -77,6 +72,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -137,11 +138,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000021'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -152,6 +148,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -212,11 +214,6 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -227,6 +224,12 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient.yaml b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient.yaml
index 1b133722..30c14904 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-single-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-single-patient.yaml
@@ -40,11 +40,6 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000020'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -55,6 +50,12 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -97,11 +98,6 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000021'
-              role:
-                coding:
-                  - code: court-appointed-personal-welfare-deputy
-                    display: Court appointed personal welfare deputy
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -112,6 +108,12 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -154,11 +156,6 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: court-appointed-personal-welfare-deputy
-                    display: Court appointed personal welfare deputy
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -169,6 +166,12 @@ ConsentMultipleRelationshipsSinglePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/multiple-relationships.yaml b/specification/examples/responses/GET_Consent/multiple-relationships.yaml
index ee24d794..768617a5 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships.yaml
@@ -40,11 +40,6 @@ ConsentMultipleRelationshipsBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -55,6 +50,12 @@ ConsentMultipleRelationshipsBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -97,11 +98,6 @@ ConsentMultipleRelationshipsBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -112,6 +108,12 @@ ConsentMultipleRelationshipsBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
@@ -154,11 +156,6 @@ ConsentMultipleRelationshipsBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000022'
-              role:
-                coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -169,6 +166,12 @@ ConsentMultipleRelationshipsBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_DEACTIVATED_END_DATE_REACHED
                   display: End date reached
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-patient.yaml b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-patient.yaml
index c85322b6..1f2011fa 100644
--- a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-patient.yaml
+++ b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-patient.yaml
@@ -69,11 +69,6 @@ ConsentSingleConsentingAdultRelationshipIncludePatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000010'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2029-02-11"
               start: "2025-02-11"
@@ -84,6 +79,12 @@ ConsentSingleConsentingAdultRelationshipIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer-patient.yaml b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer-patient.yaml
index e6142394..72d243a2 100644
--- a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer-patient.yaml
+++ b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer-patient.yaml
@@ -90,11 +90,6 @@ ConsentSingleConsentingAdultRelationshipIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000010'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2029-02-11"
               start: "2025-02-11"
@@ -105,6 +100,12 @@ ConsentSingleConsentingAdultRelationshipIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer.yaml b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer.yaml
index c8e51d63..7957a585 100644
--- a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer.yaml
+++ b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship-include-performer.yaml
@@ -60,11 +60,6 @@ ConsentSingleConsentingAdultRelationshipIncludePerformerBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000010'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2029-02-11"
               start: "2025-02-11"
@@ -75,6 +70,12 @@ ConsentSingleConsentingAdultRelationshipIncludePerformerBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship.yaml b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship.yaml
index 7ae1f72f..423399b1 100644
--- a/specification/examples/responses/GET_Consent/single-consenting-adult-relationship.yaml
+++ b/specification/examples/responses/GET_Consent/single-consenting-adult-relationship.yaml
@@ -40,11 +40,6 @@ ConsentSingleConsentingAdultRelationshipBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000010'
-              role:
-                coding:
-                - code: court-appointed-personal-welfare-deputy
-                  display: Court appointed personal welfare deputy
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: '2026-02-11'
               start: '2025-02-11'
@@ -55,6 +50,12 @@ ConsentSingleConsentingAdultRelationshipBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "court-appointed-personal-welfare-deputy"
+                  display: "Court appointed personal welfare deputy"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-patient.yaml b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-patient.yaml
index ba31b175..51011e78 100644
--- a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-patient.yaml
+++ b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-patient.yaml
@@ -69,11 +69,6 @@ ConsentSingleAdultChildRelationshipIncludePatientBundle:
                   identifier:
                     system: https://fhir.nhs.uk/Id/nhs-number
                     value: '9000000019'
-                role:
-                  coding:
-                  - code: parental-responsibility
-                    display: Parental responsibility
-                    system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
           extension:
           - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
             valueCodeableConcept:
@@ -81,6 +76,12 @@ ConsentSingleAdultChildRelationshipIncludePatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer-patient.yaml b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer-patient.yaml
index d642568e..6572d0fe 100644
--- a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer-patient.yaml
+++ b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer-patient.yaml
@@ -94,11 +94,6 @@ ConsentSingleAdultChildRelationshipIncludePerformerPatientBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000019'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2029-02-11"
               start: "2025-02-11"
@@ -109,6 +104,12 @@ ConsentSingleAdultChildRelationshipIncludePerformerPatientBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer.yaml b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer.yaml
index 56dcb1f4..e54189fb 100644
--- a/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer.yaml
+++ b/specification/examples/responses/GET_Consent/single-mother-child-relationship-include-performer.yaml
@@ -63,11 +63,6 @@ ConsentSingleAdultChildRelationshipIncludePerformerBundle:
                 identifier:
                   system: https://fhir.nhs.uk/Id/nhs-number
                   value: '9000000019'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
             period:
               end: "2029-02-11"
               start: "2025-02-11"
@@ -78,6 +73,12 @@ ConsentSingleAdultChildRelationshipIncludePerformerBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-mother-child-relationship-unknown-legal-basis.yaml b/specification/examples/responses/GET_Consent/single-mother-child-relationship-unknown-legal-basis.yaml
index c76f4903..d28196b6 100644
--- a/specification/examples/responses/GET_Consent/single-mother-child-relationship-unknown-legal-basis.yaml
+++ b/specification/examples/responses/GET_Consent/single-mother-child-relationship-unknown-legal-basis.yaml
@@ -43,11 +43,6 @@ ConsentSingleAdultChildRelationshipUnknownLegalBasisBundle:
                     system: https://fhir.nhs.uk/Id/nhs-number
                     value: '9000000111'
                   type: RelatedPerson
-                role:
-                  coding:
-                    - code: UNK
-                      display: Unknown
-                      system: https://terminology.hl7.org/CodeSystem/v3-NullFlavor
             period:
               start: '2025-02-11'
               end: '2026-02-11'
@@ -58,6 +53,12 @@ ConsentSingleAdultChildRelationshipUnknownLegalBasisBundle:
                 - system: https://fhir.nhs.uk/England/CodeSystem/England-ConsentStatusReason
                   code: ROLE_CREATED
                   display: Role created
+          - url: http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis
+            valueCodeableConcept:
+              coding:
+                - system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
+                  code: "UNK"
+                  display: "Unknown"
           - url: https://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.grantee
             valueReference:
               identifier:
diff --git a/specification/examples/responses/GET_Consent/single-mother-child-relationship.yaml b/specification/examples/responses/GET_Consent/single-mother-child-relationship.yaml
index 47e1bd17..ed0c1f04 100644
--- a/specification/examples/responses/GET_Consent/single-mother-child-relationship.yaml
+++ b/specification/examples/responses/GET_Consent/single-mother-child-relationship.yaml
@@ -38,17 +38,18 @@ ConsentSingleAdultChildRelationshipBundle:
             actor:
             - reference:
                 identifier:
-                  system: https://fhir.nhs.uk/Id/nhs-number
-                  value: '9000000019'
-              role:
-                coding:
-                - code: parental-responsibility
-                  display: Parental responsibility
-                  system: https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis
+                    system: https://fhir.nhs.uk/Id/nhs-number
+                    value: '9000000019'
             period:
               end: '2029-02-11'
               start: '2025-02-11'
           extension:
+          - url: "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+            valueCodeableConcept:
+              coding:
+                - system: "https://fhir.nhs.uk/England/CodeSystem/England-NHSProxyLegalBasis"
+                  code: "parental-responsibility"
+                  display: "Parental responsibility"
           - url: https://fhir.nhs.uk/England/StructureDefinition/Extension-England-Consent-Status-Reason
             valueCodeableConcept:
               coding:
diff --git a/specification/validated-relationships-service-api.yaml b/specification/validated-relationships-service-api.yaml
index 2cf0a202..f0f106b8 100644
--- a/specification/validated-relationships-service-api.yaml
+++ b/specification/validated-relationships-service-api.yaml
@@ -1037,8 +1037,8 @@ paths:
                   - op: add
                     path: /provision/period/end
                     value: "2026-12-31T23:59:59Z"
-              replaceLegalBasis:
-                $ref: "./examples/requests/PATCH_Consent/replace_legal_basis.yaml#/ReplaceLegalBasisRequest"
+              regulatoryBasis:
+                $ref: "./examples/requests/PATCH_Consent/replace_regulatory_basis.yaml#/ReplaceRegulatoryBasisRequest"
       responses:
         "200":
           description: Consent resource successfully updated
@@ -2324,6 +2324,7 @@ components:
           items:
             anyOf:
               - $ref: "#/components/schemas/StatusReasonExtension"
+              - $ref: "#/components/schemas/RegulatoryBasisExtension"
               - $ref: "#/components/schemas/GranteeExtension"
               - $ref: "#/components/schemas/GrantorExtension"
           description: "Additional content. For active proxy roles, grantor is required."
@@ -2373,7 +2374,8 @@ components:
                 description: "Individuals or organizations that agreed to the consent"
               role:
                 $ref: "#/components/schemas/CodeableConcept"
-                description: "Classification of the role of consent, bound to http://terminology.hl7.org/CodeSystem/v3-RoleCode"
+                description: "Deprecated. Instead use the Regulatory Basis Extension."
+                deprecated: true
 
     StatusReasonExtension:
       type: object
@@ -2386,6 +2388,17 @@ components:
           $ref: "#/components/schemas/CodeableConcept"
           description: Classification of the status.
 
+    RegulatoryBasisExtension:
+      type: object
+      properties:
+        url:
+          type: string
+          enum:
+          - "http://hl7.org/fhir/5.0/StructureDefinition/extension-Consent.regulatoryBasis"
+        valueCodeableConcept:
+          $ref: "#/components/schemas/CodeableConcept"
+          description: Classification of the regulatory basis for the consent.
+
     GranteeExtension:
       type: object
       properties: