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 31c664aa..589428cb 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
@@ -40,6 +40,11 @@ ConsentMultipleRelationshipsStatusActiveIncludeDetailsBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: "https://fhir.nhs.uk/Id/nhs-number"
               value: "9000000009"
@@ -138,6 +143,11 @@ ConsentMultipleRelationshipsStatusActiveIncludeDetailsBundle:
         resource:
           resourceType: Patient
           id: DFCC67F5
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: "https://fhir.nhs.uk/Id/nhs-number"
               value: "9000000005"
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 39ad0337..3a46d41f 100644
--- a/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml
+++ b/specification/examples/responses/GET_Consent/multiple-relationships-include-patient.yaml
@@ -15,6 +15,11 @@ ConsentMultipleRelationshipsIncludePatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000009'
@@ -92,6 +97,11 @@ ConsentMultipleRelationshipsIncludePatientBundle:
         resource:
           resourceType: Patient
           id: DFCC67F5
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000005'
@@ -166,6 +176,11 @@ ConsentMultipleRelationshipsIncludePatientBundle:
         resource:
           resourceType: Patient
           id: ZPTT32T3
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000006'
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 51072605..7fdf3278 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
@@ -40,6 +40,11 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000009'
@@ -139,6 +144,11 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: DFCC67F5
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000005'
@@ -235,6 +245,11 @@ ConsentMultipleRelationshipsIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: ZPTT32T3
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000006'
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 a3f0757f..b91b0d00 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
@@ -14,6 +14,11 @@ ConsentMultipleRelationshipsSinglePatientIncludePatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000100'
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 01d7d6be..dedd1418 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
@@ -14,6 +14,11 @@ ConsentMultipleRelationshipsSinglePatientIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000100'
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 f93a0ca4..4510271f 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
@@ -15,6 +15,11 @@ ConsentSingleConsentingAdultRelationshipIncludePatientBundle:
         resource:
           resourceType: Patient
           id: DFCC67F5
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000005'
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 1ca06a25..1c83d5a0 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
@@ -38,6 +38,11 @@ ConsentSingleConsentingAdultRelationshipIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: DFCC67F5
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000005'
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 01104808..a514ffba 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
@@ -15,6 +15,11 @@ ConsentSingleAdultChildRelationshipIncludePatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000009'
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 ba5a2095..eda8bf54 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
@@ -40,6 +40,11 @@ ConsentSingleAdultChildRelationshipIncludePerformerPatientBundle:
         resource:
           resourceType: Patient
           id: A3CC67E2
+          meta:
+            security:
+              - system: "https://fhir.nhs.uk/CodeSystem/NHSIdentityProofingLevel"
+                code: "P9"
+                display: "High level verification (P9)"
           identifier:
             - system: 'https://fhir.nhs.uk/Id/nhs-number'
               value: '9000000009'
diff --git a/specification/validated-relationships-service-api.yaml b/specification/validated-relationships-service-api.yaml
index 3154bd7c..fe5d5f94 100644
--- a/specification/validated-relationships-service-api.yaml
+++ b/specification/validated-relationships-service-api.yaml
@@ -2185,6 +2185,8 @@ components:
         id:
           type: string
           description: Unique identifier of the Patient resource
+        meta:
+          $ref: "#/components/schemas/Meta"
         identifier:
           type: array
           description: The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a [valid NHS number](https://www.datadictionary.nhs.uk/attributes/nhs_number.html).
@@ -2433,6 +2435,16 @@ components:
           type: string
           description: "The value that is unique."
 
+    Meta:
+      type: object
+      description: Metadata about a resource
+      properties:
+        security:
+          type: array
+          description: Security Labels applied a resource
+          items:
+            $ref: "#/components/schemas/Coding"
+
     CodeableConcept:
       type: object
       properties: