diff --git a/specification/patient-care-aggregator-api-consumer-api.yaml b/specification/patient-care-aggregator-api-consumer-api.yaml
index 5cb180b..9310686 100644
--- a/specification/patient-care-aggregator-api-consumer-api.yaml
+++ b/specification/patient-care-aggregator-api-consumer-api.yaml
@@ -1,7 +1,7 @@
 openapi: 3.0.3
 info:
   title: Wayfinder Patient Care Aggregator API
-  version: v3.10.0
+  version: v3.11.0
   description: |
     <div class="nhsd-m-emphasis-box nhsd-m-emphasis-box--emphasis nhsd-!t-margin-bottom-6" aria-label="Highlighted Information">
         <div class="nhsd-a-box nhsd-a-box--border-blue">
@@ -757,6 +757,19 @@ components:
                               - bookedPendingReschedule
                               - bookedPendingChange
                               - cancelledPendingReschedule
+                  - description: "Confirm Attendance - a boolean value indicating whether the patient is required to confirm their attendance before the appointment. When true, the patient should confirm; when false or the extension is absent, no confirmation is required."
+                    type: object
+                    required:
+                      - url
+                      - valueBoolean
+                    properties:
+                      url:
+                        type: string
+                        description: FHIR extension type for Appointment Confirmation Required.
+                        enum:
+                          - "https://fhir.nhs.uk/StructureDefinition/Extension-England-AppointmentConfirmationRequired"
+                      valueBoolean:
+                        type: boolean                              
                   - description: The consultation medium for the booking (face-to-face, telephone or video call). Always present if the activity is a booking, but might be blank if the underlying consultation type is not recognised. VIRTUAL is now deprecated, but remains in the API for backward compatibility reasons, so it might still be passed by systems integrated with the Aggregator.
                     type: object
                     required:
diff --git a/specification/patient-care-aggregator-api-producer-api-standards.yaml b/specification/patient-care-aggregator-api-producer-api-standards.yaml
index 2183038..da17d73 100644
--- a/specification/patient-care-aggregator-api-producer-api-standards.yaml
+++ b/specification/patient-care-aggregator-api-producer-api-standards.yaml
@@ -3,7 +3,7 @@
 openapi: '3.0.3'
 info:
   title: "Patient Care Aggregator Get Appointments, Documents and Questionnaires API Standard"
-  version: "3.11.0"
+  version: "3.12.0"
   description: |
     ## Overview 
     ![Patient Care Aggregator Get Appointments, Documents and Questionnaires API Standard context diagram](https://digital.nhs.uk/binaries/content/gallery/website/developer/api-catalogue/patient-care-aggregator-fhir-api/patient-care-aggregator-get-appointments-api-standard.svg?raw=true)
@@ -403,7 +403,20 @@ components:
                       - Pending Change 
                       - Pending Reschedule 
                       - Pending Cancellation 
-                      - Confirmed Attendance                                
+                      - Confirmed Attendance
+              - description: "Confirm Attendance - a boolean value indicating whether the patient is required to confirm their attendance before the appointment. When true, the patient should confirm; when false or the extension is absent, no confirmation is required."
+                type: object
+                required:
+                  - url
+                  - valueBoolean
+                properties:
+                  url:
+                    type: string
+                    description: FHIR extension type for Appointment Confirmation Required.
+                    enum:
+                      - "https://fhir.nhs.uk/StructureDefinition/Extension-England-AppointmentConfirmationRequired"
+                  valueBoolean:
+                    type: boolean                                                      
               - description: "Consultation medium - whether the appointment is face-to-face, on the telephone or via an online video consultation (required). VIRTUAL is now deprecated and only remains in the API spec for backwards compatibility reasons."
                 type: object
                 required: