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SNOMED CT Releases: Important Notices & Known Issues

Notification of SNOMED CT UK Clinical Edition MICRO release 03-Nov-2021

NHS Digital intend to release an unscheduled SNOMED CT UK Clinical Edition MICRO release on 03-Nov-2021.

This release is to support urgent COVID-19 pandemic requirements. The release contains 3 additional concepts.

  • Application for medical exemption from COVID-19 vaccination approved
  • Application for medical exemption from COVID-19 vaccination rejected
  • VITT - vaccine-induced immune thrombotic thrombocytopenia

The release will be available on TRUD as normal and will have a Release ID of 32.6.0 with an Effective Time of 27-Oct-2021.

Further information on the content of this release will be made available at the point of release.

SNOMED CT UK Clinical Edition 32.4.0 Micro – 08 September 2021

This release of the SNOMED CT UK Clinical Edition is a ‘Micro’ release containing only minimal changes to support the COVID-19 pandemic response.  

 

The following concepts are new for this release: 

  • 1363831000000108 Administration of fifth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363791000000101 Administration of fourth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363861000000103 Administration of third dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363851000000101 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose declined (situation) 
  • 1363841000000104 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose not given (situation) 
  • 1363811000000100 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose declined (situation) 
  • 1363821000000106 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose not given (situation) 
  • 1363781000000103 Severe acute respiratory syndrome coronavirus 2 vaccination third dose declined (situation) 
  • 1363771000000100 Severe acute respiratory syndrome coronavirus 2 vaccination third dose not given (situation) 

 

Support on the usage of these concepts will be published in the COVID-19 Vaccination codes document on the COVID-19 Information Standards page.  

Please note: There are no updates to the ICD-10 or OPCS-4.9 classification maps for this Micro release. These will be included in the next scheduled Clinical release.  

SNOMED CT Browser not displaying the current release data.

Sometimes following an update the most recent SNOMED CT UK edition content might not display correctly within the SNOMED CT Browser. This can be as a result of your browser (such as Chrome, Edge or Firefox) using its own stored data to automatically default to the last published release.

There are two workarounds for this:

  1. Open the browser using a privacy mode such as incongnito mode in Chrome, InPrivate view in Edge or Private Window in Edge.
  2. Clear your browsing data within your browser
    1. Chrome: Menu: Settings: Privacy and Security: Clear Browsing Data
    2. Edge: Menu: Settings: Privacy and Security: Clear Browsing Data
    3. Firefox: Menu: Option Preferences: Privacy and Security: Cookies and Site Data: Clear Data

If you continue to experience any further problems following then please contact  information.standards@nhs.net

Known Error - Duplicate Cross Maps within SNOMED CT RF2

There is a known issue of duplicate rows within the cross-map files. This has been present for a number of releases and we are currently investigating the issue

Changes to 2021/22 SNOMED CT and NICIP releases

After a very active and dynamic period responding to COVID-19 priorities we have taken stock of our Terminology Service and introduced changes to the 2021/22 release schedule whilst we build greater resilience, stabilise our release processes after significant process changes during the pandemic, enhance and grow our team. 

The following approach will be effective immediately:

These changes will continue until we are in a better position to resume full-service levels.

Updates and releases of the National Interim Clinical Imaging Procedure (NICIP) code set have been placed on hold with immediate effect to allow the outcome of the following:

  • a formal position is being sought from NHSX on the strategic direction of NICIP and the long-term intention to move to the use of a single terminology of SNOMED CT
  • NHS England and Improvement are looking to commission a piece of discovery work that aims to identify how to improve the collection, utility, and dissemination of the Diagnostic Imaging Dataset: this could include reviewing opportunities and impacts of updating NICIP and/or transition to SNOMED CT

In the meantime NICIP code requests can continue to be submitted to the Request Submission Portal where these will be logged until we are in a position to process them.

Any queries should be submitted to our helpdesk: information.standards@nhs.net.

SNOMED CT UK Clinical Edition 32.0.0 - 19 May 2021

Important changes and information regarding this release

This release of the SNOMED CT UK Clinical Edition is based upon the January 2021 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 content.

"On examination" and "Complaining of" concepts

In the January 2021 International release content relating to ‘On examination’ and ‘Complaining of’ concepts have been inactivated. A decision was made by the UK Edition Committee that this content needed to be made active in the UK Clinical extension due to the usage of these concepts in primary care.  This content has been reactivated for the 32.0.0 release of the SNOMED CT UK Clinical Edition.

Please note we are aware of an issue with the NHS Digital SNOMED CT browser (Termbrowser) which means the reactivated ‘On examination’ and ‘Complaining of’ concepts are not displayed correctly. We are working to fix the issue. Please read the SNOMED CT UK Clinical Extension Release Documentation for more information.

Advice on competing International and UK SNOMED CT codes

NHS Digital are aware of several new codes in the January 2021 International data (and thus in the May 2021 UK Edition) of SNOMED CT. These new codes may interfere with established UK recording of certain COVID-19 and SARS-CoV-2 data items. For example:

  • diagnostic codes for the long-term effects of COVID-19
  • SARS-CoV-2 vaccinations and adverse reactions
  • SARS-CoV-2 antibody test results.

A document COVID-19 and SARS-CoV-2 in SNOMED CT: Advice on competing International and UK codes has been produced to highlight the issues and provide advice on the steps which can be taken to minimise the impact on data quality.

SNOMED CT UK Clinical Edition 31.5.0 - 24 March 2021

Important changes and information regarding this release

This release of the SNOMED CT UK Clinical Edition® update is based on the July 2020 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 content.

IMPORTANT CODE ADDITIONS OF NOTE WITHIN 31.5.0 UK CLINICAL EXTENSION

1325901000000103| QCovid risk calculator (assessment scale)

1325891000000104| Assessment using QCovid risk calculator (procedure)

1325921000000107| QCovid risk calculator COVID associated death relative risk score (observable entity)

1325911000000101| QCovid risk calculator COVID associated death absolute risk score (observable entity)

1325931000000109| QCovid risk calculator COVID associated hospital admission relative risk score (observable entity)

1325941000000100| QCovid risk calculator COVID associated hospital admission absolute risk score (observable entity)

1325961000000104| NHS Digital COVID-19 Clinical Risk Assessment Tool (assessment scale)

1325951000000102| Assessment using NHS Digital COVID-19 Clinical Risk Assessment Tool (procedure)

1325981000000108| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and dying from COVID-19 relative risk score (observable entity)

1325991000000105| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and hospitalisation from COVID-19 relative risk score (observable entity)

1325971000000106| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and dying from COVID-19 absolute risk score (observable entity)

1326001000000109| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and hospitalisation from COVID-19 absolute risk score (observable entity)

Future release schedule

The Next Scheduled Release is

19 May 2021 TRUD Version 32.0.0 effectiveTime 20210512 Base content: January 2021 SNOMED CT International Edition New content: Any urgent COVID-19 content (as per a microrelease) ICD10 and OPCS map updates covering above new content Technical update of refsets to align with new content

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 16 June 2021 could therefore still occur, to coincide with the already scheduled 4-weekly release of the SNOMED CT UK Drug Extension.

A timetable for seven scheduled releases annually through 2021 and beyond is now posted here on DELEN

Reference sets (Refsets)

This SNOMED CT UK Edition Release is based on the July 2020 International Edition.

We have no refsets due for retirement.

Cross Mapping

The 31.5.0 mapping files includes only a small number of new UK concepts. The majority of changes made are to existing content. For further information, please see the ‘SNOMED CT to ICD-10 and OPCS-4 Classification maps - Change Report’.

SNOMED CT International Edition

No changes have been made to the SNOMED CT International Edition for this release. We will next update the SNOMED CT UK Edition with new International Content scheduled for release on 19 May 2021. Anyone wanting early sight of the expected changes can follow the links below:

The Daily Build Report within the SNOMED International Browser SNOMED International: January 2021 Release Notes

Please note: Any content (including COVID-19 content) from the International Release should only be used once incorporated into the UK Edition and in relation to COVID-19 content only if approved. Please see our guidance information on Delen for further details.

Subscriptions and licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page, https://isd.hscic.gov.uk/trud3 . This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED CT International Member territories as there are additional licensing considerations. The above releases can also be downloaded via our API servers. Details of the new API service is available on TRUD.

Regards The TRUD support team NHS Digital

Telephone number: 0300 30 34 777

e-mail to information.standards@nhs.net

Planned Changes to the SNOMED CT UK Edition Release Subfolder Structure from 19 May 2021

Planned changes to the SNOMED CT UK Edition release subfolder structure

Subscribers were previously advised that all future PRODUCTION releases of the Drug and Clinical extension content would transition from April 2020 to the BETA release bundling previously provided as technology previews.

For a more detailed explanation of the motivations for the BETA bundling, see the webinar recording. Detailed information is also provided in the UK Clinical Edition SNOMED CT Technical overview document, section 2.4.1 and 2.4.2.

To reduce burden during the pandemic, this transition was deferred. Suppliers remain recommended to transition to consuming the BETA rather than PRODUCTION bundlings, in accordance with the following revised schedule:

Throughout the remainder of 2020, PRODUCTION releases will remain as before but with the same content always co-published on TRUD in BETA format, as Test Releases.

From the first scheduled release in 2021 (expected 19 May), all PRODUCTION releases of UK Clinical and Drug will adopt the BETA encoding. All releases will then continue to be available in parallel in the older LEGACY encoding until the end of July 2021, after which the LEGACY encoding variant will be permanently withdrawn.

SNOMED CT UK Clinical Edition 31.3.0 - 27 January 2021

Important changes and information regarding this release:

This is the first minor of the SNOMED CT UK Clinical Edition® update based on the July 2020 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 and non-COVID-19 content. 

IMPORTANT CODE ADDITIONS OF NOTE WITHIN 31.3.0 UK CLINICAL EXTENSION 

12 New SNOMED codes have been created for COVID Oximetry @home providers to use 

1325251000000106 Referral to telehealth pulse oximetry monitoring service (procedure) 

1325261000000109 Referral by telehealth pulse oximetry monitoring service (procedure) 

1325271000000102 Discharge from telehealth pulse oximetry monitoring service (procedure) 

1325201000000105 Telehealth pulse oximetry monitoring ended (situation) 

1325191000000108 Telehealth pulse oximetry monitoring started (situation) 

1325211000000107 Provision of pulse oximeter (procedure) 

1325221000000101 Telehealth pulse oximetry monitoring not appropriate (finding) 

1325241000000108 Telehealth pulse oximetry monitoring declined (situation) 

1325281000000100 Discussion about telehealth pulse oximetry monitoring (procedure) 

1325681000000102 Has access to pulse oximeter (finding) 

1325701000000100 Oxygen saturation at periphery equivocal (finding) 

1325691000000100 Oxygen saturation at periphery unknown (finding) 

Future release schedule

The Next Scheduled Release is 

24 March 2021 

TRUD Version   31.5.0 
effectiveTime    20210317 

Base content:    July 2020 SNOMED CT International Edition 

New content:       Any urgent COVID-19 content (as per a microrelease) 
                        ICD10 and OPCS map updates covering above new content 
                        Full update of refsets to align with new content 

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 24 February 2021 could therefore still occur, to coincide with the already scheduled 4-weekly release of the SNOMED CT UK Drug Extension. 

A timetable for seven scheduled releases annually through 2021 and beyond is now posted here on DELEN 

Reference sets (Refsets)

This is the second minor SNOMED CT update based on the July 2020 International Edition. Although most refsets have received a minimum uplift there could be some refsets which have received more substantial uplifts.  

We have no refsets due for retirement.  

Cross Mapping

The 31.3.0 mapping files include a small number of new priority UK concepts, in addition to changes to some existing concepts.  For further information, please see the SNOMED CT to ICD-10 and OPCS-4 Classification Maps Change Report. 

SNOMED CT International Edition

No changes have been made to the SNOMED CT International Edition for this release. We will next update the SNOMED CT UK Edition with new International Content scheduled for release on 19 May 2021. Anyone wanting early sight of the expected changes can follow the links below   

The Daily Build Report within the SNOMED International Browser 

SNOMED International: January 2021 Release Notes 

Please note: COVID-19 related content from the International Release should only be used in the UK if approved. Please see our guidance information on Delen for further details.  

Subscriptions and licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page, https://isd.hscic.gov.uk/trud3 . This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED CT International Member territories as there are additional licensing considerations. 

The above releases can also be downloaded via our FTP servers if you have previously been assigned an FTP access right. Details of the new API service is available on TRUD.  

Regards  
The TRUD support team  
NHS Digital 

Telephone number:  0300 30 34 777 

e-mail to information.standards@nhs.net 

SNOMED CT UK Edition (Clinical) 31.1.0 - 2 December 2020

Important changes and information regarding this release:

This is the first minor of the SNOMED CT UK Clinical Edition ® update based on the July 2020 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 and non-COVID-19 content.

25 NEW CODE ADDITIONS WITHIN 31.1.0 UK CLINICAL EXTENSION

1325171000000109 Acute disease caused by severe acute respiratory syndrome coronavirus 2 infection (disorder)

1325081000000107 Assessment using COVID-19 Yorkshire Rehabilitation Screening tool (procedure)

1324901000000102 Assessment using Early Language Identification Measure (procedure)

1325061000000103 Assessment using Newcastle post-COVID syndrome Follow-up Screening Questionnaire (procedure)

1325101000000101 Assessment using Post-COVID-19 Functional Status Scale patient self-report (procedure)

1325141000000103 Assessment using Post-COVID-19 Functional Status Scale structured interview (procedure)

1325071000000105 COVID-19 Yorkshire Rehabilitation Screening tool (assessment scale)

1324891000000103 Cancer End of Treatment Summary Plan (record artifact)

1324961000000103 Discussion about child's language development (procedure)

1324911000000100 Early Language Identification Measure (assessment scale)

1324931000000108 Early Language Identification Measure observation score (observable entity)

1324921000000106 Early Language Identification Measure word list score (observable entity)

1324971000000105 Health visitor follow up planned (situation)

1325051000000101 Newcastle post-COVID syndrome Follow-up Screening Questionnaire (assessment scale)

1325181000000106 Ongoing symptomatic disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)

1325091000000109 Post-COVID-19 Functional Status Scale patient self-report (assessment scale)

1325121000000105 Post-COVID-19 Functional Status Scale patient self-report final scale grade (observable entity)

1325151000000100 Post-COVID-19 Functional Status Scale structured interview (assessment scale)

1325131000000107 Post-COVID-19 Functional Status Scale structured interview final scale grade (observable entity)

1325161000000102 Post-COVID-19 syndrome (disorder)

1325041000000104 Referral to Your COVID Recovery rehabilitation platform (procedure)

1325031000000108 Referral to post-COVID assessment clinic (procedure)

1325111000000104 Severe combined immunodeficiency not screened for or screening incomplete: not offered (finding)

1325021000000106 Signposting to Your COVID Recovery (procedure)

1324941000000104 Signposting to child communication development support (procedure)

Future release schedule

One further minor release of the SNOMED CT UK Clinical Edition is scheduled for 27th January 2021:

27 January 2021

TRUD Version   31.3.0
effectiveTime    20210120

Base content:    July 2020 SNOMED CT International Edition

New content:     Additional routine non-COVID-19 content for the UK
                        Any requested new COVID-19 content (as per a microrelease)
                        ICD10 and OPCS map updates covering above new content
                        Full update of refsets to align with new content

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 30 December could therefore still occur, to coincide with the already scheduled 4-weekly release of the SNOMED CT UK Drug Extension.

A timetable for seven scheduled releases annually through 2021 and beyond is now posted here on DELEN

Reference sets (Refsets)

However, 66 previously published simple Refsets are now formally deprecated at this release: in the latest snapshot, their metadata concepts are now inactive and they each have zero active members:

1129551000000102 Accommodation tenure findings simple reference set (foundation metadata concept)

999001711000000106 Action context values simple reference set (foundation metadata concept)

999001381000000100 Activity of daily living simple reference set (foundation metadata concept)

999000231000000102 Administration of medication simple reference set (foundation metadata concept)

999000241000000106 Administrative procedure simple reference set (foundation metadata concept)

999000251000000109 Adverse reaction event simple reference set (foundation metadata concept)

999001241000000101 Allergies and adverse reaction causative agent groups simple reference set (foundation metadata concept)

999000281000000103 Allergy event simple reference set (foundation metadata concept)

999000291000000101 Allergy propensity simple reference set (foundation metadata concept)

999001411000000103 Assessment procedure type simple reference set (foundation metadata concept)

999000311000000100 Blood coagulation simple reference set (foundation metadata concept)

999000321000000106 Blood pressure simple reference set (foundation metadata concept)

999000361000000103 Capacity to consent simple reference set (foundation metadata concept)

999000151000000103 Care planning administration of medication simple reference set (foundation metadata concept)

999000111000000102 Care planning discharge planning simple reference set (foundation metadata concept)

999000101000000104 Care planning intent context values simple reference set (foundation metadata concept)

991351000000101 Children and young people's health services assessment scales simple reference set (foundation metadata concept)

999002301000000103 Clinical record headings for admission simple reference set (foundation metadata concept)

999002211000000106 Clinical record headings for discharge simple reference set (foundation metadata concept)

999002281000000104 Clinical record headings for handover simple reference set (foundation metadata concept)

999002201000000109 Clinical record headings for outpatients simple reference set (foundation metadata concept)

999002291000000102 Clinical record headings for referral simple reference set (foundation metadata concept)

999001721000000100 Clinical record headings simple reference set (foundation metadata concept)

991321000000106 Clustering tools for mental health assessment scales simple reference set (foundation metadata concept)

999002321000000107 Comorbid conditions comprehensive simple reference set (foundation metadata concept)

1128151000000104 Congestive heart failure extraction specification for CHA2DS2-VASc risk score simple reference set (foundation metadata concept)

991491000000100 Country of birth findings simple reference set (foundation metadata concept)

1128171000000108 Diabetes mellitus extraction specification for CHA2DS2-VASc risk score simple reference set (foundation metadata concept)

999000711000000101 Diagnosis simple reference set (foundation metadata concept)

999000721000000107 Discharge simple reference set (foundation metadata concept)

999000731000000109 Document consent simple reference set (foundation metadata concept)

999001051000000108 Endoscopy procedures simple reference set (foundation metadata concept)

999002391000000105 Ethnic category - 2011 census England and Wales simple reference set (foundation metadata concept)

1127801000000106 Functional impairment simple reference set (foundation metadata concept)

1129121000000101 Head circumference observables simple reference set (foundation metadata concept)

999002171000000108 Health protection electronic notifications - system-initiated simple reference set (foundation metadata concept)

999002161000000101 Health protection electronic notifications - user-initiated simple reference set (foundation metadata concept)

999000791000000105 Height simple reference set (foundation metadata concept)

1128161000000101 Hypertension extraction specification for CHA2DS2-VASc risk score simple reference set (foundation metadata concept)

999000801000000109 Incidental location type simple reference set (foundation metadata concept)

991221000000104 Mental health assessment scales simple reference set (foundation metadata concept)

999002311000000101 Mode of transport provision type simple reference set (foundation metadata concept)

999001131000000102 Occupational therapy assessment scales simple reference set (foundation metadata concept)

999002081000000106 Orthopaedic outpatient foot and ankle diagnosis simple reference set (foundation metadata concept)

999002101000000100 Patient facing service findings simple reference set (foundation metadata concept)

999004511000000102 Personal Child Health Record developmental skill observables simple reference set (foundation metadata concept)

999002921000000106 Podiatric assessment scales simple reference set (foundation metadata concept)

1030481000000108 Relationship to subject type simple reference set (foundation metadata concept)

747641000000100 Reproductive and sexual health contraception findings simple reference set (foundation metadata concept)

747671000000106 Reproductive and sexual health contraception procedures simple reference set (foundation metadata concept)

747651000000102 Reproductive and sexual health early pregnancy and pregnancy choice findings simple reference set (foundation metadata concept)

747681000000108 Reproductive and sexual health early pregnancy and pregnancy choice procedures simple reference set (foundation metadata concept)

747661000000104 Reproductive and sexual health wellbeing and health issue findings simple reference set (foundation metadata concept)

747691000000105 Reproductive and sexual health wellbeing and health issue procedures simple reference set (foundation metadata concept)

999001731000000103 Rheumatology diagnosis simple reference set (foundation metadata concept)

999000871000000101 Risk to person simple reference set (foundation metadata concept)

999000911000000104 Specimen material type simple reference set (foundation metadata concept)

966271000000107 Speech and language therapy assessment procedures simple reference set (foundation metadata concept)

991161000000100 Stroke diagnosis simple reference set (foundation metadata concept)

1128181000000105 Stroke, transient ischemic attack and/or thromboembolism history extraction specification for CHA2DS2-VASc risk score simple reference set (foundation metadata concept)

1129561000000104 Suitability of accommodation findings simple reference set (foundation metadata concept)

999000951000000100 Temperature simple reference set (foundation metadata concept)

999002621000000102 Therapy Outcome Measure assessment scales simple reference set (foundation metadata concept)

1129591000000105 Transient accommodation findings simple reference set (foundation metadata concept)

1129531000000109 Usual residence type simple reference set (foundation metadata concept)

1128191000000107 Vascular disease extraction specification for CHA2DS2-VASc risk score simple reference set (foundation metadata concept

Cross Mapping

The 31.1.0 mapping files includes a small number of high priority UK concepts, in addition to changes to some existing concepts.  For further details (including information about the maps in the major 31.0.0 release), please see the SNOMED CT to ICD-10 and OPCS-4 Classification Maps Change Report.

SNOMED CT International Edition

No changes have been made to the SNOMED CT International Edition for this release. We will next update the SNOMED CT UK Edition with new International Content scheduled for release on 24 March 2021. Anyone wanting early sight of the expected changes can follow the links below  

The Daily Build Report within the SNOMED International Browser

 SNOMED International: Early Visibility Release Notices.

Subscriptions and licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page, https://isd.hscic.gov.uk/trud3 . This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED CT International Member territories as there are additional licensing considerations.

The above releases can also be downloaded via our FTP servers if you have previously been assigned an FTP access right.

Regards 
The TRUD support team 
NHS Digital

Telephone number:  0300 30 34 777

e-mail to information.standards@nhs.net

SNOMED CT UK Edition (Clinical) 31.0.0 - 11 November 2020

Important changes and information regarding this release

This is the first major SNOMED CT update based on the July 2020 International Edition. Changes within the UK Extension itself are therefore significant and not limited to COVID-19.

Changes within the new International Edition are even more substantial.

The 222 NEW CODE ADDITIONS WITHIN 31.0.0 UK CLINICAL EXTENSION:

  • 1077121000000101 Uses functional communication skills (finding)
  • 825081000000109 Traumatic dislocation of midtarsal joint (disorder)
  • 824971000000107 Traumatic dislocation of interphalangeal joint of toe (disorder)
  • 1097411000000109 Traumatic avulsion of fingernail (disorder)
  • 1089461000000102 Timed six metre walk time (observable entity)
  • 528711000000105 Thoracic spina bifida without mention of hydrocephalus (disorder)
  • 1240761000000102 Suspected coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 (situation)
  • 763071000000102 Short term drug therapy (procedure)
  • 1240681000000103 Severe acute respiratory syndrome coronavirus 2 vaccination not done (situation)
  • 1324721000000108 Severe acute respiratory syndrome coronavirus 2 vaccination dose declined (situation)
  • 1324581000000102 Severe acute respiratory syndrome coronavirus 2 ribonucleic acid not detected (finding)
  • 1324851000000106 Severe acute respiratory syndrome coronavirus 2 immunisation course started (situation)
  • 1324761000000100 Severe acute respiratory syndrome coronavirus 2 immunisation course contraindicated (situation)
  • 1090151000000104 Secondary malignant neoplasm of mastoid lymph nodes (disorder)
  • 840991000000102 Rupture of rectus femoris muscle (disorder)
  • 1099291000000106 Repair of blood vessel of abdomen with vein graft (procedure)
  • 905461000000107 Reactive arthritis after shigella infection (disorder)
  • 905421000000104 Reactive arthritis after chlamydia trachomatis infection (disorder)
  • 893541000000101 Prosthetics service (qualifier value)
  • 818291000000100 Positron emission tomography myocardial stress imaging using rubidium 82 (procedure)
  • 382551000000109 Pneumococcal vaccination given by other healthcare provider (finding)
  • 869281000000108 Percutaneous embolisation of lesion of abdomen using fluoroscopic guidance (procedure)
  • 1104941000000100 Patient Health Questionnaire-4 (assessment scale)
  • 893951000000105 Paediatric cardiology service (qualifier value)
  • 893151000000107 Nuclear medicine service (qualifier value)
  • 893141000000109 Nephrology service (qualifier value)
  • 957791000000106 Meningitis ACW and Y vaccination declined (situation)
  • 247151000000100 Measles, mumps and rubella vaccination declined (situation)
  • 810181000000105 Magnetic resonance imaging of facial nerve (procedure)
  • 827091000000102 Laparoscopic total colectomy (procedure)
  • 771891000000101 Insulin sensitivity factor (observable entity)
  • 813321000000103 Injury of tendon of toe (disorder)
  • 1149231000000105 Injection of left hip using fluoroscopic guidance (procedure)
  • 804801000000100 Immunisation due date (observable entity)
  • 931811000000104 Histopathology service (qualifier value)
  • 202281000000105 Hepatitis C screening declined (situation)
  • 1060971000000108 General practice service (qualifier value)
  • 882201000000107 First rotavirus vaccination declined (situation)
  • 747521000000106 Extension Namespace {1000237} (namespace concept)
  • 867891000000101 Erectile dysfunction due to diabetes mellitus (disorder)
  • 201311000000102 Drug addiction therapy - buprenorphine (regime/therapy)
  • 1324831000000104 Did not attend for first dose of severe acute respiratory syndrome coronavirus 2 vaccine (finding)
  • 204351000000100 Coronavirus nucleic acid detection (procedure)
  • 935481000000105 Congenital anomaly of cauda equina (disorder)
  • 893481000000108 Colectomy and end to side anastomosis (procedure)
  • 892751000000100 Clinical immunology and allergy service (qualifier value)
  • 905321000000107 Chronic pyrophosphate crystal arthropathy (disorder)
  • 1321241000000105 Cardiomyopathy caused by severe acute respiratory syndrome coronavirus 2 (disorder)
  • 804361000000106 Bone density scan due date (observable entity)
  • 759561000000108 Atrioventricular septal defect with ventricular imbalance (disorder)
  • 835141000000103 Assessment using modified Rankin scale (procedure)
  • 1240391000000107 Antigen of severe acute respiratory syndrome coronavirus 2 (substance)
  • 1324711000000102 Allergy to severe acute respiratory syndrome coronavirus 2 vaccine (finding)
  • 1324681000000101 Administration of first dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure)
  • 1066551000000108 Acquired arteriovenous malformation of stomach (disorder)
  • 1076371000000101 Able to concentrate (finding)
  • 1109511000000109 Video-assisted endoscopic cauterisation of anal fistula (procedure)
  • 804101000000105 Urine test due date (observable entity)
  • 825071000000107 Traumatic dislocation of navicular bone (disorder)
  • 825011000000102 Traumatic dislocation of metatarsophalangeal joint (disorder)
  • 824961000000100 Traumatic dislocation of joint of toe (disorder)
  • 824071000000106 Traumatic dislocation of intercarpal joint (disorder)
  • 1097401000000107 Traumatic avulsion of nail (disorder)
  • 813131000000104 Traumatic amputation of tongue (disorder)
  • 765511000000103 Tobacco use cessation case management (procedure)
  • 1087331000000109 Timed six metre walk gait speed (observable entity)
  • 956231000000101 Ticagrelor adverse reaction (disorder)
  • 792771000000106 Therapeutic operation on ileoanal pouch (procedure)
  • 1321271000000104 Swab specimen from oropharynx (specimen)
  • 957411000000105 Subcutaneous calcaneal bursitis (disorder)
  • 893461000000104 Sigmoid colectomy and end to side anastomosis (procedure)
  • 1324791000000106 Severe acute respiratory syndrome coronavirus 2 vaccination second dose not given (situation)
  • 1240671000000100 Severe acute respiratory syndrome coronavirus 2 vaccination not indicated (situation)
  • 1324781000000109 Severe acute respiratory syndrome coronavirus 2 vaccination first dose not given (situation)
  • 1324771000000107 Severe acute respiratory syndrome coronavirus 2 vaccination dose not given (situation)
  • 1240651000000109 Severe acute respiratory syndrome coronavirus 2 vaccination declined (situation)
  • 1240491000000103 Severe acute respiratory syndrome coronavirus 2 vaccination (procedure)
  • 1324881000000100 Severe acute respiratory syndrome coronavirus 2 ribonucleic acid detection result positive at the limit of detection (finding)
  • 1324601000000106 Severe acute respiratory syndrome coronavirus 2 ribonucleic acid detected (finding)
  • 1324731000000105 Severe acute respiratory syndrome coronavirus 2 immunisation course not indicated (situation)
  • 1324811000000107 Severe acute respiratory syndrome coronavirus 2 immunisation course declined (situation)
  • 1324861000000109 Severe acute respiratory syndrome coronavirus 2 immunisation course abandoned (situation)
  • 804121000000101 Semen analysis due date (observable entity)
  • 1090091000000108 Secondary malignant neoplasm of internal mammary lymph nodes (disorder)
  • 710191000000109 Screening for sepsis (procedure)
  • 868711000000104 Rotavirus vaccination declined (situation)
  • 893081000000100 Respiratory medicine service (qualifier value)
  • 286871000000107 Reinduction to buprenorphine maintenance therapy (procedure)
  • 905471000000100 Reactive arthritis after ureaplasma urealyticum infection (disorder)
  • 905451000000109 Reactive arthritis after salmonella infection (disorder)
  • 905431000000102 Reactive arthritis after clostridium difficile infection (disorder)
  • 905411000000105 Reactive arthritis after campylobacter infection (disorder)
  • 777611000000100 Quadrivalent human papillomavirus vaccination (procedure)
  • 380941000000104 Progressive encephalopathy with oedema, hypsarrhythmia and optic atrophy syndrome (disorder)
  • 956211000000109 Prasugrel adverse reaction (disorder)
  • 818301000000101 Positron emission tomography myocardial rest imaging using rubidium 82 (procedure)
  • 1324631000000100 Pneumococcal vaccination given by other healthcare provider (situation)
  • 805751000000106 Planned stop date for anticoagulation therapy (observable entity)
  • 914201000000106 Percutaneous microwave ablation of lesion of pelvis using computed tomography guidance (procedure)
  • 805341000000109 Percutaneous embolisation of gastric vein using fluoroscopic guidance (procedure)
  • 242111000000101 Pattern of onset of pain (finding)
  • 905361000000104 Paraneoplastic arthritis (disorder)
  • 893621000000109 Paediatric ear nose and throat service (qualifier value)
  • 850791000000102 Osteoarthritis of sternoclavicular joint (disorder)
  • 914741000000103 Obese class III (body mass index equal to or greater than 40.0) (finding)
  • 777591000000108 No history of diabetic nephropathy (situation)
  • 893161000000105 Neurology service (qualifier value)
  • 1240281000000101 Monitoring of clozapine therapy (regime/therapy)
  • 1099341000000108 Modified Medical Research Council dyspnoea scale (assessment scale)
  • 957771000000107 Meningitis ACW and Y vaccination contraindicated (situation)
  • 1324561000000106 Measurement of severe acute respiratory syndrome coronavirus 2 antibody (procedure)
  • 769581000000107 Mean total daily insulin dose (observable entity)
  • 1090941000000104 Malignant neoplasm of inguinal region (disorder)
  • 353471000000101 Magnetic resonance imaging defaecating proctogram (procedure)
  • 984051000000100 Learning disability excluded (situation)
  • 804081000000104 Laboratory test due date (observable entity)
  • 771881000000103 Insulin/carbohydrate ratio (observable entity)
  • 775661000000106 Insulin dose (observable entity)
  • 813111000000107 Injury of tendon of wrist joint (disorder)
  • 813311000000109 Injury of tendon of foot (disorder)
  • 1149241000000101 Injection of right hip using fluoroscopic guidance (procedure)
  • 1109641000000109 Injection of collagen into anorectal fistula (procedure)
  • 893091000000103 Infectious diseases service (qualifier value)
  • 1324671000000103 Immunisation course to achieve immunity against severe acute respiratory syndrome coronavirus 2 (regime/therapy)
  • 1097271000000100 History of dura mater graft (situation)
  • 837461000000101 High risk of cardiovascular disease (finding)
  • 285081000000106 High intensity focused ultrasound of bladder (regime/therapy)
  • 957391000000105 Gluteal bursitis (disorder)
  • 907271000000106 Genetics laboratory service (qualifier value)
  • 768291000000101 Frequency of blood glucose self-monitoring (observable entity)
  • 957321000000107 Flexor digitorum tenosynovitis of foot (disorder)
  • 1110761000000106 Fetal cleft lip (disorder)
  • 804111000000107 Faeces test due date (observable entity)
  • 1240431000000104 Exposure to severe acute respiratory syndrome coronavirus 2 infection (event)
  • 893501000000104 Excision of ejaculatory duct (procedure)
  • 231481000001106 Enhanced services general practice extraction - Human papillomavirus vaccines simple reference set (foundation metadata concept)
  • 827631000000105 Emergency ambulance service (qualifier value)
  • 1076361000000108 Does sit on potty (finding)
  • 1324841000000108 Did not attend for second dose of severe acute respiratory syndrome coronavirus 2 vaccine (finding)
  • 526091000000100 Cystic fibrosis with distal intestinal obstruction syndrome (disorder)
  • 892821000000103 Critical care medicine service (qualifier value)
  • 1321101000000103 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 excluded (situation)
  • 819931000000100 Corneal collagen crosslinking (procedure)
  • 1110551000000103 Computed tomography portal venography of thorax, abdomen and pelvis (procedure)
  • 839961000000102 Computed tomography arthrography of temporomandibular joint with contrast (procedure)
  • 200131000000104 Cognitive behaviour therapy declined (situation)
  • 893031000000104 Clinical immunology service (qualifier value)
  • 893001000000105 Clinical genetics service (qualifier value)
  • 1323741000000103 Clinical Outcomes in Routine Evaluation Outcome Measure Risk/Harm score (observable entity)
  • 144951000000106 Chronic mechanical low back pain (finding)
  • 724441000000105 Child health service (qualifier value)
  • 893061000000109 Cardiology service (qualifier value)
  • 792261000000107 Butyrylcholinesterase genotype determination (procedure)
  • 1060601000000109 Body height growth rate (observable entity)
  • 227111000000101 Attention to connection of stomach to duodenum (procedure)
  • 759551000000105 Atrioventricular septal defect with balanced ventricles (disorder)
  • 845171000000108 At risk of cardiovascular disease (finding)
  • 1099351000000106 Assessment using modified Medical Research Council dyspnoea scale (procedure)
  • 1104951000000102 Assessment using Patient Health Questionnaire-4 (procedure)
  • 1240401000000105 Antibody to severe acute respiratory syndrome coronavirus 2 (substance)
  • 862161000000101 Amygdalohippocampectomy (procedure)
  • 1324661000000105 Adverse reaction to severe acute respiratory syndrome coronavirus 2 vaccine (disorder)
  • 1324691000000104 Administration of second dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure)
  • 827621000000108 Addiction service (qualifier value)
  • 768241000000106 Active insulin time (observable entity)
  • 1066471000000100 Able to use voice output communication aid (finding)
  • 1066781000000109 Able to monitor own comprehension (finding)
  • 1066451000000109 Able to use prosody in speech (finding)
  • 905311000000101 Acute pyrophosphate crystal arthropathy (disorder)
  • 892811000000109 Adult mental health service (qualifier value)
  • 790961000000101 Antenatal depression (disorder)
  • 860581000000101 Assessment using children's global assessment scale (procedure)
  • 788921000000108 At risk of emergency hospital admission (finding)
  • 804091000000102 Blood test due date (observable entity)
  • 800851000000109 Butyrylcholinesterase measurement (procedure)
  • 894681000000107 Cholera vaccination declined (situation)
  • 893051000000106 Clinical allergy service (qualifier value)
  • 893171000000103 Clinical neurophysiology service (qualifier value)
  • 912371000000102 Computed tomography portal venography of abdomen and pelvis (procedure)
  • 1240751000000100 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 (disorder)
  • 957401000000108 Cubital bursitis (disorder)
  • 203141000000102 Dipyridamole prophylaxis (procedure)
  • 913371000000105 Endoscopy of vagina using fluoroscopic guidance (procedure)
  • 894241000000101 Excision of gonad from inguinal canal (procedure)
  • 959511000000100 Family history of end stage renal disease (situation)
  • 1034791000000105 Fluoroscopic arteriography of coronary arteries, ascending aorta and peripheral vessels (procedure)
  • 893131000000100 Genitourinary medicine service (qualifier value)
  • 285041000000103 High intensity focused ultrasound of prostate (regime/therapy)
  • 885901000000106 History of rotavirus vaccine allergy (situation)
  • 1147921000000105 Injection of bilateral hips using fluoroscopic guidance (procedure)
  • 813121000000101 Injury of tendon of finger (disorder)
  • 840611000000103 Insertion of implant to sinus tarsi (procedure)
  • 863801000000104 Intrathecal injection of skeletal muscle relaxant into lumbar subarachnoid space (procedure)
  • 893401000000103 Left hemicolectomy and end to side anastomosis (procedure)
  • 1090921000000106 Malignant neoplasm of jaw (disorder)
  • 1324611000000108 Measurement of severe acute respiratory syndrome coronavirus 2 antigen (procedure)
  • 835131000000107 Modified Rankin scale (assessment scale)
  • 777601000000102 No diabetic autonomic neuropathy (situation)
  • 932271000000104 Oral and maxillofacial surgery service (qualifier value)
  • 893761000000106 Paediatric rheumatology service (qualifier value)
  • 966871000000106 Percutaneous embolisation of artery supplying prostate gland (procedure)
  • 869511000000103 Peripheral intravenous cannula (physical object)
  • 1240551000000105 Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (disorder)
  • 809241000000104 Pre-surgery evaluation of lung recipient (procedure)
  • 1109861000000109 Radial emitting laser destruction of anal fistula using ultrasonographic guidance (procedure)
  • 905441000000106 Reactive arthritis after escherichia coli infection (disorder)
  • 905481000000103 Reactive arthritis after yersinia infection (disorder)
  • 893101000000106 Right hemicolectomy and end to side anastomosis (procedure)
  • 882221000000103 Second rotavirus vaccination declined (situation)
  • 1240381000000105 Severe acute respiratory syndrome coronavirus 2 (organism)
  • 1324821000000101 Severe acute respiratory syndrome coronavirus 2 immunisation course not done (situation)
  • 1324871000000102 Severe acute respiratory syndrome coronavirus 2 ribonucleic acid detection result indeterminate (finding)
  • 1240661000000107 Severe acute respiratory syndrome coronavirus 2 vaccination contraindicated (situation)
  • 1324741000000101 Severe acute respiratory syndrome coronavirus 2 vaccination first dose declined (situation)
  • 1324751000000103 Severe acute respiratory syndrome coronavirus 2 vaccination second dose declined (situation)
  • 944051000000105 Skull injury due to birth trauma (disorder)
  • 806781000000109 Termination of pregnancy inpatient care management (procedure)
  • 1087371000000106 Timed Unsupported Steady Stand time (observable entity)
  • 904671000000102 Transcranial repair of craniofacial cleft and reconstruction of cranial and facial bones (procedure)
  • 1097421000000103 Traumatic avulsion of toenail (disorder)
  • 825021000000108 Traumatic dislocation of metatarsal joint (disorder)
  • 906061000000107 Ultrasonography of thymus (procedure)

Future Release Schedule

One further minor release of the UK Clinical Extension is scheduled for 02 December 2020:

02 December

TRUD Version   31.1.0
effectiveTime    20201125

Base content:    July 2020 International Edition

New content:   Additional routine non-COVID-19 content for the UK
                        Any requested new COVID-19 content (as per a microrelease)
                        ICD10 and OPCS map updates covering above new content
                        Full update of refsets to align with new content

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 30 December 2020 could therefore still occur, to coincide with the already scheduled 4-weekly release of the UK SNOMED CT Drug Extension.

Subscriptions and Licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page. This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED International Member territories as there are additional licensing considerations.

The above releases can also be downloaded via our FTP servers if you have previously been assigned an FTP access right.

Reference sets (Refsets)

One new UK simple Refset is added to the 28 October 2020 release.

231481000001106 Enhanced services general practice extraction - Human papillomavirus vaccines simple reference set (foundation metadata concept)

Cross Mapping

Significantly updated SNOMED CT to OPCS-4.9 and ICD-10 5th Edition five character maps are all included in this 28 October 2020 release, including maps for much of the new International Edition content.

Delay to 31.0.0 SNOMED CT UK Drug Extension

Please note that due to a service disruption there has been a delay to the production of the 31.0.0 SNOMED CT UK Edition.

This will delay the release of the:

  • SNOMED CT International Edition
  • SNOMED CT UK Clinical Extension
  • SNOMED CT UK Drug Extension

The 31.0.0 SNOMED CT UK Edition will be published on Wednesday 11 November 2020, instead of its expected release date of Wednesday 04 November 2020.

NHS Digital is sorry for any inconvenience that this will cause you.

Notification of errors in 30.2.0 SNOMED CT UK Drug Extension

There is a known issue in the 30 September 2020 (released 07 October 2020) release with the UK Realm Language Reference set (RLR) Pharmacy Part.

50 Inactive International concepts had both their Fully Specified Name (FSN) and Preferred Synonym (preferred term) inactivated in the RLR Pharmacy Part meaning they were published in the 30.2.0 release with no active RLR entries in either the Pharmacy Part or Clinical Part.

We will publish a corrected RLR for these entries in the next UK Drug Extension release.

The concepts affected by this error are listed below:

134498003               Budesonide+eformoterol fumarate 200/6mcg bth-act dry pdr inh (product)

134587001               Gliclazide 30mg m/r tablet (product)

134648007               Iron dextran complex 100mg/2mL injection (product)

319112003               Isosorbide mononitrate 25mg m/r tablet (product)

319113008               Isosorbide mononitrate 50mg m/r tablet (product)

319248007               Nifedipine 60mg m/r capsule (product)

319519002               Dopamine hydrochloride 800mg/5mL infusion concentrate (product)

319667003               Enoxaparin 20mg/0.2mL prefilled syringe (product)

319671000               Enoxaparin 60mg/0.6mL prefilled syringe (product)

319672007               Enoxaparin 80mg/0.8mL prefilled syringe (product)

319680000               Enoxaparin 150mg/1mL prefilled syringe (product)

320118009               Salbutamol 500micrograms/1mL injection (product)

320277000               Salmeterol+fluticasone propionate 50micrograms/100micrograms breath-actuated dry powder inhaler (product)

320279002               Salmeterol+fluticasone propionate 50micrograms/250micrograms breath-actuated dry powder inhaler (product)

320280004               Salmeterol+fluticasone propionate 50micrograms/500micrograms breath-actuated dry powder inhaler (product)

320602002               Fluticasone propionate 50micrograms breath-actuated dry powder inhaler (product)

320603007               Fluticasone propionate 100micrograms breath-actuated dry powder inhaler (product)

320605000               Fluticasone propionate 500micrograms breath-actuated dry powder inhaler (product)

320824000               Loratadine 5mg/5mL syrup (product)

320962001               Codeine phosphate 15mg/5mL s/f linctus (product)

321460009               Methotrimeprazine hydrochloride 25mg/1mL injection (product)

322087003               Hyoscine hydrobromide 1mg/72hours transdermal patch (product)

323291005               Nicotine 7mg/24hours patch (product)

323349006               Acetylcysteine 2g/10mL injection (product)

326522002               Alfuzosin hydrochloride 10mg m/r tablet (product)

327413008               Ferrous fumarate 140mg/5mL sugar free syrup (product)

330114000               Baclofen 10mg/5mL intrathecal injection (product)

331054006               Ipratropium 0.03% aqueous nasal spray (product)

331065001               Fluticasone propionate 400micrograms single-use nasal drops (product)

333899005               Glycopyrronium bromide 200micrograms/1mL injection (product)

333900000               Glycopyrronium bromide 600micrograms/3mL injection (product)

354044003               Morphine sulfate 15mg/1mL injection (product)

398895004               Diazepam 2mg/5mL oral solution sugar free (product)

400780006               Insulin glargine (recombinant human insulin analogue) 100units/ml injection 3ml cartridge (product)

400877001               Insulin glargine (recombinant human insulin analogue) 100units/ml injection 3ml pre-filled disposable injection device (product)

404179005               Ispaghula husk 3.5g effervescent granules sachets gluten free sugar free (product)

408013007               Mometasone furoate 400micrograms breath-actuated dry powder inhaler (product)

408026006               Mometasone furoate 200micrograms breath-actuated dry powder inhaler (product)

409361001               Metformin hydrochloride 750mg m/r tablet (product)

410946005               Fluconazole 150mg capsule/clotrimazole 2% cream (product)

410972001               Bemiparin sodium 25000iu/mL injection solution 0.2mL prefilled syringe (product)

411533003               Metformin hydrochloride 1g m/r tablet (product)

414538008               Ipratropium bromide 20mcg CFC-free inhaler (product)

416110006               Darifenacin 7.5mg m/r tablet (product)

417289004               Darifenacin 15mg m/r tablet (product)

442323002               Fesoterodine 4mg m/r tablet (product)

442489000               Fesoterodine 8mg m/r tablet (product)

703806003               Mirabegron 25mg m/r tablet (product)

703807007               Mirabegron 50mg m/r tablet (product)

703924000               Aclidinium bromide 375micrograms inhaler (product)

SNOMED CT UK Edition (Clinical) 30.2.0 - 07 October 2020

Important changes and information regarding this release

This is the first minor SNOMED update based on the July 2019 International Edition. Changes are therefore minimal but not limited to COVID-19.

New Code Additions for 30.2.0 UK Clinical Extension

  • 148491000000104    Quality and Outcomes Framework - fractional exhaled nitric oxide test service not available (situation)
  • 1323941000000101  Group consultation via video conference (procedure)
  • 1323731000000107  Assessment using Binge Eating scale (procedure)
  • 148571000000102    Quality and Outcomes Framework non-diabetic hyperglycaemia quality indicator-related care invitation using preferred method of communication (procedure)
  • 1324501000000107  Access assessment for admission to specialised mental health service (procedure)
  • 1323741000000103  Clinical Outcomes in Routine Evaluation Outcome Measure Risk/Harm score (observable entity)
  • 1324081000000106  Perinatal Patient rated Outcome and Experience Measure score - Staff listened to me and understood my problems (observable entity)
  • 1324041000000103  Perinatal Patient rated Outcome and Experience Measure score - When I was discharged from the service, I was (observable entity)
  • 1324061000000102  Perinatal Patient rated Outcome and Experience Measure score - Staff gave me the right amount of support (observable entity)
  • 1324211000000106  Perinatal Patient rated Outcome and Experience Measure score - The unit was clean and hygienic (observable entity)
  • 1324231000000103  Perinatal Patient rated Outcome and Experience Measure score - The unit did not provide helpful activities and therapies (observable entity)
  • 1324251000000105  Perinatal Patient rated Outcome and Experience Measure score - The unit supported me in my contact with family and friends (observable entity)
  • 1324261000000108  Perinatal Patient rated Outcome and Experience Measure score - The food provided was not acceptable to me (observable entity)
  • 1324141000000102  Perinatal Patient rated Outcome and Experience Measure score - Staff helped me be more confident with caring for my baby (observable entity)
  • 1324121000000109  Perinatal Patient rated Outcome and Experience Measure score - Staff helped me to understand my illness/difficulties (observable entity)
  • 1324111000000103  Perinatal Patient rated Outcome and Experience Measure score - Staff were not sensitive to my needs (observable entity)
  • 1323791000000108  Adapted Alcohol, Smoking and Substance Involvement Screening Test Lite - Other psychoactive substance score (observable entity)
  • 1323611000000105  Paediatric inherited metabolic medicine service (qualifier value)
  • 1323571000000101  Orthogeriatric medicine service (qualifier value)
  • 1323551000000105  Inherited metabolic medicine service (qualifier value)
  • 1323531000000103  Urological physiology service (qualifier value)
  • 1323431000000104  Fetal medicine service (qualifier value)
  • 148581000000100    Personal health record provider service (qualifier value)
  • 1323921000000108  Neuropsychiatry service (qualifier value)
  • 1323881000000102  Stroke medicine service (qualifier value)
  • 1323851000000108  Paediatric hepatology service (qualifier value)
  • 1323821000000103  Paediatric clinical pharmacology service (qualifier value)
  • 1323761000000102  Medical psychotherapy (qualifier value)
  • 1323661000000107  Paediatric audiovestibular medicine service (qualifier value)
  • 1323701000000101  Vascular physiology service (qualifier value)
  • 1324181000000105  Audiovestibular medicine (qualifier value)
  • 1323651000000109  Cardiac physiology service (qualifier value)
  • 1323891000000100  Eating Disorders Quality of Life Scale (assessment scale)
  • 1323681000000103  Eating-disorder-focused focal psychodynamic therapy (regime/therapy)
  • 148471000000103    Seen by health and wellbeing coach (finding)
  • 148541000000108    Excepted from non-diabetic hyperglycaemia quality indicators - informed dissent (finding)
  • 148481000000101    Seen by care coordinator (finding)
  • 148551000000106    Excepted from non-diabetic hyperglycaemia quality indicators - patient unsuitable (finding)
  • 1323481000000100  Adult not brought to appointment (finding)
  • 1323471000000102  Maudsley Model of Anorexia Nervosa Treatment for Adults (regime/therapy)
  • 1323751000000100  Medical virology (qualifier value)
  • 1324171000000108  General internal medicine (qualifier value)
  • 1324191000000107  Intensive care medicine service (qualifier value)
  • 1323691000000101  General internal medical service (qualifier value)
  • 1323641000000106  Audiovestibular medicine service (qualifier value)
  • 1323801000000107  Paediatric oral and maxillofacial surgery service (qualifier value)
  • 1323841000000105  Paediatric palliative medicine service (qualifier value)
  • 1323871000000104  Rehabilitation medicine service (qualifier value)
  • 1323901000000104  Rare disease service (qualifier value)
  • 1323631000000102  Aviation and space medicine service (qualifier value)
  • 148621000000100    School aged immunisation service (qualifier value)
  • 1323501000000109  Special care dentistry service (qualifier value)
  • 1323541000000107  Sleep medicine service (qualifier value)
  • 1323561000000108  Gastrointestinal physiology service (qualifier value)
  • 1323601000000108  Ophthalmic and vision science service (qualifier value)
  • 1323621000000104  Medical psychotherapy service (qualifier value)
  • 1324101000000100  Perinatal Patient rated Outcome and Experience Measure score - The service provided me with the information I needed (observable entity)
  • 1324091000000108  Perinatal Patient rated Outcome and Experience Measure score - Staff did not involve me enough in my care and treatment (observable entity)
  • 1324131000000106  Perinatal Patient rated Outcome and Experience Measure score - Staff were not sensitive to the needs of my baby (observable entity)
  • 1324151000000104  Perinatal Patient rated Outcome and Experience Measure score - The service involved other relevant people in a helpful way (observable entity)
  • 1324161000000101  Perinatal Patient rated Outcome and Experience Measure score - I would recommend this service to others (observable entity)
  • 1324241000000107  Perinatal Patient rated Outcome and Experience Measure score - The unit provided a good place for my baby to be with me (observable entity)
  • 1324221000000100  Perinatal Patient rated Outcome and Experience Measure score - The unit did not provide a good place for me to recover in (observable entity)
  • 1324071000000109  Perinatal Patient rated Outcome and Experience Measure score - I did not get help quickly enough after referral (observable entity)
  • 1324051000000100  Perinatal Patient rated Outcome and Experience Measure score - Staff did not communicate with others involved in my care (observable entity)
  • 1324031000000107  Perinatal Patient rated Outcome and Experience Measure score - When I first came into contact with the service, I was (observable entity)
  • 1323931000000105  Eating Disorders Quality of Life Scale total score (observable entity)
  • 1323721000000105  Binge Eating Scale score (observable entity)
  • 148561000000109    Quality and Outcomes Framework non-diabetic hyperglycaemia quality indicator-related care invitation (procedure)
  • 1323451000000106  Specialist supportive clinical management (procedure)
  • 1323911000000102  Assessment using Eating Disorders Quality of Life Scale (procedure)
  • 1324201000000109  Streamed from emergency department to inpatient unit following initial assessment (situation)

Future Release Schedule

Two further releases of the UK Clinical Extension are scheduled in 2020: a further major release on 4 November and a minor release on 2 December. Details are in the table below:

04 November

TRUD Version   31.0.0
effectiveTime    20201028

Base content:    July 2020 International Edition

New content:     Additional routine non-COVID-19 content for the UK
                        Any requested new COVID-19 content (as per a microrelease)
                        Full ICD10 and OPCS maps covering above new content
                        Full update of refsets to align with new content

02 December

TRUD Version   31.1.0
effectiveTime    20201125

Base content:    July 2020 International Edition

New content:     Additional routine non-COVID-19 content for the UK
                        Any requested new COVID-19 content (as per a microrelease)
                        ICD10 and OPCS map updates covering above new content
                        Full update of refsets to align with new content

NB the opportunity and need for further emergency unscheduled microreleases of COVID-19 specific content in addition to the above is not excluded by the above schedule: they could still occur, though would always coincide with an already scheduled 4-weekly release of the UK SNOMED CT Drug Extension. Thus, in 2020, the only possible remaining dates for further microreleases are now 4 November and 30 December.

The subsequent timetable of scheduled releases into 2021 and beyond currently remains undecided. Opinion on a range of options was sought by means of a formal consultation, now ended. There is strong support for our recommended proposal to continue indefinitely with scheduled releases occurring (roughly) every 8 weeks – seven releases per annum - but with ad hoc microreleases also occurring at the 4-weekly midpoint in between those 8-weekly scheduled releases, and with all releases always coinciding with a 4-weekly release of the UK drug extension. However, a large minority expressed a preference for only quarterly releases, thus reducing the burden of updating other products required to be always derived from current SNOMED CT data.

Planned changes to the SNOMED CT UK Edition Release Subfolder Structure

Subscribers were previously advised that all future PRODUCTION releases of the Drug and Clinical extension content would transition from April 2020 to the BETA release bundling previously provided as technology previews here.

For a more detailed explanation of the motivations for the BETA bundling, see this webinar recording. Detailed information is also provided in the UK Clinical Edition SNOMED CT Technical overview document, section 2.4.1 and 2.4.2.

To reduce burden during the pandemic, this transition was deferred. Suppliers remain recommended to transition to consuming the BETA rather than PRODUCTION bundlings, in accordance with the following revised schedule:

Throughout the remainder of 2020, PRODUCTION releases will remain as before but with the same content always co-published here on TRUD in BETA format, as Test Releases.

From the first scheduled release in 2021 (expected 27 January), all PRODUCTION releases of UK Clinical and Drug will adopt the BETA encoding. All releases will then continue to be available in parallel in the older LEGACY encoding until the end of March 2021, after which the LEGACY encoding variant will be permanently withdrawn.

Reference sets (Refsets)

One new UK simple Refset is added to the 30 September 2020 release.

1323831000000101 Improving Access to Psychological Therapies assessment observables simple reference set (foundation metadata concept)

Cross Mapping

 The SNOMED CT to OPCS-4.9 and ICD-10 5th Edition five character maps are all included in this 30 September 2020 release; there are no significant changes in this release to the OPCS 4.9 and ICD maps. The OPCS 4.8 maps are however now deprecated: there are no active maps for OPCS 4.8 in the snapshot.

Subscriptions and licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page. This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED International Member territories as there are additional licensing considerations.

The above releases can also be downloaded via our FTP servers if you have previously been assigned an FTP access right.

Revised Autumn 2020 Schedule for UK SNOMED Releases

The next scheduled combined releases of the SNOMED UK Clinical and Drug Extensions, on 07 October, were both planned to be “major releases” involving very substantial changes imposed by rebasing the content on the latest July 2020 SNOMED CT International Edition.

Unfortunately, technical teething issues with an upgrade to our NHS Digital SNOMED CT authoring platform have eaten too far into our authoring contingency time. We have, therefore, reluctantly taken the decision to descope that “content rebasing” element from both 07 October 2020 releases.

Whilst there will still be 07 October 2020 releases for both extensions, they are both now descoped to being only a 30.2.0 “minor release”: both will remain based on the July 2019 SNOMED CT International Edition (as for the existing 30.0.0 releases). The SNOMED CT UK Clinical Extension will add only fairly modest quantities of new UK content, some of which will be specific to managing COVID-19 but most of which will not. The 30.2.0 SNOMED CT UK Drug Extension release will be a normal four-weekly release , following the immediately preceding release of 30.1.0 SNOMED CT UK Drug Extension scheduled for 9 September 2020.

The originally planned “major release” element will, therefore, now occur at a new, previously unscheduled combined release on 04 November 2020, in which all content to date in both extensions will finally become simultaneously rebased to the July 2020 SNOMED CT International Edition. Deferring until the already scheduled 02 December 2020 release date was considered, but many suppliers had previously expressed a strong preference against “major releases” in December 2020.

The  revised release schedule to the end of 2020 is, therefore:

07 October 2020

TRUD Version 30.2.0
EffectiveTime 20200930
Base Content July 2019 SNOMED CT International Edition (the same as 30.0.0 12 August 2020)
New Content
  • Additional routine non-COVID-19 content for the UK
  • Any requested new COVID-19 content (as per a microrelease)
  • Full ICD-10 and OPCS-4 maps covering above new content
  • Full updates of refsets to align with new content




04 November 2020

TRUD Version 31.0.0
EffectiveTime 20201028
Base Content July 2020 SNOMED CT International Edition
New Content
  • Additional routine non-COVID-19 content for the UK
  • Any requested new COVID-19 content (as per a microrelease)
  • Full ICD-10 and OPCS-4 maps covering above new content
  • Full updates of refsets to align with new content






02 December 2020

Known issues with the Module Dependency Refset (MDR) file

The 15 April 2020 MDR release included some off-specification duplicate rows in which the same ID and effectiveTime appeared twice, but with different data. Attempts to build the standard unique composite key on {ID, effectiveTime} on the FULL data as distributed will therefore fail.

The IDs and effectiveTimes involved are:

  • f0658b79-0cbc-116a-e044-0003ba13161a             20200415
  • f0658b79-0cbd-116a-e044-0003ba13161a            20200415

This technical error has subsequently been published in all FULL file distributions made since 15 April.

The error can not be removed by means of a further Delta, but is scheduled to be expunged from the distributed FULL files from the 7 October 2020 release.

For those affected by the error, a range of mitigations exist:

  1. Do not load (or index) the MDR content at all, if it is not in fact required by your application.
  2. Depart from the specification and apply a non-unique index over {ID, effectiveTime}. Extraction of the latest snapshot of the MDR would not be adversely affected.
  3. Manually delete the erroneous data from the FULL table, before then proceeding with the usual unique indexation:

DELETE FROM snomed.rf2_ssrefset_full WHERE ID IN (‘f0658b79-0cbc-116a-e044-0003ba13161a’,’f0658b79-0cbd-116a-e044-0003ba13161a’) AND effectiveTime = ‘20200415’ AND linkedString1 = ‘20200401’;

4. (From 7 October release) Replace your current cumulative FULL data for this table with a copy of a newer distribution, from which the error has already been removed at source.

Finally, NHS Digital would welcome more direct engagement with those who encounter this error, and especially those whose applications actively use the MDR data. We are keen to understand user expectations and experiences with it to date, and discuss other known MDR historical issues and plans for its future development.

SNOMED CT UK Edition (Clinical) 30.0.0 - 05 August 2020

The SNOMED CT UK Clinical Edition, RF2 for 12 August 2020 is now available for download from the following links:

The SNOMED CT UK Drug extension is not released as part of the SNOMED CT biannual release. The SNOMED CT UK Drug Extension data is published on a four-weekly cycle within the "UK Drug Extension, RF2" sub pack on TRUD. Please review the associated documentation for more details.

The Clinical Release documentation is now only accessible on Delen.

Please see the ‘Future release schedule’ section in this notice for important information about the release timetable and content for the remainder of the 2020 calendar year and the next calendar year, 2021.

Important changes and information regarding this release

This is the first major SNOMED release for two years to include a change in version of the International Edition it is based upon. Changes are therefore extensive and not limited to COVID-19. In addition to the very many concept inactivations and new concept creations introduced in the new SNOMED International Edition version itself, this release also includes some 500 new codes added within the UK Clinical Extension in support of a range of UK-specific collections. Their number is too numerous to list in this notice.

Future Release Schedule

Two further releases of the UK Clinical Extension are scheduled in 2020: a further major release on 07 October and a minor release on 02 December. Details are in the table below:

12 August

TRUD Version: 30.0.0
effectiveTime: 20200805
Base content: July 2019 International Edition
New content: 
    All UK content deferred from 01 April release.
    Some additional non-COVID-19 content for the UK. 
    Any requested new COVID-19 content (as per a microrelease). 
    ICD-10 and OPCS maps covering the above new content. 
    "Light touch" update of refsets to align with new content

07 October

TRUD Version: 31.0.0
effectiveTime: 20200930
Base content: July 2020 International Edition
New content: 
    Additional routine non-COVID-10 content for the UK
    Any requested new COVID-19 content (as per a microrelease)
    Full ICD-10 and OPCS maps covering the above new content
    Full update of refsets to align with new content

Other:
 Inactivation of the SNOMED CT OPCS-4.8 maps

02 December TRUD Version: 31.2.0
effectiveTime: 20201125
Base content: July 2020 International Edition
New content: 
    Additional routine non-COVID-10 content for the UK
    Any requested new COVID-19 content (as per a microrelease)
    ICD-10 and OPCS map updates covering the above new content
    Full update of refsets to align with new content

Other:
 Removal of the OPCS-4.8 maps from the UK Clinical Edition


NB: 
The opportunity and need for further emergency unscheduled microreleases of COVID-19 specific content in addition to the above is not excluded by the above schedule. They could still occur, though would always coincide with an already scheduled 4-weekly release of the UK SNOMED CT Drug Extension. Thus, in 2020, the only possible remaining dates for further microreleases are now 09 September, 04 November and 30 December.

Opinions as to the he subsequent timetable of scheduled releases into 2021 and beyond are now being sought through a formal consultation. Our current preferred option is to continue indefinitely with scheduled releases occurring every 8 weeks, with ad hoc microreleases also able to occur at the 4-weekly mid-point in between those 8-weekly scheduled releases, but with all releases always coinciding with a 4-weekly release of the UK drug extension.

Planned changes to the SNOMED CT UK Edition release subfolder structure

Subscribers were previously advised that all future PRODUCTION releases of the Drug and Clinical extension content would transition from April 2020 to the BETA release bundling previously provided as technology previews.

For a more detailed explanation of the motivations for the BETA bundling, see the following webinar recording. Detailed information is also provided in sections 2.4.1 and 2.4.2 of the UK Clinical Edition SNOMED CT Technical overview document.

To reduce burden during the pandemic, this transition was deferred. Suppliers remain recommended to transition to consuming the BETA rather than PRODUCTION bundlings, in accordance with the following revised schedule:

Throughout the remainder of 2020, PRODUCTION releases will remain as before but with the same content always co-published on TRUD in BETA format, as Test Releases.

From the first scheduled release in 2021 (expected 27 January), all PRODUCTION releases of UK Clinical and Drug will adopt the BETA encoding. All releases will then continue to be available in parallel in the older LEGACY encoding until the end of March 2021, after which the LEGACY encoding variant will be permanently withdrawn.

Reference sets (Refsets)

Three new UK mapping Refset have been added to the 12 August 2020 release.

Two are technical replacements for previously existing identical products that are themselves being withdrawn from this release. The creation of the new refsets is purely to enable bolderisation of the preferred and fully specific names of the underlying refsets:

  • 1323321000000109 Default exclusion filter professionally mediated exclusions simple reference set (foundation metadata concept)
  • 1323331000000106 Default exclusion filter professionally mediated inclusions simple reference set (foundation metadata concept)

The third is a substantive new refset:

  • 1323341000000102 Treatment Function services for England simple reference set (foundation metadata concept)

Cross Mapping

The SNOMED CT to OPCS-4.9 and ICD-10 5th Edition five-character maps are all included in the 12 August 2020 release; there are significant changes in this release to the OPCS-4.9 and ICD-10 maps.

The SNOMED CT to OPCS-4.8 maps continue to be available in this release. These maps will become inactive in the 07 October 2020 release. In line with established policy, the OPCS-4.8 maps will no longer be available in the 02 December 2020 release.

If you have any questions or feedback regarding this information, please contact the information standards helpdesk.

SNOMED CT UK Edition (Clinical) 30.0.0 ALPA Preview Release

Key Findings

The next combined release of the SNOMED CT UK Clinical and UK Drug extensions is on 12 August. This will be our first update for 2 years to be based on new content from SNOMED International: we will move from the July 2018 to the July 2019 International Edition. This update therefore brings significant quantities of content change: both retirements of old content and the addition of new content.

An advance preview technical ALPHA of these major release is now available within the SNOMED CT UK Edition Test Area of TRUDIt includes additional files detailing the new concepts and concept retirements that will be introduced by the new International Edition.

Note that the final 12 August PRODUCTION releases will be different, as outlined below. However, the vast bulk of content change likely to impact upon implementations is already present in this preview and in its final form. For some implementations, a sufficiently accurate evaluation of the resulting update penalty may therefore become possible in advance of the true PRODUCTION release on 12 August.

Full Release notes can be found on the SNOMED CT Clinical Delen Documentation pages.

Known Technical Errors

In the 30.0.0 preview data, four descriptionIds are incorrectly present in the xsct2_descriptions files of both the UK Clinical and UK Drug products. This error will be corrected for the final 30.0.0 build. However, without additional steps to handle the data issue, the duplication may cause primary key errors when loading the preview data:

descriptionId           conceptId
1086311000000115    117206007    GAD65 (glutamic acid decarboxylase 65) antibody 
1086911000000119    117206007    Glutamic acid decarboxylase 65 antibody 1649971000000118    444626001    Ara h 2 IgE (immunoglobulin E) 2188551000000115    450323004    Factor VIII specific IgE

SNOMED CT Clinical Edition: 29.1.0- Refset effectiveTime error

Please note that the refsets content changes implemented in this Clinical Release have an incorrect effectiveTIME value of 20200501, meaning some changes intended to be effected in this release will not be available to all until the 29.2.0 release on 20 May 2020. 

Implementations that process the FULL files may choose to access these changes earlier by using 20200501 as the effectiveTime for their dynamic snapshot extraction.

Implementations that process only the Snapshot files as distributed must wait until the 29.2.0 release for the changes to be accessible. 

We apologise for any inconvenience caused. 

Notification of errors in 29.0.0 / 29.1.0 SNOMED CT Clinical Edition & Drug Extension

There are two known issues in the April 2020 release:

  • There are no Refset Descriptor entries within the new OPCS-4.9 map refset
  • A very small number of concepts are showing more than one Preferred Term derivable in the Realm Language Refset (RLR), mainly for the drug extension. We will work to update these for future release, but - in the meantime - please email any RLR issues to information.standards@nhs.net
  • There are nine published entries within the RLR with description IDs. We are working to identify the root cause and will provide an appropriate fix in a future release

Filename Error in 29.1.0 / 29.1.1 SNOMED CT Drug Extension (22 April 2020)

The version for the 22 April 2020 (effective date 15 April 2020) SNOMED CT Drug Extension Release stated on TRUD and the released file is 29.1.1. The version stated within the Terminology is 29.1.0. 

We apologise for any inconvenience that this may have caused.

29.0.0 Release significantly reduced new concepts to support COVID-19

The SNOMED CT clinical release published on 01 April 2020 has significantly reduced content. It predominantly provides codes to support COVID-19.

For further details on this and further planned interim releases, please visit our COVID-19 updates page

Notification of error(s) in 28.6.0 release – duplicate FSNs

The 28.6.0 release contained 3 pairs of duplicate FSNs that were not identified before the release was built. They will be fixed in the next SNOMED CT UK Drug Extension release, 28.7.0. The affected concepts are:

  • 38075611000001102|NovoThirteen 2,500unit powder and solvent for solution for injection vials (Imported (Denmark)) (product)|
  • 37846311000001107|NovoThirteen 2,500unit powder and solvent for solution for injection vials (Imported (Denmark)) (product)|
  • 22771000122108|Catridecacog (substance)|
  • 38083111000001100|Catridecacog (substance)
  • 37846411000001100|NovoThirteen 2,500unit powder and solvent for solution for injection vials (Imported (Denmark)) 1 vial (product)|
  • 38075711000001106|NovoThirteen 2,500unit powder and solvent for solution for injection vials (Imported (Denmark)) 1 vial (product)|

Re-release of 27.1.0 4-weekly SNOMED CT UK Drug Extension: RF2 Release

This re-release includes the following fixes:

Seven Trade Family Refset members that were missed from the snapshot, delta and full releases have now been included

  • Correction of row duplication errors in the Reference set Descriptor Reference Set (RDR) and the Module Dependancy Reference set (MDR)

Subscribers are advised to implement this re-release if any of the following are used:

  • Trade Family Refset
  • RDR or MDR
  • Delta release or Delta file from the release

From October 2019, both the packaging of the SNOMED release data and how it should be processed will need to change. Further details are provided in the revised 'Technical Overview' document within this re-release.

We will engage with organisations to support the understanding of this issue, thus enabling those who use SNOMED datafiles to make any necessary changes to their processing of SNOMED release data.