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SNOMED CT UK Clinical Extension Release Documentation

The release documentation for the SNOMED CT UK Edition is separated into release notes and release documents.

Release notes section - provides a summary of clinical extension content, classification maps and reference set changes for the relevant release of the SNOMED CT UK Edition. This includes technical notes detailing any planned changes or known errors where these have been found and there is an agreed approach on how these will be fixed.

Release documents section - includes more technical information in each of the documents of the structure of the SNOMED CT UK Edition and historical changes to the releases.

For details regarding changes to the SNOMED CT drug extension, please see the relevant release documents.

For a schedule of when the SNOMED CT UK Edition will be released, please see the SNOMED CT UK Release Schedule.

Any changes and important updates of our releases will be available in the important notices and known issues page

Release ID: 32.2.0 - 14 July 2021

Release Notes

International release

The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.

The SNOMED International release notes can be found online at:

SNOMED CT January 2021 International Edition release notes

You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition:  Daily Build SNOMED CT Browser

Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.

SNOMED CT UK Drug extension

SNOMED CT UK Drug Extension data is published on a four-weekly cycle.  The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.

The 32.0.0 release (with dm+d data from release NHSBSA_6.3.0_20210628000001) of the SNOMED CT UK Drug Extension, will be synchronous with the July 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition. It will be available on 14 July 2021.

Clinical Content Changes

New SNOMED CT UK clinical extension concepts per hierarchy:

Assessment scale hierarchy – 2 new concepts

Clinical finding – 11 new concepts

Disorder hierarchy – 2 new concepts

Event hierarchy – 1 new concept

Observable entity hierarchy – 2 new concepts

Person hierarchy – 1 new concept

Procedure hierarchy – 15 new concepts

Qualifier value hierarchy – 3 new concepts

Record artefact hierarchy – 15 new concepts

Regime/therapy – 4 new concepts

Situation with explicit context – 37 new concepts

18 UK concepts have been inactivated that are duplicates of international content.

A further 10 foundation metadata concepts have been inactivated.

‘On examination’ and ‘Complaining of’ concepts 

Please note we are aware of an ongoing 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. Further updates will be provided here.

There will also be a slight delay in the update of the NHS Digital SNOMED CT browser for the 32.2.0 release.

SNOMED CT codes relating to COVID-19 Vaccination

New SNOMED CT concepts have been added to enable the recording of the maintenance protection course against SARS-CoV-2. The new content and further detailed information can be found in the COVID-19 Vaccination codes section on the COVID-19 Information Standards page.SNOMED CT to ICD-10 and OPCS-4 Classification Maps (Heading)

The majority of changes in this release are quality improvements to existing map content,  

Summary detail 

Number 

New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. 

953

New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. 

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

476

Information for future releases 

Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see theSNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)release document for additional information). 

Reference sets

There are no new Reference sets in this release:

Notice of deprecation of reference sets 

There are no reference sets due for deprecation in the next release.

Unfortunately, we are not currently in a position to proceed with requests for new reference sets at this time. Any requests we receive are being escalated and NHS Digital is currently reviewing the processes for reference set production. You may wish to submit a request via the Request Submission Portal so it can follow this escalation process.

 Technical notes 

There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.

Known issues 

There are no known issues for this release.

Release Documents

Subscription and Licensing

The SNOMED CT UK Edition can be downloaded from Technology Reference data Update Distribution - TRUD where you can register for an account to subscribe to the releases of the SNOMED CT UK Edition and other useful materials to support the UK release.

If your details change you can update your information on the TRUD registration page. 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. Details of the new API service are available on TRUD.

Release ID 32.0.0 – 19 May 2021

Release Notes

International release

The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.

The SNOMED International release notes can be found online at:

SNOMED CT January 2021 International Edition release notes

You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition:  Daily Build SNOMED CT Browser

Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.

SNOMED CT Drug extension

SNOMED CT UK Drug Extension data is published on a four-weekly cycle.  The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.

The 32.0.0 release (with dm+d data from release NHSBSA_5.0.0_20210503000001) of the SNOMED CT UK Drug Extension, will be synchronous with the May 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition. It will be available on 19 May 2021.

Clinical Content Changes

New SNOMED CT UK clinical extension concepts per hierarchy

Clinical finding – 6 new concepts

Procedure hierarchy – 5 new concepts

Situation with explicit context – 4 new concepts

Foundation metadata concepts – 2 new concepts

1 procedure concept has been reactivated for national reporting purposes

‘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.

Approximately 2000 ‘On examination’ and ‘Complaining of’ concepts have been reactivated. This means that the concepts become active in the UK clinical extension and the concept id and description ids remain the same. Due to the quantity of content to be reactivated there were technical and time limitations that meant it was not possible to fully replicate the previous hierarchical placement of the concepts. There is an expected consequence that this incomplete restoration of previous hierarchical placement may impact on data extraction and analysis.

To ensure a consistent and reproducible approach to reactivating the ‘On examination’ and ‘Complaining of’ content the previous hierarchical relationships were technically generated and where a single supertype concept was assigned to each concept, this was accepted and became the new supertype of the concept (this may have been either the inferred or stated supertype previously).

 Where the technically generated output reported concepts that had two supertype concepts, the Levenshtein distance between the reactivated Fully Specified Name (FSN) and each candidate supertype concept FSN was calculated and the lowest calculation used to assign the supertype. If the Levenshtein distance was the same, alphabetic order was used to assign the supertype.   

A strategy will be developed to address the review of this content and appropriate inactivation of the content in line with use cases and concept usage in the UK.

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. Further updates will be provided here.

 Advice on competing International and UK SNOMED CT codes 

NHS Digital are aware of a number of new codes in the January 2021 International data (and thus in the May 2021 UK Edition) of SNOMED CT which may interfere with established UK recording of certain COVID-19 and SARS-CoV-2 data items, in particular diagnostic codes for the long-term effects of COVID-19, SARS-CoV-2 vaccinations and adverse reactions and 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 which highlights the issues and provides advice on steps that can be taken to minimise the impact on data quality.

SNOMED CT to ICD-10 and OPCS-4 Classification Maps

The main change to the mapping files is the incorporation of the UK maps for the SNOMED International January 2021 release content. There are also new maps for a small number of new high priority UK concepts, along with some quality improvements to existing map content.  

Summary detail 

Number 

New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. 

2258 

New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. 

397 

Information for future releases

Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition) release document for additional information). 

Reference sets

There are two new reference sets in this release:

1326321000000103 Post-COVID assessment service simple reference set

1326311000000109 Long term effects of COVID-19 primary care simple reference set

Notice of deprecation of reference sets

As per release documentation published in 30.0.0 August 2020 there are plans to deprecate the following reference sets for the 32.2.0 July 2021 release.

999000261000000107 Adverse reaction propensity simple reference set

999001591000000108 Assessment scale simple reference set

999002331000000109 Assessment scale observables simple reference set

999000191000000106 Care planning patient outgoing referral simple reference set

999000381000000107 Correspondence care setting type simple reference set

999000391000000109 Correspondence document type simple reference set

999000401000000107 Device type simple reference set

Unfortunately we are not currently in a position to proceed with requests for new reference sets at this time. Any requests we receive are being escalated and NHS Digital is currently reviewing the processes for reference set production. You may wish to submit a request via the Request Submission Portal so it can follow this escalation process.

Technical notes

There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.

Known issues 

There are no known issues for this release.

Release Documents

Subscription and Licensing

The SNOMED CT UK Edition can be downloaded from Technology Reference data Update Distribution - TRUD where you can register for an account to subscribe to the releases of the SNOMED CT UK Edition and other useful materials to support the UK release.

If your details change you can update your information on the TRUD registration page. 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. Details of the new API service are available on TRUD.