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  • Terminology and Classifications Delivery Service Newsletter: March 2022

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    Terminology and Classifications Delivery Service Newsletter


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    Welcome to the March Newsletter. In this issue we feature:

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    National Clinical Coding Standards

    The ICD-10 and OPCS-4.9 national clinical coding standards and guidance, primarily aimed at clinical coding professionals, ensure consistent application of the classifications and associated rules.

    Taking account of a recent review of user feedback, along with improved publication methods, we plan to streamline our processes and merge the clinical coding standards as follows: 

    National Clinical Coding Standards – ICD-10 (reference books) will incorporate:

    • Coding Clinic content (diseases and related health problems)
    • COVID-19 standards and guidance

    National Clinical Coding Standards – OPCS-4 (reference books) will incorporate:

    • Coding Clinic content (interventions and procedures)
    • Chemotherapy Regimen Clinical Coding Standards and Guidance

    These changes mean that – from 01 April 2022 – all national clinical coding standards and guidance will be accessible in the applicable reference book. These will be published  by 04 March 2022 on Delen (our collaboration platform) and held in the Classifications Browser and eVersion.

    All previous Coding Clinics and Chemotherapy Regimen Clinical Coding Standards and Guidance published on Delen will be archived for historical reference.

    We also plan to engage with the clinical coding community on the clinical coding standards in development to provide an early opportunity for user feedback prior to publication and we are working through the process to achieve this.

    We are keen to continually improve our processes and provide products that meet users’ needs, make sense to our users, and add value in users’ day-to-day work. We always welcome feedback through our helpdesk information.standards@nhs.net or via our annual survey.

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    SNOMED CT 2022-23 Release Schedule

    We have reviewed the SNOMED CT release schedule for 2022-2023, with the following outcomes:

    • exact dates of the SNOMED CT UK Clinical Edition have now been set and are published on the SNOMED CT Release Schedule page.
    • we will update the SNOMED CT International release content three times this year so we can catch up with International releases
    • the SNOMED CT UK Drug Extension will remain on a four-weekly release schedule

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    2022/23 Classifications Training Schedule

    We recently made an announcement about the 2022-23 training schedule and details are available in the Latest News area.

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    New Information Standard for medication and allergy / intolerance information 

    A new Information Standard has been published to support improved medication and allergy / intolerance information sharing across healthcare services in England. The new Information Standard will standardise medication message content, enabling transfer of prescription information across health and care settings in England to help reduce medicines-related errors and improve patient safety. 

    The Standard will enable medicines information to be more efficiently shared between NHS and social care organisations, including primary and secondary care – from hospitals and GP practices to residential care homes, mental health trusts, and pharmacies. It will be particularly beneficial in reducing medication errors when patients transfer between care locations. 

    As well as providing clinicians with a more detailed and consistent source of medicines-related information across all care settings, the Standard will also enable healthcare professionals to obtain medicines information in a quicker, more efficient manner, saving valuable time and improving patient care. 

    This will be achieved by:

    • transferring medication information, using the newest UK version of FHIR (Fast Healthcare Interoperability Resource), using either ‘Medication Codable Concept’ or ‘Medication Resource’, as is most appropriate to the use case
    • usage of dose syntax to transfer the amount of medication per dose as a simple coded quantity
    • transferring allergy / intolerance information, using SNOMED CT and dm+d codes

    NHS and social care organisations will need to be compliant with the standard by 31 March 2023.

    You can view the standard via this link.

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    New Dictionary of Medicines and Devices (dm+d) e-learning Programme

    A new e-learning resource has been created to help explain what the dm+d standard is, the benefits of using it, and how dm+d can be implemented in secondary care, including hospitals, clinics and community care settings across England.

    The animated e-learning sessions aim to unlock safer care by covering key areas related to the dm+d standard.

    1. What is dm+d?
    2. Why you should adopt the dm+d standard
    3. How to adopt the dm+d standard

    Each of the sessions takes approximately 25 minutes to complete and contributes to your continuing professional development. A certificate can be downloaded on completion of each session.

    The e-learning content can be accessed on the elearning for healthcare website.

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    dm+d data now available through a web API

    dm+d, the standard dictionary of codes, descriptions and metadata for medicines and devices used across the NHS, is now available in the NHS Digital Terminology Server.

    This means that you can query the most up-to-date data from the dictionary (and seven weeks of historical data) through the Terminology Server’s web API. The old method of downloading XML files from the Technology Reference Update Distribution (TRUD) is still available.

    We plan to add Global Trade Item Numbers (GTINs, the numbers used on barcodes) and information about ingredient strength for multi-ingredient products in April 2022.

    Please see our guidance for software developers to find out how to integrate your system with the Terminology Server.

     

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    Terminology and Classifications Service Improvement Plan

    Details of our service improvement commitments – along with updates about our progress against them – can be found via this link.

     

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    Have your say

    If you would like more information about any aspect of our products or services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the Subject field and providing details of what you would like us to cover.

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    By Katy Park 3 months ago

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  • Terminology and Classifications Delivery Service external newsletter: September 2021

    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the September 2021 newsletter. In this issue, we feature:

    OPCS-4.10 Release Roadmap and extension of submission deadline.

    The OPCS-4 Release Roadmap has now been published. The roadmap provides information about key milestones for the release and indicates which dates are confirmed and which are subject to change.

    The deadline for submission of requests has been extended. Requests for content to be included in the OPCS-4.10 release must now be submitted via the Request Submission Portal by 1 December 2021.

    Please ensure that you submit requests correctly using the submission guidelines which are available on the Portal.

    The OPCS-4.10 datafiles will be published in October 2022 for implementation on 1 April 2023.

    SNOMED CT implementation - information and guidance

    We currently provide a range of information, guidance and support relating to SNOMED CT implementation, which can be accessed via this link.

    Information about the SNOMED CT Implementation Forum can be accessed via this link.

    These resources are designed for the whole NHS, rather than tailored to any specific care setting.

    If you would like to receive additional information or resources on any other areas related to SNOMED CT implementation, please contact us by emailing: snomed.implementation@nhs.net.

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    Updated "SNOMED CT UK Edition: Governance and Change Request Process" guidance

    We have recently updated the "SNOMED CT UK Edition: Governance and Change Request Process” guidance. The new version can be found within the “Requesting changes” section of the SNOMED CT area on Delen , or via this link to the SNOMED CT Request Submission Portal.

    The revised guidance aims to clarify the criteria and minimum requirements for new or change requests. We are asking requestors to familiarise themselves with the guidance so they understand how to provide as much evidence – and justification – as possible within their initial submissions, to assist the process. The clinical authoring team’s role is to review 

    submissions to evaluate their suitability for authoring and modelling in the SNOMED CT UK Edition, rather than to actively seek evidence to support the request. This underlines the importance of requestors submitting well-researched and comprehensive requests.

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    NHS Digital receives approval for the Pathology Information Standards

    The Pathology team at NHS Digital are delighted to announce the approval of the Pathology Information Standards by the Data Alliance Partnership Board (DAPB). 

    As part of NHS England’s CCIO7 workstreams, NHS Digital is delivering the future standard for sharing pathology data across health and care. This is a significant milestone in delivering the future of pathology and improving patient care.  

    We would like to thank everyone who has contributed to the development of the Pathology Information Standards, both internally, within NHS Digital, and externally, without whose input and guidance the approval of our standards would not have been possible. Although our contributors are too numerous to mention, we would like to give special thanks to our strategic partners as part of the wider NHS family, our governance boards, the Professional Records Standards Body (PRSB), the royal colleges and all of our stakeholders, including national user group members, who have lent us their time and subject matter expertise.

    To meet future NHS needs for interoperability and secondary care use within the pathology domain, three inter-related specifications have been identified based on relevant component parts of international standards, namely:

    Unified Test List (UTL) – a national catalogue of pathology test requests and results to replace the Pathology Bounded Code List (PBCL), based on SNOMED CT

    Units of Measure (UoM) – an unambiguous representation of commonly used units, aligned with the UTL, based on Unified Code for Units of Measure (UCUM)

    Pathology Message Specification – for interoperable data exchange of pathology information, based on Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) 

    Together, as an information standard, they enable the future communication and exchange of tests, results, quantities, and units used in the pathology domain across the NHS. The full standard is intended for use within laboratories, secondary care and social care (where applicable), GP systems, LIMS, order communications, pathology middleware and clinical research.

    The Information Standards Notice and supporting documentation can be found via this link  and the full announcement can be viewed on the “Latest news” area of the NHS Digital website.

    For further information about our work, please visit the Pathology information standards collaborative workspace

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    Terminology and Classifications Delivery Service – annual customer survey report

    For several years, we have held an annual customer survey to seek feedback about our products and services and to gain an understanding of the ways in which we can improve. We planned to open last year’s survey in April 2020 but delayed the launch due to the effects of COVID-19 on the professional lives of so many of our customers. We continued to monitor the situation, went live in December 2020 and kept the survey open until 31 March 2021 to give customers more time to respond in light of the impact of the pandemic. We have produced a report of the survey results, which can be accessed via this link.

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    By Claire Fennell 9 months ago

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  • Terminology and Classifications Delivery Service external newsletter: June 2021

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the June 2021 Newsletter. In this issue, we feature:

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    OPCS-4.9 development

    This is a reminder that, subject to approval by the Data Alliance Partnership Board, OPCS-4.10 will be scheduled for release to systems suppliers in October 2022, for NHS implementation on 1 April 2023.

    Change requests to be considered for inclusion in the OPCS-4.10 release, must be submitted via the Request Submission Portal by 1 October 2021. Please submit your requests as early as possible, so that we can carry out the necessary research and engagement.

    When you visit the Request Submission Portal, please take a moment to review the OPCS-4 requests that have already been submitted before submitting your own, in case your request is covered by an existing one.

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    Normal’ training service resumed?

    On 19 May 2021, the Clinical Classifications training team delivered the first face-to-face event since having to abandon the Train the Trainer Course as the first official lockdown was about to be announced in March 2020. The event was the Clinical Coding Auditor Programme (CCAP) Assessment Day – a real test of face-to-face contact, after all this time with 42 participants. It was a very surreal experience for everyone and the additional precautions put in place to ensure everyone’s safety on the day were considerable, including visiting the venue to assess safety precautions prior to the assessment day, having four smaller groups instead of three, quarantining assessment papers before and after the event, placing them in individual envelopes and assessment day packs for each candidate to minimise any contact on the day, directing candidates straight to their seats instead of the usual ‘meet and greet’ process, wearing masks (and gloves / hand sanitisers for the facilitators) all day which reduced the ability to have more relaxing conversations with people. Everyone did their utmost to maintain the 1-2m social distancing rules throughout the day. Even getting back on public transport was a renewed and daunting experience for some. You could say that a stressful day at the best of times was even more challenging for everyone. We would like to express our sincere thanks to all the CCAP assessment day candidates for their cooperation throughout the day. We have now also held the corresponding Trainer Assessment Day and our trainers look forward to being able to deliver the planned Auditor Workshops and Train the Trainer courses in a classroom environment throughout the rest of 2021/22. We will, however, continue enhancing our online delivery skills and use of online platforms with planned  online delivery of our Trainer Refresher courses and Trainer Forums to further assess how these events work in an online format. We hope the return to face to face training can continue, where appropriate, as we feel it still has a very important role for training of clinical coders in the post-pandemic world!

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      Changes to 2021/22 SNOMED CT 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, and both enhance and grow our team.

    The following approach has been introduced:

    • pause SNOMED CT International Edition uplifts (effective immediately following the May 2021 major release) until further notice (for a minimum of 12 months)
    • reduce the frequency of the SNOMED UK Clinical Edition updates for UK clinical content. the next releases will be: 14 July 2021, 6 October 2021, 1 December 2021, 23 February 2022
    • phase SNOMED CT content / backlog requests across releases planned in 2021 and 2022; the Request Submission Portal remains open 24/7
    • prioritise maintenance of key clinical terminology reference sets which may also mean new developments are put on hold

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

    There are no changes to the SNOMED CT UK Drug Extension release schedule. The SNOMED CT Release Schedule is published on Delen.

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    SNOMED CT Forum

    Following a pause in 2020, the SNOMED Implementation forum has now been reinstated. The decision to pause the forum reflected the:
     

    • significant COVID-19 pressures faced by forum members e.g. NHS staff and system suppliers, as well as by NHS Digital terminology and implementation teams
    • new communication pathways we adopted to allow us to work directly with key stakeholders to manage publication of purely COVID-related content, making us less reliant on the forum at that time.

    As COVID pressures have eased to a degree, we felt that it was appropriate to relaunch the forum, which we plan to use for consultation and dialogue, to ensure that we develop a deeper understanding of our target audience and their requirements.

    We are currently looking at ways to make the forum as effective as possible and of making the most of the huge expertise and specialist knowledge among forum members. We will work with the Terminology and Classifications Delivery Service and with our forum colleagues over the coming weeks to help with this. If you have any thoughts or suggestions or would like to receive an invitation to the next scheduled event, please email SNOMED.Implementation@nhs.net

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    National Interim Clinical Imaging Procedure (NICIP) code set

    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.

    If you have any questions, please contact the Information Standards Service Desk at information.standards@nhs.net

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    Terminology and Classifications Delivery Service - annual customer survey

    Following deferred publication to reflect the pressures of COVID-19, our most recent survey ran from 16 December 2020 to 31 March 2022 and we received 57 responses.  This represents just 26% of the 219 responses we received in 2019.  It seems likely that the pandemic directly and / or indirectly affected the survey response rate. We are very grateful to all who participated and are currently reviewing both the numerical ratings and the in-depth comments and considering how best to use the survey feedback. We will provide a further update shortly.

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    Have your say

    If you would like more information about any aspect of our products and services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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    By Claire Fennell 12 months ago

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  • Terminology and Classifications Delivery Service external newsletter: March 2021

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the March 2021 Newsletter. In this issue, we feature:

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    The NHS Digital Terminology Server

    The NHS Digital Terminology Server is a FHIR®-compliant solution that holds and disseminates assured international terminologies and classifications (such as SNOMED-CT and ICD-10) and national terminologies (such as NHS Data Model and Dictionary codes).

    We have developed the NHS Digital Terminology Server to deliver assured content in FHIR®-compliant, machine-readable formats, regardless of which terminology is being accessed. The accuracy of the content is maintained through tightly managed editorial controls. This will remove the need to manually update systems with downloaded content from TRUD and other terminology sites.

    The server also incorporates a syndication feed (API) which enables content to be syndicated across a group of terminology servers, allowing users to share their terminologies with others.

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    2021-22 SNOMED CT UK Edition Release Schedule

    Details of the 2021-22 release can be found here.

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     OPCS-4.9 Development

    The process to update OPCS-4.9 has begun and we anticipate that, subject to approval by the Data Alliance Partnership Board) OPCS-4.10 will be scheduled for release to systems suppliers in November 2022, for NHS implementation on 1 April 2023. If you would like to submit a change to be considered for inclusion in the OPCS-4.10 release, please do this via the Request Submission Portal by 1 October 2021. We intend to process requests as they are received and would appreciate early submissions, so that we can carry out the necessary research and engagement as soon as possible, rather than wait until after the submission deadline.

    When you visit the Request Submission Portal, please take a moment to review the OPCS-4 requests that have already been submitted before submitting your own, in case your request is covered by an existing one.

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    COVID-19 Codes and Clinical Coding Standards

    The diagram below shows the emergency use ICD-10 codes designated for coding of COVID-19 conditions for use in the UK:

    ICD-10 COVID-19 graphic UK NHS Digital

    In February 2021, we published two new emergency use ICD-10 codes for morbidity coding under the direction of the World Health Organization, to classify:

    U07.6 Need for immunization against COVID-19

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    U07.7 COVID-19 vaccines causing adverse effects in therapeutic use

    The COVID-19 National Clinical Coding Standards section ‘Post COVID-19 condition (U07.4)’ was also updated to ensure that - in a long episode of care where acute COVID-19 and a subsequent post COVID-19 condition are both recorded - these can be coded.

    In response to feedback from the coding service, the following changes were made to the COVID-19 National Clinical Coding Standards for implementation from 1 April 2021:

    • minor textual changes to provide clarity on instructions within the standards
    • deletion of standards associated with routine testing as this has now become standard practice on hospital admissions
    • additional examples to illustrate the use of the COVID-19 emergency use codes
    • publication of the COVID-19 standards in a downloadable format
    • inclusion of an implementation timeline for the COVID-19 codes and a Summary of Changes for the coding standards and guidance

    As more information emerges about COVID-19 and where changes to the COVID-19 standards or guidance are necessary, Delen and the COVID-19 National Clinical Coding Standards will be updated.

    We would like to thank those of you who have sent in information and queries about the coding of COVID-19 and the standards; these have allowed us to understand new and arising COVID-19 situations that need to be reflected in the clinical coding standards and guidance.

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    Coding Clinic release

    Following collaboration with clinical representatives of the NHS England Mesh Registry sub-group, we have developed a guidance table for inclusion in the April 2021 Coding Clinic to assist coders in the coding of procedures performed for female Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) that are not easily reached using the OPCS-4 Alphabetical Index. For more information, please refer to Ref 121: Procedures performed for female pelvic organ prolapse and stress urinary incontinence in the Coding Clinic, which you can read here.

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    Terminology and Classifications Delivery Service Annual Customer Survey – final call for responses

    We would like to thank everyone who has already responded to the survey and to remind anyone who hasn’t yet done so that the survey closes on 31 March. Your feedback helps us understand how useful our products and services are, as well as where we should aim to make improvements. Please try to find time to respond to our annual customer survey.

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    Have your say

    If you would like more information about any aspect of our products and services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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    By Claire Fennell 1 year ago

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  • Terminology and Classifications Delivery Service Newsletter: June 2020

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the June 2020 Newsletter. In this issue, we feature:

     

     

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    COVID-19 SNAP updates

    Our bi-weekly SNAP updates provide a summary of the activity relating to COVID-19 in relation to our Terminology and Classifications products, featuring the following:

    • Resources available
    • Classifications ICD-10 and OPCS-4
    • Pathology Tests and Results
    • SNOMED CT Clinical and Drug Extensions

    If you would like to subscribe to future SNAP updates, please email COVID19information.standards@nhs.net

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    COVID-19 & ICD-10 Classification

    In March, we launched a dedicated COVID-19 area on Delen to provide COVID-19 information from the World Health Organisation, information on the classification of COVID-19 in ICD-10 and a single authoritative location for COVID-19 national clinical coding standards for Admitted Patient Care in England.

    Coders must use the COVID-19 National Clinical Coding Standards and Guidance page on Delen in preference to DCS.XXII.5 within the ICD-10 Reference book 2020.

    We are continually reviewing the standards and guidance and will continue to update these pages as the pandemic progresses. These reviews will reflect the developing clinical knowledge of the condition, recurring issues and problems identified from helpdesk resolutions and any changes provided to us by WHO. We are working at pace to ensure the standards reflect current clinical knowledge and practice and to support the coding community, so that coders have the most up to date information to aid accurate and timely coding.

    We have taken a different approach from usual to the communication of the coding standards for COVID-19 by publishing them directly on Delen so that they are easily accessible to all and can be amended at short notice if required. The evolving nature of the pandemic, has meant that we have had to make amendments to the COVID-19 standards at a much shorter interval than would be expected. In some cases, the COVID-19 standards have contradicted existing clinical coding standards and we have received feedback that the new COVID-19 standards do not align. However, because of the exceptional nature of the pandemic, this has been necessary to ensure that current and future analysis of the pandemic in an admitted patient care setting is accurate, meaningful, and complete. We can also assure you that the standards we have released align with the advice and information we have received from the WHO.

    We have seen a large increase in queries related to COVID-19 and continue to prioritise both their resolution and publication on the Query Resolution Database. Please continue to send us COVID-19 related queries, along with supporting documentation, as they inform the current standards and guidance. However, please ensure that you have searched the Query Resolution Database before sending a query, to check whether it has already been addressed. This will help us to manage resolution response times.

    We realise that it has been a difficult time for coders working in Trusts and are aware of the changes you have had to make to your working practices and the difficulties you have had in accessing local information. We would like to thank those of you who have sent in information and queries about the coding of COVID-19 and for raising issues and asking questions about the standards as these have allowed us to understand what new and arising COVID-19 situations need to be reflected in the standards and guidance.

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    SNOMED CT News

    A further interim release of the UK SNOMED CT Clinical Release Edition is scheduled for 17 June. Further information about new SNOMED CT Concepts, including the metadata concepts for simple map reference sets, needed for filing pathology results into Primary Care systems can be found in the 05 June SNAP update.

    A consultation on the release timetable and content for the remainder of the 2020 calendar has now closed and the outcomes will be published in our Consultation area on Delen.

    NHS Digital continues to work with the Professional Records Standard body (PRSB) to raise awareness of the SNOMED CT response to COVID-19 and to gather, coordinate and prioritise multi-professional input into new content requests.  Further information can be found by visiting the COVID-19 Information Standards page and the PRSB FAQ page.

    Our SNOMED CT Terminology Releases page on Delen provides information about:

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

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    2020/21 Classifications Training Schedule update

    Following our previous update published on Delen in March 2020, we recognise that we won’t be able to compress a full year’s delivery schedule into six months. We have updated our 2020/21 training schedule, which will remain subject to possible revision based on government guidance and social distancing restrictions due to the COVID-19 pandemic.

    The five ‘Introduction to Classifications’ events for trainers are planned to go ahead during September and November – approved trainers should refer to the Approved Trainer Workspace for further information.

    Regrettably, we have cancelled the Clinical Coding Auditor and Clinical Coding Trainer Programme Assessment Days and associated courses for this financial year as we have to remain vigilant and mindful about the potential social distancing logistics hosting these programmes would cause due to the high number of applicants involved. We appreciate that cancelling these two programmes is not ideal and will be a huge disappointment to those candidates who had submitted successful applications. Further information relating to the cancellation of these programmes can be found on Delen

    We will post further updates on Delen as and when required and always in line with the latest government guidance and social distancing criteria.

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    Clinical Coding Training Programme & Clinical Coding Auditor Programme Framework Consultation

    Our consultation describes how elements of the Clinical Coding Auditor Programme, and Clinical Coding Trainer Programme frameworks can be adapted or expanded to make the requirements framework more robust.

    We would appreciate your comments on this proposal, which is open for feedback until 30 June 2020.

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    Classifications Query Resolution Form

    For all classifications-related queries, please use the new Query Resolution form which is available on the Clinical Coding Query Mechanism page.

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    NHS Digital Classifications Browser

    The NHS Digital Classifications Browser was updated in March to include the OPCS-4.9 Classification, National Clinical Coding Standards for ICD-10 and OPCS-4 2020 and Chemotherapy Regimens Clinical Coding Standards and Guidance 2020. The links within the OPCS-4.9 Classification go directly to the National Clinical Coding Standards OPCS-4 2020. You can now access OPCS-4.8 and OPCS-4.9 in the Browser.

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    OPCS-4.9 eVersion & National Clinical Coding Standards Guidance

    For those who continue to use the eVersions, the OPCS-4.9 eVersion Book and National Clinical Coding Standards (NCCS) reference book (2020) are available to download from TRUD.

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    Chemotherapy Regimens Clinical Coding Standards Guidance

    The Chemotherapy Regimens Clinical Coding Standards and Guidance April 2017 were updated, for use from 1 April 2020, to remove any reference to the use of high cost drugs to align with the changes made to the High Cost Drugs Clinical Coding Standards. The chemotherapy Procurement and Delivery codes (X70-X74) have not changed in OPCS-4.9 and the regimens list 17-18 remains the same. Coders must continue to code chemotherapy regimens using the OPCS-4 classification codes, Clinical Coding Standards and Guidance and the 17-18 regimens list from April 2020.

    We previously advised that the April 2017 standards and regimens would be the last planned update to the regimen list by NHS England and Improvement in this format, as they were working on a revised approach to capturing information about chemotherapy delivery mechanisms and generating appropriate reimbursement ready for implementation in 2019/20. This revised approach is still being agreed and the collection of OPCS-4 codes for chemotherapy are still required.

    We will communicate further when the revised approach has been agreed and the effect on OPCS-4 codes and standards is known.

    The Chemotherapy Regimens Clinical Coding Standards and Guidance 2020 and the Regimens List 17-18 are available from Delen and the Classifications Browser.

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    March & September 2020 NCCQ Examinations - COVID-19

    Due to the current situation regarding the COVID-19 precautions, IHRIM announced the cancellation of the March 2020 and more recently the September 2020 National Clinical Coding Qualification (UK) Examinations. Further details can be found on the IHRIM website.

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    National Clinical Coding Standards ICD-10 & OPCS-4 Reference Books (2020)

    In February, we published the National Clinical Coding Standards ICD-10 and OPCS-4 reference books for use from 01 April 2020, the OPCS-4.9 Supplementary Information and OPCS-4.9 Key Learning Points on the Publications & Resources page.

    Following the initial release of the reference books, they were both updated in March with minor alterations:

    ICD-10 Reference Book (2020)

    The clinical coding standard DCS.XXII.5: Novel Coronavirus (2019-nCoV) (U07.1) was updated to DCS.XXII.5: COVID-19 (U07.1) to reflect the change to the name designated by WHO.  Although there was no change to the coding instruction for hospital providers, additional guidance was provided, however coders must use the COVID-19 National Clinical Coding Standards and Guidance page on Delen in preference to DCS.XXII.5 within the reference book.

    OPCS-4 Reference Book (2020)

    PCSX24: High Cost Drugs (X81 – X98) was updated following feedback from the National Casemix Office to make it clear that X90.4 Intravenous nutrition Band 1 must be assigned once on every episode that a patient receives parenteral nutrition.

    Only the updated versions are available on Delen and from the Classifications Browser and eVersion books for download from TRUD.

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    Have your say

    If you would like more information about any aspect of our products and services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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  • Terminology and Classifications Delivery Service Newsletter: January 2020

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the January 2020 Newsletter. In this issue, we feature: 

     

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    NHS Digital Classifications Browser

    The NHS Digital Classifications Browser is now available at https://classbrowser.nhs.uk/.

    The Browser contains the OPCS-4 Classification of Interventions and Procedures version 4.8 (OPCS-4.8).  It allows you to search and browse the classification online and offers the following benefits and improvements on the eVersion:

    • Accessible from any computer with an internet connection
    • Content is automatically updated with the latest OPCS-4 triennial release e.g. OPCS-4.9, without users having to download new content files etc.
    • Contains links to the National Clinical Coding Standards that are updated automatically with the annual release of the coding standards
      • Coders in Northern Ireland, Scotland and Wales can access their respective standards via the links in the Resources page
    • Powerful search facility which includes: search history, search filter, wildcard search and fuzzy match, search help and a clear display of where results are located in the Classification with the ability to minimise and maximise search results
    • Ability to add browser bookmarks and favourites to chapters, categories and codes
    • Resources page with links to other useful Classification publications and a list of intended enhancements.

    OPCS-4.9 content will be available in the browser shortly.

    The next phase of development will include the ability to create and share notes and include ICD-10 content (subject to World Health Organization agreement).

    The Classifications Browser will, eventually, replace the NHS Digital eVersion when the same or improved functionality (including the creation and sharing of notes) and content (OPCS-4 and ICD-10) is available. In the meantime you can still download the eVersion from TRUD and OPCS-4.9 content will be available for download from TRUD to load into the eViewer application shortly.

    We hope you find the Classifications Browser useful; if you have any feedback on the Browser please send it to us using the “Contact us” link on the homepage.

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    Delen Refresh

    We’re pleased to announce that the Delen site has entered the new year with a brand-new look and structure.

    The site has been redesigned to better reflect our core products and the services that we provide, to make it easier for our users to find the information that they’re looking for, quickly.

    Below is a brief summary of the additions and changes we’ve made:

    Summary of changes

    • The colour of the main interface has changed to give the site a cleaner, fresher look
    • The navigation images on the homepage have been modernised and we’ve added links to:
    • SNOMED CT, dm+d, ICD-10, OPCS-4, NICIP
    • SNOMED CT to Classification Maps
    • ICD-11 evaluation
    • Education & e-Learning materials
    • Past and present consultations – to gain input from our users to help us make better decisions and help us understand the priorities of our stakeholders
    • Support and advice – to provide guidance for users with specific queries
    • Our Service Improvement Plan – to indicate progress against our commitments agreed within our Annual Survey
    • Popular publications and education materials have been added onto our product pages, with the aim that everything our users need is in one place  
    • The latest news has been condensed so that users can see – at a glance – the top ten latest articles, categorised by publication date

    Although this is a major refresh, we are committed to continuous improvement, so please use the contact us link on the homepage to let us know how we can make Delen even better.

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    OPCS-4.9 update

    Publication of OPCS-4.9 Information Standards Notice

    Acting under delegated authority from the Secretary of State for Health and Social Care, the Data Coordination Board (DCB) approved the OPCS Classification of Interventions and Procedures Version 4.9 (OPCS-4.9) for publication under Section 250 of the Health and Social Care Act 2012.

    The Information Standards Notice (ISN) describes the mandate for NHS implementation on 1 April 2020.

    OPCS-4 information and resources, including guidance for trusts on preparing for implementation of OPCS-4.9 is available on our OPCS-4 page.

    Publication of OPCS-4.9 Systems Data Files

    The OPCS-4.9 Systems Data files and specifications (including XML format), to support OPCS-4.9 implementation on 1 April 2020, are available to download from TRUD, subject to registration and acceptance of the Licence Agreement.

    The data files are designed for NHS information departments and / or NHS system suppliers to upload into systems. They are not designed or intended for training purposes.

    OPCS-4.9 Classification Volumes I and II in printed format

    OPCS-4.9 will be available in the NHS Digital Classifications Browser shortly, but for those who still wish to use OPCS-4.9 printed volumes, information on how to order these from The Stationery Office (TSO) is available on our OPCS-4 page.

    Summary of Changes from OPCS-4.8 to OPCS-4.9

    An updated version of the Summary of Changes from OPCS-4.8 to OPCS-4.9 – including details of three changes that were omitted from the original version - was issued at the end of November. 

    The updated Summary of Changes document is available on Delen and in the key documents published with the ISN.

    A dedicated OPCS-4.9 presentation slide deck and associated exercise and answer booklets will be available on the Approved Trainer and Clinical Coding Manager workspaces by end of January 2020.

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    ICD-11 Chapter Reviews

    As part of our ICD-11 evaluation we are inviting a clinical review of ICD-11 content by chapter to help identify if there are any:

    • diagnoses or conditions that are missing but important to include
    • code descriptions which are ambiguous or incorrect

    The World Health Assembly adopted ICD-11 in May 2019 with the expectation that member states will start to report in ICD-11 from January 2022 as detailed in the World Health Organization resolution.  The implementation roadmap for the UK has yet to be determined and no decision has been made on the implementation date of ICD-11 for morbidity coding in England. 

    The chapter reviews will form part of content review along with other research and evaluation that would be necessary for the transition from ICD-10 to ICD-11.

    Our dedicated ICD-11 Chapter Reviews page includes instructions on how to complete the chapter reviews and an overview of the ICD-11 chapters. The overview contains information that clinicians may find useful about each chapter, including what is classified within each chapter; a comparison between ICD-10 and ICD-11 block structure; chapter structure and rationale. At the end of the review, there is the opportunity to submit proposed changes to NHS Digital.

    Please feel free to forward this information to clinicians who may not see this newsletter and who might be interested in taking part.

    The ICD-11 Chapter reviews can be accessed on Delen.

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    National Interim Clinical Imaging Procedures code set (NICIP) - update to release schedule

    The next release of the NICIP code set will be on 1 April 2020.  However, due to new tooling development and scheduling, we are currently unable to add new NICIP short codes and descriptions.  The SNOMED CT and OPCS maps in the release files will be updated to their most current version.

    The new platform development is underway and will be delivered to enable new NICIP content to be added for the October 2020 release, along with an increased number of one-to-one maps from NICIP to SNOMED CT.

    The impact of this is that requests received for new NICIP content anticipated to be available for April 2020 will not be available until October 2020. 

    We apologise for this alteration to our normal service. 

    For further information or queries, please contact information.standards@nhs.net

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    SNOMED CT in Mental Health

    SNOMED CT Resources checklist

    The SNOMED CT in Mental Health team has developed a one-page Resources checklist to highlight useful documents in the implementation of SNOMED CT. The document links directly to some introductory resources and training which you can cascade to relevant stakeholders.

    Webinars

    Sign-up to one of our monthly, live webinars to gain a basic understanding of how SNOMED CT is used in Mental Health. These sessions also illustrate how to use the NHS Digital browser to quickly find terms that you can use in templates to match to your local codes.

    CQUIN payments: submitting SNOMED CT to the Mental Health Services Dataset (MHSDS)

    NHS England and NHS Digital are running a number of webinars to illustrate how to identify appropriate SNOMED CT codes to submit to the MHSDS in order to be eligible for CQUIN payment. You can book onto a webinar via our SNOMED CT in Mental Health page.

    Training Animations

    A number of training animations have been developed and are available on the SNOMED CT in Mental Health Education and Training page.

    Technical Resources

    A library of useful resources is available on the SNOMED CT in Mental Health page, including a range of training materials, guidance documents and an interactive forum where members can raise questions and contribute to discussions.

    Note: Although these documents have been developed for the implementation of SNOMED CT in Mental Health, they may still be of interest across wider healthcare services.

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    SNOMED CT Request Submission Portal (RSP) Requests

    Migration to a new terminology tooling platform, the subsequent deferment in 2019 of taking the SNOMED International releases for January 2019 and July 2019 and compacted timescales for authoring will result in a reduced capacity to add new SNOMED CT content.  Requests from National Programmes and bodies have therefore been prioritised.  The impact of this is that requests received via the SNOMED CT RSP anticipated to be available for April 2020 will not be available until October 2020. 

    We apologise for this alteration to our normal service.

    For further information or queries please contact information.standards@nhs.net

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    Product Support Helpdesk

    In 2019, we announced some important clarifications around the scope of the Product Support Helpdesk. To support the guidance for coding professionals, we have updated the Coding Query Mechanism and provided further information about what happens to your query once we receive it.

    Despite the clarification of the scope, we still receive queries that we consider to be out of scope of the helpdesk, and these are consequently rejected. If you are in any doubt as to whether your query is considered in scope, please refer to the Clinical Coding Query Mechanism for advice on how to resolve your query locally.

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    2019 Annual Survey and Service Improvement Plan

    Your feedback is very important to us and we appreciate the time spent completing our annual survey. By providing us with your views, it helps us to improve our services and products.

    We received a number of survey comments and feedback relating to the National Clinical Coding Standards reference books, and we wanted to address these points to reiterate the use of the Clinical Coding and describe some of the improvements we will be making.

    Our Service Improvement Plan (SIP) reflects our commitments in response to annual survey input and other customer feedback and we have now incorporated a number of new initiatives. Actions which we have completed have now been removed from the SIP and but can be accessed via a link within the Plan.

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    Publication of Draft 2020/21 Training Schedule

    We are pleased to announce the draft training schedule of planned dates for our 2020/21 training events.

    The draft has been published to allow you to provisionally book potential dates in your diary, but these may be subject to change depending on logistical considerations.

    The final training schedule confirming venues and prices will be published on Delen at the end of January.

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    Have your say

    If you would like more information about any aspect of our products and services, please let us know. Just write to use at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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  • Terminology and Classifications Delivery Service Newsletter: August 2019

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the August Newsletter. In this issue, we feature:

     

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    Annual customer survey

    The Terminology and Classifications Delivery Service annual customer survey ran from 20 March to 17 May 2019 and we were delighted to receive 219 responses, many of which included constructive and very useful narrative comments. We are analysing the comments and intend to produce a service improvement plan which will be hosted on Delen, then maintained to reflect progress against our commitments. Our survey report summarises statistical responses and provides commentary about the feedback we received. Thank you to all who responded to the survey. 

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    Delen Refresh

    Following beta testing, our refreshed Delen site went live at the beginning of May.

    Thank you to everyone who took time to provide feedback on the design. We are particularly grateful to those of you with additional needs who provided detailed advice to help us build Delen in a way that works well for you. Feedback has been overwhelmingly positive and entirely constructive, and we hope the revised site meets your needs.

    Below is a brief summary of the changes we’ve made:

    • Fewer Navigational Layers

    By using some new features, such as carousels and accordions, we are able to place a large amount of information on a single page without making the page look cluttered or dense. This allows you to see at a glance a broad set of information topics and then reveal the detail under those that interest you. Our hope is that this will help you get to the information you need as quickly as possible, reducing the need to chase information through layers of pages and navigate back and forth.

    • Improved Accessibility

    We’ve designed Delen in a way that we hope provides a good experience for all of our users with additional accessibility needs. The interface has been kept clean and simple and all graphical elements have supporting text that can be processed by screen readers and other accessibility tools. For autistic and neuro-diverse users, we have ensured navigation mechanisms are consistent and have removed “busy” and moving content.

    • Promoting content

    As well as making Delen easier to navigate, we have also brought the content that our users access most frequently to the front of the site. This means you will find the Query Resolution Database and Read to SNOMED CT mapping tables on the landing page, along with our latest news items. We have also tried to make the network of Delen workspaces more visible, so that you can see all the workspaces and what each workspace is for and request access where appropriate.

    Although this is a major refresh, we are committed to continuous improvement, so please use the feedback mechanism on the new site to let us know how we can make Delen even better.

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    SNOMED CT in Mental Health Webinars

    Adoption of SNOMED CT in mental health systems and provider organisations is to be undertaken by April 2020. Data submitted to the Mental Health Services Data Set has been acceptable in SNOMED CT since 2016 and is to be provided in SNOMED CT by, at the latest, 2020.

    A collaborative project within NHS Digital is coordinating activity to achieve SNOMED CT adoption. For those unfamiliar with SNOMED CT, we are running monthly “Introduction to SNOMED CT for Mental Health” webinars.

    This webinar provides a basic understanding of SNOMED CT for Mental Health and it illustrates how to use a browser to find terms. The session covers different ways of searching and understanding our four key hierarchies.

    You may also be interested in the workbook (and associated answers) that provides short exercises to help you practice what the webinar covers.

    The main themes covered in the webinars are:

    • What is SNOMED CT?
    • Why SNOMED CT?
    • Brief overview of SNOMED CT fundamentals
    • SNOMED CT Content – Using Browser
    • Classifications and SNOMED CT
    • Subsets (Refsets)
    • Useful Information on SNOMED CT

    There will also be an opportunity to ask questions.

    You can register for one of our webinars by visiting the Education and Training area of our SNOMED CT in Mental Health Delen workspace.

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    Auditor e-Assessment Tool

    The Auditor e-Assessment Tool has been designed to replace the former one-day Auditor Refresher Workshop following service feedback that the workshop involved too much time and expense for little benefit.

    The Classifications Training team and a member of the Business Management Team (BMT) designed the Tool to refresh the practical skills and theoretical knowledge of all approved clinical coding auditors. It comprises two modules:

    • Module 1 tests an auditor’s ongoing error key assignment skills and has a pass mark of 95%
    • Module 2 tests an auditor’s ongoing understanding of the Clinical Coding Audit Methodology, the Clinical Coding Auditor Requirements Framework, the Data Security Protection Toolkit Data Standard 1 in respect of clinical coding audit, GDPR and Data Protection and has a pass mark of 90%.

    As part of the development, we asked all approved clinical coding auditors to upload five anonymised clinical coding audit worksheets across all specialties to a dedicated area on our Approved Clinical Coding Audit Workspace for us to review, update and use to populate Module 1 of the e-Assessment. We drafted a number of theory-based audit questions in multiple formats to populate Module 2. We also established a dedicated Auditor Sub-Group to test the Tool and modules at various stages of development. Feedback from this Sub-Group informed several changes before it was demonstrated at the four Auditor Forums held during March 2019 where further feedback was taken and actioned by the BMT before going live.

    The Auditor e-Assessment went ‘live’ on the IT Skills Pathway LMS platform on 1 April 2019 and will be completed by all 227 approved clinical coding auditors at a time that’s convenient to them before 31 March 2020 as part of their ongoing Continuing Professional Development. To date 121 approved auditors have registered to access the Tool and 88 have successfully completed both modules. We will continue to take feedback throughout 2019/20 ready to inform v2.0.

    We’re confident that this Tool will help support an auditor’s ongoing CPD and will be an excellent mechanism for ensuring that the clinical coding audit methodology is applied correctly and consistently across the service supporting high quality audits of coded clinical data over the coming years.

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    ISO9001: 2015 Certification

    Following a Surveillance visit by Certification Europe in March 2019, Terminology and Classifications have maintained our ISO9001: 2015 certification. The audit involves an inspection of our processes, quality assurance, stakeholder engagement, leadership and governance.

    This is an excellent reflection of the hard work and dedication of the team and our commitment to the continual improvement of our operations, taking into account feedback from our customers.

    We will continue to work hard to improve in all areas and to prepare for a surveillance visit in September and a full external audit in February 2020. 

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    World Health Assembly endorsement of ICD-11

    The World Health Organization announced the outcome of the World Health Assembly meeting at which Member States agreed on 25 May 2019 to adopt the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), to come into effect on 1 January 2022.

    NHS Digital is the UK WHO-Family of International Classifications Collaborating Centre (in partnership with the Office of National Statistics) and the classifications team worked closely with WHO through the WHO-FIC Network over the past four years to field test ICD-11 using the WHO ICD fit platform (our initial field trial findings were published on Delen) as well as participation in various WHO-FIC working groups focusing on definitions, morbidity rules, education and training etc. There is still work to do to inform and support implementation.

    ICD-11 is included in the draft Clinical Information Standards framework for England which accompanies the October 2018 Secretary of State policy paper ‘The future of healthcare: our vision for digital, data and technology in health and care’. The draft framework describes plans for the future, indicative roadmap and dependencies.

    The WHO statement included:

    “ICD is the foundation for the identification of health trends and statistics globally, and the international standards for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions.

    The ICD also captures factors influencing health, or external causes of mortality and morbidity, providing a holistic look at every aspect of life that can affect health.

    Understanding what makes people sick, and what eventually kills them, is at the core of mapping disease trends and epidemics, deciding how to programme health services, allocate healthcare spending, and invest in improving therapies and prevention.

    ICD-11 has been updated for the 21st century and reflects critical advances in science and medicine. It can be well integrated with electronic health applications and information systems. This new version is fully electronic, allows more detail to be recorded and is significantly easier to use and to implement, which will lead to fewer mistakes and lower costs, and make the tool much more accessible, particularly for low-resource settings.”

    You can find out more by visiting the WHO website.

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    Have your say

    If you would like more information about any aspect of our products or services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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    By Katy Park 2 years ago

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  • Request to re-register for Terminology & Classifications Communications

    Published: April 2019

    If you have received an email asking you to re-register for Terminology and Classifications Newsletters, please find time to do so if you wish to continue receiving our communications. From 8 May, our Newsletters will only reach you if you have subscribed via this link.

    We have previously accepted registration through different channels and the new approach will move us to a single, automated process of maintaining our distribution list. If you have previously registered using the above link, you shouldn't have received the email and don't need to take any action.

    We apologise for the inconvenience for those re-registering but the process is simple and should only take a minute or two.

    Kind regards

    Terminology & Classifications Delivery

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    By Katy Park 3 years ago

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  • Terminology and Classifications Delivery Service Newsletter: February 2019

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    Terminology and Classifications Delivery Service Newsletter


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    Welcome to the February Newsletter. In this issue we feature:

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    NHS Digital, Data and Technology Standards Framework

    In October 2018, Secretary of State for Health and Social Care, Matt Hancock, published a policy paper entitled The future of healthcare: our vision for digital, data and technology in health and careThis paper announced that "our ambition should be for the use of the best technology available for the NHS and social care sector". The vision is underpinned by a commitment to the development and use of standards that allow the full potential of modern technology to be put in the service of health and care.

    On the page you will see a number of icons that link to the current draft documents which are structured in a format that allows you to comment on each section and view the comments provided by other reviewers. Please note that although comments are anonymous, they will be visible to anyone who visits the site.

    The Clinical Information Standards Specification focusses specifically on SNOMED CT and the Clinical Classifications ICD-10, ICD-11 and OPCS-4 and we strongly recommend you read this information so that you are aware of the vision for Clinical information standards and provide your comments on the vision.

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    Annual Survey and Service Improvement Plan

    After each customer annual survey, we produce a Service Improvement Plan to address important issues identified in the responses. You can review the commitments within the plan – and the ongoing updates – via this link.

    We are currently finalising the content of our 2019 survey which we expect to go live in March. The survey will be hosted on Delen and we will issue a communication to announce the launch.

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    Delen Refresh

    In our 2018-19 Service Improvement Plan, we committed to making Delen more accessible. Over the next few weeks, we will incorporate a number of significant improvements to both content and structure and these will be contained in "Beta" pages that exist alongside the current pages.

    This will allow you to carry on using the familiar navigation, while also being able to see and become familiar with the developing design. In addition to seeing the work in progress, each Beta page will contain a feedback link, so you can tell us what you like or don't like. 

    We intend to complete the work by the end of March 2019 and switch to the new design on April 1st.

    Our aim is to provide you with a fresh Delen experience that enables you to get to the content you need within two or three clicks and to help you see all that is available across the Delen platform. We hope you enjoy seeing the new pages develop and - if you can spare a few minutes - please do give your feedback on how we're doing.

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    New Delen Workspaces

    We have recently launched two new Delen workspaces to help members of the clinical coding community connect with each other and share information.

    The Mental Health Unification Group provides a dedicated space for Mental Health clinical coders to manage their Unification Group meetings, discuss ideas and share documents.

    The Clinical Coding Managers' Workspace provides a similar place for coding managers across the country to connect with each other, engage in discussions on matters such as professional development, staff training and implementation of coding standards and to share examples of best practice.

    Within the Clinical Coding Managers' Workspace, we are also creating dedicated spaces for regional coding groups, to help manage meetings, reduce email traffic and streamline document reviews and action tracking. We are delighted that our colleagues in the South West Clinical Coding Reference Group have chosen to be early adopters of this functionality.

    The new Workspaces can be reached via the above links but users will need to register first to gain access. To register, follow the above links and 'contact the site owner' to request access.

    Note: Only Clinical Coding Managers and members of the Mental Health Unification Group will be granted access.

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    New Community Database of Clinical Coding Resources 

    One of the reasons for creating Delen was to help our clinical coding colleagues across the NHS to find the information they need to carry out their work. We hope that we have succeeded in making our own materials more accessible, but we would also like to provide a way for you to highlight other resources that you think would be useful to your colleagues.

    In the next few weeks we will launch a new service that will allow you to submit details of websites, documents, services, tools and other resources that you have come across (or even ones you have produced) that you think would be of value to your fellow clinical coders. We will add the details of submitted resources to a searchable database so that people can quickly find and use them.

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    National Clinical Coding Training Material update

    The training team are currently updating the following materials for release to approved clinical coding trainers for use from 1 April 2019:

    • Clinical Coding Standards Course
    • Clinical Coding Standards Refresher Course – a totally new suite of materials for this version
    • NCCQ (UK) Revision Programme

    We will start to issue these documents from the end of February. To speed up the process, we will release course materials as they are ready rather than wait until all course content is available. We will stagger the release to approved clinical coding trainers throughout March.

    We will also update the copyright and version number details for the Mental Health Clinical Coding Standards and Standards Refresher Courses. Please note that the content will be updated during 2019/20 in consultation with the mental health clinical coding community.

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    OPCS-4.9 update

    We are currently developing OPCS-4.9. We have received more than double the number of requests that were received for the update to OPCS-4.8 and many of the requests are very complex.

    The intended implementation date for OPCS-4.9 is 1 April 2020. The list below outlines the provisional dates for release of the OPCS-4.9 deliverables (dates are subject to change):

    Publication of OPCS-4.9 products

    • July 2019

    Draft Summary of Changes published for consultation

    • October 2019

    Information Standards Notice

    Implementation Guidance

    Final Summary of Changes

    • November 2019

    Electronic data files and specifications distributed via the Technology Reference-data Update Distribution Service (TRUD)

    • January 2020

    OPCS-4.8 Online Classification

    OPCS-4.9 Tabular List and Index Manuals via TSO

    OPCS-4.9 National Clinical Coding Standards (NCCS) reference book

    OPCS-4.9 Training materials

    OPCS-4.9 Key Learning Points

    • Mid-March 2020

    Maps from SNOMED CT to OPCS-4.9

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    Publication of National Clinical Coding Standards reference books 2019

    The National Clinical Coding Standards ICD-10 and OPCS-4.8 reference books (2019), for use from 1 April 2019, are now available to download from the Main Publications page on Delen.

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    Classifications Online

    Over the past year, we have been developing an online version of the Classifications to replace the current eVersion. The Classifications Online will bring a number of benefits and improvements on the eVersions. The improved features include:

    • accessibility from any computer with an internet connection
    • no requirement to download or install software
    • fast and effective search facility, which includes:
      • a filter to search on individual sections of the classification
      • "wildcard" and "fuzzy" searches
      • search history
      • ability to minimise and maximise search results
      • visual display of the section in which search results are located
    • links from Chapters, Categories and Codes to relevant clinical coding standards which, when selected, open the standard within the reference book

    Our user group has been testing Classifications Online and providing us with feedback. The group has been invaluable in the development of the application as we have been able to ensure that the tool meets user needs. The group has also given us some highly practical suggestions for improvements and enhancements, and we would like to thank them for sparing their time and for their excellent ideas.

    We aim to release a browsable and searchable version of the Classifications Online around April which will contain OPCS-4.8. This will not be the final version as we will enhance and refine the application over the coming year and add the facility to create and share notes and annotations. We intend to include ICD-10 and will include OPCS-4.9 when this is released. We will release more information, including details of how you can access Classifications Online, in the next few months.

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    ICD-11 update

    We completed the third round of the ICD-11 Field Trials in November last year and are currently reviewing and analysing the data. You can find summary figures on the third round on the ICD-11 page on Delen. We aim to publish a report on the field trials later this year. You can access the report on our findings from rounds One and Two of the field trials on the ICD-11 page on Delen.

    If you are still not familiar with ICD-11, please read the ICD-11 Overview that we have produced. It sets out why and how ICD-11 is being produced, its benefits and the main changes between ICD-10 and ICD-11. We have also produced overviews describing how to use the two ICD-11 electronic tools; the Coding Tool and Browser, which are accessible in different formats on the ICD-11 page on Delen.

    There is currently no decision on the implementation of ICD-11 in England, however we are undertaking a number of activities, including the field trials (and chapter reviews described below), that will help inform the decision on implementation, build up our knowledge on ICD-11, and help us understand what effect ICD-11 will have on our products and services, coders and the wider NHS.

    ICD-11 Chapter Reviews

    We undertook an initial review of all ICD-11 Chapters around 18 months ago and are keen to further explore the major changes to the chapters now that ICD-11 is considered stable. We would like to involve clinicians to review chapters pertinent to their specialist area. We are currently working to produce individual papers that outline the major changes to relevant chapters and working through chapters where we have already received interest from clinicians and working groups. We want to give clinicians the opportunity to review these chapters and provide us with their feedback.

    In order to perform the chapter reviews, we have produced a very brief list of simple questions based on the questions asked by WHO in the earlier chapter reviews, that will allow us to identify any specific issues and explore the completeness of the chapter, e.g. if there are any missing conditions, illnesses or diagnoses.

    If you are a clinician or you know a clinician who would like to contribute, please send expressions of interest to icd-11@nhs.net and we will send you more information when this is available.

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    Have your say

    If you would like more information about any aspect of our products or services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the Subject field and providing details of what you would like us to cover.

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    By Katy Park 3 years ago

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  • Terminology and Classifications Delivery Service Newsletter: December 2017

     

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    Terminology and Classifications Delivery Service Newsletter

     

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    Welcome to our December Newsletter. In this issue, we feature:

     

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    Coding of Sepsis: Consultation Results and last chance to comment on the Proposed Update to DChS.I.1 Sepsis

    The results of the Coding of Sepsis Consultation (July to September 2017) are now available in the Consultation area on Delen. The document summarises the issues identified in the consultation and contains our responses as well as the actions we have taken. We would like to thank everyone who responded to this consultation and contributed their feedback.

    We have drafted a proposed update to DChS.I.1: Sepsis, septic shock, severe sepsis and neutropenic sepsis using the feedback received from the Coding of Sepsis Consultation. The Proposed Update is available for review and comment in the Consultation area on Delen. Thank you to everyone who has responded to date but if you have not yet done so, there is still time. Please provide us with your feedback, including any comments by tomorrow [Friday 8 December].

    We have also published a knowledge sharing article provided by Southend University Hospital NHS Foundation Trust (SUHNFT) which illustrates the importance and benefits of engaging with clinical teams when coding sepsis. It describes the processes that SUHNFT have put in place locally to ensure sepsis is recorded and coded correctly. The document ‘Coding of Sepsis at SUHNFT’ can be found in the Resource Library on Delen and is an excellent example of the type of material that will be included in our new Delen Community Library (see below).

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    SNOMED CT confirmed as UK's core national information standard for pathology and laboratory medicine

    The National Information Board (NIB) in 'Personalised Health and Care 2020: A Framework for Action' recommended SNOMED CT as the single terminology for the direct management of care of an individual, across all care settings in England. The Digital Delivery Board, chaired by NHS England, subsequently confirmed that SNOMED CT will be the core national terminology for pathology for all clinical information flows.

    This decision does not prevent any current LOINC users in NHS laboratories from continuing to use LOINC in their systems, although work to develop LOINC as a potential national information standard has ceased.  However, those laboratories will, in future, need to ensure that when communications with other laboratories, GP practices or NHS organisations are required, they include the appropriate SNOMED CT encoding as per the approved Information Standards Notice.  

    NHS Digital will undertake development work in consultation with stakeholders to identify and develop content that is missing in SNOMED CT, which will offer significant benefits in terms of interoperability and analytics. NHS Digital, with support from SNOMED International and member countries, aims to provide the new content during 2018-19.

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    SNOMED International to support the Olympic Healthcare Interoperability Initiative at Tokyo 2020

    The aim of this initiative is to advance the seamless exchange and use of health information, using established international standards, to support an integrated medical services infrastructure at each Olympic Games site. The OHI network connects pre-Games, person-specific healthcare information with information generated at Games time by Olympic and Host City service providers. The OHI proposes to work with the Olympics’ medical services team in delivering a fully interoperable infrastructure that would make it possible for athletes’ records to be accessible on site based on recognised international standards.

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    SNOMED CT Expo – update from Bratislava

    Members of our terminology team participated in the 2017 SNOMED CT Expo, held in Bratislava. A link to all presentations from the Expo can be found here.

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    World Health Organization Family of International Classifications Annual Meeting: update from Mexico City

    As part of our commitment to the World Health Organization Family of International Classifications (WHO-FIC), we are obliged to participate in committee and reference group work items which support the overall WHO-FIC Strategic Workplan.

    The Terminology and Classifications Delivery Service and the Office of National Statistics provide staff to serve as voting members of the various committees and reference groups of WHO-FIC. These committees and reference groups recently met for the WHO-FIC Annual Network Meeting in Mexico City (16 -21 October 2017). Lynn Bracewell (Head of Terminology and Classifications Delivery) and Hazel Brear (Principal Classifications Specialist) attended and participated in 19 face-to-face sessions. The poster booklet from the meeting can be downloaded from the WHO site via this link (note this is an 11Mb zip file).

    High level priority items which were discussed, debated and progressed during the meeting centred around the continuing development of ICD-11. During the meeting, the World Health Organization (WHO) confirmed that:

    • A final version of ICD-11 will be published in 2018 for testing and implementation according to countries' specific timelines and requirements
    • The final publication of ICD-10 will be in 2019.

    NHS Digital Plans:

    We are developing our five-year strategic roadmap, the first iteration of which will published in the new year, but our current thinking includes the following provisional milestones*:

    • [01-Apr-2018]*

    Decision on whether UK will implement ICD-10 6th Edition or move to ICD-11 from ICD-10 5th Edition

    • [01-Jun-2018 - 31-Mar-2019]*

    ICD-11 Field Testing

    Following field testing, we will consider the readiness of the health and care system for an ICD-11 migration and consider potential dates for this migration.

    *Please note that these dates are indicative of current thinking only and will change as our roadmap develops.

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    Launch of Clinical Coding Specialty Workshop: Obstetrics & Perinatal

    You may remember an announcement made over the summer for a new pilot project to trial an alternative approach to the development of Clinical Coding Specialty Workshops. We are pleased to announce that the Specialty Workshop Collaborative Development Pilot launched in July 2017 and will run until March 2018. It focusses on a single specialty: Obstetrics and Perinatal and the development is being led by MIAA Clinical Coding Academy (CCA) with support from West Midlands CCA.

    The purpose of the pilot is to trial a collaborative approach to the development of the clinical coding specialty workshops. By drawing on the expertise of people involved in the day-to-day coding and training delivery, the materials will better reflect the nature and demands of real life clinical coding. Additionally, by sharing the development work across a greater number of people, it should be possible to redevelop the workshops more quickly and more substantially.

    The workshops will be modular in nature and will cover different levels of coding, so that coders and coding managers have access to more flexible and more relevant training. Contributions are invited from across the clinical coding community (trainers, coding managers, coders) to take part in the pilot. All contributions are welcome no matter how big or small. This could be take the form of ongoing QA support, knowledge-sharing, submission of case studies, etc.

    If you would like to get involved or find more information about how you can be a part of this collaboration, please visit the Delen page for the CCA Specialty Workshop Pilot here.

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    Request Submission Portal: Closed for CTV3 Requests

    In anticipation of the last release of CTV3, and in preparation for the full implementation of SNOMED CT in general practice, the Read Codes Submission Portal will close to new requests on 15 December 2017.  After that date, all terminology requests should be submitted via the SNOMED CT Submission Portal. The Read Portal will remain available until completion of the April 2018 release, when it will be archived and accessible via a link on the SNOMED CT Submission Portal.

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    Suppliers invited to assess ICD web services

    To support the development of ICD-11, the World Health Organization wishes to engage with a wide variety of implementers to gather feedback on the ICD-API Services.

    During early 2018, there will be an opportunity for suppliers to become involved in early testing. If you would like to take part, or would like further information, please make contact via ICD-11@nhs.net providing your name, contact details and organisation.

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    e-Learning: New Classification Modules

    A new interactive presentation, “Coding for non-coders”, is available in the Education and Training Resource Library. The presentation may be shared with clinicians and other health care professionals to give an overview of coding and the classifications.

    We are also excited to be working on the launch of an e-Learning platform – more news coming soon.

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    New Delen Community Library

    We are building a new resource, called the “Delen Community Library”, which will allow you as members of the Delen user community to share material you think will be of interest to the rest of the community. You will be able to upload your own ideas, examples of good practice, case studies, solutions you have developed locally and other items of relevance to users of terminology and classifications products and services.

    We hope that this will grow into a rich, user led resource, so if you have something you would like to be added to the library, simply upload it here and provide us with brief details. Once it has been submitted, we will contact you to get it ready for publication.

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    Clinical Contacts: get in touch

    Do you have clinical contacts, or are you a clinician who would be happy to provide advice to help us develop the Classifications coding standards and guidance?

    When developing national clinical coding standards and guidance and the ICD-10 and OPCS-4 Classifications, we draw on a wide range of knowledge, expertise and information sources, in addition to the classifications knowledge we have within the team. It is important that developments are based on sound and up-to-date clinical input, so if you are a clinician with an interest in the classifications or are a coding professional who has contact with clinicians who would be willing to help us, please get in touch using this form which can also be accessed via the contact us page on Delen.

    Contact details will not be shared outside of our team without prior consent.

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    Key Messages

    We have recently added a number of new key messages on Delen. Please use this page to find answers to the most frequently asked questions relating to our products and services. If you have a question you would like us to answer, please send it through using the contact us link on Delen.

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    Our Five-Year Roadmap

    We are currently developing our five-year roadmap for terminology and classifications products. An initial draft of the roadmap will be published in the New Year and will describe - at a high level - our planned activities and milestones for SNOMED CT, dm+d, ICD-10, ICD-11, OPCS-4 and NICIP. We are very much looking forward to sharing the roadmap with you, listening to your feedback and working collaboratively with you and our partner organisations.

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    Our Service Improvement Plan

    As you will be aware, following the annual survey which we ran earlier this year, we published a Service Improvement Plan which set out a number of commitments relating to four areas of our business. We are making good progress in all of the areas and will publish a progress report on Delen, early in January, so look out for this.

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    NHS Digital at EHI Live 2017

    NHS Digital representatives attended EHI Live 2017 in Birmingham on 31 October and 1 November.

    The event described itself as the UK’s number one show for those involved in digital health, hospital information and healthcare innovation. More than 4,000 professionals dedicated to IT healthcare came together to discuss frontline use of healthcare technology and what products would shape the future of the healthcare industry. This year was the 10th anniversary of EHI Live.

    The event provided us with a platform to engage with and build new contacts with several target audiences simultaneously, including CIOs, CCIOs, IT professionals, healthcare leaders, managers, and clinicians involved in the procurement, management and frontline use of information systems.

    Over the two days, we hosted our own NHS Digital stand, had speakers giving talks on the main stage, and ran multiple sessions in our own theatre – involving over 25 speakers and panel sessions.

    Our contributions included:

    • The keynote speech from our Deputy Chief Executive, Rob Shaw
    • Our Chairman, Noel Gordon, opening the conference and chairing the NHS Leadership Forum
    • Chief Nurse, Anne Cooper, speaking about the importance of giving nurses better quality clinical information
    • Head of Cyber Security, Dan Taylor, moderating a panel discussion on future NHS cyber security threats
    • Health and Social Care Network Programme Director, Dermot Ryan, talking about how better connectivity is transforming health and care services; and
    • Professor Daniel Ray discussing the development of data analytics

    In our own theatre sessions, we spoke about “Health as an Open Platform” and building a digital NHS involving the NHS Apps Library, digital medicines, and the new personal health records.

    We streamed all of our theatre sessions to a YouTube link, so you can watch the action as it unfolded.

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    Digital Ready Workforce Consultation

    We want you to have your say in the “Building a Digital Ready Workforce” online consultation, which is open to people working across the health and care workforce until 13 December 2017. We’re working with Health Education England to find out what can be done to improve the digital skills and knowledge of people working in health and care by asking them directly.

    After the consultation closes, we aim to turn your input into the practical solutions to support the whole health and care workforce.

    Join and share the online conversation on LinkedIn, and Twitter #DigitalReady.

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    By Katy Park 4 years ago

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