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SNOMED CT UK Clinical Extension Release Documents
Release ID 37.6.0 – 20 March 2024
International release
The SNOMED CT UK Clinical edition is based on the July 2023 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT July 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser: however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 37.2.0 release of the SNOMED CT UK Drug Extension, will be synchronous with the 22 November 2023 SNOMED CT UK Clinical Extension and the July 2023 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 5 areas with a total of 414 new concepts. 4 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated | Other change |
Foundation Metadata Concept | 3 | - | - |
Physical Object | 46 | - | - |
Product | 340 | 4 | 2 |
Qualifier Value | 9 | - | - |
Substance | 16 | - | - |
Total | 414 | 4 | 2 |
Clinical Content Changes
Advance notice of change to SNOMED CT UK Edition releases - Concrete Value files
NHS England intends to start publishing Concrete Value files for all SNOMED CT UK Edition releases from the 38.0.0 17 April 2024 release.
These files will follow the standard naming convention for this type of file, for example sct2_RelationshipConcreteValues_UKDRSnapshot_ GB1000001_ 20240410.txt
For more information on the structure of these files please see the Concrete Value File Specification from the SNOMED CT Release File Specifications.
Initially we expect these files to be empty apart from the header row, with UK Drug content appearing from either the 38.1.0 15 May 2024 or 38.2.0 12 June 2024 releases.
This change is to support the work of the UK Medicines Terminology Futures programme. It is required to support the addition of 'Ingredients for VTMs' in the dm+d (XML) release files and the SNOMED CT UK Drug Extension.
We currently do not expect to there will be any Concrete Values in the SNOMED CT UK Clinical Extension.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 5 areas with a total of 13 new concepts. 3 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated | Other change |
Foundation Metadata Concept | 2 | - | - |
Observable Entity | - | - | 63 |
Procedure | 10 | - | - |
Qualifier Value | 1 | - | - |
Regime/Therapy | - | 3 | - |
Total | 13 | 3 | 63 |
Inactivation of 724401000000107 |National Public Health Classification data (qualifier value)| hierarchy (Heading)
NHS England intends to inactivate the following concept and all its children 724401000000107 |National Public Health Classification data (qualifier value)|.
The concepts are being made Inactive as the classification is no longer in use and has no place in SNOMED CT.
Most concepts will be made Inactive with no historical association. However, we are seeking to identify any concepts that are in regular use so replacement concepts can be identified using the historical associations.
If you are aware of any concepts in this hierarchy that are in active use and require replacement please contact the Clinical Terminology via information.standards@nhs.net with the subject “National Public Health Classification data”.
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to ICD-10 or OPCS-4.10 classification maps in this release.
Map updates will be included in the 38.0.0 - 17 April 2024 release, which will also incorporate the map content for:
- 5.0 – 21 February 2024
- 6.0 - 20 March 2024
- UK maps for the September 2023 to February 2024 International Edition
See the SNOMED CT UK Edition 2023-2024 and 2024-2025 Release Schedules for more information.
Reference sets
The following are new refsets along with their opening member counts:
ID | Refset | Count |
1167361000001108 | Cardiovascular Disease Prevent GPES - angiotensin receptor neprilysin inhibitor | 10 |
1157121000001105 | Cardiovascular Disease Prevent GPES - mineralocorticoid receptor antagonist | 310 |
1167371000001103 | Cardiovascular Disease Prevent GPES - sodium glucose co-transporter 2 inhibitors | 76 |
1955851000000101 | NHS secondary use data exclusions due to Gender Recognition Act 2004 | 97 |
1955841000000104 | NHS secondary use data exclusions due to Human Fertilisation and Embryology Act 2008 | 493 |
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known issues
There are no known issues for this release.
Release ID 37.5.0 – 21 February 2024
International release
The SNOMED CT UK Clinical edition is based on the July 2023 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT July 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser: however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
Details are in the following table:
Tag | Inactivated | Other change |
Observable Entity | 2 | 6 |
Total | 2 | 6 |
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 37.2.0 release of the SNOMED CT UK Drug Extension, will be synchronous with the 22 November 2023 SNOMED CT UK Clinical Extension and the July 2023 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 4 areas with a total of 514 new concepts. 84 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated |
Physical Object | 49 | 22 |
Product | 417 | 61 |
Qualifier Value | 41 | 1 |
Substance | 7 | - |
Total | 514 | 84 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 8 areas with a total of 121 new concepts. 2 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated | Other change |
Assessment Scale | 7 | - | - |
Disorder | 4 | - | - |
Finding | 5 | - | - |
Observable Entity | 52 | 2 | 51 |
Procedure | 11 | - | - |
Qualifier Value | 37 | - | - |
Record Artifact | 1 | - | - |
Situation | 4 | - | - |
Total | 121 | 2 | 51 |
Inactivation of 724401000000107 |National Public Health Classification data (qualifier value)| hierarchy
NHS England intends to inactivate the following concept and all its children 724401000000107 |National Public Health Classification data (qualifier value)|.
The concepts are being made Inactive as the classification is no longer in use and has no place in SNOMED CT.
Most concepts will be made Inactive with no historical association. However, we are seeking to identify any concepts that are in regular use so replacement concepts can be identified using the historical associations.
If you are aware of any concepts in this hierarchy that are in active use and require replacement please contact the Clinical Terminology via information.standards@nhs.net with the subject “National Public Health Classification data”.
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to ICD-10 or OPCS-4.10 classification maps in this release.
Map updates will be included in the 38.0.0 - 17 April 2024 release, which will also incorporate the map content for:
- 5.0 – 21 February 2024
- 6.0 - 20 March 2024
- UK maps for the September 2023 to February 2024 International Edition
See the SNOMED CT UK Edition 2023-2024 and 2024-2025 Release Schedules for more information.
Reference sets
There are no new reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known issues
There are no known issues for this release.
Release ID 37.2.0 - 29 November 2023
International release
The SNOMED CT UK Clinical edition is based on the July 2023 SNOMED International release.
The SNOMED International release notes can be found online at SNOMED CT July 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser: however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
There have been concept changes in 1 area with one new concept. 9 existing concepts have been made inactive.
Details are in the following table:
Tag | Inactivated | Other change |
Observable Entity | 9 | 242 |
Total | 9 | 242 |
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 37.2.0 release of the SNOMED CT UK Drug Extension, will be synchronous with the 22 November 2023 SNOMED CT UK Clinical Extension and the July 2023 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 4 areas with a total of 707 new concepts. 2 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated |
Physical Object | 89 | - |
Product | 613 | 2 |
Qualifier Value | 4 | - |
Substance | 1 | - |
Total | 707 | 2 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 9 areas with a total of 140 new concepts. 2 existing concepts have been made inactive while 1 has been reactivated.
Details are in the following table:
Tag | New | Reactivated | Inactivated | Other change |
Assessment Scale | 11 | - | - | - |
Disorder | 12 | - | - | - |
Event | 1 | - | - | - |
Finding | 11 | - | 2 | - |
Foundation Metadata Concept | - | 1 | - | - |
Observable Entity | 89 | - | - | 279 |
Procedure | 10 | - | - | 1 |
Record Artifact | 3 | - | - | - |
Situation | 3 | - | - | - |
Total | 140 | 1 | 2 | 280 |
Changes to History Substitution and Query Tables from 31.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
The mapping files will be larger than usual as they incorporate the following:
- The 36.4.0 - 09 August 2023, 37.0.0 - 04 October 2023 and 37.2.0 29 November UK Edition maps
- The UK maps for the February 2023 to July 2023 International Edition content
- Reinstatement of approximately 24,000 active concept ICD-10 maps that were inactivated in the 19 April 2023 release
- Inactivation of the OPCS-4.9 maps (OPCS-4.10 is now the mandated intervention/procedure classification. For more information, please see the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets)
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 2484* |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 704 |
* This figure includes new concept maps and existing concepts where the previous map has been changed in some way. It does not include the reinstated ICD-10 maps.
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
The next planned release of the maps will be on 17 April 2024. See the SNOMED CT UK Edition 2023-2024 and 2024-2025 Release Schedules for more information.
Reference sets
There are no new reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known Issues
There are no known issues for this release.
Release ID 37.0.0 - 4 October 2023
International release
The SNOMED CT UK Clinical edition is based on the July 2023 SNOMED International release.
The SNOMED International release notes can be found online at SNOMED CT July 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
There have been concept changes in 2 areas with one new concept. 2 existing concepts have been made inactive.
Details are in the following table:
Tag | Inactivated | Other change |
Foundation Metadata Concept | 1 | - |
Observable Entity | 1 | 72 |
Total | 2 | 72 |
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 37.0.0 release of the SNOMED CT UK Drug Extension, will be synchronous with the 27 September 2023 SNOMED CT UK Clinical Extension and the July 2023 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 4 areas with a total of 794 new concepts. 43 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated | Other change |
Physical Object | 122 | - | 9 |
Product | 659 | 27 | 3 |
Qualifier Value | 6 | - | - |
Substance | 7 | 16 | - |
Total | 794 | 43 | 12 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 13 areas with a total of 75 new concepts. 36 existing concepts have been made inactive.
Details are in the following table:
Tag | New | Inactivated | Other change |
Assessment Scale | 2 | 1 | - |
Disorder | - | 1 | 1 |
Event | - | 1 | - |
Finding | 3 | 7 | 2 |
Foundation Metadata Concept | 6 | - | - |
Observable Entity | 13 | 5 | 37 |
Occupation | 1 | - | - |
Physical Object | - | - | 24 |
Procedure | 39 | 12 | 31 |
Product | - | - | 15 |
Qualifier Value | - | 4 | - |
Regime/Therapy | 9 | 3 | 1 |
Situation | 2 | 2 | 1 |
Total | 75 | 36 | 112 |
Inactivation of Ethnic and Racial Group Social Context Content
SNOMED International plans to inactivate the subtypes of 372148003 |Ethnic group (ethnic group)| and 415229000 |Racial group (racial group)|. SNOMED International has published more information on this here: https://confluence.ihtsdotools.org/display/cmag/Inactivation+of+Ethnic+and+Racial+Group+Social+Context+Content
This planned inactivation does not affect the UK specific Ethnic category census findings under 397731000 |Ethnic group finding (finding)|. The Ethnic categories derived from the census still remain the preferred method for recording ethnic category in the UK: https://www.datadictionary.nhs.uk/data_elements/ethnic_category.html
To record the language spoken by a patient we recommend using the 370157003 |Main spoken language (finding)| hierarchy.
To record the need for an interpreter we recommend using the 315594003 |Interpreter needed (finding)| hierarchy.
If anyone has requirements for additional ethnic or racial groups then please submit a RSP request (https://isd.digital.nhs.uk/rsp/) with a reliable national source for that ethnicity or race being accepted in the UK.
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.10 classification maps in this release.
It was recently identified that approximately 22,000 active concepts had their maps inactivated in the 36.0.0 – 19 April 2023 release. We are currently working to locate the root cause, find a solution to reinstate these maps and prevent this occurring in future releases.
Please note, the Full and Snapshot files in this release pack are from the most recent update of the maps (36.2.0 -14 June 2023) and therefore also contain these inactivated maps.
The next planned release of the updated maps is in the 37.2.0 – 29 November 2023 release, which will also include:
- The 4.0 - 09 August 2023 and 37.0.0 - 04 October 2023 UK Edition maps.
- The UK maps for the February 2023 to July 2023 International Edition content.
- Reinstatement of the active concept ICD-10 maps that were inactivated in the 19 April 2023 release
- Inactivation of the OPCS-4.9 maps (OPCS-4.10 is now the mandated intervention/procedure classification). For more information, please see the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets
Reference Sets
The following are new refsets along with their opening member counts:
ID | Refset | Count |
1853441000000109 | Mental Health Services Data Set assessment procedures | 13 |
1853451000000107 | Mental Health Services Data Set medication and physical therapy interventions | 21 |
1853461000000105 | Mental Health Services Data Set psychological therapies | 62 |
1853481000000101 | Mental Health Services Data Set psychosocial interventions | 53 |
1853551000000106 | Pathology and laboratory medicine observable entity | 3,846 |
1853561000000109 | Pathology and laboratory medicine procedure | 356 |
The following are refsets that have been inactivated:
44991000237108 |Unified Test List simple reference set (foundation metadata concept)|
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known Issues
There are no known issues for this release.
Release ID 36.4.0 – 9 August 2023
International release
The SNOMED CT UK Clinical edition is based on the January 2023 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT January 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
The content of the SNOMED CT UK Pathology extension is now only available as part of the SNOMED CT UK Clinical extension. All content from the Pathology extension is now released as part of the Clinical Extension. There will be no more separate releases of the SNOMED CT UK Pathology extension.
The following are the counts of SNOMED concept changes to the respective hierarchy:
Tag | Inactivated | Other change |
Observable Entity | 2 | 1 |
Total | 2 | 1 |
SNOMED CT UK Drug extension
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New (active) | New (inactive) | Inactivated |
Physical Object | 186 | - | - |
Product | 706 | - | 50 |
Qualifier Value | 7 | 1 | 1 |
Substance | 11 | - | 5 |
Total | 910 | 1 | 56 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated |
Assessment Scale | 4 | - |
Disorder | 3 | - |
Finding | 12 | - |
Foundation Metadata Concept | - | 5 |
Observable Entity | 5 | - |
Procedure | 23 | 2 |
Regime/Therapy | 1 | - |
Situation | 6 | - |
Total | 54 | 7 |
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.10 classification maps in this release. The 36.4.0 - 09 August 2023 UK Edition content will be mapped and included in the 37.0.0 - 04 October 2023 release, along with the UK maps for the February 2023 to July 2023 International Edition. Further information about the 2023-24 map releases can be found in the 2023-2024 Release Schedule.
Information for future releases
The OPCS-4.9 maps will still be included in the 37.0.0 - 04 October 2023 release but will be set to inactive. (For more information, please see the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets document.)
Reference sets
We have made the following refsets Inactive:
- 1321201000000107 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 health issues simple reference set (foundation metadata concept)
- 1321211000000109 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 presenting complaints simple reference set (foundation metadata concept)
- 1321191000000105 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 procedures simple reference set (foundation metadata concept)
- 1321181000000108 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 record extraction simple reference set (foundation metadata concept)
- 999001951000000107 Personal welfare lasting power of attorney findings simple reference set (foundation metadata concept)
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 36.2.0 – 14 June 2023
International release
The SNOMED CT UK Clinical edition is based on the January 2023 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT January 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
The content of the SNOMED CT UK Pathology extension is now only available as part of the SNOMED CT UK Clinical extension. All content from the Pathology extension is now released as part of the Clinical Extension. There will be no more separate releases of the SNOMED CT UK Pathology extension.
The following are the counts of SNOMED concept changes to the respective hierarchy:
Tag | Inactivated | Other change |
Foundation Metadata Concept | - | 1 |
Observable Entity | 7 | 3,576 |
Total | 7 | 3,577 |
SNOMED CT UK Drug extension
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated |
Physical Object | 326 | 1 |
Product | 1,131 | 17 |
Qualifier Value | 8 | - |
Substance | 91 | - |
Total | 1,556 | 18 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated | Other change |
Assessment Scale | 2 | - | - |
Finding | 6 | - | - |
Observable Entity | 2 | - | 3 |
Occupation | 1 | - | - |
Procedure | 7 | 1 | - |
Record Artifact | 1 | - | - |
Regime/Therapy | 4 | - | - |
Situation | 5 | - | - |
Total | 28 | 1 | 3 |
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed, and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed cannot correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
As well as the maps for ICD-10 and OPCS-4.10, OPCS-4.9 maps are also provided to support the coding of episodes finishing on or before 31 March 2023. Although the number of content changes are fewer than in the last release, the mapping files remain larger than usual due to the inclusion of two versions of OPCS-4 (also see Information for future releases section below).
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 89 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 68 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
There will be no updates to the ICD-10 or OPCS-4.10 classification maps in the 36.4.0 – 09 August 2023 release. The August 2023 maps will be included in the 37.0.0 – 04 October 2023 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International February 2023 to July 2023 content.
The OPCS-4.9 maps will be included in the 37.0.0 release but will be set to inactive. (For more information, please see the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets document.)
Further information about the 2023-24 map releases can be found in the 2023-2024 Release Schedule.
Reference sets
We intend to Inactivate the following reference sets (refsets) in the 36.4.0_20230802 (released 20230809) release:
- 1321181000000108 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 record extraction simple reference set (foundation metadata concept).
- 1321191000000105 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 procedures simple reference set (foundation metadata concept).
- 1321211000000109 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 presenting complaints simple reference set (foundation metadata concept).
- 1321201000000107 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 health issues simple reference set (foundation metadata concept).
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 36.0.0 – 19 April 2023
International release
The SNOMED CT UK Clinical edition is based on the January 2023 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT January 2023 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
This release contains a major update to the Pathology extension.
A majority of the Pathology extension concepts are now sufficiently modelled and have been classified.
This represents a significant step forward for the Pathology extension. It should be noted however that there is ongoing work in continuing to assess and improve the classification and the modelled content of the UTL. Further work is also underway to model the PBCL/SNOMED content (which is currently unmodelled).
The following are the counts of SNOMED concept changes to the respective hierarchy:
Tag | New | Inactivated | Other change* |
Observable Entity | 18 | 11 | 2,424 |
Total | 18 | 11 | 2,424 |
Other change includes modelling of the content to include the following attributes where a suitable value is available in SNOMED CT:
- Property
- Component
- Relative to
- Inhers in
- Direct site
- Technique
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 36.0.0 release of the SNOMED CT UK Drug Extension will be synchronous with the 19 April 2023 SNOMED CT UK Clinical Extension and the January 2023 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated | Other change |
Clinical Drug | 1 | - | - |
Navigational Concept | - | 3 | - |
Product | 360 | - | - |
Qualifier Value | 1 | - | 1 |
Substance | - | 1 | - |
Total | 362 | 4 | 1 |
Clinical Content Changes
Retiring "Other health care professional" concepts
As part of ongoing Quality Initiative work, we are retiring ambiguous concepts. Included in this work are concepts which state an action has been carried out by 'Other' healthcare professional.
This is because, once records move about between institutions, you can no longer assume that whoever did do the procedure, wasn't the healthcare provider where the record is being viewed.
The concepts below are used in Seasonal Flu and Childhood Flu services and will be retired after 31st March 2024:
955661000000102 First intranasal seasonal influenza vaccination given by other healthcare provider (situation)|
955681000000106 Second intranasal seasonal influenza vaccination given by other healthcare provider (situation)|
945831000000105 First intramuscular seasonal influenza vaccination given by other healthcare provider (situation)|
955651000000100 Seasonal influenza vaccination given by other healthcare provider (situation)|
955671000000109 Second intramuscular seasonal influenza vaccination given by other healthcare provider (situation)|
along with
527961000000108 Counselling about alcohol by other agency (procedure)
1104601000000107 Cervical smear screening done by other healthcare provider (situation)|
895641000000103 Substance misuse treatment programme delivered by other healthcare provider (finding)|
The concepts below are used in other vaccination services and will be retired after 31st March 2025:
68511000000106 Herpes zoster vaccination given by other health care provider (finding)|
957751000000103 Meningitis ACW and Y vaccination given by other healthcare provider (situation)|
1037011000000108 Booster meningitis B vaccination given by other healthcare provider (situation)|
958381000000107 First meningitis B vaccination given by other healthcare provider (situation)|
958401000000107 Second meningitis B vaccination given by other healthcare provider (situation)|
1037251000000102 First measles mumps and rubella vaccination given by other healthcare provider (finding)|
1037271000000106 Second measles mumps and rubella vaccination given by other healthcare provider (finding)|
956971000000108 Pertussis vaccination in pregnancy given by other healthcare provider (finding)|
1324631000000100 Pneumococcal vaccination given by other healthcare provider (situation)|
965851000000105 Human papillomavirus vaccination given by other healthcare provider (situation)
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated | Other change |
Disorder | 3 | 1 | - |
Observable Entity | 15 | 3 | - |
Procedure | 12 | 60 | 2 |
Qualifier Value | - | 8 | - |
Record Artifact | - | 1 | - |
Regime/Therapy | 2 | - | - |
Total | 32 | 73 | 2 |
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
This release incorporates the 35.6.0 – 22 March 2023 UK Edition map content, along with the UK maps for the August 2022 to January 2023 International Edition.
As well as the maps for ICD-10 and OPCS-4.10, OPCS-4.9 maps are also included to support the coding of episodes finishing on or before 31 March 2023.
As two versions of OPCS-4 are included, the mapping files will be considerably larger than usual. (Please see the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets document for information about the lifecycle of the maps.)
Information about International Edition content changes can be found in the associated SNOMED International release notes.
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 2572 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 554 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
Further information about the 2023-24 map releases can be found in the 2023-2024 Release Schedule.
Reference sets
NHS England proposes to inactivate the following reference sets (refsets) in the 36.4.0_20230802 (released 20230809) release
- 1321191000000105 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 procedures simple reference set (foundation metadata concept)
- 1321201000000107 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 health issues simple reference set (foundation metadata concept)
- 1321181000000108 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 record extraction simple reference set (foundation metadata concept)
- 1321211000000109 |Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 presenting complaints simple reference set (foundation metadata concept)
These refsets currently do not have an owner or a clear use-case. We therefore intend to Inactivate them unless clear Ownership and use-cases are identified.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 35.6.0 – 22 March 2023
International release
The SNOMED CT UK Clinical edition is based on the July 2022 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT July 2022 International Edition release notes.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser.
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
There are no new pathology concepts in this release.
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle.The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 35.6.0 release of the SNOMED CT UK Drug Extension will be synchronous with the 22 March 2023 SNOMED CT UK Clinical Extension and the July 2022 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated |
Physical Object | 99 | - |
Product | 456 | 308 |
Qualifier Value | 5 | - |
Substance | 3 | - |
Total | 563 | 308 |
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
Tag | New | Inactivated |
Assessment Scale | 7 | 1 |
Finding | 14 | - |
Foundation Metadata Concept | - | 1 |
Observable Entity | 35 | 1 |
Procedure | 18 | 1 |
Qualifier Value | 1 | - |
Record Artifact | 2 | - |
Situation | 2 | - |
Staging Scale | 1 | - |
Total | 80 | 4 |
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.10 classification maps in this release. The March 2023 UK Edition content will be mapped and included in the 36.6.0 - 05 – 19 April 2023 release, along with the UK maps for the August 2022 to January 2023 International Edition. Further information about the 2023-24 map releases can be found in the 2023-2024 Release Schedule.
Reference sets
No new reference sets have been added to this release.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 35.5.0 – 22 February 2023
International release
The SNOMED CT UK Clinical edition is based on the July 2022 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT July 2022 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
There are no new pathology concepts in this release.
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 35.5.0 release of the SNOMED CT UK Drug Extension will be synchronous with the 22 February 2023 SNOMED CT UK Clinical Extension and the July 2022 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 6 areas with a total of 604 new concepts, of which 2 are inactive. 403 existing concepts have been made inactive.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 2
- Disorder – 1
- Finding – 19
- Foundation metadata concept – 1
- Observable entity – 48
- Procedure – 79
- Qualifier value – 1
- Record artifact – 10
- Regime/therapy – 5
- Situation – 9
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed, and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed cannot correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
This release contains maps for ICD-10, OPCS-4.9 and OPCS-4.10 (refSetId: 1382401000000109).
The maps for the 35.2.0 - 30 November 2022 SNOMED CT UK Edition and missing SNOMED International February 2022 content are also included in this release.
OPCS-4.10 must be used to code all episodes finishing on or after 1 April 2023. The OPCS-4.9 maps are included in the release to allow coding of episodes finishing on or before 31 March 2023. As two versions of OPCS-4 are included, the mapping files will be considerably larger than usual. Information about the lifecycle of the maps can found in the SNOMED CT to ICD-10 and OPCS-4 Cross-Mapping Retired Reference Sets document.
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 507 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 772* |
NB: Map changes between the current and previous release can be found within the Delta mapping file. * This figure only represents new concepts mapped to an OPCS-4.10 code or existing concepts where the OPCS-4 map has changed. The total number of changes in the release files will be considerably larger as all active concepts which were previously in scope of OPCS-4.9 are also in the OPCS-4.10 map reference set.
Information for future Releases
There will be no updates to the ICD-10 or OPCS-4.10 classification maps in the 35.6.0 – 22 March 2023 UK Edition release. The March 2023 content will be mapped and included in the 36.6.0 - 05 – 19 April 2023 release, along with the UK maps for the August 2022 to January 2023 International Edition. Further information about the 2023-24 map releases can be found in the 2023-2024 Release Schedule.
Reference sets
No new reference sets have been added to this release.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 35.2.0 – 30 November 2022
International release
The SNOMED CT UK Clinical edition is based on the July 2022 SNOMED International release.
The SNOMED International release notes can be accessed here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
There are no new pathology concepts in this release.
SNOMED CT UK Drug extension
The SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 35.2.0 release of the SNOMED CT UK Drug Extension will be synchronous with the 23 November 2022 SNOMED CT UK Clinical Extension and the July 2022 SNOMED International Edition.
The following are the counts of new SNOMED concepts added to the respective hierarchy:
There have been concept changes in 6 areas with a total of 604 new concepts, of which 2 are inactive. 403 existing concepts have been made inactive.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 3
- Disorder - 1
- Finding – 4
- Morphologic abnormality - 3
- Observable entity – 37
- Procedure – 18
- Qualifier value - 1
- Record artifact – 1
- Regime/therapy – 4
- Situation – 7
UPCOMING CHANGE TO MONKEYPOX CONCEPTS
The WHO (World Health Organization) has recommended a new name for monkeypox disease of ‘mpox’. This change came too late to be represented in this release. We therefore intend to make the necessary changes to reflect this recommendation in the 35.5.0_20230215 (released 20230222) release.
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.9 classification maps for this release.
The 35.2.0 - 30 November 2022 SNOMED CT UK Edition and missing SNOMED International February 2022 release content will be mapped and included in the 35.5.0 – 22 February 2023 release.
As well as the OPCS-4.9 and ICD-10 maps, the February 2023 release will also include the maps to OPCS-4.10. The OPCS-4.10 maps must not be used in live systems until 1 April 2023 onwards.
Reference sets
No new reference sets have been added to this release.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 35.0.0 – 05 October 2022
International release
The SNOMED CT UK Clinical edition is based on the July 2022 SNOMED International release.
The SNOMED International release notes can be accessed here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
No changes.
SNOMED CT UK Drug extension
The SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 35.0.0 release (with dm+d data from release NHSBSA_9.2.0_20220919000001) of the SNOMED CT UK Drug Extension, will be synchronous with the October 2022 SNOMED CT UK Clinical Extension and the July 2022 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 1
- Finding – 5
- Observable entity – 5
- Procedure – 26
- Record artifact – 5
- Foundation metadata concept – 10
- Regime/therapy – 2
- Situation – 2
There are 16 new SNOMED codes that relate to the sending of invitations to receive COVID vaccinations.
CHANGES TO HISTORY SUBSTITUTION AND QUERY TABLES FROM 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In the future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed, and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed cannot correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
This release incorporates maps for the 34.1.0 -10 August 2022 and 35.0.0 – 05 October SNOMED CT UK Clinical Edition content, along with the UK maps for the February 2022 to July 2022 SNOMED International Edition releases.
The new concept ‘1382401000000109 |Office of Population Censuses and Surveys Classification of Interventions and Procedures Version 4.10 complex map reference set (foundation meta data concept)’ has been authored in this release, in preparation for update to the maps for OPCS-4.10 during the next authoring cycle (please see Information for future releases section below).
Content changes made by SNOMED International (SI) between February 2022 and July 2022, include the inactivation endoscopy procedure concepts stating ‘therapeutic’ or ‘diagnostic’ intent and replacement with concepts without stated intent. This may result in some OPCS-4.10 codes no longer being reached via a map from a SNOMED CT concept. As recommended in the SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition) document (section 2.2), systems should already incorporate the ICD-10 and OPCS-4 Titles and Metadata files to allow manual input of any classification codes that can’t be reached from a map. Further Information on SI content changes can be found in the associated release notes.
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 1553 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 789 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 35.2.0 – 30 November 2022 release. The November 2022 SNOMED CT content will be mapped and included in the 35.5.0 – 22 February 2023.
As well as the OPCS-4.9 and ICD-10 maps, the February 2023 release will also include the maps to OPCS-4.10. The OPCS-4.10 maps must not be used in live systems until 1 April 2023 onwards.
Reference sets
The following new Reference sets have been added for this release:
1382481000000104 Advance care plan type simple reference set (foundation metadata concept).
1382491000000102 Advance decision findings simple reference set (foundation metadata concept).
1382501000000108 Dietary requirement findings simple reference set (foundation metadata concept).
1382511000000105 Dietary requirement regimes simple reference set (foundation metadata concept).
1382471000000101 Emergency care assessment tool observables simple reference set (foundation metadata concept).
1382451000000105 Emergency care coded findings simple reference set (foundation metadata concept).
1382461000000108 Emergency care coded observations simple reference set (foundation metadata concept).
1382531000000102 Emergency care diagnosis max simple reference set (foundation metadata concept).
1382541000000106 Emergency care sickness absence category.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release ID 34.1.0 – 10 August 2022
International Release
The SNOMED CT UK Clinical edition is based on the January 2022 SNOMED International release.
The SNOMED International release notes can be accessed here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser. However, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser.
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
No changes.
SNOMED CT UK Drug extension
The SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 34.0.0 release (with dm+d data from release NHSBSA_6.3.0_20220627000001) of the SNOMED CT UK Drug Extension, will be synchronous with the July 2022 SNOMED CT UK Clinical Extension and the January 2022 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 8
- Finding – 5
- Observable entity – 16
- Procedure – 9
- Record artefact – 1
- Foundation metadata concept – 2
- Regime/therapy – 2
- Situation -17
The following new concepts have been authored to support the response to the Monkeypox:
Concept | Tag | Preferred Term |
1373781000000107 | finding | Did not attend for first dose of smallpox virus vaccine |
1373791000000109 | finding | Did not attend for second dose of smallpox virus vaccine |
1373801000000108 | finding | Did not attend for third dose of smallpox virus vaccine |
1373761000000103 | finding | Did not attend smallpox virus vaccination |
1373821000000104 | regime/therapy | Immunisation course to achieve immunity against monkeypox virus |
1373811000000105 | regime/therapy | Immunisation course to achieve immunity against smallpox virus |
1373891000000101 | situation | Smallpox virus immunisation course abandoned |
1373861000000107 | situation | Smallpox virus immunisation course declined |
1373911000000103 | situation | Smallpox virus immunisation course completed |
1373871000000100 | situation | Smallpox virus immunisation course not done |
1373841000000106 | situation | Smallpox virus immunisation course not indicated |
1373881000000103 | situation | Smallpox virus immunisation course started |
1373621000000100 | situation | Smallpox virus vaccination dose declined |
1373681000000104 | situation | Smallpox virus vaccination dose not given |
1373651000000105 | situation | Smallpox virus vaccination first dose declined |
1373691000000102 | situation | Smallpox virus vaccination first dose not given |
1373771000000105 | situation | Smallpox virus vaccination invitation SMS (short message service) text message sent |
1373661000000108 | situation | Smallpox virus vaccination second dose declined |
1373701000000102 | situation | Smallpox virus vaccination second dose not given |
1373671000000101 | situation | Smallpox virus vaccination third dose declined |
1373721000000106 | situation | Smallpox virus vaccination third dose not given |
Changes To History Substitution And Query Tables From 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In the future, it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed, and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed cannot correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.9 classification maps in this release. The August 2022 SNOMED CT content will be mapped and included in the 35.0.0 – 05 October 2022 SNOMED CT UK Clinical Edition, which will also include the UK maps for SNOMED International Edition February 2022 to July 2022 releases.
Reference sets
The following new References have been added for this release:
1373501000000105 Social prescribing issues simple reference set (foundation metadata concept).
1373511000000107 Social prescribing support procedures simple reference set (foundation metadata concept.
Technical notes
There are currently no planned UK changes. The Proposed SNOMED International changes can be found in the relevant release folder.
Known Issues
There are no known issues for this release.
Release ID 34.0.0 - 22 July 2022
International Release
The SNOMED CT UK Clinical edition is based on the January 2022 SNOMED International release.
The SNOMED International release notes can be accessed here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
No changes.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 34.0.0 release (with dm+d data from release NHSBSA_6.3.0_20220627000001)
of the SNOMED CT UK Drug Extension, will be synchronous with the July 2022 SNOMED CT UK Clinical Extension and the January 2022 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 2
- Finding – 1
- Observable entity – 4
- Procedure – 3
- Record artifact – 4
Changes to History Substitution and Query Tables from 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
This release incorporates maps for the 33.1.0 – 15 June 2022 and 34.0.0 – 22 July SNOMED CT UK Clinical Edition content, along with the UK maps for the September 2021, October 2021, November 2021, and January 2022 SNOMED International Edition releases. Information on content changes made by SNOMED International can be found in the associated release notes.
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 1595 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 407 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 34.1.0 August 2022 release. The August 2022 SNOMED CT content will be mapped and included in the 35.0.0 – 05 October 2022 SNOMED CT UK Clinical Edition, which will also include the UK maps for SNOMED International Edition February 2022 to July 2022 releases.
Reference Sets
There are no new Reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known Issues
There are no known issues for this release.
Release ID 33.1.0 - 15 June 2022
International Release
The SNOMED CT UK Clinical edition is based on the July 2021 SNOMED International release.
The SNOMED International release notes can be accessed here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
No changes.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 33.1.0 release (with dm+d data from release NHSBSA_5.4.0_20220530000001)
of the SNOMED CT UK Drug Extension, will be synchronous with the June 2022 SNOMED CT UK Clinical Extension and the July 2021 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment Scale - 3
- Disorder - 4
- Event - 6
- Finding - 10
- Observable entity - 10
- Procedure - 4
- Record artifact - 6
- Regime/therapy - 0
- Situation - 14
Clinical content to represent Monkeypox information
- Diagnosis of Monkeypox
For any case of suspected or confirmed Monkeypox infection identified clinicians are advised to use the following code: 359814004 |Monkeypox (disorder)|
This code has been in the SNOMED CT UK Edition since 2002 so should be available in clinical systems. If this code is not available in your clinical system, please contact your system supplier.
It is not recommended that the following code is used: 359811007 |Human monkeypox (disorder)|. This code will be made Inactive in a future release of the SNOMED CT UK Edition.
- Monkeypox outbreak
To support the response to the ongoing Monkeypox outbreak NHS Digital has authored 38 new concepts:
Concept | Tag | Preferred Term |
1290681000000106 | assessment scale | Monkeypox severity scale |
1290801000000102 | disorder | Encephalopathy caused by monkeypox virus |
1290821000000106 | disorder | Corneal disorder caused by monkeypox virus |
1290841000000104 | disorder | Sepsis caused by monkeypox virus |
1290721000000104 | event | Close exposure to monkeypox virus |
1310721000000106 | event | Close exposure via sexual partner to monkeypox virus |
1290411000000102 | event | Exposure to confirmed case of monkeypox virus |
1290711000000105 | event | Exposure to monkeypox virus |
1290431000000105 | event | Exposure to suspected case of monkeypox virus |
1290521000000109 | event | Occupational exposure to monkeypox virus |
1290741000000106 | finding | At increased risk of exposure to monkeypox virus |
1290781000000103 | finding | High priority for vaccination against monkeypox |
1290771000000100 | finding | High risk category for developing complication from monkeypox |
1290751000000109 | finding | Low risk category for developing complication from monkeypox |
1290761000000107 | finding | Moderate risk category for developing complication from monkeypox |
1290831000000108 | finding | Monkeypox virus detection result positive |
1290881000000107 | finding | Monkeypox virus detection result unknown |
1290861000000103 | finding | Monkeypox virus detection result negative |
1290811000000100 | observable entity | Monkeypox severity scale score |
1290531000000106 | observable entity | Monkeypox virus qualitative result |
1290551000000104 | observable entity | Monkeypox virus DNA (deoxyribonucleic acid) qualitative result by PCR (polymerase chain reaction) |
1290471000000107 | observable entity | Monkeypox virus DNA (deoxyribonucleic acid) qualitative result in specimen |
1290461000000100 | observable entity | Monkeypox virus RNA (ribonucleic acid) qualitative result by PCR (polymerase chain reaction) |
1290541000000102 | observable entity | Monkeypox virus RNA (ribonucleic acid) qualitative result in specimen |
1290671000000109 | procedure | Assessment using monkeypox severity scale |
1290661000000102 | procedure | Taking of swab for monkeypox virus |
1290441000000101 | situation | Advice given about monkeypox |
1290421000000108 | situation | Advice given about monkeypox by telephone |
1290391000000102 | situation | Educated about monkeypox |
1290891000000109 | situation | History of monkeypox |
1290641000000103 | situation | Monkeypox confirmed by laboratory test |
1290651000000100 | situation | Monkeypox confirmed using clinical diagnostic criteria |
1290581000000105 | situation | Monkeypox excluded |
1290611000000104 | situation | Monkeypox excluded by laboratory test |
1290621000000105 | situation | Monkeypox excluded using clinical diagnostic criteria |
1290511000000103 | situation | Provision of advice, assessment or treatment delayed due to monkeypox outbreak |
1290481000000109 | situation | Provision of advice, assessment or treatment limited due to monkeypox outbreak |
1290561000000101 | situation | Suspected monkeypox |
Changes to History Substitution and Query Tables from 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
There are no updates to the ICD-10 or OPCS-4.9 classification maps for this release. The June 2022 SNOMED CT content will be mapped and included in the 34.0.0 – 13 July 2022 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International January 2022 content.
Reference Sets
There are no new Reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known Issues
There are no known issues for this release.
Release ID 33.0.0 - 18 May 2022
International Release
The SNOMED CT UK Clinical edition is based on the July 2021 SNOMED International release.
The SNOMED International release notes are accessible here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
No changes.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 33.0.0 release (with dm+d data from release NHSBSA_5.0.0_20220502000001)
of the SNOMED CT UK Drug Extension, will be synchronous with the May 2022 SNOMED CT UK Clinical Extension and the July 2021 SNOMED International Edition.
Clinical Content Changes
- Assessment scale – 1
- Disorder – 0
- Finding – 3
- Observable entity – 1
- Procedure – 9
- Record artifact – 2
- Regime/therapy – 0
- Situation – 4
Changes to History Substitution and Query Tables from 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classifications Maps
This release includes the maps for the 32.12.0 – 20 April 2022 and 33.0.0 - 18 May 2022 SNOMED CT UK clinical content, along with the UK maps for the SNOMED International July 2021 content.
The solution deployed to resolve the issue of the previously reported duplicate rows within the mapping files continues to show no evidence of reoccurrence. However, any historical duplications prior to deployment will remain in the files.
Summary detail | |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 1924 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 359 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 33.1.0 – 15 June 2022 release. The June 2022 SNOMED CT content will be mapped and included in the 34.0.0 – 13 July 2022 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International January 2022 content.
Reference Sets
There are no new Reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known Issues
There are no known issues for this release.
Release ID 32.12.0 - 20 April 2022
International Release
The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.
The SNOMED International release notes are accessible here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
No changes.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The reference sets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 32.12.0 release (with dm+d data from release NHSBSA_4.0.0_20220404000001) of the SNOMED CT UK Drug Extension, will be synchronous with the April 2022 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Assessment scale – 0
- Disorder – 3
- Finding - 0
- Observable entity - 8
- Procedure - 4
- Record artifact - 0
- Regime/therapy - 0
- Situation - 13
Changes to History Substitution and Query Tables from 32.12.0
A bug has been identified in how the History Substitution table determines some values for IS_AMBIGUOUS.
The build algorithm traverses chains of historical associations in order to identify active substitute(s) for each inactive concept. Where the traversed chain involved both WAS-A and MAYBE flavours of association, the algorithm previously collapsed this into a flavour of MAYBE (IS_AMBIGUOUS = 1 or 3). In future it will collapse this into a flavour of WAS-A (IS_AMBIGUOUS = 2). The table size is unaltered; only some values for IS_AMBIGUOUS are changed.
This change in the History Substitution table, however, has a very large direct knock-on effect upon the Query Table: a recomputed Query Table for the 32.10.0 release was 11,769,032 million rows smaller than the published original (11,627,761 rows compared with 23,396,793). Releases of the Query Table starting with 32.12.0 will therefore have similarly reduced row counts.
The algorithmic and semantic basis for the correction to both products is well understood, circumscribed and defined. The resulting changes involve almost exclusively only the removal of semantically invalid inferences and so are expected to be beneficial overall going forward. However, previous releases of the Query Table did include a small volume of cases of "right answer for wrong reason": some factually correct rows now being removed can not correctly be derived from the available semantics.
Some level of prior clinical risk may have been associated with the historical publication of incorrect Query Table data in particular. However, a detailed analysis of the Query Table rows now being removed suggests that the huge majority would rarely if ever have been used to drive patient-level care decisions.
SNOMED CT to ICD-10 and OPCS-4 Classifications Maps
There are no updates to the ICD-10 or OPCS-4.9 classification maps for this release. The maps for the 32.12.0 - 20 April 2022 content will be included in the 33.0.0 - 18 May 2022 SNOMED CT UK Clinical Edition, along with the maps for the SNOMED International July 2021 content.
Information for future releases
Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).
Reference Sets
There are no new Reference sets in this release.
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known Issues
There are no known issues for this release.
Release ID 32.10.0 - 23 February 2022
International Release
The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.
The SNOMED International release notes are accessible here.
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser.
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology Extension
No changes.
SNOMED CT UK Drug Extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 32.10.0 release (with dm+d data from release NHSBSA_2.0.0_20220207000001) of the SNOMED CT UK Drug Extension, will be synchronous with the February 2022 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Regime/therapy – 6
- Procedure – 11
- Finding – 11
- Assessment scale – 3
- Disorder – 0
- Observable entity – 5
- Record artifact – 4
- Situation – 13
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code during this release cycle. | 188 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code during this release cycle. | 91 |
NB: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 32.12.0 20 April 2022 release. The April 2022 SNOMED CT content will be mapped and included in the 33.0.0 - 18 May 2022 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International July 2021 content.
Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).
Reference Sets
There are no new Reference sets in this release.
The following two refsets have been inactivated in this release:
- 999000381000000107 - Correspondence care setting type simple reference set (foundation metadata concept)
- 999000391000000109 - Correspondence document type simple reference set (foundation metadata concept)
Technical Notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known Issues
There are no known issues for this release.
Release ID 32.7.0 – 03 December 2021
International release
The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT January 2021 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
No changes.
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 32.6.0 release (with dm+d data from release NHSBSA_11.2.0_20211115000001) of the SNOMED CT UK Drug Extension, will be synchronous with the December 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.
Clinical Content Changes
The following are the counts of new SNOMED concepts added to the respective hierarchy:
- Regime/therapy – 11
- Procedure – 15
- Finding – 20
- Assessment scale – 4
- Disorder – 3
- Observable entity – 6
- Record artifact – 1
- Situation – 12
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
The concept 1365731000000103 Vaccine-induced prothrombotic immune thrombocytopenia (disorder), authored as part of the 32.6.0 - 03-Nov-2021 micro release, is now included in the mapping tables along with the associated ICD-10 map.
Summary detail | Number |
New concepts mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 4 |
Existing concepts mapped to ICD-10 or assigned an excuse code updated during this release cycle. | 99 |
New concepts mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. | 33 |
Existing concepts mapped to OPCS-4 or assigned an excuse code updated during this release cycle. | 195 |
Please Note: Map changes between the current and previous release can be found within the Delta mapping file.
Information for future releases
Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).
Reference sets
There are no new Reference sets in this release.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder here.
Known issues
There are no known issues for this release.
Release ID 32.6.0 – 03 November 2021
International release
The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.
The SNOMED International release notes can be found online at: SNOMED CT January 2021 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
No changes.
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 32.5.0 release (with dm+d data from release NHSBSA_9.2.0_20210920000001) of the SNOMED CT UK Drug Extension, will be synchronous with the October 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.
Clinical Content Changes
The following new SNOMED concepts have been added:
- 1365751000000105
FSN Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination approved (finding)
PT Application for medical exemption from COVID-19 vaccination approved
- 1365761000000108
FSN Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination rejected (finding)
PT Application for medical exemption from COVID-19 vaccination rejected
- 1365731000000103
FSN Vaccine-induced prothrombotic immune thrombocytopenia (disorder)
PT VITT - vaccine-induced immune thrombotic thrombocytopenia
Please note: we will not be updating the NHS Digital SNOMED CT Browser with the 32.6.0 release. These changes will be apparent when we update to the 32.7.0 release in December.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
The ICD-10 map for 1365731000000103 Vaccine-induced prothrombotic immune thrombocytopenia (disorder) will be included in 32.7.0 - 01 December 2021 release.
The concepts 1365751000000105 Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination approved (finding) and 1365761000000108 Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination rejected (finding) are out of scope of ICD-10.
Information for future releases
Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).
Reference sets
There are no new Reference sets in this release:
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.
Known issues
There are no known issues for this release.
Release ID 32.5.0 – 06 October 2021
International release
The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.
The SNOMED International release notes can be found online at:
SNOMED CT January 2021 International Edition release notes
You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser
Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.
SNOMED CT UK Pathology extension
Following the approval of the DAPB4017 Pathology Test and Results Standard by the Data Alliance Partnership Board we are pleased to announce version 1.0.0 of the Unified Test List has now been published on TRUD in machine-readable form as the SNOMED CT UK Pathology Extension.
This release contains 4,220 SNOMED CT concepts:
- 3866 reportable observable entities
- 354 requestable procedure codes
- Replacements for all legacy Pathology Bounded Code List concepts
- Full coverage for Blood Sciences and Microbiology specialisms
Pathology and Diagnostics Information Standards Collaboration Space
SNOMED CT UK Drug extension
SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.
The 32.5.0 release (with dm+d data from release NHSBSA_9.2.0_20210920000001) of the SNOMED CT UK Drug Extension, will be synchronous with the October 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.
Clinical Content Changes
New SNOMED CT UK clinical extension concepts per hierarchy:
- Regime/therapy – 5 new concepts
- Qualifier value hierarchy – 9 new concepts
- Person hierarchy – 1 new concept
- Event hierarchy – 0 new concepts
- Clinical finding – 5 new concepts
- Assessment scale hierarchy – 2 new concepts
- Disorder hierarchy – 1 new concepts
- Observable entity hierarchy – 43 new concepts
- Procedure hierarchy – 22 new concepts
- Record artifact hierarchy – 34 new concepts
- Situation with explicit context – 37 new concepts
0 UK concepts have been inactivated that are duplicates of international content.
0 foundation metadata concepts have been inactivated.
14 concepts have been inactivated with replacements in the SNOMED CT Pathology extension, in accordance with the Unified Test List design principles for pathology and diagnostics SNOMED CT concepts.
‘On examination’ and ‘Complaining of’ concepts
We are aware of an ongoing issue with the NHS Digital SNOMED CT browser (Termbrowser) which means the reactivated ‘On examination’ and ‘Complaining of’ concepts are not displayed correctly. We are working to fix the issue. Further updates will be provided here.
There will also be a slight delay in the update of the NHS Digital SNOMED CT browser for the 32.5.0 release.
SNOMED CT codes relating to COVID-19 Vaccination
New SNOMED CT concepts have been added to enable the recording of the maintenance protection course against SARS-CoV-2. The new content and further detailed information can be found in the COVID-19 Vaccination codes section on the COVID-19 Information Standards page.
SNOMED CT to ICD-10 and OPCS-4 Classification Maps
A solution for the previously reported issue of duplicate rows within the mapping files has been deployed, with no evidence of reoccurrence for this release. We will continue to monitor the situation for future releases, to check for any ongoing issues.
Due to work being carried out to resolve the duplicate row issue, the number of map changes are smaller than usual. Updates of note include the remapping of over 90 ‘situation’ concepts previously allocated a ‘#NC’ excuse code and the inclusion maps for the COVID-19 vaccination content released in the 32.4.0 Micro – 08 September 2021 SNOMED CT UK Clinical Edition.
Summary detail | Number |
New or existing concepts which have been mapped to ICD-10 or assigned an excuse code (excluding #NEW) during this release cycle. | 191 |
New or existing concepts which have been mapped to OPCS-4 or assigned an excuse code (excluding #NEW) during this release cycle. Please note: All map changes between the current and previous release can be found within the Delta mapping file. | 144 |
Information for future releases
Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).
Reference sets
There are no new Reference sets in this release.
Notice of deprecation of reference sets
There are no reference sets due for deprecation in the next release.
Unfortunately, we are not currently in a position to proceed with requests for new reference sets at this time. Any requests we receive are being escalated and NHS Digital is currently reviewing the processes for reference set production. You may wish to submit a request via the Request Submission Portal so it can follow this escalation process.
Technical notes
There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder.
Known issues
There are no known issues for this release.
Release Documents
- SNOMED CT Refset Overview - this document provides a brief description of the UK specific reference set files included in the release of SNOMED CT UK Edition.
- SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition) - the Terminology and Classifications Delivery Service develops and maintains the UK cross-maps. Cross-map content is updated to include additions and changes to both SNOMED CT and the classifications. The UK cross-maps are provided as part of the SNOMED CT UK Edition released by NHS England as the UK National Release Centre (UK NRC) for SNOMED CT. This document provides an overview of these cross-maps.
- SNOMED CT General Overview- this document gives a brief description of the UK specific files included in the SNOMED CT UK Edition.
- SNOMED CT Technical Overview - this document provides technical details of the UK release files included in this release of SNOMED CT UK Edition.
- SNOMED CT to ICD-10 and OCS-4 Cross-Mapping Retired Reference Sets - this document describes the content and scope of the retired RF2 cross-map releases for reporting, research or data warehousing purposes.
- SNOMED CT UK Clinical Edition SNOMED CT Query Table 20200812
- SNOMED CT UK Clinical Edition UK Concept History Substitutions Table 20200413 - see the "SNOMED CT UK Query Table and History Substitution Table" releases on TRUD. A table of concept substitutions is included in the main release which identifies, for all active concepts, one or more replacement concepts along with a crude indicator of the certainty that the history data implies for each substitution. This table is computed solely from the contents of the SNOMED CT history mechanism as set out in the document which is bundled together with the table itself.
- Data Migration Workbench Instructions
- Data Migration Workbench User Guide
- Tags
- SNOMED CT