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