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.

The February 2023 release will also include the maps to OPCS-4.10. The 4.10 maps must not be used in live systems until 01 April 2023 onwards.

There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 34.1.0 – 10 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.

Updates to the SNOMED CT to ICD-10 and OPCS-4 maps are included in the 33.0.0 – 18 May 2022 release, but there will be no further updates to the maps for 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.

Errors have been reported in relation to Release ID 33.0.0

SNOMED CT Drug extension simple map

The simple map refset file in the SNOMED CT UK Drug Extension release contains members that refer to a refset ID that does not exist in the corresponding concept table.

ID	EffectiveTime	Active	ModuleID	RefsetID	ReferencedComponentID	MapTarget
0b830cac-00cd-484c-a25f-bcdaf36b9ebd	20220511	1	999000021000001108	13088201000001103	1144607003	SUPPORTING_DATA
1f54fc6b-0fc7-44f4-bcb4-93a5a205b4a0	20220511	1	999000021000001108	13088201000001103	1155971003	SUPPORTING_DATA
20580ee7-c57d-42f7-83bf-a3bbbcead17e	20220511	1	999000021000001108	13088201000001103	1137367000	SUPPORTING_DATA
30fc0cdd-e86e-4dfc-a838-069a24851b8b	20220511	1	999000021000001108	13088201000001103	1148537007	SUPPORTING_DATA
38be27ca-1ef7-4db2-b7d8-0efecd318707	20220511	1	999000021000001108	13088201000001103	1149496005	SUPPORTING_DATA
4599da49-e615-4b46-b308-37729c07c1c9	20220511	1	999000021000001108	13088201000001103	1162689008	SUPPORTING_DATA
497231a5-4adc-4e1e-9a01-c51e559fc24f	20220511	1	999000021000001108	13088201000001103	1157170002	SUPPORTING_DATA
49aacf72-f54a-477f-8161-b8040c1d6df9	20220511	1	999000021000001108	13088201000001103	1145127006	SUPPORTING_DATA
55314bf8-3194-4e51-a869-74b4b449b1f8	20220511	1	999000021000001108	13088201000001103	1144477009	SUPPORTING_DATA
a5037b79-fb44-4b02-aef0-e24c9ca50e2a	20220511	1	999000021000001108	13088201000001103	1145150000	SUPPORTING_DATA
d218ba0f-4e8a-46f3-bd10-e295a6832744	20220511	1	999000021000001108	13088201000001103	1156877005	SUPPORTING_DATA
e84c5218-66c8-4142-9153-5d01dd866437	20220511	1	999000021000001108	13088201000001103	1148549008	SUPPORTING_DATA
efdee66a-89a5-4a84-a8b1-6259f0f3c0b7	20220511	1	999000021000001108	13088201000001103	1137366009	SUPPORTING_DATA
fb85fbbf-ba50-4957-8ae7-cbf00e271a84	20220511	1	999000021000001108	13088201000001103	1144610005	SUPPORTING_DATA
fd8f50cd-354c-4328-b647-e84053e002e4	20220511	1	999000021000001108	13088201000001103	372691000221100	SUPPORTING_DATA

The above members have all been released in error and will be removed from all release types in the 33.1.0 release.

SNOMED CT Clinical extension RLR entries

The following four concepts all lack entries in the 999001261000000100 |National Health Service realm language reference set (clinical part)| (the RLR) that refer to Active descriptions. Currently their RLR entries refer to Inactive descriptions:

• 440701000124107 |Inadequate vitamin B6 intake (finding)|
• 440711000124105 |Inadequate vitamin B12 intake (finding)|
• 440741000124109 |Excessive vitamin B6 intake (finding)|
• 440751000124106 |Excessive vitamin B12 intake (finding)|

All four concepts are Inactive.

This error will be fixed in the 33.1.0 release.

An error has been reported in relation to Release ID 32.10.0

The following six concepts relating to the pathology module:

• 50321000237103 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) RNA nucleic acid amplification qualitative result
• 50581000237106 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgM antibody in serum qualitative result
• 51631000237101 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antigen in serum qualitative result
• 62641000237109 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgA antibody in serum qualitative result
• 63001000237108 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgG antibody in serum qualitative result
• 66641000237105 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibody in serum qualitative result

Were erroneously included within the following two refsets in the clinical refsets module:

• 1321181000000108 - COVID-19 record extraction simple reference set
• 999004331000000102 - Summary Care Record inclusion simple reference set

These have been removed and the relevant packs re-issued on the same day as the original release (23^rd Feb 2022).

This affects the following release packages on TRUD:

UK SNOMED CT Clinical Edition, RF2: Full, Snapshot & Delta

UK SNOMED CT Clinical Edition, RF2: Delta

SNOMED CT human-readable subset - UK Clinical Extension

If you have downloaded the above packs on 23^rd Feb 2022, you are advised to download them again and re-apply them.  If you use only the delta, the replacement delta will need to be applied to the 32.7.0 release as before

Updates to the SNOMED CT to ICD-10 and OPCS-4 maps have been included in the 32.10.0 - 23 February 2022 release, but there will be no further map updates for 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

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.

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

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

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

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

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

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

The following concepts are new for this release: 

• 1363831000000108 Administration of fifth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
• 1363791000000101 Administration of fourth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
• 1363861000000103 Administration of third dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
• 1363851000000101 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose declined (situation) 

• 1363841000000104 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose not given (situation) 
• 1363811000000100 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose declined (situation) 
• 1363821000000106 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose not given (situation) 
• 1363781000000103 Severe acute respiratory syndrome coronavirus 2 vaccination third dose declined (situation) 
• 1363771000000100 Severe acute respiratory syndrome coronavirus 2 vaccination third dose not given (situation) 

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

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

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

There are two workarounds for this:

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

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

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

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

The following approach will be effective immediately:

• pause SNOMED CT International Edition uplifts (after the May-21 major release) until further notice (for a minimum of 12 months)
• reduce the frequency of the SNOMED UK Clinical Edition updates for UK clinical content. The next releases will be: 14 July 2021, 6 October 2021, 1 December 2021, 23 February 2022
• phase SNOMED CT content / backlog requests across releases planned in 2021 and 2022; the Request Submission Portal remains open 24/7
• prioritise maintenance of key clinical terminology reference sets which may also mean new developments are put on hold

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

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

• a formal position is being sought from NHSX on the strategic direction of NICIP and the long-term intention to move to the use of a single terminology of SNOMED CT

• NHS England and Improvement are looking to commission a piece of discovery work that aims to identify how to improve the collection, utility, and dissemination of the Diagnostic Imaging Dataset: this could include reviewing opportunities and impacts of updating NICIP and/or transition to SNOMED CT

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

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