Yes. Our expectation is that we will have a number of pilot sites that enable us to understand the challenges relating to the various ICD-11 use cases and implementation contexts. As part of our pre-implementation work in 2022-23 we will determine the types of pilot sites that are needed and the criteria for selecting these sites. Pilots would then be run during the implementation phase of our work, which will commence in 2023.

This is an important area that we will be looking at carefully in collaboration with the clinical coding community and the World Health Organization. Our expectation is that there will be a reduced need for national standards due to ICD-11 better reflecting current clinical practice and having more comprehensive content, e.g. in relation to rare conditions. There will however still be a need for principles and some standards and we will work with our stakeholders to ensure these are provided in a way that works for the clinical coding community.

Yes. We are aware that some individuals and organisations are already using ICD-11 at a local level within the UK and we are keen to connect with these early users to learn from their experiences and to support them where we can. ICD-11 cannot yet be submitted via national data sets, so if information captured locally using ICD-11 is required to be submitted as part of a national data set, then there will be a need to map from ICD-11 to ICD-10 until such time as the national data sets are able to carry ICD-11 data. Tools are available to support mapping between ICD-10 and ICD-11 (see separate FAQ) and we are keen to work with early users of ICD-11 to see how we can support the mapping process.

No. SNOMED CT is a clinical terminology, designed to provide a machine-readable version of the information recorded by clinicians at the point of care. It is a highly expressive terminology that supports a broad range of use cases, including interoperability, decision support and reporting, but it is not designed to be a classification. ICD-11 is the global standard for the classification of diseases and related health conditions and has been purpose built to provide stable, comparable, clinically and statistically validated data. By combining SNOMED CT and ICD-11, users can benefit from both rich, machine-processible point of care data and robust statistical data.

Much of the knowledge and skills acquired by coders through their training is relevant to coding as a whole, rather than to specific versions of the classifications, so staff who have completed their training prior to the implementation of ICD-11 will still have benefited from that training, which will then be supplemented with ICD-11 specific training. We also encourage clinical coders to familiarise themselves with ICD-11 through the range of online resources provided by the World Health Organization.

Yes. We will provide extensive communications and reference materials to help clinical coders (and all stakeholders) understand what the move to ICD-11 will involve. We will also run interactive engagement sessions to share our plans and receive feedback and suggestions from all our stakeholder groups. Our ICD-11 pages on Delen will be the main source of information.

The WHO has provided a useful ICD-11 Reference Guide and within this Annex A ICD-11 Updating and Maintenance sets out the update cycle. In summary:

• Official releases of the ICD-11 MMS (Mortality and Morbidity Statistics) linearization will be produced annually. These releases will not impact on the 4 and 5 character structure.
• Releases that do impact the 4 and 5 character structure will be released on a five yearly cycle.
• Updates to mortality and morbidity rules will happen on a 10 yearly cycle.

The WHO expects and encourages member countries that have implemented ICD-11 to take the annual updates and all versions of ICD-11 will be permanently accessible via the ICD-11 API.

We are engaging with system suppliers to ensure they have the information they need about ICD-11, including the technical support available through the World Health Organization (WHO) provided API and embedded tools. We expect suppliers to work with their customers to identify the best technical approach for integrating ICD-11 within their PAS/EPR/encoder systems. The WHO has provided considerable technical resources and implementation guidance to help with this and we will work with suppliers to identify any additional support that is required for the NHS context.

The World Health Organization (WHO) has provided a very useful website and a sophisticated and freely available set of tools (ICD-11 Browser, ICD-11 Coding Tool and ICD-11 API), as well as an Implementation Guide, reference materials and training resources to support users of ICD-11 and those wishing to familiarise themselves with the classification. During the ICD-11 Pre-Implementation project (2022-23) we will spend time listening to stakeholders to understand their expectations, priorities, questions and support requirements, so that these can inform our implementation approach and timescales.

We will have a better idea of this once we have developed our ICD-11 implementation plan, which is expected to be ready by the end of March 2023 and when we have completed some pilot implementations. There will be a very significant amount of work involved in making the transition from ICD-10 to ICD-11, including the formal governance process for having ICD-11 replace ICD-10 as the mandated national information standard for the classification of diseases. Our current assumption is that ICD-11 will not be mandated as a national information standard before April 1st 2026, but this is an assumption only at this stage and should not be interpreted as implying that ICD-11 will be mandated on April 1st 2026.