ICD-11 for Technology Suppliers

Help us develop our ICD-11 Implementation Plan

We are in the early stages of preparing for the implementation of ICD-11 across the NHS in England and we want to work with technology suppliers to develop an implementation plan that is ambitious but realistic. You can get involved by reviewing our implementation approach, joining our supplier focussed interactive Q&A sessions and reviewing our use cases.

Technology Supplier Resources

We will continually update and expand our ICD-11 resources based on feedback and requests from stakeholders. If there is something we don't currently provide that you think we should, please let us know and we will do our best to help. Our current resources are provided below.

Access the freely provided ICD API for programmatic access to the International Classification of Diseases. The link takes you to a WHO maintained page where you can register for the API, access up to date documentation on using the API and manage the keys needed for using the API.

Join our technology supplier discussion forum where you can raise matters relating to ICD-11 with other suppliers and NHS England. You will first need to register, which you can do here.

The Implementation and Transition Reference Guide highlights important aspects of ICD-11, the benefits ICD-11 brings and some of the technical considerations that should be factored into implementation planning. It is recommended reading for anyone implementing ICD-11.

Our FAQ database contains a number of questions that have been submitted via our helpdesk or in response to questionnaires. We encourage you to search the database before contacting our helpdesk, but if your question hasn't been answered, please do contact us via our helpdesk.

Technology Supplier FAQs

You can browse our full ICD-11 FAQ database, but below are some of the questions that relate specifically to technology suppliers.

How long will it take for the NHS to implement ICD-11?

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.

Is the intention that software providers will still provide encoders that support the recording of ICD-11 in hospital systems?

NHS trusts and other organisations will continue to manage their technology requirements and their relationships with suppliers in the way that best meets their local needs. The World Health Organization has provided technical guidance and products, including the ICD-11 API and embedded Browser and Coding Tool, which will enable organisations and system suppliers to take advantage of ICD-11 with a reduced technical burden.

Will ICD-10 be mapped to ICD-11?

Yes. The World Health Organization has provided bi-directional maps between ICD-10 and ICD-11 and we are reviewing these to ensure they work as required. The maps will be essential for any implementations of ICD-11 that take place before ICD-11 is mandated as a national standard, in order that data recorded using ICD-11 can be mapped back to ICD-10 for national data submissions.

How is ICD-11 going to work with our current hospital systems and in particular PAS/EPR? What do we/our system suppliers need to do?

We will engage 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.

Will we have to implement ICD-11 in all its complexity from day one?

We will work with stakeholders, including the World Health Organization to confirm the options available for the implementation of ICD-11, but we are keen to take advantage of the capabilities that come from the greater level of sophistication ICD-11 provides compared with ICD-10. But we are also aware that ICD-11 is a more complex classification than ICD-10 and aspects such as post-coordination will require careful review in order to determine the scale and nature of the challenges they present to system developers, clinical coders, data pipeline developers, data set developers and analysts. We will ensure the implementation of ICD-11 is guided by a full understanding of the real-world context in which it will be used and we will adjust our timeline and approach as necessary to achieve a controlled implementation that works well for all affected parties.

Will the trust be trying to build a system or use the WHO system which is already running?

Local trusts will make decisions based on their priorities and informatics strategies, so we expect there will be a variety of approaches taken across the NHS. The API and its embedded browser and coding tool which are provided free of charge by the WHO will make it significantly easier for ICD-11 to be incorporated into existing IT systems than it would be if they had to be produced from scratch by each organisation, system supplier or country.

Has mapping for ICD-11 and SNOMED CT been completed and will we see ICD-11 mapping codes in the SNOMED CT browser?

Mappings for ICD-11 and SNOMED CT have not been completed yet and there are currently no timescales available for this. There are some international mapping exercises underway and NHS Digital are contributing to these. When ICD-11 is adopted and implemented in the UK we would expect the maps to be included in the UK Edition of the SNOMED CT Browser.

Can ICD-11 be used before it is mandated nationally?

Yes. We are aware that some organisations are already using ICD-11 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 and we are keen to work with early users of ICD-11 to see how we can support the mapping process.

Does SNOMED CT remove the need for ICD-11?

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 in an Electronic Patient Record (EPR). 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 is the global standard for the classification of diseases and related health conditions and ICD-11 has been purpose built to provide stable, comparable and statistically valid data. By combining SNOMED CT and ICD-11, users can benefit from both rich, machine-processible point of care data and robust statistical data.

How frequently will ICD-11 be updated?

The World Health Organization (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 four and five character structure.
  • Releases that do impact the four and five 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 we will work with stakeholders to decide whether we should move to annual updates or retain our current 3-yearly update cycle. All versions of ICD-11 will be permanently accessible via the ICD-11 API.