Are there going to be ICD-11 pilot sites?

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.

• General Information

At the moment we have lots of important handwritten notes in our ICD-10 books referencing National Standards and Local Policies - how will these notes work with ICD-11's electronic format?

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.

• National Standards

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.

• Timelines

Can you advise on whether the ICD-10 6th Edition will be released in the interim whilst preparations for ICD-11 implementation are underway? You stated in your Service Improvement Plan that you would provide an updated regarding future intentions for ICD-10 on Delen by 31 December 2021. However, we are still awaiting this information and it is now June 22.

We had hoped to publish a decision on this last year but this was delayed while we prioritised our work on OPCS-4.10. We expect to publish a decision shortly, which will be communicated via our normal channels. We will then update this response.

• Timelines

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.

• SNOMED CT

Given that banding for qualified coders varies significantly across England and Wales do you foresee this changing with the implementation of ICD 11?

This is not a matter that falls within the responsibilities of the Terminology and Classifications Delivery Service or the scope of the ICD-11.

• General Information

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.

• SNOMED CT

How do I find out what’s happening with ICD-11?

Our ICD-11 pages on Delen provide an authoritative source of information about ICD-11 for the NHS in England.  You can also access information directly from the ICD-11 pages of the World Health Organization website. We will provide updates in our Terminology and Classifications Newsletter, which you can subscribe to here and we will be running targeted awareness raising and stakeholder engagement sessions, details of which will be publicised on Delen.

• General Information

How do I get access to the Kahootz site where these issues are being discussed?

Information about the implementation of ICD-11, including information about engagement sessions and questionnaires will be shared publicly via the ICD-11 page of Delen. No registration is required to access this site.

• General Information

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.

• Timelines