Many thanks to all who attended the "SNOMED Supporting Clinicians" session at the 2019 SNOMED international Business meeting. The presentations, and links to various information are now available on a dedicated Confluence page - 2019-04-08 "SNOMED supporting clinicians".

Please review the information and use as you require.

We would also welcome feedback on the day, and also suggestions for future sessions dedicated to the promoting a clinical perspective of SNOMED CT.

Comments can be made via, or directly to Ian Green ( or Jane Millar (

What is SNOMED CT and why are we using it?

What is SNOMED CT?

SNOMED CT is a standardised health care vocabulary and we are adopting it within the development of the UKCRC Tissue Directory. Every project involving data will have some form of data standard, whether it is formalised to the level of SNOMED CT or whether it is just an informal understanding.

Much of the work we have undertaken to date was based on the excellent work of the Confederation of Cancer Biobanks (CCB) and their data standard. The CCB data standard as drafted, however, did not define the terms to be used and this is why we have turned to SNOMED CT.

The we use SNOMED CT is linked heavily to the decision to use it within all health care environments within the UK. The hope is that by adopting SNOMED CT, and by building this into our systems (and therefore into how sample resources describe themselves), we will help sample resource be prepared for handling SNOMED CT terms from other healthcare systems.

In 2012, the then Prime Minister David Cameron announced funding for the 100,000 Genomes Project, to be organised by Genomics England (GE), a private company formed by the Department of Health in 2013. Through this project, GE works in partnership with NHS England (itself a non-departmental public body of the Department of Health) to integrate WGS into the NHS. The 100,000 Genomes Project aims to sequence 100,000 genomes from NHS patients with cancer and rare diseases. Data collected from the 100,000 Genomes Project can inform research on rare diseases, or benefit patient care potentially by streamlining the diagnostic process and tailoring care to the individual.

The project has strict inclusion criteria, to ensure data of clinical and research benefit is gathered. For over 300 rare diseases, specific criteria[1] are applied to maximise chance of recruiting individuals whose disease may have a Mendelian basis. The project also requires submission of phenotypic data using SNOMED[2] (standardised healthcare terminology used for electronic health records and coding in over fifty countries terms, and evidence of previous genetic testing (to screen out previously known mutations). A patient’s whole blood samples must pass quality assurance and quality control tests. When relevant, close relatives (usually the parents) of the patient also undergo WGS. In the case of autosomal dominant conditions all affected members may be sequenced.

As a result of historic investment and forward-planning for developments in informatics, the Salford Royal Foundation Trust is currently in an enviable position as one of the most digitally mature NHS Trusts in England.

The Trust’s EPR system was implemented in 1999 and now holds 1.3 million patient records, with millions of documents, diagnoses and diagnostic results.

This wealth of clinical data has proved to be a powerful research resource, with a number of successful studies carried out by partner organisation North West Ehealth.

Additionally, SRFT has been chosen as one of the twelve organisations to take part in the Global Digital Excellence programme. It will be funded to accelerate them towards achieving Healthcare Information Management Systems Society (HIMSS) level 6 and 7 status.

There will be a strong emphasis on standardisation of systems (Snomed CT, GS1 and FHIR) and these technologies will form the basis of a powerful interoperability platform, providing a much improved research resource.

The Emergency Care Data Set (ECDS) is the new national data set for urgent and emergency care. ECDS is implemented in consultant-led 24hr (Type 1) Emergency Departments and specialist (Type 2) Emergency Departments from October 2017. ECDS is being implemented in Minor Injury Units/ Urgent Care Centres and Walk-in Centres (Types 3 & 4 respectively) Emergency Departments by October 2018.

The ECDS covers "Reason for Attendance", "Chief complaint", " Acuity" and "Diagnosis". The set is specified and collected in SNOMED CT form. Further details can be found in the attachment.

The Academy of Medical Royal Colleges in the UK have produced a Good Practice Guide to inform hospital doctors about current developments in medical record keeping standards for the Electronic Patient Record (EPR). It describes why standards are needed for the structure and content of medical records and how their introduction will affect our work.

The document is structures as follows

– A guide for clinicians

– Why have standards for the structure and content of medical records?

– What are standards for the structure and content of medical records?

– The Electronic Patient Record

– Where are we now?

– What does it mean for me?

– What is happening next?

– Where can I get more information?

– References

The document can be accessed here -

Dear all,

As from today the mailing lists for all CRG's will n o longer notify you of changes on the site. The approach is in line with the latest privacy legislation. You will need to look at the individual sites to obtain information on updates and postings.

SNOMED International will issue a communication to any current mailing lists requesting explicit consent to contact you for the purposes of promoting SNOMED International, the SNOMED Community, along with updates specific to SNOMED International events. Emails sent from this service already have unsubscribe links to allow recipients to change and update their preferences.

You will need to actively “Opt-In” to be able to receive email notifications from Confluence by “watching” specific groups or pages. Information on how to do this can be found here -

Please see the mail you will have received from Confluence.

If you have any concerns regarding this matter please email myself (

Kind regards,

Ian Green

Our thanks to everyone who attended the clinical session at the SNOMED International business meeting in London on April 9.

This is the first such general clinical session we have organised and the focus was on the clinical engagement strategy and the work to establish Clinical Reference Groups, including the use of confluence. We received some really helpful feedback and further direction, which was very helpful.

We attach here the slides of the session and welcome further input/feedback. In addition, your thoughts on what a clinical session might cover at our Vancouver meeting in October 2018 would be very helpful

Best wishes

Jane Millar

Ian Green

Clinical Engagement Reference Groups moving forward_09042018_v1.2.pdf

April Business Meeting

A reminder to register for the April Business Meeting if you have not already done so. Supporting information complete with registration links and agenda can be found here:

Please also note that NHS Digital has organized a 'Clinical Terminology Service Connectathon' that will run on the Thursday and Friday (independent of SNOMED International meetings.) Interested parties may register for the session via the business meeting registration link.  

Dear all,

Please be aware that due to technical reasons we have had to move the individual group pages within Confluence. Due to this, if you have previously bookmarked the pages the bookmarks will no longer function. The links to the individual groups are available from Directory - Clinical Reference Groups, please update your bookmarks as required.

Kind regards, Ian Green

Special Interest Groups (SIG's) have been a core component of the work of the IHTSDO/SNOMED international from the beginning, and in some cases predate the organisation itself. As we move to a new approach, using Clinical Reference Groups (CRG's), it seems a good time to look back at all that has been achieved over the years.

Over the years, SIG's have been used to both inform developments by providing expertise, and in some cases to also deliver specific items. Both of these have been crucial to ensure that SNOMED CT and also derivative products have been fit for purpose. Members of all SIG's have shown great commitment to SNOMED CT over the years. SIG's have provided expert domain input to SNOMED International from enthusiasts, in the specific field, who recognise the value of SNOMED CT and have given considerably of their time, sometimes without financial assistance and at their own expense. SNOMED International would like to acknowledge the commitment of all SIG members over the years, and hopes for the continued commitment of individuals going forwards.

As we move forwards, the range of groups will be much broader than in the past, and we would encourage existing members to continue to support there own specific specialties, and also to reach out to colleagues to encourage them to be part of newer groups.

Details of all groups can be found at Directory - Clinical Reference Groups

Dear all,

As you will be aware from our discussions within each Special Interest Group (SIG), we are moving away from a model of using SIG’s to a virtual based approach.
Each existing clinical SIG, including the Mapping SIG, has its own new dedicated Confluence site. The links to these sites can be found at the following - Introduction - Clinical Reference Groups
We have created a number of Confluence pages to support these changes starting from Clinical Engagement, which covers Clinical Engagement, and provides link to a front page for Clinical Reference Groups.
We have created the email distribution lists for each of the new groups based on the existing Membership list for each SIG. If you no longer wish to be a part of the relevant Clinical Reference Group, please send a notification to myself (
In addition, if you have any feedback on the Confluence pages themselves, please let me know, your feedback would be much appreciated,
Kind regards,
Ian Green
Clinical Engagement and Education Services Business Manager