The best way to organize an NRC depends on a wide range of factors, including the number of potential Affiliates, the vision and strategy for use of SNOMED CT in the country, the national eHealth infrastructure, the extent of customization, etc. But Members of IHTSDO are, at a minimum, required to fulfill a set of core responsibilities within the Member's territory, as shown in Figure 2 and specified in the Articles of Association. Typically, the NRC fulfills most of these obligations, however a Member may make other arrangements to fulfill some of the obligations.
The Articles of Association for IHTSDO can be found here: http://snomed.org/articles.

Figure 2 Obligations of IHTSDO Members.

• NRCs are required to serve as primary points of contact for IHTSDO with regards to all aspects of the management of the terminology products.
• NRCs are the primary points of contact for Affiliates within a Member country.
  • Affiliates should be able to contact the NRC for guidance and direction with respect to implementation and use of SNOMED CT within the Member country.
  • The NRCs should serve as intermediaries between the Affiliates and the SNOMED CT community, for example:
    • Encouraging experts and other appropriate persons to contribute to the work of IHTSDO;
    • Assisting IHTSDO to communicate with Affiliates and experts entitled to and wishing to be enrolled as IHTSDO Affiliates.
• NRCs are required to establish and maintain processes necessary for distribution and licensing of SNOMED CT and the other terminology products.
  • This includes developing the appropriate mechanisms for users to gain access to National (where applicable) and International Editions of SNOMED CT and related products, and mechanisms to retrieve and manage Affiliate licenses. (See section 9 on tooling for process support.)
  • This includes managing license reporting annually and reporting Affiliates' activities in non-Member countries to IHTSDO.
• NRCs are required to ensure that any deployment of a terminology product owned by IHTSDO conforms to IHTSDO standards.
• NRCs must facilitate feedback from users on SNOMED CT, including managing change requests.

Besides these areas, there is a range of other responsibilities that NRC may decide to undertake. The table below lists a set of possible responsibility areas. The list is not exhaustive but includes the main areas that NRCs currently cover. Some of the areas are marked as "Required," as these are part of the core responsibility areas.
Table 1. NRC Responsibility areas

NRC competencies

The competencies required for an NRC are dependent on what services the NRC chooses to deliver. However, most NRC staff should have a general understanding of SNOMED CT and IHTSDO.
If an NRC is unable to provide a specific type of service, it should seek to identify other resources that are able to meet the requirements of implementers and users in the Member country.
The following core competencies are typical for the work of an NRC. Some of these competency areas can be considered assignment-specific, as they will not be required as a constant competency within the NRC but are required to fulfill specific assignments, such as translation, mapping and development of Reference sets.

Specific competencies required to undertake particular NRC related tasks are outlined in Table 2.
Table 2 Competencies and skills required to undertake particular NRC tasks