Chris Netherton, M.D.

Making sure that all our healthcare systems speak the same language

The initiative taken by NHS Digital to standardise all their clinical terminology using SNOMED CT is an important step forward for healthcare provision in the UK.

To achieve the full benefits of interoperability and therefore to be able to deliver better integrated care, it is vital that we can have accurate and consistent sharing of data across systems. Within General Practice there are currently two different Read code systems in place for the recording of patient information, Read v2 and CTV3. Used for over twenty years, neither of these can meet the requirements of the NHS in the future and in any case, parts of the vocabulary for these current systems are full, which creates problems for analysis.

SNOMED CT is a comprehensive clinical vocabulary which is already used internationally and has been implemented in over 75 countries. It provides the clear and unambiguous coding that the NHS needs and can be used across primary and secondary healthcare settings. The vocabulary covers content such as diagnoses, interventions, symptoms, allergies and family history.


SNOMED is already used in over 75 countries.

NHS primary care providers will move to SNOMED CT from April 2018. At Microtest, we are fully supporting this move and putting a great deal of resource behind it. We believe that it will help facilitate a transformation in our healthcare services.

Not only does SNOMED CT provide a bigger vocabulary for recording information, it is also more nuanced and better reflects the range and complexity of the symptoms and diagnoses that we now need to record. It allows for a level of expansion and improvement in the future that the other systems would never have coped with. Medical practice is constantly changing and evolving, and SNOMED CT can adapt to meet those challenges.

This is not an easy change. Although every effort is being taken to ensure minimum impact for surgeries, the transition will require education and training across the NHS. However, it is more than justified in the benefits it will bring, both in improvements to patient care and in the more effective analysis of patient data (nationally and internationally).

I am really looking forward to seeing the impact that this initiative will have. At Microtest, we dedicate ourselves to creating clinical software solutions that help our healthcare professionals to work as effectively as possible. To this end, we have invested a large amount of development effort to minimise the impact the new coding functionality will have on clinicians and practice staff, and to ensure that our SNOMED implementation is as easy to use as possible. The arrival of SNOMED CT will mean that clinical software systems can be used to their full potential. It will become a key building block for the NHS services of the future.

It is also well worth being aware of the international perspective.

SNOMED CT is already being used in a wide range of applications in countries around the world, including Australia, Czech Republic, Denmark, Hong Kong, Ireland, Israel, Malaysia, Netherlands, Singapore, Spain, Sweden, and the USA.

However, I understand that, of all the countries using SNOMED CT, only the UK and New Zealand are currently working on programmes that would see it adopted right across their national healthcare systems.

In New Zealand, there is a programme underway to make a complete transition to SNOMED CT. The first district health boards and primary health organisations are now migrating their systems from Read codes to SNOMED CT and pilot projects around New Zealand are showing the benefits to care coordination, clinical decision support and interoperability that SNOMED CT makes possible. Pilot projects already underway include:

  • St John Ambulance’s electronic patient report form
  • Nelson-Marlborough DHB’s emergency department at a glance information system
  • New Zealand Universal List of Medicines (NZULM)
  • Midlands Health Network’s new multi-practice, multi-specialty patient management system
  • South Island Patient Information and Communication System (SIPICS)
  • Although great strides forward are being taken in New Zealand, they will not have completed comprehensive migration to SNOMED CT right across primary care from April 2018, our deadline in the UK.

So, it appears that NHS could achieve a world first in their national use of SNOMED CT.

It is really exciting to see the NHS breaking new ground in this way and really inspiring to be part of making such a significant change happen.