Implementing the NHS dictionary of medicines and devices

Implementing the NHS dictionary of medicines and devices (dm+d) presented by Jo Goulding Head of Pharmacy Terminology Implementation

What is dm+d? 2

What is dm+d? dm+d is: • Text – standardised UNIQUE description for each entry The human readable bit • Code – SNOMED CT The computer readable bit • Paracetamol 500 mg tablets 322236009 dm+d is not: • A computer system • Decision support 3

dm+d links to SNOMED CT SNOMED® CT™ International Release etc IS_A cardiovascular drug IS_A NHS dictionary of medicines and devices calcium channel blocking agent IS_A VMP Nifedipine 30 mg modified-release tablets (product) VMPP Nifedipine 30 mg modifiedrelease tablets 28 tablet (product) VTM Nifedipine (product) AMP Adalat LA 30 mg tablets (Bayer Plc) (product) AMPP Adalat LA 30 mg tablets (Bayer Plc) 28 tablet 2 x 14 tablets (product)

Why is dm+d important? 6

Why dm+d – historical drivers • The 1998 Government White Paper ‘Information for Health’ noted: “There is a lack of standardisation in the UK in describing medicines, appliances and medical devices, in how such descriptions are organised, and in linking knowledge required for decision support to these descriptions” • The UK Clinical Products Reference Source (UKCPRS) programme was initiated to deliver a terminology to address this lack of standardisation • dm+d is the product of the UKCPRS programme 7

Why dm+d – current context • ‘The Power of Information’ (May 2012) “At the moment different areas of the health and care system use different coding terminologies – this means that information cannot flow around the system well……. . all relevant systems should use the same terminology to exchange coded information; SNOMED CT, adapted to fit all necessary uses, is the appropriate terminology to base this on. Similarly, to allow drugs to be consistently referenced, systems will consistently use the electronic drugs dictionary (dm+d)”

National Information Board • National Information Board (NIB) - ‘Personalised Health and Care 2020: A Framework for Action’ “The NIB endorses the move to adopt a single clinical terminology – SNOMED CT – to support direct management of care, and will actively collaborate to ensure that all primary care systems adopt SNOMED CT by the end of December 2016; the entire health system should adopt SNOMED CT by April 2020” (p 30 -31) • Noting that SNOMED CT includes dm+d

dm+d – the NHS Standard • ISB 0052 • Dictionary of Medicines and Devices (dm+d) The Standards primary purpose is to support interoperability. Therefore electronic systems that exchange or share information about medicines relating directly to a patients care must adhere to the Standard by using dm+d identifiers and descriptions when transferring information • Implementation Date 30 th June 2017 • Standard is still applicable (moving to SCCI) 10

The Carter Context – supporting Hospital Transformation Recommendation 3 • Recommendation 3(a) – HPTP planning and governance • Recommendation 3(b) – clinical pharmacy and infrastructure services • Recommendation 3(c) – Electronic prescribing and medicines administration • Recommendation 3(d) – Accurate coding of medicines • Recommendation 3(e) – Top 10 drug saving opportunities • Recommendation 3(g) – Medicines stock-holding and supply chain 11

The Carter Context – supporting Hospital Transformation Recommendation 3 • Recommendation 3(a) – HPTP planning and governance • Recommendation 3(b) – clinical pharmacy and infrastructure services • Recommendation 3(c) – Electronic prescribing and medicines administration • Recommendation 3(d) – Accurate coding of medicines • Recommendation 3(e) – Top 10 drug saving opportunities • Recommendation 3(g) – Medicines stock-holding and supply chain 12

The Carter Context – supporting Hospital Transformation Recommendation 3 • Recommendation 3(a) – HPTP planning and governance • Recommendation 3(b) – clinical pharmacy and infrastructure services • Recommendation 3(c) – Electronic prescribing and medicines administration • Recommendation 3(d) – Accurate coding of medicines • Recommendation 3(e) – Top 10 drug saving opportunities • Recommendation 3(g) – Medicines stock-holding and supply chain 13

The Carter Context – supporting Hospital Transformation Recommendation 3 • Recommendation 3(a) – HPTP planning and governance • Recommendation 3(b) – clinical pharmacy and infrastructure services • Recommendation 3(c) – Electronic prescribing and medicines administration • Recommendation 3(d) – Accurate coding of medicines • Recommendation 3(e) – Top 10 drug saving opportunities • Recommendation 3(g) – Medicines stock-holding and supply chain 14

What do you have to do? 15

Current Landscape • Primary Care – EPS, GP 2 GP, SCR – Good dm+d coverage – ISB 0052 compliance 16

Current Landscape • Primary Care – EPS, GP 2 GP, SCR – Good dm+d coverage – ISB 0052 compliance • Secondary Care – No programmes – Poor coverage (polite) – Not a hope…. 17

dm+d in Secondary Care • There is a long way to go in Secondary Care • Small steps – being here today is a good first step • NIB, NHSE, Hospital Transformation – Beginning to define requirements • What do you have to do? – Think – are you dm+d ready? – Talk to your Pharmacy IT lead or the PBTG – Speak to your suppliers • Get dm+d on your roadmap 18

How will NHS Digital help? 19

Pharmacy Terminology Implementation • Small team - we have to be realistic with what we can achieve, and how we set about to achieve it • Same as that used for Primary Care – Direct liaison with Central initiatives and drivers – Working with system suppliers – Implementation guidance • Educational materials to support implementers and front line staff 20

Information sources • • • General enquiries – nhsbsa. dmdenquiries@nhs. net. Implementation queries – information. standards@nhs. net dm+d website dm+d Browser dm+d download - TRUD dm+d education materials – Current resources on TRUD for download – New portal arriving soon 21

www. digital. nhs. uk @nhsdigital enquiries@nhsdigital. nhs. uk 0300 303 5678

dm+d Webinars – coming soon…. . • • • Webinars already developed and ready to be released once site agreed: – Downloading dm+d and SNOMED CT UK Drug Extension files from TRUD – BSA dm+d Browser In development: – The NHS dictionary of medicines and devices - A brief introduction to dm+d, what it is and why we need it Planned: – dm+d model – dm+d or SNOMED CT Drug Extension? – dm+d Standard 23