Introduction of the dictionary of medicines and devices (WHC/2024/042)

Status: 

Compliance.

Category: 

Data standards.

Title:

Introduction of the dictionary of medicines and devices (dm+d).

Date of review:

31 January 2028.

Action by:

• NHS local health boards.
• NHS trusts.
• NHS special health authorities.

For information:

Digital health and care suppliers.

Required by:

With immediate effect.

Sender:

Mike Emery,
Director for Digital and Technology,
Digital Transformation / Chief Digital Officer,
Health, Social Care and Early Years Group,
Welsh Government.

Welsh Government contacts:

Amir Ramzan,
Senior Manager,
Digital Health Standards,
Health, Social Care and Early Years Group,
Welsh Government.

Address:

Cathays Park,
Cardiff,
CF10 3NQ.

Email: amir.ramzan@gov.wales.

Enclosures:

Guidance document.

Background

Dear colleagues,

The digital and data strategy for health and social care in Wales, published in 2023, recognises the central importance of standards-based rules governing access to a shared health and social care record for different uses including clinical care, planning, and managing health services, research, and innovation.

To achieve this, Welsh Government requires the adoption of 4 guiding principles for health and social care data (FAIR). Data should be:

• findable
• accessible
• interoperable
• reusable

To support these principles, Welsh Government has mandated several open standards to ensure data is described in relation to its syntax, schema, data dictionary or reference. Also, that it adopts, where possible, internationally recognized, well documented, openly available standards to maximise interoperability.

Such an approach means that access to and making use of the data require no additional special efforts at mapping and transformation, maintaining both structure and context to improve data quality and integrity.

The NHS dictionary of medicines and devices (dm+d) is a dictionary containing unique identifiers and associated textual descriptions for medicines and medical devices. It has been developed for use throughout the NHS (across all care settings) as a means of uniquely identifying the specific medicines or devices used in the healthcare of patients.

Use of the unique identifiers in dm+d enables interoperability between diverse clinical systems, ensuring safe and reliable exchange of medicines information. dm+d has been developed to allow IT systems to easily and safely communicate information about medicines with each other. It is an interoperability standard in England (SCCI0052) where electronic systems must use dm+d when exchanging or sharing information about medicines relating directly to a patient's care. Other content in dm+d, such as medical devices, are excluded in terms of complying with the standard.

The dm+d model currently has 5 components. Each component describes a product at different levels of granularity to support various use cases. Each component of the model comprises a list of concepts, each with a description and a unique identifier. All unique identifiers used in dm+d are SNOMED CT concept identifiers (thus linking to the NHS clinical terminology of choice). For more information on dm+d, overview, documentation, webinars and link to the dm+d browser see the NHS Business Services Authority dm+d website.

dm+d is owned by the Department for Health and Social Care of the Government of the United Kingdom. Its maintenance is the joint responsibility of the NHS Business Services Authority Prescription Services (NHSBSA PS) and NHS England.

dm+d data is released weekly in a set of XML files, via the NHS England Technology Reference Data Update Distribution Service (TRUD). It is licensed under Open Government Licence and free for use. Users must accept the licence terms in order to download the dm+d files from TRUD.

dm+d cannot be used on its own, it must be used within IT systems. It is the responsibility of health and care organisations to ensure that their IT systems use dm+d safely. Consideration should therefore be given to implementing dm+d natively in systems.

The adoption of this fundamental standard aligns NHS Wales strategically with the NHS in England and will improve and ensure consistency and efficiency of medicines management in Wales, due to its potential to help improve interoperability and thus patient care and patient outcomes.

This facilitates alignment with international trends, as other dictionaries have been developed for use by national healthcare bodies, including RxNorm in the United States and AMT (Australian Medicines Terminology) in Australia.

Implementation requirements in Wales

NHS local health boards, NHS trusts, and NHS special health authorities must ensure that where a digital system records medication and transfers that information to another system, dm+d is used to identify that medication at the appropriate structural level.

Further information on dm+d, including its structural levels, can be found on the following websites:

• NHS Business Services Authority
• dm+d browser (search dm+d content)
• NHS England dm+d website and the dm+d eLearning for healthcare (supporting documentation and eLearning resources)
• NHS England Technology Reference Data Update Distribution Service (TRUD) (used by NHS England to license and distribute reference data)
• NHS England terminology server (a FHIR compliant solution that holds and disseminates assured national and international terminologies and classifications (such as SNOMED CT and ICD-10) and terminologies mandated for use in England like dm+d)
• NHS England UK medicines terminology futures for latest information on dm+d developments

For access to dm+d, and for implementation support in Wales, please contact the Welsh Reference Terminology Service at DHCW.ReferenceDataTeam@wales.nhs.uk.

It is recognised that not every possible use of medicines data requires implementation of the full content of dm+d, and only those aspects that are relevant to the intended use of a system are required to be implemented. NHS local health boards, NHS trusts, and NHS special health authorities must ensure that these requirements are appropriately identified when creating, procuring, or updating a digital system that records medication and transfers that information to another system. Other content in dm+d, such as medical devices, are excluded in terms of complying with the standard.

It is the responsibility of each NHS local health board, NHS trust, and NHS special health authority to ensure that their digital systems can receive and appropriately process any dm+d code that is relevant to their use case.

dm+d is updated every week and is supplied as data files for use within information systems. Health and care organisations should ensure systems are kept updated, and frequency of updates should be driven by a programme requirement or specific use case.

Yours sincerely,

Mike Emery,
Director for Digital and Technology,
Digital Transformation / Chief Digital Officer,
Health, Social Care and Early Years Group,
Welsh Government.