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) as a foundational standard in all NHS bodies in Wales.

Date of review:

4 November 2027.

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,
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 four guiding principles for health and social care data; data should be Findable, Accessible, Interoperable and Reusable (FAIR). 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, and 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 Dictionary of Medicines and Devices (DM+D) is a classification containing unique identifiers and associated textual descriptions for medicines and medical devices, including information regarding the relationships between similar medications, their human readable names, and additional rules to support their implementation. It has been developed by NHS England for use throughout the NHS (in primary and secondary care) as a means of uniquely identifying the specific medicines or devices used in the diagnosis or treatment of patients.

The dictionary of medicines and devices:

a. Can join concepts such as routes and units of measure, brand prescribing, facilitating accurate identification and helping reduce errors in prescribing, dispensing and administration.  
b. Contains unique identifiers and associated textual descriptions for medicines and medical devices, including information regarding the relationships between medications, their human readable names, and additional rules to support their implementation.
c. Enables interoperability of medicines related patient information using a common language, thereby enhancing collaboration and ensuring consistency and seamless transitions of care.

The use of SCCI0052: Dictionary of Medicines and Devices (DM+D) was adopted by NHS England as a national information standard, on 7 April 2017 and is a contractual requirement for NHS England systems providers from that date. The primary purpose was to support interoperability. All NHS healthcare providers in England that exchange or share information about medicines relating directly to a patient's care must use DM+D identifiers and descriptions when transferring information. Other content in the DM+D, such as medical devices, are excluded in terms of complying with the standard. However, users can use all the content of the DM+D if it supports their needs.

The United Kingdom Department of Health and Social Care own the DM+D through the NHS Business Services Authority, with responsibility for maintenance and distribution of the classification under the Open Government License through NHS England, formerly NHS Digital. NHS England releases the dictionary through the Technology Reference Update Distribution (TRUD) service or the Terminology Server.

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

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

Implementation requirements

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, the DM+D is used to identify that medication at the appropriate structural level.

It is recognised that not every possible use of medicines data requires implementation of the full content of the 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.

As the DM+D is updated on a weekly basis, it is the responsibility of each NHS local health boards, NHS trusts, and NHS special health authorities to ensure that their digital systems can receive and appropriately process any valid DM+D codes that are relevant to the system.

Yours sincerely,

Mike Emery,

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