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dictionary of medicines and devices (dm+d)

dm+d is a dictionary of descriptions and codes which represent medicines and devices in use across the NHS. It must be used when electronic systems exchange or share information about medicines relating directly to a patient's care.

dm+d is a clinical vocabulary readable by computers

The NHS dictionary of medicines and devices (dm+d) is the NHS standard for identifying medicines and medical devices used by the NHS.

dm+d gives clinical IT systems a single shared language of medicines which makes exchanging information between systems easier, safer and more accurate.

Also see dm+d introduction eLearning for more information.


Benefits

Benefits of using dm+d include
  • Interoperability of medicines information between clinical systems

  • Clear, consistent recording and communication of information relating to medicines and devices used in patient care

  • Improved patient safety and experience

  • Reduction in transcription of medicines information

  • Improved retrieval, reporting and analysis

  • Improved access to information


National requirements for dm+d

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.

The use of dm+d is a national information standard, and therefore a contractual requirement; further details can be obtained in the dm+d Information Standards Notice (SCCI0052). The implementation guide and Requirement Specification in the Release section of the standard provide useful information.

dm+d must also be used in DAPB4013: Medicine and Allergy/Intolerance Data Transfer.

DAPB4013 outlines the requirements that a dm+d enabled system must adhere to in order to support interoperability involving the latest FHIR standards by March 2023.


dm+d Data Model

The dm+d product provides: 

  • a unique identifier (code) for all medicines items
  • a standard term (description) for all medicines items
  • a structure in which the above information is held

dm+d data also contains a huge variety of information, including: 

  • a link to the supply chain by the inclusion of GS1 Global Trade Item Numbers (GTINs or ‘barcodes’) wherever possible
  • whether a product will be reimbursed by NHSBSA, if submitted for reimbursement by a dispensing contractor
  • the indicative price of each pack of a product (where a price is maintained)
  • current and discontinued products and packs available from manufacturers and suppliers

dm+d does NOT provide:

  • application functionality
  • decision support functionality; dm+d is not a decision support system although it does provide information that these systems will utilise

The dm+d model and format

dm+d currently consists of five distinct concept classes. Each component describes a product at different levels of granularity to support various use cases.

dm+d 5-box data model

Concept classes and key use cases of dm+d

The diagram above contains 5 boxes describing the five distinct concept classes in dm+d. Each component describes a product at different levels of granularity to support various use cases.

Virtual Therapeutic Moiety (VTM)

Nifedipine

Key use cases include:

  • dose based prescribing (most commonly used prescribing model in secondary care)
  • recording of partial medication information

Virtual Medicinal Product (VMP)

Nifedipine 30mg modified-release tablets

Key use cases include:

  • product (generic) based prescribing (most commonly used prescribing model in primary care)
  • product identification and selection for dispensing/administration
  • recording of information within patient records

Virtual Medicinal Product Pack (VMPP)

Nifedipine 30mg modified-release tablets 28 tablet 2 x 14 tablets

Key use cases include:

  • identification/selection of pack size for dispensing
  • to record dispensed items including pack size
  • providing information for electronic reimbursement and secondary care tendering

Actual Medicinal Product (AMP)

Adalat LA 30mg tablets (Bayer Plc)

Key use cases include:

  • product (brand/manufacturer) based prescribing
  • product identification and selection for dispensing/administration
  • recording of information within patient records

Actual Medicinal Product Pack (AMPP)

Adalat LA 30mg tablets (Bayer Plc) 28 tablet 2 x 14 tablets

Key use cases include:

  • identification of pack size and availability
  • to record dispensed items including pack size and manufacturer/brand   
  • pricing
  • links to supply chain (such as GTIN (barcode) mapping)
  • Providing information for electronic reimbursement

Also see An introduction to the dm+d 5-box data model eLearning for more information.


SNOMED CT UK Drug Extension

All unique identifiers used in dm+d are SNOMED CT codes. To support users implementing SNOMED CT structures for clinical terming NHS England take the core dm+d data (XML file format) and transform it into a fully compliant SNOMED CT release (‘RF2 format’) with added information to support (primarily) secondary care users.

See the video 'dm+d and SNOMED CT Learnathon - Extensions and enhancements' for an overview of the two terminologies, their alignment challenges and changes being made to overcome these.


Development

There are some differences in the content of dm+d and the SNOMED CT UK Drug Extension and the timing of updates to them. This means that data sent between primary and secondary care cannot always be processed by the IT systems that receive it. This can lead to transcription and/or clinical errors for patients.

Digital Medicines is making changes to help ensure that information about patient medications, allergies, intolerances and prescriptions can be shared seamlessly between clinical IT systems.

To support this, several changes are being made to dm+d and SNOMED CT UK Drug Extension to make these two terminologies more closely aligned in terms of content and availability.

For more information see - UK Medicines Terminology Futures

For queries about changes to dm+d – [email protected]


Implementing dm+d

Guidance on adopting dm+d, suitable for anyone involved in implementing dm+d in a clinical system, is available from NHS England. This includes:

  • dm+d Implementation Guidance (Primary Care) 
  • dm+d Implementation Guidance (Secondary Care) 
  • dm+d Mapping Guidance
  • Secondary Care Guidance on Mapping to Specials in dm+d

The NHS Business Services Authority (NHS BSA) website also contains:

  • dm+d description guidance (see implementation guidance tab)
  • dm+d code system structure guide (see NHS England Terminology Server tab)

Accessing dm+d

Terminology Server - our recommended method for accessing dm+d is the NHS Terminology Server. It is a terminology solution available over the internet (Web API) designed to help healthcare IT systems speak the same language and make mapping codes between organisations faster and easier.

dm+d picking lists: Using the Terminology Server

 

Technology Reference data Update Distribution (TRUD) - raw data files for dm+d (XML) and the SNOMED CT UK Drug Extension are available to be downloaded from TRUD.

dm+d browser – Official dm+d browser provided by the NHS Business Services Authority.

SNOMED CT browser - This online browser is the preferred SNOMED CT Browser for the NHS to use. It contains the SNOMED CT International release, the UK Clinical Extension, the SNOMED CT UK Drug Extension, and the UK Pathology Extension.


dm+d resources

Delen (dm+d) – information on dm+d and SNOMED CT UK Drug Extension and Implementation Support

Delen (SNOMED CT) – information about SNOMED CT (including SNOMED CT UK Drug Extension Editorial Policy)

NHS Business Services Authority – dm+d policies and specifications

Dictionary of Medicines + Devices - elearning for healthcare (e-lfh.org.uk)

ePrescribing and Medicines Administration Toolkit for NHS Hospitals

Community of Practice - Medicines Optimisation Digital Learning Network - FutureNHS Collaboration Platform


Contact us

For enquiries about changes or additions to dm+d data, Editorial Policy Content requests or to raise an issue with dm+d visit Dictionary of medicines and devices (dm+d) on the NHSBSA website

For support, implementation and technical queries about the dm+d XML files and TRUD and for enquiries about the SNOMED CT UK Drug Extension email [email protected]

For queries relating to UK Medicines Terminologies Futures (development changes) work email [email protected].

Last edited: 18 July 2023 4:12 pm