The NHS England Terminology Server
A terminology solution to help healthcare IT systems speak the same language, and make mapping codes between organisations faster and easier.
What is a terminology server?
Healthcare organisations often use different software and different words, or 'terminologies', to record health information: what one doctor records in their system as a 'chest infection', for example, might be recorded as 'upper-respiratory infection' in another, so the two systems might not be able to match the information up.
A terminology server transforms the way in which data is captured, shared and analysed across health and care, meaning more effective, efficient and safer decision-making. This makes providing healthcare services, treatment and cures more efficient and cost-effective.
It also makes it possible to load local codes and map these to national codes, or other local or system codes.
The NHS England Terminology Server
The NHS England Terminology Server is a FHIR® compliant solution that holds and disseminates assured international terminologies and classifications (such as SNOMED CT and ICD-10) and terminologies mandated for use in England, such as the dictionary of medicines and devices (dm+d).
We have developed the NHS England Terminology Server to deliver assured content in FHIR® compliant, machine readable formats – regardless of which terminology is being accessed. The accuracy of the content is maintained through tightly managed editorial controls. This will remove the need to manually update your systems with downloaded content from TRUD and other terminology sites.
There is also a syndication feed (API) which enables content to be syndicated across a group of terminology servers. This allows you to share your own terminologies with others.
Our goal
- simplify the use of clinical terminology and other code systems by addressing the key challenges faced by implementers
- encourage vendors, health care organisations, researchers etc to adopt terminology products and services
- create a central repository of assured international and national code systems
- improve collaboration between the producers and consumers of terminology products and services
- enable benefits from adoption of terminologies and classifications, such as seamless interoperability, enhanced reporting, and advanced analytics
How it can be used
Who can use it
The terminology server is for:
- providers of health and care services
- commissioners of health and care services
- population health managers
- suppliers in the health and care market
- researchers and analysts
Content included in the Terminology Server
Code systems, value sets and concept maps for a growing number of national and internationally assured terminologies and classifications are included in the NHS England Terminology Server.
Currently loaded are:
- SNOMED CT - current version and current-1 at a minimum
- Human Phenotype Ontology (HPO) (20201207)
- ICD-10 - including historical versions (4.0 and 5.0)
- NICIP codes - including historical versions (2017-2020)
- OPCS-4 - (4.8, 4.9 and 4.10)
- READ codes (4 byte, V2 and CTV3) - including historical versions (2009-2018)
- UCUM (2.1)
- FHIR® - including all published CodeSystems, ValueSets and ConceptMaps
- dm+d - including historical versions, GTINs, ingredient strength, historical codes, dm+d links to BNF codes and VTM ingredients (these will be gradually populated from Quarter 4 2024)
We plan to load:
- Data Dictionary - including all reference data national codes and historical versions
Complex mapping tables between the loaded code systems are NOT currently available via the Terminology Server. Future software developments should enable this capability so please check back.
In the interim, please contact the individual teams for copies of complex mapping tables by following the links above.
The various environments
There are several different environments that make up the Terminology Server solution.
Find out more in the NHS England Terminology Server environments webpage.
How to get access
Individual users can access content on the NHS England Terminology Server with a registered account (authenticated) or without a registered account (non-authenticated).
Guidance for how to register for an account as an individual is provided in our account management guide.
If you wish to access the Terminology Server from a software application or to syndicate content to your own terminology server, rather than access via a browser, you will need a system-to-system account.
Details of the current status of the service, and any periods of forecast unavailability due to changes, can be found on our supplier-hosted Service Navigation and Status page.
How to integrate your system
See the guidance for software developers to understand more about how to integrate your system with the Terminology Server.
Information hub
We understand that people will want to know more about the Terminology Server but will have different levels of knowledge and understanding. To help, we have gathered an extensive collection of information and split it into two categories.
Quick start for beginners
What is FHIR®?
The Terminology Server stores information in the HL7 FHIR® (Fast Healthcare Interoperability Resources) standard.
Read more about it at hl7.org/fhir/
More information about how NHS England use FHIR® can be found in the NHS England FHIR® API website.
How to add content
Adding content to the Terminology Server can be done using the Snapper:Author web tool.
Quick start for developers
How to use your credentials
Please see the following link for some further information about the supported operations and examples of how to use the system-to-system credentials to get a token and make an API request:
How to use FHIR®
The terminology server is FHIR R4 compliant and the API parameters and operations are as specified in the FHIR standard:
The key Resources you will likely be interested in are:
Code system
Value set
Concept map
Where the standard indicates implementation discretion you will find more specifics here: Ontoserver – (csiro.au)
Example interactions
To help make it easier to begin using the Terminology Server we have created a repository of examples that are specific to the various code systems we hold.
We have stored these examples in an area of GitHub.
The examples contained in the repository also contain pointers to other sources of information that will help you understand more and develop queries of your own.
Parameters used in HTTP requests need to be URL encoded prior to sending.
Using the environments
You can find an explanation of the various environments on our Terminology Server environments page.
To use or consume existing content for exploration and analysis then you should use Production 1.
Testing should also be carried out on Production 1.
The Authoring Server is restricted for the internal validation and release of national code systems. If you feel you need to use the Authoring Server specifically then please email [email protected] to discuss this further.
For runtime use in a clinical system there is a dedicated Production Server (Production 2) but you will need to explain your intended use in order to gain access. This process is managed by the system to system account request form process.
GitHub repository
This repository aims to provide a library of useful examples/code snippets to help users of the NHS England Terminology Server become more familiar with the basic functions and operations of the server.
Use cases
A repository has been created to provide code snippets to demonstrate how the Terminology Server can be used.
Code has been provided to connect Power BI to the server.
Error codes
We have provided some help below on the most popular errors that you might receive when querying the Terminology Server.
If you receive an error that is not listed below, please report it to the helpdesk at [email protected].
Communities
Communities are a way of managing and granting access to collections of FHIR resources, either for read or write access.
Find more information on how communities work.
If you are interested in using a community, please contact us at [email protected] to discuss it further.
Contact us for system support
In-hours support
Monday to Friday 9am to 5pm excluding English bank holidays:
- email: [email protected]
- portal: https://www.support.digitalservices.nhs.uk
- phone: 0300 303 4777
Out of hours support
High Severity Service Incidents (such as, the system is unavailable or there has been a security breach):
- phone: 0300 303 5035
- portal: https://www.support.digitalservices.nhs.uk
Non-High Severity Service Incidents (your incident ticket will be reviewed the following working day):
- email: [email protected]
- portal: https://www.support.digitalservices.nhs.uk
Full instructions on how to use our new support portal, including how to register.
The Terminology Server is protected by a platinum service management contract which provides cover 24 hours a day, 365 days a year.
Incident resolution times (within business hours):
Severity 1 | 2 hours |
Severity 2 | 4 hours |
Severity 3 | 8 hours (Monday to Friday, between 8am and 6pm, excluding bank holidays) |
Severity 4 | 30 hours (Monday to Friday, between 8am and 6pm, excluding bank holidays) |
Severity 5 | 100 hours (Monday to Friday, between 8am and 6pm, excluding bank holidays) |
Please also see our supplier-hosted service page for the current status of the Terminology Server.
For a copy of the Clinical Safety Case Report, please contact: [email protected].
Last edited: 4 February 2025 11:38 am