ECDS guidance and documents

This information is designed to support users to implement the ETOS v4.0.8 from 1 April 2025:

Users should read the detail of all changes on the Change Control worksheet, however a number of key changes from ETOS v4.0.7 are summarised below:

Changes from ETOS v4.0.7 are shown from Change ID 2982 to 3171 inclusive on the Change Control worksheet.

• Some SNOMED codes included in ECDS Refsets have been given a ‘Valid_To’ date of 31/03/2026 in line with the annual ECDS SNOMED change cycle which runs from April to March of the following year.
• SNOMED codes have been added to the ECDS Refsets with ‘Valid_From’ dates of 01/04/2025 as per the annual change cycle set out above.  
• Where SNOMED codes are being introduced to replace existing codes, improved wording has been added to Column O of the Change Control worksheet and ‘Notes’ Column of the relevant Refset for both the code being added and code being replaced.
• Amendments to elements such as, ECDS Search terms, ECDS description, UK Preferred Term, Fully Specified Name, Flags, Groups and Mappings (full list available in the Change Control worksheet).  

The ECDS Enhanced Technical Output Specification includes a full list of the ECDS Diagnosis Core codes, together with hierarchical and search terms that are designed to make it easy to find individual diagnosis codes.

At the implementation date of ECDS v4.0 (1 July 2023), approximately 1,200 SNOMED codes were able to be submitted for the data item ‘URGENT AND EMERGENCY CARE DIAGNOSIS (SNOMED CT)’ in ECDS v4.0. 

ECDS v4.0 introduced ECDS Diagnosis Max, a significantly expanded list of an additional and approximate 58,000 SNOMED codes, allowing more granularity and greater accuracy in recording diagnosis and to support new models of Urgent and Emergency care, such as SDEC (Same Day Emergency Care).  

This expanded list of diagnosis codes, which can be submitted in SUS+ for ECDS v4.0 for the data item ‘URGENT AND EMERGENCY CARE DIAGNOSIS (SNOMED CT)’ is available in the ‘ECDS Refset MAX Specification’ above.

ECDS Diagnosis Max was implemented from 29 November 2023 with the ECDS Refset MAX Specification v4.0.1.

The ECDS Refset MAX Specification has now been updated to reflect amendments to the DIA Refset within the ETOS v4.0.8 and changes to Descendant level codes following these amendments.

Therefore, the ECDS Refset MAX Specification v4.0.3 has now been published. Consistent with the approach for the ETOS v4.0.8, these changes will be implemented from 1 April 2025.

The ECDS v4.0 XML schema has been published and can be downloaded via the TRUD (account required).

You may have to ‘Subscribe’ to ECDS updates to download the file.

This additional guidance complements existing SUS+ submission guidance and is being made available to support the implementation of ECDS v4.0.

CDS ACTIVITY DATE

CDS ACTIVITY DATE is set to the new data element in ECDS v4.0, URGENT AND EMERGENCY CARE ACTIVITY START DATE AND TIME (which replaces EMERGENCY CARE ARRIVAL DATE which is in CDS v6-2-3 Type 011 (ECDS v3.0)).

As per existing SUS submission guidance, the CDS ACTIVITY DATE (for ECDS v4.0 URGENT AND EMERGENCY CARE ACTIVITY START DATE AND TIME as per the NHS Data Model and Dictionary) must be within the CDS REPORT PERIOD START DATE and CDS REPORT PERIOD END DATE header to the CDS record.

Net and Bulk submissions for ECDS v4.0

The ECDS v4.0 Information Standard Requirements Specification states at Section 3.1:

“All providers who are submitters of ECDS v4.0 SHOULD submit changes using the Data Set Net Change Protocol.  This requires that all Providers ensure their suppliers of relevant clinical systems, patient administration systems and / or XML Middleware can incorporate the required changes to meet this capability.”

However, it is recognised that many Bulk submissions are still currently made for ECDS as at the ECDS v4.0 implementation date of 1 July 2023.

Net submissions

For Net users – each record has a Mandatory CDS UNIQUE IDENTIFIER which enables a single record previously submitted as Net in a data file, to be updated, as per the instruction given in the CDS UPDATE TYPE which is also in the header. 

Therefore, if using Net to update the Urgent and Emergency Care Extended Care Episode activity type, the Provider needs to resubmit the Urgent and Emergency Care Extended Care Episode activity type records which need to be updated (for example when this closes), with their mandatory CDS UNIQUE IDENTIFIER and an instruction to update them.

Bulk submissions

Consistent to the principles of existing SUS guidance, all ECDS v4.0 activity types (Emergency Care Attendance, Same Day Emergency Care Attendance, Urgent and Emergency Care Extended Care Episode and Hot Clinic Attendance (when pilots enabled)) belong to the same Bulk Replacement Group.  A sender should include all records for all these activity types in the same bulk interchange when they belong to the same period.  

For example, sending Emergency Care Attendances, then Urgent and Emergency Care Extended Care Episode activity type in separate interchanges for the same period will result in only the Urgent and Emergency Care Extended Care Episode activity type appearing in SUS data for that period.

This means that for example, providers would need to submit the entire interchange they submitted on the day that included the Urgent and Emergency Care Extended Care Episode record, in order to close the Urgent and Emergency Care Extended Care Episode.

You can access the earlier ECDS guidance through our archive.  

Copies of the webinars and slides which took place between 2018 and 2020 are available from our archive page

Read the Emergency Care Data Set (pilot) Direction 2016.