Pathology information standards review

The NHS England Pathology Standards Programme have revised the governance around pathology data flows by making changes to 3 interlinked information standards:

1. The legacy ISB 1557 EDIFACT Pathology Messaging Standard (Amd 39/2003 EDIFACT v1.003) which governs the use of the Pathology Messaging – EDIFACT integration.
2. The DAPB4017: Pathology Test and Results Standard which was introduced in 2021 with the intention that it would replace ISB 1557 – which was formally retired November 2023.
3. The new DAPB4101 Pathology and Laboratory Medicine Reporting Information Standard (AMD 63/2023) has been developed and was published in April 2024, which replaces the above standards.   

DAPB4101 supports the interoperable sharing of pathology reports between laboratories and GP practices (extending to other healthcare settings in time, including secondary care) using the Pathology Messaging – FHIR integration.

The Pathology Standards Programme team’s overall objective is to improve the current pathology reporting data flow in primary care, through:

• removing reliance on the use of Read v2 codes (deprecated in 2019) for the payload and PMIP EDIFACT as the messaging standard
• moving to a messaging standard that uses SNOMED CT as mandated by SCCI0034, and FHIR R4

Moving the pathology estate away from the legacy, out of date terminology and messaging standards will:

• improve overall the way that current pathology requests and results can be flowed
• allow new content to be flowed, which something that previously caused significant informatic complications during the pandemic, by the constraints on the payload to Read V2.   

To achieve these benefits, ISB 1557 was deprecated and DAPB4101 initiated concurrently in April 2024, enabling a legal mechanism to enforce the change. Although DAPB4017 was designed to introduce the technical capability as detailed above a decision was made to retire this standard as the key data product SNOMED CT PaLM reference set. In addition, standardisation of other data elements mandated by DAPB4017 were out of initial scope of DAPB4101.

In the pathology report sent from laboratories to general practice, DAPB4101 governs the use of:

• SNOMED CT Observable entity concepts to represent specific pathology laboratory test result codes
• SNOMED CT Procedure concepts to represent the specific laboratory test initially requested (including panels/batteries of tests)

To support complex pathology reporting structures containing fully atomic, coded results, DAPB4101 mandates the use of pathology-specific UK Core FHIR R4 profiles, the goal being the interoperable sharing of pathology reports for the purpose of direct care.

DAPB4101 does not govern how variants of the EDIFACT messaging standard (such as NHS002 or NHS004 messages) are used to exchange pathology data, such as in Bowel Cancer Screening – EDIFACT or Cervical Screening – EDIFACT.

DAPB4101 has been approved by the Data Alliance Partnership Board and was published on 15 April 2024. The Information Standards Notice provides an overview of scope and implementation timescales. The requirements specification and implementation guidance provides further detail for those who have to implement the information standard.

To help providers and system suppliers integrate our data products we will work directly with system suppliers and the Digital Primary Care Programme to provide support, establish an implementation approach and to develop a roadmap for national conformance with DAPB4101.

May 2025 has been proposed as the full conformance date to meet DAPB4101, at which point ISB 1557 will be retired and the Pathology Messaging – EDIFACT integration will cease to flow.

Please bookmark the NHS England Pathology Standards and Implementation webpage for information about our data products, information standard, and implementation support.

If you require further information, please contact us at [email protected].