This article contains frequently asked questions about INC-1390. If your GP Practice has not been contacted about this incident, you have not been impacted.
What is a SNOMED Code?
SNOMED Codes are a structured clinical vocabulary used in electronic health records.
Accurx allows users to apply SNOMED Codes to SMS Messages, Questionnaires and Accumail to facilitate efficient, safe and accurate exchange of information between clinical IT systems.
How does Accurx decide which SNOMED codes to support?
Accurx aims to support as broad a range of SNOMED codes as possible to support the many different ways our users work. Whilst we don’t support every code available in the SNOMED CT library, we reactively incorporate SNOMED codes into our product at the request of our users, following testing to ensure they are technically compatible with the medical records we save back to. These “administration” vaccination codes were originally requested by users to be incorporated into Accurx for usage.
What is in place to help prevent the accidental selection of an incorrect SNOMED code?
Users can search our library of supported SNOMED codes when sending a message or creating a Questionnaire or template. We display the description term and the concept ID so a user can easily verify that the SNOMED code they are selecting is the correct one for the data, status or action they want to capture. It was first highlighted to us in February 2025, that users might be making the error of selecting the “administration” code for RSV vaccination instead of an “invitation” code. This was picked up as users were adding these codes, followed by a quick deletion, suggesting they had been added in error.
In response, we updated the description of the SNOMED code 1303503001 to an alternative synonym from CT browser to make the distinction between "invitation" and "administration" clearer in the case of the RSV vaccination. Following this we saw a reduction in usage of this code in batch messaging, with an increase in the usage of the “invitation” code instead.
On the 17th June 2025, after discussion and collaboration with NHSE, we decided on balance to remove all vaccination administration SNOMED codes from Accurx templates, Custom Questionnaires and the dropdown selector within the Accurx product. This included the RSV related code, as well as 14 other vaccination-related codes.
What is the potential clinical impact of this incident?
Risk: In instances where an incorrect code is selected by a user / clinician, and not noticed or removed, the impact is on the potential onward care of a patient, who may not receive another invitation for a vaccination they are eligible for and need and could potentially not receive that vaccination.
Breadth of potential impact: We know from our data that multiple practices across the UK (351) have used one of 10 of the 15 codes whilst sending a batch message (5 codes were never used in batch messaging at all). Whilst we communicated with each of these practices about the batch messages sent with these codes attached, the scale of potentially affected patients is likely to be much less as:
Patients would still receive the intended communication about vaccination in instances where the “invitation” code was incorrectly substituted.
A proportion of these batch messages have been sent to the same patients multiple times. This also implies that the use of a “vaccination” code in error did not necessarily always preclude further invitations
There may be genuine use cases for saving the code in this way to represent a true vaccination event (although we determined on balance that it is more likely to represent user error)
We have been informed by NHSE that a proportion of the codes added by mistake were noticed and deleted by clinicians / users directly in their medical system
Even where the original code was entered in error and not corrected, a proportion of patients would have still gone on to arrange vaccination or decline it.
You can view the full Clinical Assessment at the bottom of this article.
What if an affected patient is no longer registered at my practice?
If your practice identifies a patient who has a vaccination procedure code recorded in
error (i.e. did not receive the intended vaccination) and the patient is no longer
registered with your practice, please complete the PDF attached at the bottom of this article.
Details and instructions can be found in the attached PDF titled: Vaccination record correction letter template for patients that have moved practices