International Classification of Diseases eleventh edition: letter to stakeholders, Mental Health Leads Network and health boards

International Classification of Diseases, eleventh edition, mental, behavioural and neurodevelopmental disorders

The implementation and promotion of ICD 11 across all mental health services is an action within the Scottish Government’s Mental Health Transition and Recovery Plan. Scotland is one of the first countries worldwide taking steps to implement and promote ICD 11.

A Scottish ICD 11 Implementation Group was established in April 2021 and is chaired by Dr John Mitchell CBE. Membership includes representatives from Health Boards, Public Bodies, a range of Mental Health Professions, Lived Experience organisations and WHO. Overall consensus is that the move from ICD 10 to ICD 11 will be beneficial to clinicians and patients, particularly as a means of improving diagnostic interactions. 

Psychiatrists in NHS Highland successfully started using ICD 11 from January 2022.

Next steps

The Minister for Mental Wellbeing and Social Care has been advised by the implementation group and has agreed to a clinical implementation date for ICD 11 MBND of 1 November 2022. In line with our commitment within the Transition and Recovery Plan, this change will initially apply to mental health practitioners and clinicians involved in diagnostic conversations in this area. This is to ensure that our approach to metal health services and associated interventions is based on the most up to date international understanding of mental illness.

As part of the Data Strategy for Health and Social Care, currently being consulted on, the Scottish Government will consider the transition to ICD 11 for physical health and other conditions. Implementation for physical health and other considtions will require a considerable programme of work, and so recognising the immediate benefits ICD 11 can bring in Mental Health, we have chose to take an iterative approach to implementation. We will offer further advice about what this transition will mean in practice and outline any further actions we intend to take to support this in due course.

To support the initial transition, we are working with NHS Education for Scotland to develop training for multidisciplinary clinicians, available by October 2022, which will explain the key changes and the impact they may have in practice. We would not expect this training to be mandatory, but ask that relevant clinicians are made aware of it so they can include it in their ongoing continuous professional development. In addition, highly specialist training, targeted at those with particular interests, has been developed by the WHO and is available free. 

To help increase broader understanding and awareness, we are developing a short animation and patient information leaflet for people who have a mental health condition, learning disability or autism. 

Data collection and coding

This change will have wider implications on how we manage and record data. The Scottish Government is engaging with Public Health Scotland to manage the coding transition from ICD 10 to ICD 11 for data sets in the medium to longer term. More immediately, Public Health Scotland are developing a tool to map the ICD 11 codes used in diagnosis to ICD 10 codes for data collection purposes. We will write to boards again in the coming months to provide further guidance on this for both clinicians and coders. 

Wider dissemination

To support clinicians to use ICD 11 codes in their diagnostic interactions from 1 November, can we ask that this information is disseminated across your board areas and networks to all relevant staff including psychiatrists, psychologists, nurses, allied health professionals and mental health officers. More information can be found at: ICD-11 (who.int)

Yours sincerely,

Gregor Smith

Professor Sir Gregor Smith, Chief Medical Officer