Content updates

Our clinical team are continuously broadening, updating, and refining the Concentric ontology (i.e. the treatment templates), and updates are released every few weeks.

Most healthcare organisations use the main (‘master’) version of the Concentric ontology – those using this version will see updates as per the below release notes. Deployments using a locally modified version of the Concentric ontology sometimes receive updates on different dates to the main version, and the content of the updates can be different – including further local modifications requested.

Release notes for the last 6 content updates are presented in reverse chronology (most recent first). Earlier release notes are available on request. The list of all the treatment templates available within Concentric, presented by specialty, is maintained in our treatment template list.

Each release goes through a thorough release process, as outlined within our release process page. These release notes highlight the recent areas of focus, listing new treatment templates made available and reviews undertaken, but do not detail every change within a release. Our reviews involve a review of the existing template alongside clinician feedback received, a review of the published evidence-base, and insights gathered from real-world use of the template – for example patterns in terms of risks modified or added.

If you don’t currently have access to Concentric but would like to see the Concentric ontology in context within the application please contact us to request demo access.

Release 64 - 6 May 2025

New templates released:

• Anaesthetics: Conscious/ketamine sedation
• Dentistry: Special care dentistry - comprehensive dental care
• Generic: Genetic testing, Whole genome sequencing for cancer/rare disease, National Genomic Research Library
• General Surgery: Botulinum toxin injection in abdominal wall muscles
• Medicine: Exercise/Methacholine/Hypoxic challenge test
• Obstetrics & Gynaecology: Various combined Gynae-Onc procedures, Sentinel lymph node biopsy of the pelvis
• Oncology: High dose dexamethasone/prednisolone/methylprednisolone, High dose methotrexate
• Radiology: Image-guided percutaneous radiofrequency/microwaves/cryoablation of lung/liver/renal tumour
• Urology: Intravesical gemcitabine/docetaxel chemotherapy, Hyperthermic intravesical chemotherapy/Radiofrequency induced thermo-chemotherapy with mitomycin C/epirubicin

Review conducted: Dexamethasone, Prednisolone, Lenalidomide, Thalidomide, Pomalidomide, Isatuximab, Daratumumab, Pemetrexed, Raltitrexed

Release 63 - 11 Apr 2025

New templates released:

• Anaesthetics: Serratus anterior plane block
• Colorectal: Loose seton insertion/removal for pilonidal sinus, Fissurectomy
• ENT: Internal/external nasal splint, Septal/auricular/costal/cadaveric costal cartilage graft, Mastoid bone graft
• Maxillofacial: Temporomandibular joint arthroscopy, Open temporomandibular joint surgery
• Obstetrics & Gynaecology: Transcervical ultrasound-guided radiofrequency ablation of uterine fibroids (Sonata)
• Ophthalmology: Single (medial) wall/transnasal endoscopic single (medial) wall orbital depression
• Radiology: MRI scan with off-label Cardiac Implantable Electronic Device (CIED)
• Urology: iTind (temporary inserted nitinol device) prostate surgery, Intravesical immunotherapy with BCG, Urodynamic studies, Video-urodyanmic studies

Review conducted: Orbital decompression

Release 62 - 14 Mar 2025

New templates released:

• Anaesthetics: Ligament/Tendon prolotherapy
• Breast: Sentinel lymph node biopsy of the axilla with radiotracer and blue dye/Magtrace and Sentimag system
• Dentistry: Rapid maxillary/quad helix expander, Interproximal reduction, Protraction facemask, Mandibular Advancement device
• Endocrine: Robot-assisted parathyroidectomy
• Medicine: Thrombolysis for stroke, Botulinum toxin injection for spasticity/cervical dystonia/hemifacial spasm/blepharospasm
• Obstetrics & Gynaecology: Vaginoscopy, Argon plasma coagulation/CO2 laser ablation of vulval/vaginal/cervical lesion
• Paediatric: Safeguarding skeletal survey
• Paediatric surgery: Excision of pre-auricular tag/pilomatricoma/external angular dermoid cyst
• Urology: Ureterocele puncture

Review conducted: Sacral nerve stimulation, PV/DRE added to TURBT/bladder outflow procedures, Hysterosalpingo contrast sonography

Release 61 - 21 Feb 2025

New templates released:

• Dentistry: Crown/bridge insertion, Veneer fitting, Dental hard tissue graft, Guided bone regeneration, Sinus lift, Dental block grafting, Dental soft tissue graft, Free gingival graft, Subepithelial connective tissue graft, Gingival pedicle graft
• Dermatology: Punch excision of a skin lesion, Wide local excision of a scar
• Endoscopy: Patency capsule test, Pan-enteric capsule endoscopy
• General surgery: Laser haemorrhoid ablation
• Genetics: Genetic testing/storage for breast cancer
• Oncology: External beam radiotherapy for bladder cancer
• Orthopaedics: Foot/midfoot exostectomy
• Paediatric surgery: Laparotomy for NEC

Review conducted: Wide local excision/excision/excision biopsy of a skin lesion/cancer, Punch/shave/incision biopsy of a skin lesion, Curettage and cautery, Mohs micrographic surgery, Manual removal of placenta, Pull through procedures for Hirschsprung’s, Capsule endoscopy

Banners: Info banner added to relevant procedures to prompt editing the procedure name to state body part/digit/spinal level(s) etc. For more detail regarding this functionality see section ‘Clinician view guidance banners’ in release 88 of the product release notes.

Release 60 - 4 Feb 2025

New templates released:

• Dentistry: Functional orthodontic appliance, Orthodontic mini-screw insertion, Removable brace (appliance), Clear aligner orthodontic treatment, Hawley/Clear Plastic/Bonded retainer
• ENT: Intracapsular tonsillectomy/adenotonsillectomy, Trans-oral robot-assisted tonsillectomy
• HPB: Laparoscopic/robot-assisted left/right hemihepatectomy
• Obstetrics & Gynaecology: Robot-assisted laparoscopic excision of pelvic endometriosis/excision of bowel endometriosis/myomectomy/oophorectomy/ovarian cystectomy/salpingo-oophorectomy, Hysteroscopic division of intrauterine adhesions
• Oncology: BEAM chemotherapy (and autologous stem cell transplant), High-dose melphalan and autologous stem cell transplant, Melphalan with dexamethasone (M-dex), Intravenous/oral melphalan (with prednisolone), Cyclophosphamide and granulocyte-colony stimulating factor (G-CSF) for stem cell mobilisation, Granulocyte-colony stimulating factor (G-CSF) (for stem cell mobilisation), Carmustine, Autologous stem cell transplant, Plerixafor
• Orthopaedics: Removal of metalwork from the jaw/hip/spine, Intra-articular injection into ACJ, ACL reconstruction with quadriceps autograft, Tarsometatarsal joint fusion

Review conducted: Tonsillectomy, Adenotonsillectomy, Pancreaticoduodenectomy

Release 59 - 6 Jan 2025

New templates released:

• Orthopaedics: Intra-articular steroid injection into the carpometacarpal joint of the thumb, Complex primary total knee replacement
• Radiology: CT scan under general anaesthetic
• Anaesthetics: Costochondral joint injections, Fascia iliaca block, Sacrococcygeal injection, Fluoroscopy guided costotransverse joint injection, Interspinous ligament injection, Pulsed radiofrequency treatment to sympathetic chain, Posterior superior iliac spine injection, Transverse process injection
• Maxillofacial: Exposure of a tooth, Surgical dental extraction
• Endoscopy: Endoscopic gastric tissue sampling

Review conducted: Hydrocele repair, Fixed orthodontic appliance