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 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

Release 58 - 2 Dec 2024

New templates released:

• ENT: Robot-assisted hemi/total/completion thyroidectomy, Thyroid isthmusectomy, Excision of external ear lesion, Nasal cautery, Reduction of inferior turbinates, Nasal turbinate cauterisation, Radiofrequency nasal turbinate reduction, Revision septoplasty, Examination of nose/nostril under anaesthesia, Navigational endoscopic sinus surgery, Endoscopic excision of sinonasal tumour, Endoscopic repair of CSF leak, Trans-oral laser microsurgery base of tongue, Open pharyngeal pouch repair, Endoscopic dilatation of airway stenosis
• Generic: Drug challenge, Oral food challenge
• Medicine: Allergen immunotherapy injections, Omalizumab, pH-study, pH-impedance study
• Paediatric medicine: Paediatric flexible bronchoscopy
• Urology: Open/laparoscopic simple cystectomy and ileal conduit formation/orthotopic neobladder reconstruction, Removal of a female urethral diverticulum with Martius graft interposition, Abdominal/vaginal vesicovaginal fistula repair, Laser treatment to penis

Review conducted: Hormone replacement therapy (oral/transdermal/implant), Tonsillectomy, Septorhinoplasty, Partial/total laryngectomy, Parotidectomy, Endoscopic sinus surgery, Frontal sinus trephination, Dacryocystorhinostomy

Release 57 - 8 Nov 2024

New templates released:

• Cardiac surgery: Pleural effusion surgery, VATS/open bullectomy (+pleurectomy, +talc pleurodesis)
• Dermatology: Patch testing
• ENT: Steroid injection into larynx/trachea, Injection laryngoplasty, Botox toxin injection into salivary gland/palate/larynx/facial intradermal
• Nutrition: Endoscopic insertion and change of various feeding tubes, Radiological insertion and change of various feeding tubes, Cut and push removal of PEG, Endoscopic removal of PEG
• Obstetrics & Gynaecology: Induction of labour, Wide local excision of the vulva + inguinal sentinel lymph node biopsy with or without inguinofemoral lymphadenectomy
• Oncology: Palliative radiotherapy
• Ophthalmology: EUA eye, Lacrimal gland biopsy, Nasalacrimal stent insertion/removal, Punctoplasty
• Orthopaedics: Closed reduction of joint dislocations and fractures, Examination under anaesthesia of various joints
• Respiratory: Rigid/robotic with EBUS/navigational bronchoscopy
• Urology: Male urethrectomy, Incision/excision biopsy of a penile skin lesion, Removal of a female urethral diverticulum, Open/laparoscopic partial cystectomy, Total/partial penectomy, Dynamic sentinel inguinal lymph node biopsy, Glansectomy with primary closure/skin graft
• Vascular: Transmetatarsal amputation, Supraclavicular/transaxillary first and/or cervical rib resection with/without scalenectomy, Scalenectomy

Review conducted: Planned caesarean birth with bilateral tubal ligation, Assisted vaginal birth with or without caesarean birth, Tarsorrhaphy, Syringing and probing of lacrimal ducts, Ectropion repair