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ai scribes in the nhs: what they are (and aren’t)

a non-hype guide to ambient scribing: safety, accountability, data flows, and why governance matters more than features.

The Bottom Line

  • Treat ambient scribing as clinical documentation support, not autonomous decision-making.
  • Assume the clinician remains accountable for the record; review and edit is non-negotiable.
  • In the NHS, compliance expectations typically touch DTAC, clinical safety (DCB0129/0160), and (if relevant) MHRA medical device status.
Ambient scribing products listen to a consultation (or parts of it) and generate structured documentation (e.g., a draft note, letter, or coding suggestions). The product value is administrative acceleration — not clinical reasoning. The practical risk is that teams accidentally treat drafts as ‘truth’, or introduce uncontrolled patient data flows into third-party systems.

The safest operating principle

If it ends up in the clinical record, a clinician must read it, correct it, and consciously sign it off. Any workflow that bypasses that review step is asking for downstream harm.
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Step 1 — Define the use case tightly

Decide what you want produced: consultation note, referral letter, patient summary, admin task list. Narrow scope reduces risk and makes evaluation possible.
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Step 2 — Map your data flow

Write down what audio/text leaves your environment, where it is processed, what is stored, and for how long. If you can’t describe the flow, you can’t govern it.
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Step 3 — Decide what must never be captured

Agree ‘red lines’ locally (e.g., sensitive third-party information, certain categories of patient data, safeguarding details). Train staff to pause/disable capture when needed.
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Step 4 — Make review explicit in the workflow

Build time for verification (even 30–60 seconds) and define what “good” looks like: completeness, correct negatives, correct meds, correct safety-netting language.
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Step 5 — Pilot with measurement

Measure time saved AND error rates (near misses, corrections per note, missing key items). If quality drops, the ‘time saved’ is debt.
Practice

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SourceNHS England: Guidance on AI-enabled ambient scribing products
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SourceNHS England: DTAC (Digital Technology Assessment Criteria)
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SourceGMC: Artificial intelligence and innovative technologies (professional standards)
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Official Sources

NHS England — Guidance on AI-enabled ambient scribing products
NHS England — Digital Technology Assessment Criteria (DTAC)
GMC — AI and innovative technologies (how GMC guidance applies)