Executive summary
The conversation around ambient voice technology—or AI scribes—in the NHS has reached a pivotal moment. NHS England has now published dedicated guidance on AI-enabled ambient scribing, setting clear expectations for adoption and establishing essential safety guardrails. The potential impact is significant: the largest NHS trial to date, reported by the HSJ, found that the technology could increase capacity in emergency departments by enabling staff to see approximately 13% more patients, with national modelling suggesting staff-time savings could approach £1 billion.
However, for clinical leaders and procurement teams, the path to realising these benefits is paved with rigorous governance. This guide provides a clinician-centred framework to compare the leading AI medical scribe UK tools—from mature suites like Microsoft's DAX Copilot to high-growth independents like Abridge and UK-centric players like Tortus and Heidi Health. We will cover the evidence, the non-negotiable compliance checks (DTAC, DCB0129/0160), and how to build a business case that is both ambitious and safe.
What counts as an “ambient scribe” (and what it should do)
As defined by NHS England, an AI scribe is a tool that uses "always-on" conversational capture to support clinical documentation and workflow. The core functions include:
- Listening to a clinician-patient consultation.
- Generating a structured summary, clinical note, or letter.
- Suggesting relevant clinical codes.
More advanced systems may also assist with queueing up orders or other workflow actions. The primary outcomes to measure are clear: reductions in documentation time and after-hours work, improved accuracy and completeness of the clinical record, and a positive impact on clinician burnout and the patient experience.
UK governance first: what your trust must evidence
Before any AI scribe is piloted or procured, it must meet a clear set of UK governance standards.
- NHS England ambient scribe guidance: This is the foundational rulebook, outlining expectations for roles, risk management, patient consent, transparency, and audit trails.
- DTAC (Digital Technology Assessment Criteria): This is the mandatory procurement baseline for any digital tool entering the NHS, covering five pillars: clinical safety, data protection, technical security, interoperability, and usability.
- Clinical safety (DCB0129/0160): The supplier must provide their DCB0129 manufacturer safety case. The adopting NHS organisation must complete a local DCB0160 deployment safety case, signed off by a nominated Clinical Safety Officer.
- Regulatory hygiene: Heed the warnings from the professional press and NHS notifications. Stop the use of any unregistered or non-compliant tools immediately.
Evidence & impact: what rigorous studies and trials suggest
- NHS ED trial headlines: The widely reported HSJ exclusive on the largest NHS trial in emergency departments provides the most compelling UK data to date, with its model of ~£834m in staff-time savings and a 13% throughput uplift. While these are extrapolations, they provide a powerful signal of the technology's potential.
- Peer-reviewed evaluations: Emerging studies, such as those on Nuance DAX, are beginning to provide peer-reviewed evidence of a positive impact on reducing administrative burden and clinician burnout (ScienceDirect).
- UK policy direction: The government's own plans have highlighted AI scribes as a key productivity lever for the NHS, signalling strong top-down support for the adoption of compliant solutions (The Guardian).
Clinician-centred evaluation criteria
When comparing vendors, use this practical checklist:
- Accuracy & fidelity: How well does it capture speaker attribution, medications, allergies, and red flags?
- Latency: Is the transcription live, near-real-time, or batched after the consultation?
- Controls & editability: Can you create custom templates? Does it generate letters and referrals automatically?
- EHR integration: What are the pathways for integrating with Epic, Oracle Cerner, EMIS, or SystmOne?
- Governance: Can the vendor provide a complete DTAC pack and a DCB0129 safety file?
- Security & data residency: Does the vendor offer UK or EU data hosting options? What are the recording retention policies?
- Accessibility & specialties: How well does it handle different accents, multi-speaker environments, and specialties like paediatrics or mental health?
- Commercials: What is the licensing model (per-seat, per-minute)? What does the pilot and rollout support look like?
Vendor snapshots (capabilities, UK readiness, notable proof-points)
A) Microsoft Dragon/DAX Copilot (Nuance, Microsoft)
- What’s notable: The market incumbent, combining Dragon Medical One dictation with the ambient DAX Copilot. Its UK availability has been announced, with features including order generation and problem-based charting.
B) Abridge
- What’s notable: Features "Linked Evidence" that maps summaries back to the source audio for verification. It has deep EHR integrations and has announced multiple large-scale US health-system rollouts. A $150m Series C in 2024 was followed by a further $250m raise in 2025.
C) Nabla Copilot
- What’s notable: An ambient AI assistant with wide adoption claims and a recent $70m Series C funding round.
D) Suki
- What’s notable: A voice assistant with ambient note generation, backed by a $70m Series D in 2024.
E) Augmedix (AUGX)
- What’s notable: An ambient AI platform that also offers human-in-the-loop quality assurance options. As a public company, its revenues are disclosed, providing context on vendor risk.
F) Solventum (3M) – M*Modal Fluency
- What’s notable: An established speech and ambient suite. The 3M healthcare business was spun-out as the new company Solventum in 2024.
G) Tortus (UK-centric)
- What’s notable: A UK start-up that has been central to NHS pilots, including the large-scale London evaluation. It has a partnership with X-on Health for UK primary care and featured in the news regarding the ED efficiency study.
H) Scribetech / Augnito Omni (UK)
- What’s notable: A UK-based company that positions its Augnito Omni product as an "NHS-approved AI scribe" and claims alignment with NHS guidance.
I) Heidi Health (operating in UK & abroad)
- What’s notable: Has a clear UK-facing product position and is in use in multiple UK GP practices. It offers multilingual transcription and letter generation.
J) ClinicLetter.ai / Medscribe (UK letter tools)
- What’s notable: These are more focused tools for letter generation and transcription, which can be useful adjuncts in outpatient workflows.
Funding & viability snapshot
For buyers, understanding a vendor's financial stability is crucial.
- Large, strategic backers: The integration of Nuance into Microsoft and the spin-out of Solventum from 3M signal long-term stability.
- Venture-backed growth: The huge funding rounds for Abridge, Nabla, and Suki indicate strong market confidence but also pressure for rapid growth. The seed round for Tortus shows early-stage backing for a UK-focused player.
- Public market signals: Augmedix's public disclosures provide a transparent look at revenues and market sensitivity.
What good deployment looks like
- Start with governance: Follow the NHS ambient scribe guidance from day one. Run a full DCB0129/0160 process and complete all DTAC due diligence.
- Consent & transparency: Implement an explicit patient consent script and provide clear notices in waiting areas and on your website.
- Pilot design: Define your KPIs in advance (e.g., documentation minutes saved, clinician wellbeing scores) and compare different modes (live vs. near-real-time).
- EPR workflow: Test the integration deeply, including problem-based charting, letter automation, and coding prompts.
- Scale economics: Cross-reference your local pilot results with the national modelled savings from the ED trial to build a credible business case.
Comparison table
| Product | Mode | EHRs Supported | Letters/Referrals | Orders | UK Deployments |
|---|---|---|---|---|---|
| Microsoft DAX Copilot | Live/Ambient | Epic, Cerner, etc. | Yes | Yes | Announced |
| Abridge | Live/Ambient | Epic, etc. | Yes | Emerging | No (US focus) |
| Nabla Copilot | Live/Ambient | Multiple | Yes | No | Check status |
| Suki | Voice Assistant | Multiple | Yes | Yes | Check status |
| Tortus | Live/Ambient | Varies by site | Yes | No | Yes (NHS pilots) |
| Accurx Scribe | Live/Ambient | EMIS/SystmOne | Yes | No | Yes (Primary Care) |
| Heidi Health | Live/Ambient | EMIS/SystmOne | Yes | No | Yes (Primary Care) |
FAQs
- Are ambient scribes medical devices?
- It depends on their claims and functions. However, NHS England guidance is clear that any tool performing summarisation must be registered as at least an MHRA Class I device. All tools require DTAC and DCB0129/0160 compliance for NHS use.
- Do they really save time?
- Yes. The NHS ED trial is the most significant piece of evidence, suggesting major time savings and throughput gains. However, you must validate this in your own specialty and setting with a controlled pilot.
- Which vendors are “NHS-ready”?
- Start your evaluation with vendors that explicitly align to the NHS England ambient scribe guidance and can provide a full set of clinical safety and information governance artefacts for your review.