Executive summary
In 2025, the conversation around ambient voice technology (AVT), or AI scribes, in the UK has reached a critical juncture. NHS England has published formal guidance for its adoption, setting clear expectations and safety guardrails. This move is underpinned by compelling evidence; the largest NHS study in emergency settings modelled potential staff-time savings of nearly £1bn (£834m) annually if scaled nationally, alongside a 13% increase in the number of patients seen, placing scribes squarely on the national productivity agenda (hsj.co.uk).
Three providers are at the forefront of this UK rollout: Tortus, which has led a nine-site NHS evaluation; Accurx Scribe (powered by Tandem), which is leveraging its vast primary care footprint; and Heidi Health, which is also active across UK general practice. For any NHS organisation, the key to harnessing the benefits of this technology lies in a rigorous, compliance-first approach. This means ensuring any chosen tool meets the DTAC baseline, has the required DCB0129/0160 clinical safety cases, and aligns with the principles in the NHS AI Knowledge Repository.
What counts as an “AI scribe” (NHS definition & scope)
As defined by NHS England, an AI-enabled ambient scribing tool is one that supports clinical documentation and workflow. The typical functions include transcribing a patient consultation, summarising it into a structured clinical note, suggesting relevant codes, and drafting letters for the clinician to review and save to the EPR (NHS England).
While these tools offer the clear promise of reduced administrative burden and better patient engagement, they also introduce risks around accuracy, privacy, and clinical over-reliance. The final, verified note remains the clinician's responsibility (BMJ).
Buyer’s checklist (UK governance first)
Before any pilot or procurement, a robust governance check is non-negotiable.
- DTAC baseline: The Digital Technology Assessment Criteria is the mandatory starting point, covering clinical safety, data protection, cybersecurity, interoperability, and usability (NHS Transformation Directorate).
- Clinical safety: The supplier must provide their DCB0129 manufacturer safety case and hazard log. Your organisation must complete a local DCB0160 deployment safety case, signed off by your Clinical Safety Officer (NHS England Digital).
- Follow NHSE’s ambient-scribe guidance: The April 2025 guidance is the definitive rulebook for safe adoption.
- Regulatory hygiene: Heed professional press warnings and do not deploy unregistered or unsanctioned tools. Any tool that performs summarisation must be registered as at least an MHRA Class I medical device.
Comparative overview
| Product | NHS Footprint/Evidence | Integration | Notable Claims | Compliance Notes |
|---|---|---|---|---|
| Tortus | Nine-site NHS evaluation (GOSH-led); ED pilots report 13% more patients seen, ~47 mins admin saved/shift. | Integrations vary by site; strong focus on ED and outpatient pilots. | 23.5% increase in direct patient time; high patient consent (92%). | Vendor claims DTAC assured; provides DCB0129 pack. |
| Accurx Scribe (Tandem) | Rolling out to 200k+ NHS staff on the Accurx platform. | Writes back to EMIS/SystmOne. | Documents, codes, drafts letters and A&G from the consultation. | Tandem engine is MHRA Class I; Accurx publishes compliance docs. |
| Heidi Health | Active across multiple UK GP practices (public patient notices). | Check local integration path. | Multi-language transcription, structured notes, referrals. | UK product presence; check local assurance artefacts at procurement. |
Vendor snapshots (what to know before a pilot)
Tortus
- What it does: Provides ambient transcription that is drafted into notes and letters for clinician sign-off. Its primary evidence base comes from ED and multi-setting hospital pilots.
- Evidence signal: The Great Ormond Street Hospital-led study across nine NHS sites is a key piece of evidence, showing a 23.5% increase in patient interaction time and significant throughput gains in the ED.
- Governance note: The vendor states it is DTAC assured and provides its DCB0129 documentation. A deploying Trust must still complete its own DCB0160 and DPIA.
Accurx Scribe (powered by Tandem)
- What it does: Offers real-time transcription, coding, and the drafting of notes and letters, with the key feature of being able to write back directly to EMIS and SystmOne. It is available through the familiar Accurx desktop, web, and mobile interfaces.
- Scale advantage: Its biggest advantage is its distribution. By leveraging Accurx’s existing footprint in 98% of GP practices, it can be rolled out rapidly to a huge user base.
- Adoption tip: Align its use with your existing Accurx workflows (like patient messaging and Advice & Guidance) to compound the efficiency gains.
Heidi Health
- What it does: Offers multi-language transcription (over 110 languages), structured notes, and the drafting of referrals and patient handouts. Its use by multiple UK GP practices is evidenced by public-facing patient notices.
- Market signal: A recent large Series B funding round ($65m) indicates strong investor confidence and plans for continued expansion. As with any tool, validate the local integration path and request all assurance documentation at the procurement stage.
Evidence & ROI: what to measure
- System-level bounds: The HSJ-reported model of ~£834m in potential staff-time savings and a 13% ED throughput uplift should be treated as upper-bound scenarios to be validated against your own local baselines.
- Local KPIs: Focus on measurable, tangible metrics: minutes-per-note, percentage of time spent with patients, letters completed per session, coding completeness, patient consent rates, and, crucially, any safety events or near-misses.
- Published case signals: Early study summaries from the GOSH/St George’s pilots provide useful benchmarks, such as a 23.5% increase in patient time and an 8.2% reduction in appointment length.
Implementation playbook (90 days)
- Read the official NHSE scribe guidance, appoint a Clinical Safety Officer, and prepare your Data Protection Impact Assessment (DPIA).
- Pick one clinical setting (e.g., an ED majors cubicle or a single GP's daily surgery sessions).
- Baseline your KPIs for 2–4 weeks before introducing the tool.
- Pilot one or two vendors, running them in parallel if possible (A/B test) or sequentially (stepped-wedge).
- Assure: Collect and review all DTAC and DCB0129/0160 artefacts.
- Decide to scale based on your measured productivity gains and safety metrics, then publish your findings to the NHS AI Knowledge Repository.
Risks, Safeguards & Ethics
- Unregistered tools: Follow the clear warnings from the BMJ and professional bodies. Stop the use of any unregistered tools and replace them with compliant, governed solutions.
- Automation bias: The human-in-the-loop is non-negotiable. Mandate that every clinician personally reviews and signs off on every AI-generated note.
- Consent & transparency: Use clear, simple patient notices and verbal consent scripts at the start of every consultation, as demonstrated by UK practices already using tools like Heidi.
FAQs
- Are AI scribes “approved” for NHS use?
- They must be procured and deployed in line with the official NHSE ambient-scribe guidance. This means they must pass the DTAC, have the required DCB0129/0160 safety cases, and be appropriately registered with the MHRA. The decision to use an assured tool is then made locally by the Trust or practice.
- Do they really save time?
- Yes, NHS-based studies and pilots consistently report substantial time savings and throughput gains, but it is essential to validate these against your own local baselines.
- Which integrates best with GP systems?
- Accurx Scribe is built to support direct EMIS and SystmOne write-back, which is a key advantage in UK primary care.
- Is Heidi used in the NHS?
- Yes, multiple UK GP practices have published patient notices confirming their use of Heidi Health's AI scribe. As with any tool, individual practices must complete their own assurance and integration checks.