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AI scribes in the NHS
AI scribes write up clinical notes from a recording of the consultation. NHS England warned in 2025 that many suppliers had not met its standards, and in July 2026 the MHRA said that some products solely intended to transcribe or summarise are not medical devices.
- NHS England publishes guidance on AI scribing products
- A letter warns that many suppliers have not met basic NHS governance standards
- TORTUS results shared from nine London NHS sites
- NHS England launches a self certified supplier registry
- MHRA says some products that only transcribe or summarise are not medical devices
Summary
- An AI scribe is software that listens to a consultation and writes up the clinical notes, which the clinician checks before it is saved.
- The worry is that the software can add words the patient never said, which the clinician must catch. The other worry is whether suppliers meet NHS standards.
- NHS England published guidance on 27 April 2025. In June 2025 its chief clinical information officer warned, in a letter seen by Sky News, that "many of these vendors have not complied with basic NHS governance standards".
- Great Ormond Street Hospital (GOSH) shared results of a trial of TORTUS, an AI scribe, in September 2025. Across over 17,000 encounters at nine London sites, direct time with patients rose 23.5% and appointments were 8.2% shorter.
- On 29 July 2026 the MHRA said that products solely intended to transcribe or summarise are not medical devices. A product counts as a device when its intended purpose is medical, such as diagnosis or treatment. NHS England's letter that day told organisations that users remain responsible for checking AI output.
- In January 2026 NHS England opened a registry of suppliers that have certified themselves against NHS requirements. It does not endorse any of them, so each NHS body buys for itself.
Dig deeper
- The government's 10 Year Health Plan, published in July 2025, promised to help providers roll out ambient voice technology. NHS England's Medium Term Planning Framework tells providers to deploy it "at pace".
- The plan credits a London study led by GOSH's Data Research, Innovation and Virtual Environments unit with cutting paperwork time by 51.7%. GOSH has a partnership with TORTUS, and NHS England's Midlands team calls the 23.5% study an NHS England sponsored study.
- In July 2026 the Midlands region ran one procurement for all 1,239 of its GP practices. NHS England's July 2026 letter says national support will start in outpatient settings.
- The same question of who answers for an AI error arises in AI Breast Screening, where AI would replace one of two readers.
Ethical issues
| Principle | How it applies here |
|---|---|
| Autonomy | The patient needs to know the consultation is recorded and what for. The GOSH FAQ does not address consent to the evaluation, and a trade press report gives a 92% consent figure without saying how patients were asked. |
| Beneficence | The 10 Year Health Plan says the technology allows clinicians "to better engage with patients", but it also expects the saving to mean more appointments, so the time may go to more patients rather than longer with each one. |
| Non maleficence | The July 2026 letter makes users responsible for checking the note. But a 2024 study of a speech recognition tool found invented phrases in roughly 1% of transcriptions, and a checker has to notice a sentence that was never said. |
| Justice | Fairness asks who the saving reaches. The 10 Year Health Plan estimates over 2,000 full time equivalents of GP capacity from 90 seconds saved per appointment. |
Interview questions
- What do you know about AI scribes in the NHS?
- What happened when NHS England published its guidance on AI scribing products in April 2025?
- A patient asks whether an AI tool is recording the consultation. What do you tell them, and what do you do next?
- You read the AI draft of a note and find a sentence the patient never said. What do you do?
- Who should answer for an error in an AI written note: the clinician, the hospital or the software company?
- Why might a hospital adopt a scribe that a national letter said did not meet NHS standards?
- Should a tool that only transcribes a consultation be regulated as a medical device?
Sources
- gosh.nhs.ukgosh.nhs.uk/…/ambient-voice-technology-ai-scribe-faqs
- arxiv.orgarxiv.org/…/2402.08021
- NHS Englandengland.nhs.uk/…/guidance-on-the-use-of-ai-enabled-ambient-scribing-products
- healthcare-management.ukhealthcare-management.uk/…/doctors-unapproved-ai-software-record-appointments-investiga
- htn.co.ukhtn.co.uk/…/gosh-publish-study-into-ai-scribe-pilot-across-nine-london-n
- GOV.UKgov.uk/…/ambient-voice-technology-enabled-products
- NHS Englandengland.nhs.uk/…/medical-device-regulation-for-ambient-voice-technology-produ
- digital.nhs.ukdigital.nhs.uk/…/ambient-scribing
- assets.publishing.service.gov.ukassets.publishing.service.gov.uk/…/fit-for-the-future-10-year-health-plan-for-england.pdf
- NHS Englandengland.nhs.uk/…/medium-term-planning-framework-delivering-change-together-20
- medrxiv.orgmedrxiv.org/…/2025.11.27.25340564
- NHS Englandengland.nhs.uk/…/midlands-leads-the-way-on-ambient-voice-technology
Photo: Jacek Halicki, CC BY-SA 4.0, via Wikimedia Commons, colour altered.
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