Purpose

This document offers high-level information for NHS senior executives and Board members on ambient scribing products that feature Generative Artificial Intelligence (AI), for use across health and care settings in England. These products are sometimes referred to as ambient scribes or AI scribes and include advanced ambient voice technologies (AVTs) used for clinical or patient documentation and workflow support.

Ambient scribing products offer an important opportunity for the NHS to improve patient care, enhance clinical efficiency and productivity, address poor data quality and automate coding.

Further support

The document is accompanied by guidance aimed at Chief Information Officers (CIOs) and Chief Clinical Information Officers (CCIOs) leading AI adoption in health settings. The guidance details key safety and regulatory considerations and includes an Appendix with further actionable steps for technical and product teams.

To support the widespread opportunity for ambient scribing and automation enabled by AI, a programme of work is underway to deliver a national proposition. This will support all care settings including Primary and Secondary care organisations, to rollout assured, standardised services across England in a safe and compliant way. This is in recognition of the significant interest and transformative capabilities this technology provides to reimagine care technology.

Introduction

We are living through a technology revolution, which has transformed our lives. Rapidly evolving digital capabilities and growing consumerism, along with demographic and economic changes, have changed most sectors and continue to disrupt healthcare globally. Yet the NHS remains in the foothills of digital transformation.

Artificial intelligence (AI) could revolutionise health care, helping to secure the sustainability of the NHS by improving the quality of patient care and freeing up staff time. Ambient scribing products, which, when combined with Generative AI, hold transformative potential for the NHS. These products can listen to the ‘patient – clinician’ conversation and convert that speech directly into structured medical documentation, such as notes and letters.

The opportunities of Artificial intelligence (AI)

The Government has recently published recommendations to capture the opportunities of AI in the AI Opportunities Action Plan. This underpins the Government’s Health Mission to build a reformed health and social care system fit for the future, structured around three shifts.

What are ambient scribing products

Ambient scribing products, including ambient voice technologies (AVTs), unobtrusively record the patient and caregiver conversation in the background and then convert that dialogue into text and other outputs, requiring minimal user intervention. These technologies utilise advanced speech recognition and integrate powerful capabilities driven by Generative AI and Large Language Models (LLMs).

Ambient scribing products are designed to support clinical or patient documentation and workflows. So, rather than focusing on the computer screen, keyboard or dictaphone, the caregiver can focus on the patient in front of them, with confidence that their conversation will translate into an accurate draft summarisation for review and validation after the visit.

Benefits of ambient scribing products

The adoption of ambient scribing products and AVTs can transform any care setting by improving clinical efficiency, enhancing patient care, reducing clinician workload and addressing the challenges of poor data quality. They facilitate on-demand interactions and streamline processes, enabling caregivers to dedicate more time to providing care rather than documenting it.

Several regions and trusts are already trialling and deploying ambient scribing products. The largest related pilot was conducted in the London Region across diverse clinical settings (including primary and secondary care, ambulance, and community and mental health sites).

The following provide early indications of benefits from ongoing trials:

1. Enhanced clinical efficiency and workflow

• reduced administrative burden: less time spent on manual data entry and administrative tasks and a reduction in tasks (for example, typing and note-taking) during consultations.

2. Improved patient care

• increased face-to-face time: focusing on the patient and the conversation, rather than the technology or looking at a screen, enhances the quality of consultations and improves overall patient satisfaction. There have been reported increases in the proportion of clinicians reporting that they could give their full attention to patients and having sufficient time to consult with each patient.
• accurate documentation: by capturing detailed and accurate notes in real-time, ambient scribing products can help ensure that patient records are comprehensive and up-to-date, supporting better clinical decision-making.

3. Addressing poor data quality

• consistent data capture: standardising the way clinical information is recorded could reduce variability and errors in data entry within electronic patient record (EPR) systems. AVT use appears to enable an increase in the use of EPR solutions, which can lead to improved data quality and support frontline digitisation goals.

4. Cost savings

• operational efficiency: by reducing the administrative workload and minimising errors, ambient scribing products could lead to significant cost savings. Some care settings reported early findings for a reduction in overall appointment times.
• reduced burnout: alleviating the administrative burden on caregivers can help reduce burnout and improve productivity.

5. Promoting scalability and interoperability

• by integrating with existing EPRs and being adaptable to diverse environments, ambient scribing products support a wide range of use cases, from primary, community and care home through to specialised hospital settings. They can also enable intelligently automate workflow.

Key considerations and next steps

There is a compelling rationale for the adoption and implementation of ambient scribing products across all care settings to address current challenges, whilst ensuring regulatory compliance, data governance and AI assurance processes are adhered to. Creating a strategic roadmap for ambient scribing products to integrate within existing digital systems and aligning adoption with broader transformation and innovation goals is key. The accompanying guidance describes these next steps and how to implement these products locally.

Conclusion

Ambient scribing products offer a transformative opportunity for the NHS to enhance clinical efficiency and productivity, improve patient care, and address the challenges of poor data quality. By strategically integrating these products, the NHS can drive innovation, achieve cost savings, and support the well-being of its workforce, ultimately leading to better health outcomes for patients.

Publication reference: PRN01734_ii