NHS England in the Midlands is the first region to have procured at scale a provider of Ambient Voice Technology (AVT) for all its 1,239 GP practices as well as over 70,000 clinicians across 15 acute and community trusts, allowing more patients to be seen and reforming traditional administration practices.

AVT, sometimes known as ambient scribing, can be best described as recording the patient / clinician conversation.  But when combined with generative AI, it can convert speech into structured medical documentation, such as notes and letters which can be uploaded to patient records or sent to other NHS providers as referrals.

The technology records the consultation conversation which allows the clinician to focus on the patient rather than a computer screen.  The technology provides the confidence that the conversation will be captured into an accurate draft summarisation which is then reviewed and validated before being actioned.

This region-wide procurement creates a single route for all GP practices in the Midlands to access AVT, giving every practice the opportunity to benefit from the procurement without needing to undertake a separate local procurement process, and there are plans to further deploy AVT across the whole region.

A major NHS England sponsored study showed a 23.5% increase in direct patient interaction time during appointments, alongside an 8.2% reduction in overall appointment length when AI-scribes were used.

The competitive procurement process, led by Dudley Group and Sandwell and West Birmingham Hospitals, has named Heidi as the preferred provider.

Heidi Healthcare is one of 23 suppliers included on NHS England’s self-certified AVT registry, which launched in January. 

The technology was piloted at a Same Day Emergency Care (SDEC) unit and in a rheumatology clinic in Dudley and delivered an 80 per cent reduction in documentation time in the SDEC, equivalent to the capacity of one junior doctor, and cut a six-month rheumatology letter backlog down to 14 days.

The progress the Midlands region has made fits the ambition of one of the governments’ three shifts for the NHS – analogue to digital – as well as being outlined as one of the eight priorities NHS England has asked of ICBs and trusts. 

The Primary Care GP contract for this financial year asks ICBs to support primary care providers to deploy ambient voice technologies, ensuring the time freed up is used to see additional patients.

Ravinder Sahota, Group Chief Information Officer at the Dudley Group NHS Foundation Trust and Sandwell and West Birmingham Trust said:
“Dudley had seen first-hand what was possible. Our clinicians were spending less time on documentation and more time with patients, and that told us we needed to find a way for the whole region to benefit. We built the clinical safety case, the business case, and the evidence base so that other trusts would not have to start from scratch. This framework shows what we can achieve when the NHS works collaboratively to get safe, effective AI into the hands of clinicians at scale.”

Will Goodwin, Regional Director of Digital Transformation in NHS England – Midlands adds: “By collaborating across the region, we have done the heavy lifting centrally on governance and compliance, meaning individual ICBs and GP practices don’t have to repeat that work locally. Ultimately, it allows teams to deploy this technology much faster to support their clinicians, while using our collective scale to secure excellent value for money.”

Dr Anand Rischie is a GP partner at Modality Pleck Health Centre in Walsall and is an advocate of AVT, both in supporting his patients and saving time on administrative tasks. The practice has over 8,000 patients and has been piloting AVT since July 2024 and has seen many benefits, including better engagement with patients.

“The essence of general practice is the doctor-patient relationship which starts from building a rapport between doctor-patient, having that eye contact, having a conversation which leads to discussions and shared management”, says Dr Rischie.

“I think AVT is helping to bring that back and helping patients feel more listened to.”

Dr Rischie has 20 consultations every day and used to spend his Friday afternoons and often late into the evening writing referral letters and completing other administrative tasks. This process is now much quicker as AVT also supports the drafting of letters along with consultation and supervision note summary. AVT is currently used by all GPs and non-medical prescribers at the practice, and they are currently in the process of rolling out AVT with nurses.

“AVT allows you to give more time to the patient. I think at our practice, we have got less tired partners, people who are more engaged, people who are more excited to work and see patients because they are not worried about administrative burden.

“After COVID, we were so overburdened with keeping accurate and detailed notes for the benefit of clinicians and patients. I believe there is nothing wrong in using AI if it is helping you to become more efficient and if it helps bring back more traditional general practice communication skills.”

Dr Rischie and his colleagues gain consent from patients to use AVT at the start of the appointment and are responsible for checking the accuracy of the notes at the end of the consultation.