The Download: Resistance is futile

Those close to the process say there is a lot of last-minute movement on what is and isn’t going to be in the 10-Year Health Plan.

This means leaders may find themselves under pressure to deploy systems that aren’t in the plan but are the pet project of someone powerful at the centre – ie the plan might not be the whole of the plan.

The Download understands trusts will be told they have to adopt ambient voice technology or explain how they will achieve comparable efficiencies.

The good news:

• There’s a lot of it out there, with dozens of firms doing only this – a “red hot” market, as one industry figure described it to The Download.
• Increasingly accepted by clinicians. Already used in primary care to some extent, some consultants say an organisation’s use or not of AVT would be factor in whether they took a job there.

The bad news:

• It might not release much in cash savings. The time not spent on note taking is going to be spent on more patients? Maybe.
• Where is the monitoring of this new technology?

What’s the state of monitoring now?

Robin Carpenter, head of AI governance and policy at healthtech start-up Newton’s Tree, told The Download that oversight of these AI scribes was currently “not very good”.

He said: “This is alarming because when they are classed as a medical device, and most of the time they should be, the regulation demands active oversight. But often this oversight is weak, and sometimes it is not happening at all.

“Few people seem to be checking if the model is making more stuff up over time, and nobody seems to be checking if staff have stopped checking what the Scribe has outputted – which is a real phenomenon that happens, and the standards say you should be checking for it.

“I find this lack of monitoring remarkable because there is pretty much global alignment that this should be being checked.”

There are other regulations complicating AI deployments, including section 22 of the General Data Protection Regulation (GDPR). This says when you are fully automating a process (no human oversight), you have to determine whether it could have a “significant effect” on someone, a patient in this instance.

At the moment, there is no real definition of what a “significant effect” might be in healthcare.

Mr Carpenter said: “Scribes are less of a concern currently, but other uses of automation, like appointment scheduling, very much could be a concern.”

He has called on the Information Commissioner to clarify “where the lines in the sand are”, adding that the guidance currently “doesn’t tell people what to do”.

Ahead of the curve

One hospital group has decided to get ahead of this anticipated change in approach in the 10-Year Health Plan.

University Hospitals of Leicester and Northamptonshire group chief executive Richard Mitchell sent an update to stakeholders last week that stated, by April 2027, “no time will be spent on a task that digital could do better, quicker or to the same standard”.

In the same update, Mr Mitchell stated the ambition that the group would become the “first AI-empowered NHS group” in the country.

This is likely to be supported through the group’s partnership with Microsoft, being the national NHS lead partner for the software giant.

The group is also working with NHS England to help develop products on the Federated Data Platform.

Increasing uptake of the FDP and other large national solutions is likely one of the motivations behind the anticipated change in approach from the centre.

If the noise is to be believed, trusts will no longer be able to say they simply do not want to use FDP and will instead have to take the time to provide evidence that they can achieve the same results another way – although Wes Streeting has already said the “glacial” pace of FDP adoption must be picked up.

Some areas may welcome this national intervention if it means they can more rapidly improve their digital maturity, but others may see it as creeping centralisation and an effort to stop any dissent from national projects.