GPs urged to use NHSE-listed AI transcription tools in patient consultations

GPs are now able to select AI transcription tools from a new ‘national registry’ of suppliers that have been backed by NHS England for use in clinical consultation.

The NHS England Ambient Voice Technology (AVT) Supplier Registry, which includes 19 software suppliers, allows providers to choose and implement the technology ‘safely and effectively’, it said. 

However, asked if GP practices would only be permitted to buy AVT from suppliers on the list, NHS England said final assurance and decision-making sits with the supplier’s local NHS organisation, not NHS England.

And, with regards to liability, the commissioner reiterated that its current guidance on using the technology still applies. This states GP practices ‘may still be liable’ for clinical negligence claims arising from the use of artificial intelligence (AI). 

Arguing the use of AVT will save clinician time, NHSE pointed to results from a study carried out last year, which showed an increase of nearly a quarter (23.5%) in ‘direct patient interaction time’ during appointments and an 8.2% reduction in overall appointment length when AI scribes were used. The study, led by Great Ormond Street Hospital, included nine hospital sites and one GP practice (Crosslands Surgery in Southall, in west London).

NHS England chief clinical information officer Dr Alec Price-Forbes said AVT tools would ‘free up more time’ for staff to ‘focus on their patients’ rather than ‘typing up notes or looking at a screen’.  

‘We are working with NHS organisations to help them implement the technology safely and effectively – helping to make the NHS the most AI-enabled healthcare system in the world, as we shift from analogue to digital’, he said. 

AI featured heavily in the NHS 10 year health plan published last year, in which the Government said the technology was ‘liberating staff from bureaucracy’.

Medico-legal experts welcomed the new approved supplier list but urged GPs to ensure all AI transcriptions and summaries are ‘human-reviewed and validated’.

Medical Defense Society chief executive Rohan Simon told Pulse that while the registry standardises tools, it ‘does not change the standard of care’.

He said: ‘Like all AI tools, the our position has been that the clinical and legal responsibility for medical record accuracy remains with the clinician, as such we emphasis that AI transcription is an assistive tool, not an autonomous professional. Practices must ensure every AI-generated summary is human-reviewed and validated.’

Medical director at Medical Protection Dr Pallavi Bradshaw told Pulse that this registry will provide practices with ‘some reassurance’ that the supplier they engage complies with the required standards on clinical safety, technology and data protection, but that clinicians are ‘likely to remain ultimately responsible’ for their actions when using AI.

She said: ‘The way in which transcribing software is used by GPs should consider data protection and consent and be consistent with the GMC’s Good Medical Practice.

‘For example, it is important to ensure the software has accurately summarised the consultation and has not added in or omitted potentially relevant information, such as red flags. 

‘This will help in justifying a decision about a patient’s care, in the event of a claim or complaint. Those using the software should also be adequately trained.

‘It is sensible to take care with any contracts or agreements entered into with AI suppliers and be cautious about agreeing to indemnify against any claims that may arise.’

MDDUS joint head of legal James Doake told Pulse: ‘The registry is a positive step toward clearer standards and will help GP practices show that they’ve acted responsibly when choosing an AI system.

‘However, if something goes wrong, liability will still depend on whether the doctor or practice used the tool appropriately and in line with accepted clinical practice. GPs could not necessarily rely on faulty AI alone as a defence in a negligence case.’

GP practices have been advised to appoint a ‘clinical safety officer’ (CSO) with two days’ training before using medical transcription tools.

Local GP leaders have called for better medico-legal protection for GPs using AI. At last year’s England LMCs conference, a motion was carried demanding state-backed indemnity be extended to cover claims associated with ‘failures in AI triage, assessment, documentation and management leading to delay in treatment or direct patient harm’.