NHS England sets out the rules for safe use of ambient AI scribes

With interest in AI tools growing rapidly, particularly those designed to ease the administrative burden on clinicians, NHS England has published new national guidance on the safe use of AI enabled ambient scribing products in health and care settings. These products passively capture clinical conversations and automatically generate consultation notes or correspondence, commonly referred to as “ambient scribes”. The guidance includes sections for patients, healthcare professionals and information governance professionals. 

Importantly, the guidance is focused on responsible deployment in environments handling sensitive personal data. NHS England highlights that while ambient scribes can free up clinical time and improve record-keeping, robust information governance, transparency and respect for patient rights are essential.

Developed with regulators and data guardians

This guidance was developed in collaboration with the Information Commissioner’s Office and the National Data Guardian, in recognition of the significant data protection, confidentiality and ethical issues these tools raise. NHS England’s information governance professionals and the Health and Care Information Governance Working Group also contributed, marking a coordinated national approach over fragmented local decision-making.

This collaborative approach is crucial, as ambient scribes operate at the intersection of clinical safety, digital transformation, and data protection law. NHS England has worked to align the guidance with UK GDPR, common law confidentiality, and existing NHS information governance standards.

Enabling adoption

The guidance provides a practical framework for organisations considering adoption. It outlines how ambient scribing products process information, what safeguards are necessary, and how organisations can fulfil their obligations as data controllers while still deploying innovative technologies.

A central message is that explicit consent is not required for ambient scribes in direct care, but transparency is vital. Patients must be informed at the start of each interaction if an ambient scribe is in use and given a clear chance to object; if a patient dissents (indicating you cannot rely on their implied consent), healthcare professionals should respect their wishes. This ensures patient choice remains central, even as AI becomes more integrated into clinical workflows.

The guidance also clarifies that clinical responsibility remains with healthcare professionals. Clinicians are accountable for the accuracy of clinical records, and outputs generated by ambient scribes must be reviewed and validated before inclusion in patient records.

Supporting safe, scalable deployment

For NHS organisations, the guidance supports safe, consistent adoption at scale. It complements the NHS England Ambient Voice Technology Supplier Registry launched in early 2026 to bring order to a “Wild West” market.

As NHS England sets boundaries for emerging technologies, this guidance gives organisations confidence to explore ambient scribing while keeping public trust, legal compliance, and patient rights at the forefront of digital transformation.

Large scale rollouts

A contract with Australian supplier Lyrebird Health underpins the most significant ambient scribing deployment seen so far in the NHS, announced on 7 April by the South West London Acute Provider Collaborative. The rollout will deploy ambient scribing technology to 10,000 clinicians in its first year, scaling to 20,000 clinicians over four years. The programme will also introduce automated clinical coding and referral to treatment (RTT) capture, marking a first for NHS deployment at this scale and representing the largest ambient scribing rollout by headcount to date.

The announcement follows other large scale deployments across hospital groups, including joint procurements such as the collaboration between University Hospitals of Leicester NHS Trust and University Hospitals of Northamptonshire Group, which selected ambient scribing solutions from Tandem and Accurx.

The rise of patient side AI

While NHS England’s guidance centres on clinician‑facing ambient scribes, patient‑side AI is beginning to surface. One early example is Emilia, a patient‑facing scribe developed by Canadian company Lime Health. Unlike clinician‑led tools, Emilia produces plain‑language consultation summaries for patients, helping them understand discussions, recall follow‑up actions and manage next steps in their care.

Patient‑side AI offers clear opportunities – supporting shared decision‑making and improving health literacy but also introduces new risks, particularly around accuracy, accountability and how AI‑generated outputs are validated before being relied on by patients outside the clinical record.

For a wider exploration of surveillance and monitoring in healthcare settings, see our series of blogs on safety and privacy, staff awareness of monitoring, best practice guidance, the use of facial recognition technologies in the workplace, and how healthcare professionals should respond when patients wish to record their consultations. These issues sit alongside NHS England’s new guidance, underscoring the importance of strong governance, transparency and trust as digital tools become embedded in everyday care.

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