NHS England’s recently published Medium-Term Planning Framework represents an important next step in the delivery of the 10-Year Plan. It takes the digital ambitions set out in that Plan – including “digital by default”, greater interoperability, and the use of AI to release time for care – and translates them into a defined, three-year roadmap.
For many across the system, this alignment between national strategy and local delivery will be welcomed. The Framework gives health and care organisations a clearer sense of direction. What matters now is how those ambitions are turned into practical action.
The Framework’s focus on productivity, the NHS App and neighbourhood health services reflect a clear recognition that technology must support the people delivering care, not just measure them. The target of a 2 per cent productivity gain is ambitious but realistic, provided that the digital tools in use actually save time on the ground.
Digital by default
The emphasis on “digital by default”, which can often feel like a blanket requirement, needs to translate into giving clinicians solutions they want to use because they make their work easier. It’s why the inclusion of Ambient Voice Technology (AVT) among the national priorities is critically important. Documentation remains one of the biggest sources of pressure for staff; automating it safely can deliver transformative results.
The challenge is in the execution. Scaling AVT “at pace” across a workforce as large and diverse as the NHS will only be successful if policy teams consider learnings from the experience of early adopters. There are already live examples where AVT is being embedded into clinical systems. Therefore, understanding what has worked and where implementation has been difficult will ensure the wider national rollout meets its objectives.
Learning from deployments
For example, four NHS trusts – Oxleas, North East London, Lancashire and South Cumbria, and Kent Community Health – are introducing an AI-powered dictation tool developed with Microsoft and integrated within Access Rio, England’s most widely used electronic patient record (EPR) across mental health and community trusts.
The tool, SmartNotes, automatically transcribes consultations and produces structured, accurate summaries. For doctors, nurses, community workers and allied professionals working in mental health, community health, hospitals, clinics and in external settings – such as the patient’s home – it means recording patient interactions instantly (instead of manually writing up notes at the end of the day). Staff also have the option to supplement it with their own notes as needed. For those based in the community, without internet connection, this can prove particularly beneficial.
And initial feedback shows the trusts could expect to achieve an average saving of three minutes per case note. This is equivalent to around 1.2 million days of clinical time each year across the Rio EPR user community, but only if tight integration with the local EPR is in place in order to avoid a “cut and paste” activity for the user/clinician.
While the productivity benefits will be important, the implementation lessons are just as valuable. Success depends on involving clinicians from the outset and throughout, integrating AVT seamlessly into existing workflows and ensuring there is strong local digital leadership to champion the project.
These insights, as the four trusts go-live and manage the longer-term implementation plans, need to be captured and shared if we are to see AVT scaled “at pace.”
Scaling safely
The government’s commitment to accelerating deployment must also be matched with safeguards that maintain public and professional confidence. The 10-Year Plan made it clear that ethical AI is a prerequisite for digital progress, rather than an afterthought.
The SmartNotes AVT tool was built with that principle at its core. It runs on a secure, ring-fenced AI model, meaning patient data is not used for external training. And it is registered as a Class 1 Medical Device with the MHRA, meeting NHS regulatory requirements for AI summarisation.
These features shouldn’t be considered “nice to haves”. They are essential. Scaling quickly without these safeguards risks eroding trust amongst users and patients and creating unwanted variation in quality and safety.
Supporting neighbourhood health
Thinking about the wider shift towards neighbourhood-based care – AVT can play a key role here too. The new service delivery model will rely on digital tools that support collaboration across organisational boundaries. When voice-captured notes are integrated into interoperable EPRs, information can be shared securely across care settings. Clinicians can see the same, up-to-date information, recorded once and reused multiple times.
This kind of joined-up documentation strengthens both productivity and continuity of care. It also reinforces the message that digital transformation doesn’t replace human interaction but rather enables more effective joined-up working.
Building from the ground up
We have an exciting three years ahead, as the NHS moves beyond local pilot projects to sustainable, digitally enabled change to remove the administrative burden.
However, to do that, national leaders will need to balance pace with realism – scaling what works, learning quickly from early deployments and resisting the temptation to treat technology as a single, uniform solution.
And collectively, if we can combine the policy direction of the 10-Year Plan with grounded insight from the organisations already using these tools, digital transformation will help supercharge staff, their roles and the care they can provide to patients. AVT isn’t a silver bullet, but it has rightly been recognised as one of the most practical steps organisations can take towards a more efficient and sustainable NHS.
By Steve Wightman, Managing Director, Access Health and Integrated Care
