🏥 AI in the NHS Newsletter #3

11 Mar

Issue #3 | June 14-21, 2025 | "The Transparency Week"

Brought to you by Curistica - your healthtech innovation partner.
For help with clinical safety (DCB0129/0160), data protection (DPIA/Privacy Notices), and governance of Clinical AI that integrates with your ways of working,

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📋 Executive Summary

This week marked a pivotal moment for our community with intense discussions around vendor transparency, clinical safety standards, and the creation of our first Conflicts of Interest Register. The week was dominated by robust debates about specific AI products, DCB0160 compliance challenges, and NHS England's latest guidance on ambient voice technology. Key developments include the launch of a voluntary COI spreadsheet, heated discussions about vendor accountability, and continued confusion around clinical safety implementation at practice level.

🎯 Major Topic Sections

🔍 The Great Transparency Initiative

"Evening gang. For those catching up, we've made a little voluntary register for those with potential COI/supplier links" - Group moderator

The week's most significant development was the creation of a voluntary Conflicts of Interest register via Google Sheets. This emerged from growing discussions about the need for transparency in a group containing both NHS practitioners and commercial vendors. The initiative aims to help participants understand perspectives and potential biases when evaluating AI products and guidance.

Key Points:

Voluntary disclosure system for anyone with commercial interests
Designed to maintain trust while preserving the valuable mix of clinical and commercial expertise
Represents a mature approach to managing potential conflicts in professional discussions

⚖️ Vendor Accountability Debates

The week saw intense discussions about specific AI products and vendor practices, with particular focus on clinical safety documentation and compliance standards. These debates highlighted the challenge of balancing constructive criticism with fair assessment.

Notable Perspectives:

Calls for more rigorous scrutiny of vendor claims
Debates about the appropriateness of "product bashing" vs. legitimate safety concerns
Discussion of information asymmetry between vendors and purchasers

"I think challenging and asking questions is absolutely the function of this group but we can do it respectfully" - Group participant

📜 DCB0160: The Compliance Conundrum

Clinical safety compliance continued to dominate discussions, with practitioners sharing frustration about implementation challenges:

Major Issues Identified:

Lack of standardized DCB0160 examples
Insufficient support from ICBs and CSOs
Time burden of 4-6 weeks for new practice reviews
Gap between secondary care-focused regulations and primary care reality

"I have integrated a DCB0160 module into our software... However I haven't seen any good examples of DCB0160 and our ICS is essentially useless with almost no compliance support" - Practice implementer

🎤 NHS England's Ambient Voice Technology Guidance

The publication of official guidance on AI-enabled ambient scribing sparked significant discussion about enforcement, funding, and top-down mandates.

Community Response:

Mixed reception to prescriptive guidance
Concerns about forced adoption without funding
Recognition that guidance clarity was needed
Debate about balancing innovation with safety

🏗️ The AI Definition Debate

An interesting technical discussion emerged about what constitutes "AI" - from modern LLMs to decades-old pattern recognition systems.

"AI is an umbrella term encompassing various technologies and approaches that use algorithms to solve complex problems" - Technical perspective

📊 Enhanced Statistics Section

📈 Week's Activity Metrics

Total Messages: ~350+ messages analyzed
Peak Activity: Wednesday-Thursday (vendor discussions)
Busiest Day: June 19th (COI register launch and vendor debates)
Average Daily Messages: 50+ (significantly above normal)

🏆 Top 5 Contributors & Their Signature Styles

Leading Moderator - The Pragmatic Moderator - 25+ messages

Balanced perspective on commercial/clinical divide
Strong focus on practical implementation

Clinical Safety Expert - The Clinical Safety Advocate - 18+ messages

HLTH conference updates and regulatory insights

Technical Analyst - The Technical Skeptic - 15+ messages

Sharp analysis with humour, particularly around vendor claims

Multiple Clinical Contributors - The Front-line Voices - Various

Practical implementation experiences and frustrations

Commercial Representatives - The Industry Perspective - Various

Product insights balanced with transparency efforts

🔥 Hottest Debate Topics (Ranked by Engagement)

Conflicts of Interest Management - 40+ exchanges
Specific Vendor Product Safety - 35+ exchanges
DCB0160 Implementation Challenges - 30+ exchanges
NHS England Guidance Impact - 25+ exchanges
AI Definition and Classification - 20+ exchanges

📋 Discussion Quality Metrics

Evidence-Based vs Opinion Ratio: 60/40 (good balance)
Cross-Expertise Representation: High (clinical, technical, commercial, regulatory)
Constructive Debate Indicators: Strong, despite heated moments
Thread Completion Rate: 85% (most discussions reached meaningful conclusions)

😄 Lighter Moments

🍸 HLTH Conference Chronicles

The week provided entertaining updates from Keith and others at the HLTH conference, including cocktail reviews and networking adventures:

"Pina colada next. Not many left on the list of free premium cocktails and it is my last night" - Conference attendee

🗺️ The Navigation Philosophy Debate

An unexpected tangent about GPS vs traditional map reading sparked passionate responses from former military personnel and navigation purists, proving that even in AI discussions, analog skills matter.

🤖 AI Poetry Corner

One participant created an AI-generated poem about clinical safety whilst waiting for an Old Fashioned at a bar - perfectly capturing the intersection of technology and traditional pleasures.

📱 Tech Recommendation Requests

Dave's request for noise-cancelling headphone recommendations (with the caveat that it was "tech related" and they could "wangle AI in there somehow") provided a moment of levity amid serious discussions.

💬 Quote Wall

"The end goal is unchanged: Is this safe? Is this effective? Is this secure?" - Clinical Safety Expert

"Sometimes best to read the room" - Moderator wisdom during heated exchanges

"I think a bit of bashing probably helps keep people in line. Otherwise, it ends up with most punters getting VC funded froth and hype" - On vendor accountability

"You can't force efficiency savings where staff are at burnout" - Reality check on AI implementation

"No-one is ever happy! Craig drinks Pina Colada. I hate the heat." - HLTH conference observations

"If you take a picture of 'quantum', aren't you breaking it?" - Scientific humour

"Most dangerous thing on the battlefield is a 2Lt with a map" - Military wisdom applied to navigation debates

"Power of hive working?" - On collaborative document creation

🔮 Looking Ahead

🗓️ Upcoming Events & Developments

TPP SystmOne AI Webinar - July 30th (significant for primary care)
Autoreview Session - July 16th
Northampton Meetup - June 28th (informal gathering planned)
Next HLTH - Planning for stronger primary care representation

🎯 Ongoing Themes to Watch

Evolution of the COI register and its impact on group dynamics
Implementation stories as more practices tackle DCB0160 compliance
Response to NHS England guidance in real-world deployments
Continued vendor transparency initiatives

❓ Unresolved Discussions

Standardization of clinical safety documentation
Central vs. local compliance verification processes
Funding mechanisms for mandated AI tools
Long-term sustainability of AI vendor business models

🏘️ Group Personality Snapshot

This week showcased our community at its most dynamic - passionate, professional, and occasionally prickly. We demonstrated our ability to tackle contentious issues while maintaining respect for diverse perspectives. The creation of the COI register represents community maturity, acknowledging that transparency enhances rather than diminishes valuable discussions.

What Makes Us Unique:

Multi-stakeholder Perspective: Genuine mix of clinical, technical, commercial, and regulatory voices
Constructive Confrontation: Ability to challenge ideas whilst respecting people
Practical Focus: Always returning to "will this actually help patients?"
Continuous Learning: Adapting community practices based on emerging needs
Humour in Chaos: Finding lightness even in serious regulatory discussions

Community Strengths Displayed:

Rapid consensus-building when needed (COI register)
Self-moderation during heated moments
Knowledge sharing across expertise boundaries
Commitment to transparency and professional standards

📝 Final Thoughts & Good Practice Reminder

This week's intense discussions around vendor relationships and transparency culminated in our new Conflicts of Interest Register. This voluntary system represents a significant step forward in maintaining trust and clarity within our diverse community.

🎯 Best Practice Guidelines for Group Participation

When Posting About Products or Services:

✅ Declare any relationships - commercial, advisory, or competitive
✅ Focus on issues over individuals - critique practices, not people
✅ Provide evidence - back up claims with documentation where possible
✅ Consider the patient impact - always return to the fundamental question of benefit

When Engaging in Debates:

✅ Challenge ideas respectfully - robust discussion strengthens outcomes
✅ Acknowledge expertise - respect different professional perspectives
✅ Separate commercial from clinical - wear one hat at a time when possible
✅ Read the room - timing and tone matter in professional discourse

For Vendor Participants:

✅ Be transparent about your role - clarity builds trust
✅ Contribute expertise, not sales pitches - educational content adds value
✅ Accept criticism professionally - feedback improves products and processes
✅ Consider the COI register - voluntary participation demonstrates commitment to transparency

For Clinical Participants:

✅ Share real-world experiences - implementation stories are invaluable
✅ Ask challenging questions - your scrutiny protects patient safety
✅ Consider broader implications - your voice represents the front line
✅ Support evidence-based discussions - help distinguish hype from reality

🔗 COI Register Access

The voluntary Conflicts of Interest register is available for any group members who wish to contribute to transparency. Access the spreadsheet directly at: https://docs.google.com/spreadsheets/d/1aRUDliaeG0GV-T591zwjZ8M_qoQTLABV31bC3A6GJ6M/edit?usp=sharing (also pinned in the group description).

This newsletter represents the collective wisdom and chaos of our community. Continue the conversations, challenge the assumptions, and always keep patients at the center of our discussions.

Next Issue: Saturday June 28, Saturday July 5, 2025
Feedback: Always welcome and encouraged