Aipedia: Doctors and medical practices

AI scribes in consultations: rules and liability

Aipedia, by the Apex broking team · Last reviewed 2026-10-27

Doctors can use AI scribes, but they must review and approve every note and letter the tool produces, because the record remains theirs. A transcription error that changes a drug, dose or side can harm a patient and lead to a claim.

Part of: AI in doctors and medical practices

In short

Ambient voice technology listens to a consultation and drafts the clinical note, coding and letters. NHS England guidance says generative summarisation is likely a medical device, its Supplier Registry requires at least MHRA Class I, suppliers must meet DTAC and DCB0129, and deploying organisations need DCB0160 safety cases and a DPIA. Patients must be told before processing starts. GMP para 69 still requires clear, accurate, contemporaneous records. NHS England warns that if no supplier accepts responsibility, liability may default to the trust or practice, so contracts and review habits both matter.

How doctors use AI scribes

An ambient scribe records the conversation in a consultation, transcribes it and, in many products, uses generative AI to summarise it into a structured note. Many tools also suggest clinical codes, draft referral or clinic letters and populate patient instructions. GPs, outpatient clinicians and private consultants use them to reduce typing and keep eye contact with the patient. The doctor reviews the draft and files it in the record.

The rules that apply

NHS England's guidance on AI-enabled ambient scribing products (now version 2) is the main reference:

Device status: transcription-only tools are likely not medical devices; generative summarisation is likely a medical device and must be MHRA-registered.
Supplier Registry: the AVT Supplier Registry, available from 16 January 2026, requires at least MHRA Class I. It is self-certified, NHS England does not endorse listed suppliers, and NHS bodies must run their own procurement.
Safety and data: suppliers must meet DTAC and DCB0129; deploying organisations must complete DCB0160, including a safety case, hazard log and monitoring, plus a DPIA and retention periods for audio, transcripts and outputs.
Patients: they must be told before processing starts and given a chance to object.
Clinicians: users must review and approve outputs, with an "ongoing responsibility for practitioners to review and revise the outputs".

Good medical practice adds the professional duty. Para 69 requires records to be "clear, accurate, contemporaneous" and legible, para 70 that they show who created them, and para 71 that they are kept secure. The GMC's AI resource confirms these apply to AI tools, and para 73 requires you to report adverse incidents involving software.

What can go wrong

Illustrative scenario: a GP discusses stopping a blood thinner before a procedure. The scribe summarises the plan as continuing it, and the draft letter to the hospital repeats the error. The GP, running late, approves the note without reading the plan section. The patient follows the letter, the procedure goes ahead on the wrong footing and the patient is harmed.

Other common failures are misheard drug names, wrong laterality, symptoms the patient denied recorded as present, and "hallucinated" examination findings that were never performed. Because the note looks polished, errors are easy to miss, and once filed they flow into letters, coding and the next clinician's decisions.

Who is liable and how indemnity usually responds

NHS England calls AI liability "complex and largely uncharted". If no liable party can be found or the supplier does not accept responsibility, liability may default to the trust or primary care provider as a "non-delegable duty", so it recommends clear supplier contracts. For NHS work, a clinical negligence claim is usually handled under CNST or CNSGP. For private consultations, the doctor's own arrangement responds, subject to its terms. One defence organisation's published position only assists where a human remains the decision maker and excludes system failures, defects and data breaches, so a scribe malfunction or a leak of recordings may need separate cover such as cyber insurance.

Practical controls

Use only tools your organisation has approved, with a completed DCB0160 safety case and DPIA.
Tell patients before recording and record any objection.
Read the plan, medication and safety-netting sections every time before approving.
Check that examination findings were actually performed.
Correct errors in the record openly, showing who amended it and when.
Report scribe errors that cause or nearly cause harm under para 73.
Keep notes of how you review AI drafts; see what to document about AI use.

How Apex helps

Apex arranges indemnity for doctors and clinics, including private work outside NHS schemes. A broker reviews your cover and how your policy treats AI-assisted records, including gaps outside CNST and CNSGP.

Sources

Frequently asked

Do I need patient consent to use an AI scribe?

NHS England guidance says patients must be told before processing starts and given a chance to object. Whether consent is the lawful basis for data processing should be confirmed with your information governance lead. One defence organisation's advice suggests seeking informed consent where data goes to third parties.

Is an AI scribe a medical device?

NHS England says transcription-only tools are likely not medical devices, but tools that use generative AI to summarise are likely to be, and must be MHRA-registered. Its Supplier Registry requires at least MHRA Class I, although listing does not mean NHS England endorses the product.

Who is responsible if the scribe gets the note wrong?

You are, for the content you approve. GMP para 69 requires accurate records, and NHS England expects practitioners to review and revise outputs. The organisation may also be liable, and liability may default to the trust or practice if the supplier does not accept responsibility.

Check your indemnity covers how you use AI

Tell us about your practice and the work you do. A broker will review how your current cover treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.

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Apex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.