AI Features

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The Signposting Toolkit includes AI-powered tools to help improve symptom instructions and generate safe triage questions. All AI-generated content requires mandatory clinical review before publication, ensuring safety and clinical oversight.

Overview

The AI features are designed to support, not replace, clinical judgement. They assist with:

• Improving clarity and readability
• Generating appropriate triage questions
• Maintaining consistent tone and structure

All AI output is subject to the same clinical governance requirements as manually-written content.

AI Instruction Editor

The AI Instruction Editor helps improve the clarity and tone of symptom instructions while maintaining clinical accuracy.

How It Works

1. Admin Initiates Request
   • Admin clicks “Customise Instructions” on a symptom
   • AI processes the current instructions
   • Generates improved version
2. AI Generation
   • AI rewrites for clarity
   • Maintains clinical accuracy
   • Preserves key information
   • Uses plain English principles
3. Draft Creation
   • Suggestion stored as DRAFT
   • Original content remains unchanged
   • Admin can preview changes
4. Clinical Review Required
   • Draft automatically enters PENDING state
   • Must be reviewed before publishing
   • Reviewer can approve, modify, or reject
5. Publication
   • Only after clinical approval
   • Original version retained in history
   • Full audit trail maintained

Features

• Clarity Improvement — Rewrites complex sentences
• Tone Consistency — Maintains NHS style guide
• Plain English — Ensures readability (reading age 9-12)
• Clinical Preservation — Keeps medical accuracy
• Undo Capability — Can revert to previous version

Safety Checks

• Never publishes automatically
• Always requires human review
• Original content preserved
• Change history tracked

AI Suggested Questions

AI Suggested Questions generates grouped triage-style questions to help staff gather information safely and consistently.

Question Categories

Generated questions are organised into logical groups:

1. Red Flags
   • Critical symptoms requiring immediate attention
   • Safety indicators
   • Urgency markers
2. Urgency/Timing
   • How quickly care is needed
   • Time-sensitive factors
   • Appointment priority
3. Pathway Suitability
   • Which service is appropriate
   • Referral criteria
   • Alternative options

How It Works

1. Generate Questions
   • Admin clicks “Get Questions to Ask”
   • AI analyses symptom context
   • Generates relevant question sets
2. Review Required
   • Questions enter PENDING state
   • Must be clinically reviewed
   • Can be edited during review
3. Approval
   • Clinician reviews for safety
   • Verifies appropriateness
   • Approves or modifies
4. Usage
   • Available on symptom pages
   • Staff can reference when needed
   • Supports consistent triage

Safety Considerations

• Questions screened for appropriateness
• No automatic publication
• Clinical review mandatory
• Can be rejected or modified

Smart Symptom Updates

When base library content is updated centrally, surgeries can choose to adopt updates or keep their local versions.

Update Detection

• System detects base library changes
• Surgeries notified of available updates
• Comparison shows differences

Update Process

• Admin reviews changes
• Can accept, modify, or decline
• Accepted changes enter review workflow
• Local customisations preserved

Benefits

• Stay current with best practice
• Maintain local adaptations
• Choose what to adopt
• Complete control over updates

Feature Flags

AI features can be enabled or disabled at multiple levels:

Control Levels

• Superuser — Global feature control
• Surgery — Per-practice enablement
• User — Individual user overrides (if surgery enabled)

Current Features

• ai_instructions — AI Instruction Editor
• ai_questions — AI Suggested Questions
• smart_symptom_updates — Smart update notifications

Management

• Surgery admins can enable/disable
• Superusers control globally
• Features respect review workflow regardless of flag status

AI Safety Principles

Core Principles

1. Human in the Loop
   • All AI output reviewed by clinicians
   • No automatic publication
   • Human judgement always final
2. Clinical Governance
   • Same review process as manual content
   • Audit trail maintained
   • Reviewer accountability
3. Transparency
   • Clear indication of AI-generated content
   • Original versions preserved
   • Change history visible
4. Accuracy Preservation
   • Clinical facts maintained
   • No unsupported changes
   • Medical accuracy prioritised
5. Reversibility
   • Can undo AI changes
   • Previous versions accessible
   • No permanent modifications

AI Technology

Platform

• Azure OpenAI (secure server-side calls)
• Server-side processing only
• No client-side AI operations
• Secure API integration

Privacy & Security

• No patient data used
• Secure server communication
• Audit logging of all AI usage
• Token usage tracking

Best Practices

For Admins

• Review AI suggestions carefully
• Modify before approval if needed
• Test with staff before publishing
• Use for clarity, not clinical decisions

For Reviewers

• Verify clinical accuracy
• Check for appropriateness
• Ensure plain English
• Approve only when confident

For Staff

• AI questions are guides, not scripts
• Use clinical judgement
• Report concerns via suggestions
• Understand AI supports, not replaces

Limitations

What AI Cannot Do

• Replace clinical judgement
• Make clinical decisions
• Bypass review workflow
• Access patient data

What AI Can Do

• Improve clarity
• Suggest questions
• Maintain consistency
• Support efficiency

Related Pages

• Clinical Governance — How AI content is reviewed
• Symptom Library — Where AI tools are used
• Developer Guide — Technical implementation

Last updated: December 2025