Question 1

Who is clinically accountable for AI-supported triage decisions?

Accepted Answer

Every TriageNix deployment names a Clinical Safety Officer (CSO) under DCB0129 and a Caldicott Guardian for information governance. The AI is a decision-support tool — final clinical accountability sits with the registered clinician (or the named CSO for autonomous self-care advice pathways) acting within their NHS organisation's governance framework.

Question 2

How do clinicians override or override-block an AI recommendation?

Accepted Answer

All triage outputs render with a one-click 'Override disposition' control on the clinician console. Overrides require a structured reason (clinical rationale, safety concern, patient preference, or other) and are logged immutably against the case. Overrides never disadvantage the patient — the higher-acuity pathway always wins between the AI suggestion and the clinician decision.

Question 3

Is there always a human-in-the-loop for high-acuity outputs?

Accepted Answer

Yes. Any disposition of Urgent (same-day) or Emergency (999/A&E) is mirrored to a live clinician queue and to the Care Coordination team. Self-care and routine GP pathways are auto-released, but patients can request a clinician callback at any point and a sample of self-care cases is reviewed weekly under our Quality Assurance plan.

Question 4

How does the platform detect and escalate red-flag symptoms?

Accepted Answer

Red-flag detection uses a layered approach: (1) deterministic rule-based checks for NICE/NEWS2-aligned safety-netting criteria (chest pain, stroke FAST, sepsis screen, paediatric warning signs, mental health crisis, safeguarding concerns); (2) LLM-based contextual review with conservative thresholds; (3) a final safety filter that escalates on ambiguity. A positive red flag short-circuits the conversation and routes to 999 or the urgent clinician queue immediately.

Question 5

What happens if the patient is in immediate danger?

Accepted Answer

The interface displays a full-screen 999 prompt with the local emergency number and the recommended action, the case is flagged red in the clinician dashboard with an audible alert, and an incident is opened in the Clinical Care Record (CCR) for follow-up. For mental health crisis pathways, Samaritans (116 123) and NHS 111 option 2 are surfaced alongside 999.

Question 6

How are 'near-miss' or missed red flags handled?

Accepted Answer

Any clinician override that upgrades acuity, plus any patient outcome captured via 48-hour follow-up that contradicts the original disposition, automatically opens a Clinical Change Request (CCR) tagged 'Potential safety event'. The CSO triages within one working day and, where DCB0129 hazard log criteria are met, a hazard is logged, mitigated, and reported through the trust's Datix / equivalent incident system.

Question 7

How often are AI decisions audited?

Accepted Answer

Three cadences run continuously: (1) automated daily audits of 100% of cases for rule conformance and red-flag coverage; (2) weekly clinician-led random sampling of at least 2% of completed triages (minimum 50 cases/week) reviewed against the agreed rubric; (3) monthly Clinical Governance review covering trends, overrides, complaints, and CCR outcomes — minutes shared with the commissioning organisation.

Question 8

What is captured in the audit trail?

Accepted Answer

Every conversation persists the full transcript, model version, prompt template version, retrieved knowledge sources, AI suggested disposition, clinician decision, override reason (if any), red-flag triggers, time stamps, and the acting user. Records are retained per the NHS Records Management Code of Practice and are exportable for CQC, ICB, or coroner requests.

Question 9

How is model and prompt change managed?

Accepted Answer

Model upgrades, prompt changes, and knowledge-base updates follow our Clinical Change Request (CCR) workflow: proposal → safety case impact assessment → regression test pack against a curated golden set of historical cases → CSO sign-off → staged rollout with monitoring. Material changes trigger a refreshed DCB0129 Hazard Log and Clinical Safety Case Report before go-live.

Clinical Governance & Leadership FAQ

Human oversight

Red-flag handling

Audit frequency

Report a safety concern or near miss

If a patient is in immediate danger

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