TORTUS featured in the MHRA AI Airlock Phase 2 Programme Report
TORTUS
← For NHS trusts · Green Book business case

Green Book business case
for TORTUS.

The full five-case appraisal — strategic, economic, commercial, clinical safety, assurance and deliverability — for an NHS trust deciding on TORTUS.

Book a demo →Back to NHS Trusts
 

What this page covers.

  1. 1Executive summary · the ask, the model, the headline position
  2. 2Strategic case · why ambient AI fits an NHS trust's operating model
  3. 3The product · Meeting Mode, EHR Integration, Data Insights
  4. 4Economic case · time, capacity and the YHEC modelling
  5. 5Commercial case · fixed licence, partnership tier, no surprises
  6. 6Clinical safety · the Shell, live monitoring, peer-reviewed evidence
  7. 7Assurance & governance · regulation, data, sub-processors
  8. 8Deliverability · deployment, integration, support
Section 01

Executive summary.

TORTUS proposes to deploy ambient voice technology across your trust's clinical workforce on a fixed annual licence, banded by deployment scope. Clinicians get time back on every encounter, the trust lifts documentation quality and consistency across services, and finance gets a cost base it can model on one line.

The ask

Approve the deployment of TORTUS — Meeting Mode, EHR Integration, and Data Insights — to the in-scope clinical workforce, on a fixed annual licence agreed in advance, with an independent evaluation period of the trust's choice before wider rollout.

Fixed annual licence

Banded by deployment scope. No per-seat surcharge, no per-minute meter, no end-of-year true-ups. Your finance team can model it on one line.

Predictable from day one

All-in for the in-scope workforce. The cost of expanding to a new specialty is known in advance; the cost of a busy week is not a surprise.

Partly self-funding

TORTUS displaces documentation and transcription effort the trust already carries. Where time recovered is converted to locum substitution, the saving is cashable from month one.

Assured route

MHRA-registered Class I medical device, listed on the NHS England AVT Supplier Registry, procurable through compliant NHS routes.

>2.5Mconsultations to date
1,000+NHS organisations
4 yrslive across the NHS
50+clinical settings, A&E to mental health

Recommendation. Move from initial conversation to a scoped deployment in the in-scope workforce on the fixed-licence terms set out below, with the optional Data Insights validation piloted and priced separately.

Section 02 · The case for change

Strategic case.

Documentation load, variable record quality and workforce fatigue are no longer outliers — they are the operating environment. TORTUS is the deployment pattern that addresses them inside the trust's existing governance, without a new screen or a new workflow.

Investment objectives
  1. 01Reduce the clinician time spent on documentation per encounter across the in-scope workforce, measurably, within the first months of use.
  2. 02Improve the consistency and completeness of the clinical record across clinicians, specialties and shifts — a clinical-safety and medico-legal benefit before it is an efficiency one.
  3. 03Reduce documentation-driven administrative load as a contribution to workforce wellbeing and retention.
  4. 04Do all of the above on a cost base banded by deployment scope and agreed in advance.
Royal Devon University Healthcare NHS Foundation TrustLondon Ambulance Service NHS TrustSomerset NHS Foundation TrustSt George's University Hospitals NHS Foundation TrustGreat Ormond Street Hospital for Children NHS Foundation Trust
Section 03 · What the trust is buying

The product, in three parts.

Meeting Mode captures the encounter. EHR Integration lands the note in the record the clinician already uses. Data Insights turns the resulting corpus into ward and service-level intelligence. One platform, three deliverables.

01 · Capture

Meeting Mode

Ambient capture for any clinical encounter

TORTUS listens in the background during the consultation, ward round, MDT or telephone triage and turns the conversation into a structured clinical note in the clinician's own voice. No prompting, no template-picking, no second screen.

  • Face-to-face, telephony and video — the same instrument across modes.
  • Clinician-approved drafts, edited inline before they go anywhere.
  • Audio is never retained; the trust's data is never used to train models.
02 · Land it in the record

EHR Integration

Contextual launch. Signed note out.

TORTUS deploys inside the clinician's existing EHR session — no parallel system, no copy-paste, no new login. It launches from inside the patient's chart, pulls the context that is already there, and writes the signed note back to the record.

  • Direct Epic and Oracle Health (Cerner) integration; EMIS, TPP, SystmOne and Access via Tortus SDK and partners.
  • Templates mapped to local documentation, coding and specialty workflows.
  • Deployed inside trust IG — same hazard logs, same assurance pack, no shadow IT.
03 · Learn from it

Data Insights

Quality and intelligence across every encounter

Every encounter that flows through TORTUS is unusually rich. Data Insights turns that into ward, service and trust-level intelligence: documentation quality, time-on-task, disposition appropriateness and audit cohorts — measured continuously, not sampled twice a year.

  • Quality and audit agent — assesses notes and dispositions against the trust's own criteria.
  • Service and specialty dashboards for CCIO, operational and audit leads.
  • Validated against trust-supplied criteria in a short, no-obligation pilot before any commitment.
EHR Integration · how it lands

Contextual launch. Signed note out.

Clinicians never leave the EHR. TORTUS launches from inside the patient's chart, pulls the context that's already there, captures the encounter, and writes the signed note back to the record - no copy-paste, no new login, no parallel system. This mitigates the biggest single risk of copy-paste in AVT - into the wrong patients notes.

Section 04 · Value for money

Economic case.

The economics lead with time returned to clinicians and with documentation quality. Both are measured. The cashable line items follow — they are not the headline claim.

Independent economic modelling · YHEC for NHS England

What TORTUS is worth to a trust — and to the NHS.

York Health Economics Consortium modelled time and capacity gains in the Emergency Department: a 51.7% reduction in documentation time per task and 47 minutes saved per clinician shift — enough to see one additional patient per shift.

Sensitivity, stated plainly. Where the trust converts recovered time into substitution rather than throughput, the cashable line item is locum and agency spend. Where it converts into throughput, the operational line item is patients seen on the same rota. Both are modelled against the trust's own baseline before any commitment — not against a generic vendor calculator.

Built from your baseline, not ours

Request a business case for your trust.

Send us your ED rota, outpatient list size, or community caseload. We'll return a modelled business case — time, capacity, locum substitution, payback — reviewable by your finance team before any commitment.

Request a business case →
Section 05 · The deal

Commercial case.

Everything the trust would pay for, set out in one place. Core TORTUS is priced on a fixed annual licence banded by deployment scope; the optional Data Insights validation is piloted and priced separately. No NDA, no anchoring on a list price the trust will not pay.

Core licence

Fixed annual fee, banded by the in-scope clinical workforce. All Meeting Mode capture and EHR Integration included. No per-seat surcharge, no per-minute meter.

Procurement routes

Direct trust contract, NHS Workforce Alliance frameworks, and joint routes via system partners. Compliant with NHS procurement; subject to the trust's standard terms.

Data Insights · optional

Begins with a no-obligation validation pilot on the trust's own audit criteria and data. Priced and agreed only once the validated output proves its worth.

Partnership tier

For trusts that want more than a vendor relationship: co-evaluation with the trust's research office, co-authored publication, and roadmap input on the specialties and workflows the trust cares about.

The trade, stated plainly

A fixed annual licence is the reward for committing the in-scope workforce in advance. In return, the trust gets a cost base its finance team can model on one line, and no usage-based surprises. The optional Data Insights layer is priced separately so the core decision is never bundled with capability the trust has not validated.

Section 06 · Clinical safety

Accuracy that matters, backed by the Shell.

Hallucinations and omissions are the failure modes that matter in a clinical note. The Shell is the runtime safety layer inside every TORTUS note that detects, removes and verifies them before a clinician ever sees the draft. Not a marketing number — a control that runs on every note.

Detected hallucinations removed92.7%
Major hallucination reduction (peer-reviewed)75%
Post-Shell residual rate0.18 per note
Evaluation frameworkCREOLA · open method

We will show you the live hallucination and omissions rate for your trust's deployment of TORTUS — in real time. It is the same evidence we use ourselves; it is also the post-market surveillance every medical device is required to perform.

Read the Shell briefing ↗See your trust's live rate
The published evidenceAll Labs publications →
  1. Peer-reviewed · 2025
    A framework to assess clinical safety and hallucination rates of LLMs for medical text summarisation.Asgari E, Montaña-Brown N, Dubois M, Khalil S, Balloch J, Au Yeung J, Pimenta D. npj Digital Medicine, 2025. The CREOLA evaluation method, in use across nine NHS sites.
  2. Independent eval · 2025
    The Use of Ambient Voice Technology with Generative AI in Multiple Clinical Settings across the NHS.GOSH DRIVE for NHS England, Phase 4 final report. Economic analysis by York Health Economics Consortium. Report ↗
  3. Deployment evidence
    TORTUS in routine NHS clinical practice.Evaluations across St George's, London Ambulance Service, Great Ormond Street, Royal Devon University Healthcare and University College London Hospitals. Full list on Labs →
Section 07 · For your IG team

Assurance & governance checklist.

TORTUS is regulated to the highest standard in the world for ambient voice technology, and ready to deploy today.

Request the evidence pack →
MHRA UKCA Class I

Registered UK medical device. Class IIa submission in progress via Scarlet AB (notified body).

Registered · UK
ISO 13485

Quality Management System for medical devices.

Certified
ISO 27001

Information Security Management. LRQA, UKAS-accredited.

Certified
Cyber Essentials Plus

Government-backed cyber security certification, independently verified.

Certified
DTAC

Digital Technology Assessment Criteria — NHS England.

Compliant
DCB0129 / DCB0160

Clinical risk management hazard logs available to your CCIO on request.

Maintained
DSPT

Data Security and Protection Toolkit, NHS Digital.

Standards exceeded
AVT Supplier Registry

Listed on NHS England's Ambient Voice Technology supplier registry.

Listed
Data residency · UK

All processing and storage UK-based. No audio retained. No training on patient data.

Guaranteed
Section 08 · Deliverability

How a trust goes live.

TORTUS integrates into every NHS EHR (Epic, Cerner, IM1 to EMIS/TPP, Medicus) and can be deployed in a new EHR in as little as a few minutes via our custom SDK.

  1. Weeks 0–2
    Governance pack shared. CIO, CCIO and IG team receive DTAC, DSPT, DCB0129/0160, ISO 13485, ISO 27001, sub-processor list and clinical risk hazard log. No NDA required.
  2. Weeks 2–6
    EHR Integration. Direct integration scoped with the trust's Epic, Oracle Health or primary-care team. Templates mapped to local documentation, coding and specialty workflows.
  3. Weeks 6–8
    Clinician onboarding. Cohort go-live in the agreed first specialty. A single session per clinician; in-clinic support for the first week.
  4. Weeks 8+
    Measured scale. Independent evaluation against the trust's own baseline. Extension across additional specialties on the same contract and the same governance package.

"This will be game-changing for patient care. It will allow our clinicians to focus on what they do best — treating patients — whilst speeding up processes and ensuring that patient notes are accurate and easier to understand."

Adrian Harris · Chief Medical Officer, Royal Devon University Healthcare · Press release ↗
Independent evaluation reference — GOSH DRIVE for NHS England, The Use of Ambient Voice Technology with Generative AI in Multiple Clinical Settings across the NHS (Phase 4, July 2025). Economic analysis by York Health Economics Consortium.

Time back at the bedside.

Fixed licence. Independent evaluation. Deployed inside your governance. Ready when your CIO, CCIO and finance team are.

Book a demo →Request the evidence pack

Are you ready to build with TORTUS?

Get in touch with our team.