Early insights from GP practices piloting Surgery Intellect, powered by TORTUS, across face-to-face and telephone consultations.

Overview

Surgery Intellect, powered by TORTUS, is a voice-enabled AI assistant designed for clinical documentation in UK primary care. Developed by X-on Health in partnership with TORTUS, it supports both face-to-face and telephone consultations to capture up to 30% more patient interactions.

Present in 40 ICBs already, consistent patterns are emerging around usability, workflow fit and clinician confidence. This case study brings together those early learnings, alongside the wider clinical safety foundations that underpin Surgery Intellect.

Clinical safety and assurance: setting the foundations

From the outset, Surgery Intellect has been built with safety, governance and clinician control at its core.

Powered by TORTUS technology, the solution is supported by:

  • UK MHRA Class I medical device registration (with Class IIa in progress)
  • Compliance with NHS DTAC, DSPT and clinical safety standards
  • Inclusion on the NHS England Ambient Voice Technology (AVT) Registry as a self-certified supplier

The TORTUS technology that powers it has been evaluated through large-scale, independently-led NHS studies, including a 17,000-patient NHS England–sponsored evaluation coordinated by Great Ormond Street Hospital. 

Key findings from this work included:

  • 23.5% increase in direct patient interaction time
  • 8.2% reduction in overall appointment length
  • 35% reduction in clinicians feeling overwhelmed by notetaking
  • 92% patient and carer acceptance

A parallel simulation study at GOSH found:

  • 100% of AI-assisted notes rated “good” or “very good”, compared to 43% for typed notes
  • 26% reduction in consultation time without reducing dialogue
  • Lower cognitive load and fewer task-switching disruptions

This is reinforced by The Shell, TORTUS’ automated quality-assurance layer, which verifies every line of AI-generated notes against the source transcript and has been shown to remove around 93% of hallucinations in testing across approximately 200,000 clinical notes.

Together, this means Surgery Intellect sits on proven safety, assurance and governance foundations, allowing practices to focus on workflow fit and day-to-day use rather than clinical risk.

The challenge

General practice continues to face rising demand alongside constrained capacity and growing workforce pressure. Clinical documentation remains a significant contributor, with clinicians often completing notes after clinics for both face-to-face and telephone consultations.

This can lead to:

  • Reduced appointment availability
  • Disrupted consultation flow
  • Increased cognitive load and risk of burnout
  • Ongoing unpaid admin outside clinical hours

While ambient voice technology has emerged as a potential way to ease this burden, many tools have struggled to meet the realities of primary care, particularly around clinical safety, governance and everyday workflow fit. Practices need solutions that support documentation without shortening consultations, work consistently across consultation types, and can be adopted safely at scale.

The solution

Practices introduced Surgery Intellect, powered by TORTUS, into day-to-day consultations with minimal change to existing ways of working. Key aspects of the pilot approach included:

  • Use across both telephone and face-to-face consultations
  • Integration with Surgery Connect and Phonebar, avoiding system switching
  • Clinician review and approval of notes before filing
  • Flexibility to adjust output style and level of detail

The pilots focused on real consultations rather than test scenarios, allowing feedback to reflect everyday use.

Early results

Greater focus on the patient

Many clinicians report being able to stay present in the consultation, with less distraction from typing or screen use.

Common feedback includes:

  • Less screen time and fewer interruptions
  • Improved eye contact and consultation flow
  • Patients appearing more engaged and comfortable

“Fantastic software, I can now focus more on keeping eye contact with the patient rather than staring at my screen. You can really tell the patients appreciate the consultation more with the GP, without the worry of remembering and typing up the consultations.”
GP, Mount Pleasant Medical Centre

“It means we can focus more on the patient in the moment which I’m sure they appreciate.”
GP Partner, Sheet Street Surgery 

“It’s reduced my admin time and allows me to solely focus on the patient.”
Registrar, Sheet Street Surgery

Reduced cognitive load and admin, especially for complex consultations

Clinicians described spending less time typing during consultations and completing notes afterwards. Surgery Intellect is often used most where consultations are longer or require higher cognitive effort, such as:

  • Complex or multi-issue appointments
  • Mental health discussions
  • Longer telephone consultations

“The transcribing saves time, without the manual typing and they can see a difference in time saving.”
Clinician, Park View Medical Practice

“It makes my job easier and definitely saves time.”
Clinician, The Fryent Way Surgery

“We use in our complex consultations more than in triage calls. Complex consultations are typically longer and take more cognitive capacity. It definitely has saved time.”
Doctor, Westongrove Partnership

“It creates very detailed notes and doesn’t pick up other non-clinical chat. It helps me to also recall small details in the consultation that I might have forgotten whilst writing.”
Registrar, Sheet Street Surgery

Workflow fit and ease of use drive adoption

Where adoption is strongest, feedback consistently points to how well Surgery Intellect fits into existing systems and workflows.

Key factors include:

  • Seamless integration with telephony and Phonebar
  • No need for separate microphones or systems
  • Familiar formatting, especially for long-time TORTUS users

“We found it easy to use and as it’s seamlessly integrated with our phone system and the Phonebar there is less ‘faff’ compared to other scribes.”
Clinician, The Downend Group Practice

“I am very impressed with it. I like the fact it is integrated into the telephone system so minimal number of extra administrative tasks required. The AI component is impressive – quick and accurate. Breaking it down into the various headings is helpful.”
GP, Sheet Street Surgery

“From a workflow perspective, it integrates well into routine consultations without feeling overly intrusive.”
Advanced Clinical Practitioner – Digital Lead, Whitley Road Medical Centre

“We love how seamless Surgery Intellect is and how intuitive the product is.”
Chatham Street Surgery

Editing is expected and clinician control is valued

Clinicians are clear that notes must be reviewed and edited, and see this as part of safe and effective use.

“It has to be edited prior to transfer to EMIS but is really useful at picking up everything discussed and often just needs a few tweaks to reflect the tone of the consultation.”
GP, Sheet Street Surgery

“The notes it generates are close to what I would usually document myself. I like being able to toggle between style and detail level. I like being able to add in my examination findings or info into the ‘context’ box to add to the consultation notes.”
GP, The Burbage Surgery

What this tells us

These early results suggest that adoption is driven less by headline features and more by practical fit.

In particular:

  • Clinicians engage when the tool feels like part of their workflow, not an add-on
  • Confidence comes from safety, control and transparency
  • Value is strongest where documentation load is highest, rather than in every consultation

Rather than replacing how clinicians work, Surgery Intellect appears most effective when it quietly supports existing behaviours.

Looking ahead

Surgery Intellect has now received IM1 assurance to file to record for EMIS and TPP/SystmOne. While pilots included in this case study did not yet benefit from this, it unlocks a clear next step for practices moving forward.

With IM1 in place, practices can expect:

  • Consultation summaries filed directly into the patient record
  • Clinician control over what is written back
  • Less manual copying and pasting after clinics
  • More consistent, structured documentation

As pilots continue, focus is shifting to using this capability in live workflows, alongside ongoing refinement of templates and formatting based on real use. Together, this marks the transition from early learning to broader, governed adoption, with safety and clinician control remaining central.

Summary

Early pilot feedback shows Surgery Intellect fitting naturally into primary care workflows, particularly where documentation load and cognitive demand are highest.

With strong clinical safety foundations already in place, practices are using Surgery Intellect to explore how ambient voice technology can support better consultations, reduce admin pressure and improve day-to-day working life.