Clinically governed shared record Patient rights-holder · NHS Digital Identity Trust custodian
· Mrs A. Patel · vault: nhs.id/a-patel-1952 · Access requested by Ridgeway Surgery… Live
Clinical AI status local model active version locked · Qwen 2.5 32B diode enforced audit logging on clinician sign-off required
Consultations
Dictations
11:35
In progress
No patient name
Expires: 21h 48m
12:43
In progress
No patient name
Expires: 22h 56m
13:45
In progress
Mrs A. Patel — DOB 14/03/1952
Expires: 23h 58m
Vault access: granted · 14:02
▷ Start consultation
consultation at 13:45
Context persists ×
Consent: care + audit
Text notes
Images
Documents
1

Consultation summary

Tortus scribed live
Full note ▾

Presenting complaint:

History:

Examination:

Impression:

Plan:

2

Context for AI

select what the model sees
Leg rash ×
Prev visit ×
📷 Drop image or tap
3

AI opinion

new
Ridgeway local model Qwen 2.5 32B · on-premise · Mac mini M4
Awaiting context…
Inference ran locally · No identifiable data left the practice · Logged to vault audit trail
4

Patient summary letter

draft
Edit Send to vault
To: Mrs A. Patel · via NHS App · reading age: ~12
Subject: Your visit today — leg rash, 7 May 2026
Drafted by Ridgeway local model · Reviewed by Dr Lloyd · Saved to patient vault on send
Allergy:
Penicillin (rash)
Active problems
Type 2 diabetes
Hypertension
Osteoarthritis (R knee)
Medications
Metformin 1g BD
Amlodipine 5mg OD
Atorvastatin 40mg ON
Last BP
138/84
22/03/2026
HbA1c
58 mmol/mol
January 2026
Context history
3 prior visits logged. Last note: "Leg swelling worsening, referred for Doppler."
= data field sourced from patient vault · Vault custodian: NHS Digital Identity Trust · Patient access: nhs.app/myrecord · All access logged · Patient access rights governed · emergency/safeguarding overrides audited

POST-EMIS ARCHITECTURE

Clinically governed shared record
Patient rights-holder · NHS Digital Identity Trust custodian
↓ scoped, time-limited access
Local clinical inference
Mac mini M4 · Qwen 2.5 32B · sees identifiable data
↓ boundary diode
Boundary diode
Outbound: synthetic test outputs · structured metrics · model hashes only
↓
Cloud assurance harness
Synthetic + public material · multi-grader benchmarking · never sees patient data
Governance wrap: DCB0129/0160, DPIA, named clinical safety officer, immutable audit, triadic care attribution.
Phase: idle