Resources

Architecture, compliance, and integration documentation

Technical reference for NHS procurement, clinical safety review, and integration planning. FHIR R4 staging, human-in-the-loop review, and compliance design pathways for primary and secondary care.

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NHS-readyFHIR R4GDPR Art. 9MHRA-awareHuman-in-the-loop

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Jump to architecture, compliance, integration, security, API contracts, or onboarding pathways.

Architecture

Five-layer clinical AI design from intake through governed export.

Compliance

NHS clinical safety, DTAC alignment, and GDPR Art. 9 design pathways.

DCB0129 hazard log

Safety case in progress, with hazard log structure outlined.

DTAC checklist

Alignment status across the five DTAC assessment domains.

Integration

FHIR R4 staging, EMIS Web, and SystmOne interoperability patterns.

Security

Data protection, RBAC, audit trails, and tenancy boundaries.

API

REST endpoints, adapter contracts, and integration boundaries.

Onboarding

Organisation access requests and individual account setup.

Technical reference

Architecture and review specification

Compliance badges describe aligned design pathways and control mapping. They do not represent certification, accreditation, or regulatory approval. Resources below describe design alignment, not certification or regulatory approval.

Architecture

Five layers from intake to export

Aksh Health organises clinical AI into five layers: intake, agent orchestration, synthesis, review queue, and export. Consultation data flows through named clinical agents. Outputs land in a draft review queue. No autonomous write-back to active clinical records.

1Five layers: intake, agents, synthesis, review, export
2Seven agents: VOICE, SYNTHESIS, Dr.Assist, GUARDIAN, ORACLE, EQUITY, SHIELD
3FHIR R4 resources staged as DRAFT until named reviewer approval
4Human-in-the-loop on every clinical output before record impact

Human-in-the-loop

Named reviewer approval on every output

Every AI-generated clinical output requires named clinician review before it reaches a care record or pathway. Queue items carry agent badges and DRAFT status until a reviewer records a decision.

1Accept: freeze evidence artifacts and append FHIR AuditEvent to export bundle
2Edit: reviewer modifies draft content before acceptance
3Reject: discard output with audit trail; no write to clinical record
4Draft-only writes: no production record impact without explicit approval

Governance & interoperability

Compliance, safety case, and FHIR staging

Design alignment for NHS clinical safety, DCB0129 hazard log status, DTAC evidence, and EHR integration pathways.

Compliance

Aligned design pathways, not certification claims

Aksh Health aligns with NHS clinical safety and digital technology assessment pathways. We do not claim certification. Internal clinical safety evidence remains confidential; public resources describe design alignment only.

1DCB0129 clinical safety case pathway in active development
2DTAC-aligned evidence scaffolding for NHS procurement
3GDPR Art. 9 special category health data handling
4MHRA-aware positioning: decision support, not autonomous diagnosis
5Human-in-the-loop review on every clinical output

DCB0129 hazard log

Safety case in progress: hazard log structure

The clinical safety case for Aksh Health follows the DCB0129 hazard log structure. This build has not completed a signed-off safety case; the outline below describes the working structure our clinical safety officer maintains internally.

1Hazard identification: catalogue where an agent output could cause patient harm if acted on unreviewed
2Risk evaluation: likelihood and severity scoring per hazard, aligned to NHS clinical risk grading
3Mitigation: control measures, including the human-in-the-loop review gate on every clinical output
4Residual risk sign-off: named clinical safety officer approval before any production deployment
5Status: safety case in progress. No production EHR write-back is enabled until sign-off completes

DTAC checklist

DTAC alignment checklist status

The NHS Digital Technology Assessment Criteria covers five domains. Status below reflects design alignment work completed in this build, not a submitted or approved DTAC assessment.

1Clinical safety: DCB0129 hazard log in progress (see above)
2Data protection: GDPR Art. 9 handling and RBAC design in place
3Technical assurance: FHIR R4 staging and audit trail architecture documented
4Interoperability: EMIS Web and SystmOne integration paths designed, not yet live
5Usability and accessibility: WCAG 2.1 AA target across dashboards, ongoing review

FHIR & interoperability

FHIR R4 staging above existing EHR systems

Clinical outputs are staged as FHIR R4 draft resources for reviewer inspection. Integration architecture is designed for EMIS Web and SystmOne, the dominant UK primary care EHR systems. Production EHR connections are not live in this build.