These core principles include transparency, consent, child centred design, robust evaluation, equity and strong data governance.
This position statement also provides recommendations for NHS organisations and vendors to ensure that AVT enhances paediatric care without compromising safety, trust or clinical standards. It is also important, as ever, that all involved acknowledge that implementing AVT in paediatric settings is not the same as doing so in adult settings. Children have unique needs and present additional opportunities beyond those that exist in adult care settings.
Background
AVT refers to systems that capture and process spoken clinical interactions to support documentation, workflow, and communication. These tools are already being piloted in several NHS trusts (for example, Great Ormond Street and Alder Hey Children’s hospitals) and are expected to become more widely available as part of digital transformation programmes.
Paediatric practice presents unique considerations, including communication with children and young people, safeguarding, consent and the sensitivity of clinical encounters, which require tailored guidance.
Potential benefits
AVT has the potential to support clinicians and improve care when implemented safely and thoughtfully. Key opportunities include:
- Reduced documentation burden: AVT can generate clinical notes in real time, reducing time spent typing and navigating electronic patient records, and potentially improving clinician wellbeing.
- Enhanced quality and consistency of records: Automated capture may lead to more complete documentation, better structured information for multidisciplinary teams, and fewer omissions in high pressure environments.
- Automated clinical coding: AVT provides the opportunity to automate clinical coding within notes and thus improve clarity, accuracy, analysis and sharing of notes across clinicians and disciplines.
- Improved patient and family experience: By reducing screen time, AVT can support more direct engagement with children and families and may enhance shared decision-making.
- Support for safety and quality improvement: Structured outputs and automated prompts can help identify missing information and support audit, learning and service improvement.
Risks and challenges
The introduction of AVT also brings important risks that must be carefully managed.
- Data security and governance: Voice data requires robust safeguards, clear data flow mapping and compliance with NHS and UK GDPR standards, particularly when cloud based processing is involved.
- Accuracy and reliability: Transcription errors may occur, especially with children’s speech, distress, crying, accents, dialects or neurodiversity. Over-reliance on automated outputs is a risk.
- Consent, transparency and safeguarding: Children and families must understand when AVT is being used. Sensitive consultations may require alternative approaches and opt out mechanisms must be clear.
- Equity and inclusion: Speech recognition models may perform differently across demographic groups. Evaluation in paediatric populations is essential to avoid widening inequalities.
- Integration and workflow: AVT must integrate smoothly with existing Electronic Patient Record (EPR) systems and complement clinical workflows. Staff training and change management are critical.
Principles for safe and effective use
Any deployment of ambient voice technology in paediatric settings should be grounded in a set of core principles that ensure safety, transparency and child‑centred practice.
At the heart of this is the need for child‑centred design, ensuring that technology supports, rather than disrupts, communication with children, young people and their families. Transparency is essential, with clear explanations provided whenever AVT is in use, alongside accessible consent and opt‑out processes that respect family preferences. Strong data governance and data minimisation must underpin all implementations, ensuring that only essential information is captured and stored securely.
AVT should only be introduced following robust evaluation in real paediatric environments, with particular attention to how the technology performs across different ages, communication needs and clinical contexts. Ensuring equity is critical, and organisations should monitor performance across diverse populations to avoid embedding or amplifying bias. Clinicians must retain full oversight of documentation, reviewing and validating all outputs. Finally, AVT must be used in a way that is fully compatible with safeguarding requirements, recognising that some consultations may not be appropriate for audio capture or automated transcription.
Recommendations for NHS organisations
NHS organisations considering the adoption of AVT should take a structured and proactive approach to implementation. This begins with undertaking local digital clinical safety risk assessments and Data Protection Impact Assessments (DPIAs) to ensure that data flows, storage and governance arrangements meet NHS and UK GDPR standards.
Procurement processes should explicitly include paediatric‑specific requirements, recognising the unique communication and safeguarding needs of children and young people. Successful implementation will depend on providing training and support for clinicians and staff, ensuring that AVT enhances clinical workflows. Organisations should establish mechanisms to monitor accuracy, user experience and unintended consequences, adapting processes as needed.
Engagement with children, young people and families is essential, both during evaluation and throughout ongoing use, to ensure that the technology remains acceptable and appropriate.
Finally, organisations must put in place clear governance arrangements for data retention, access, and deletion, ensuring that AVT is used responsibly and in line with national standards.
Conclusion
Ambient voice technology has significant potential to enhance paediatric care by reducing administrative burden and improving documentation quality. However, its use must be carefully governed, transparently communicated and rigorously evaluated to ensure safety, equity and trust.
RCPCH supports the thoughtful, evidence based adoption of AVT and will continue to work with clinicians, families, NHS organisations and industry partners to shape best practice as the technology evolves.