Safety of Orwyn’s musculoskeletal (MSK) clinical decision supportWritten rules, not AI.
Orwyn is not artificial intelligence (AI). It cannot make up an answer, as AI tools sometimes do. Every answer comes from rules written by a named consultant knee surgeon and being checked against national guidance, and Orwyn shows the reasons for what it suggests.
Every suggestion can be shown and inspected
Orwyn runs on rules written by a named consultant surgeon, Dr Arj Imbuldeniya. They are built from national guidance and research evidence. The sources include the National Institute for Health and Care Excellence (NICE) and the Getting It Right First Time programme. They also include the British orthopaedic specialist societies, such as the British Orthopaedic Association and the British Association for Surgery of the Knee. Orwyn is being built to NICE’s latest standards for digital health tools. Its rules are being checked against current NICE guidance. Any departure from it is stated, and the clinical safety officer is responsible for it. These are our own checks: none of these bodies has assessed or endorsed Orwyn. It is not a computer model with hidden reasoning. Anyone reviewing a case can be shown the reasons behind each suggestion.
Safety questions come before anything else
The safety questions come first, and the clinician confirms them before anything else appears.
A learning record, never a scoreboard
In the demo, Orwyn records its plan and the clinician’s decision, with the reason for any change. Records for real patients, the outcome coming back to the clinician and the link to the record system are planned. The record’s one purpose is to improve the criteria and to tell the referring clinician what became of each referral. Three limits are part of its design.
It will teach as it is used
Once the outcome comes back, the clinician will be able to see what happened to their own patients, if they choose. There will be no league table, no ranking and no comparison against colleagues, at any level that could identify a person.
It is not a management report
No line manager, appraiser or service lead will receive outcome or disagreement data that identifies an individual clinician. Disagreeing with the tool is expected, useful, and never counted against anyone.
The software does not learn from it
Nothing in that record changes how Orwyn behaves. The criteria change only when a named consultant surgeon changes them, in writing, with a version and a date.
Being built for the standard it will be held to
Orwyn is health technology being built towards the engineering and safety standards expected of regulated clinical software. Clinical risk management follows DCB0129, the National Health Service (NHS) standard for makers of health software. The named clinical safety officer is Dr Arj Imbuldeniya, appointed on 19 August 2026.
Every rule carries a version, a date and a source you can open and read. Every suggestion traces to the exact rule behind it, and the criteria change only in writing.
Orwyn's knee safety rules are written and reviewed by its clinical safety officer. The current demonstration (version 0.19, October 2026) uses draft rules awaiting final sign-off, and example patients only. Before Orwyn goes live in any service, the clinical safety case report will be completed. The NHS organisation will also carry out its own assessment, with our support. That assessment follows DCB0160, the companion standard for organisations that use health software.
Knee first, then hip, then the rest of the musculoskeletal system. One joint done properly before the next.
Surgeon-governed decision support for first contact MSK clinicians.
The demo uses draft rules awaiting final sign-off, and example patients only.