Orwyn logoorwyn
Safety and how it is built

Written rules, not a black box.

Explainable by design

Every decision can be shown and inspected

Orwyn runs on rules a named consultant surgeon has written and signed off, built from the strongest available research evidence and national guidance: NICE, the Getting It Right First Time programme and the British orthopaedic specialist societies, including the British Orthopaedic Association, the British Association for Surgery of the Knee and the British Hip Society. It is not a model whose reasoning cannot be inspected. Anyone reviewing a decision can be shown why it was made.

Safety first, deliberately

Safety questions come before anything else

Safety questions must be answered before Orwyn will suggest anything at all. That behaviour is deliberate and it does not bend.

What the record is for

It is a learning record, never a scoreboard

Orwyn records every decision, every time a clinician disagrees with it, and what happened to the patient in the end. That record has one purpose, which is to improve the criteria and to tell the clinician who made a referral what became of it. Three limits are built in rather than promised.

Feedback goes to the individual

A clinician sees the outcomes of their own patients. There is no league table, no ranking and no comparison against colleagues, at any level that could identify a person.

It is not a management report

Outcome and disagreement data is not provided to a line manager, an appraiser or a service lead in a form 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, so every decision can be traced to the exact rule that produced it.

Safety and governance stack A five-step governance architecture covering safety questions, written rules, clinician decision ownership, version-controlled change and outcome awareness. Safety is not a disclaimer. It is the architecture of the decision. STEP 1Safety gateNothing appears until safety questions are complete.STEP 2Written rulesNamed, inspectable criteria, no hidden score. STEP 3Clinician decidesAgree or disagree; the clinician owns the decision.STEP 4Versioned changeRules change deliberately, with author, version and date. STEP 5Outcome awareWhat happened returns to the clinician and the service. Safety by design Safety questions first. Reasons are inspectable. Clinician retains control. Every rule is traceable.
Safety is structural rather than a disclaimer: the gate, the written rules, the clinician’s decision, versioned change, and the outcome coming back.
Standards

Built for the standard it will be held to

Orwyn is health technology built to the engineering and safety standards expected of regulated clinical software. Clinical risk management follows DCB0129, the NHS standard for manufacturers of health software, and the named Clinical Safety Officer is Dr Arj Imbuldeniya, appointed on 19 August 2026.

He is also the surgeon who wrote the rules, and we would rather say so than have you find it. It is permitted under the standard and it is ordinary in a company this size, but it puts the weight on the parts that do not depend on trusting one person: every rule carries a version, a date and a source you can open and read, every decision traces to the exact rule that produced it, and the criteria change only in writing.

The nine knee safety rules are approved for implementation and for evaluation. They are not approved for live clinical use, which additionally requires the completed clinical safety case report and the deploying organisation's own assessment under the companion standard, DCB0160.

Knee first, then hip, then the rest of the musculoskeletal system. One joint done properly before the next.

Who wrote the rules?

Orwyn is founded and led by a dual fellowship-trained consultant orthopaedic knee, hip and trauma surgeon, with over a decade's experience as a consultant and more than 25 years in orthopaedics and musculoskeletal care.

Who is behind Orwyn
Decision support for clinicians only. The clinician assesses the patient and makes every decision. Orwyn is not a service for patients and gives no advice directly to patients or the public.