System C CareFlow Ambient AI vs TORTUS (2026)
Both are ambient scribes built for NHS clinics, and both have been through UK device regulation, but they sit in different places in a trust's systems. CareFlow Ambient AI lives inside System C's CareFlow record. It launches in the patient's record with no separate login, drafts letters on the trust's templates, writes structured data and outcome codes straight into CareFlow, and sends letters through MESH. It is registered with the MHRA as a Class I device, carries a DCB0129 safety case, requires sign off on every output, and transcribes in English only. It works only for trusts running CareFlow, and Buckinghamshire Healthcare NHS Trust is its first customer, with outpatient go live planned for summer 2026. TORTUS works across record systems. Its OSLER agent reads what is on screen and acts inside the record, and it has recorded more than 2.5 million consultations in ambulance hubs, emergency departments, outpatients and general practice. It is certified as a UKCA Class IIa device by a UK Approved Body and documents how it checks for errors: a safety layer that verifies each generated statement against the consultation, with results published in npj Digital Medicine. They are priced differently too. System C charges for CareFlow Ambient AI per appointment without publishing the rate, while TORTUS lists an NHS trust price of £200,000 a year for up to 100,000 hours of audio. For a CareFlow trust the trade is native integration against a longer track record and published error data; for a trust on another record system, only TORTUS applies.
- Native to CareFlow EPR: launches in patient context and writes structured data and outcome codes directly into the record.
- Covers outpatients and the emergency department, including Emergency Care Data Set fields and discharge summaries.
- MHRA Class I registration, a DCB0129 safety case and clinician sign off before anything is committed.
- Runs on Microsoft Azure with data stored and processed in the UK, from a supplier certified to ISO 27001 and ISO 27018.
- Works across record systems, natively, through an SDK, or by reading screen context and acting inside the record.
- More than 2.5 million consultations across ambulance hubs, emergency departments, outpatients and general practice.
- UKCA Class IIa certification from a UK Approved Body, with ISO 13485, ISO 27001 and Cyber Essentials Plus.
- A published NHS price and documented error rates, including a 75 percent reduction in major hallucinations in npj Digital Medicine.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. System C CareFlow Ambient AI and TORTUS are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | System C CareFlow Ambient AI | TORTUS |
|---|---|---|
| Primary category | Ambient Scribes | Ambient Scribes |
| Founded | Not recorded | 2022 |
| Headquarters | Oxford, United Kingdom | London, United Kingdom |
| Website | systemc.com | tortus.ai |
Side by Side
Select any grade to read the note behind it.
Each vendor in one paragraph
Written to be quoted whole. Each paragraph states what the AI Health Index verified about the vendor, with the caveats attached.
CareFlow Ambient AI is System C's ambient voice module inside CareFlow EPR, which System C says is deployed in 25 NHS trusts. It transcribes consultations in English, drafts letters on trust templates, writes structured data and outcome codes into the record and sends letters through MESH, with an emergency care version for triage, clerking and discharge. It is registered with the MHRA as Class I, runs on Azure in the UK, and Buckinghamshire Healthcare NHS Trust signed as its first customer in April 2026.
Source: AI Health Index, September 2026
TORTUS is a UK clinical AI company whose OSLER agent combines voice, vision and click based interaction to act inside the record, generating notes, referral letters and coding for clinician approval. It has recorded more than 2.5 million consultations across NHS settings, was certified as a UKCA Class IIa device in June 2026, documents its hallucination checking method and results, and lists an NHS trust price of £200,000 a year on the G-Cloud framework.
Source: AI Health Index, September 2026
Questions buyers ask
Can CareFlow Ambient AI be used without CareFlow EPR?
No. System C builds it into CareFlow EPR, where it launches in patient context and writes directly into the record. TORTUS works alongside a range of record systems, natively, through an SDK, or by reading what is on screen and acting inside the record. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 15, 2026. No vendor pays for placement.
How are they regulated?
System C states that CareFlow Ambient AI is registered with the MHRA as a Class I medical device with a DCB0129 clinical safety case. TORTUS was certified as a UKCA Class IIa medical device by a UK Approved Body in June 2026, after taking part in the MHRA AI Airlock. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 15, 2026. No vendor pays for placement.
What do they publish about accuracy?
TORTUS describes a safety layer that checks each generated statement against the consultation, reports 92.7 percent of detected hallucinations removed on its live platform, and published a 75 percent major hallucination reduction in npj Digital Medicine. System C describes testing for accuracy, completeness and clinical appropriateness but has not published accuracy or error figures for CareFlow Ambient AI. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 15, 2026. No vendor pays for placement.
How are they priced?
System C's G-Cloud listing charges CareFlow Ambient AI per appointment, with overage volumes agreed in the contract, and the rate is not published. TORTUS Enterprise for NHS trusts is listed at £200,000 a year for up to 100,000 hours of audio, then £2 an hour, with unlimited user licenses. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified September 15, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers. The full set for this category is on the Ambient Scribes page.
TORTUS's consultation count and live platform figures are its own, and one result is published in a peer reviewed journal. System C has published no results yet for CareFlow Ambient AI and charges per appointment without publishing the rate.