Proven, published systems already in use across the NHS 

SOLUTION – Delivering more effective/objective risk stratification and prioritisation of waiting lists 

C2-Ai has adapted and automated existing systems in use in the NHS and globally for 15 years. Unique, approved, and referenced systems that do risk stratification and prioritisation at individual patient level, calculating risk of mortality and complications plus the impact of deterioration on the waiting list.
Evolved around the world’s largest referential dataset of over 450 million patient records, published in the BMJ and available via G-Cloud.
The system has been used to identify patients suitable for health coaching with significant results. 

Professor Rowan Pritchard Jones talks about the impact of C2-Ai’s risk stratification and prioritisation of the elective waiting list



adoption in NHS ICS regions


person years of surgeon time could be saved (at scale in NHS)


Bed-days saved per 1,000 patients


reduction in emergency admissions

SOLUTION – ICS Observatory – Unique horizon scanning across 100% of acute care 

Basic statistics on hospital activity do not fully reflect how seriously ill patients are on admission or other conditions they may have.
This makes it impossible to understand where there has been genuine avoidable harm (and therefore how to fix it), but this ability is fundamental for meaningful monitoring of hospital performance.
ICS Observatory uses the most advanced, risk-adjusted horizon scanning for system-wide patterns & trends in avoidable harm and variation built around tracking 3,300 discrete metrics (many built up from individual level, proven precision clinical risk assessment) across the whole of acute care (medicine, surgery, mat/neo and nursing care).
  • Strengthen oversight and understand real performance and productivity across the whole of acute care provision (medical, surgical, mat/neo and nursing care)
  • Drilling down from hospital balanced scorecards through speciality, sub-specialty, complication, trigger, down to individual patient level
  • Driving the quality and clinical cost-effectiveness of each hospital to make optimal use of every healthcare pound
  • Provide region-wide risk profiling of acute care admissions
  • Make inferences about potential deficiencies in primary care from trends and disease progression from those admitted into acute care
  • Support planning for service provision in the shorter term, and inform evidence-based strategic transformation
  • Relating to the uniqueness of the patient profile and local challenges
  • Design policy, initiatives and interventions to respond to the detailed patient outcomes
  • Demonstrate appropriate governance
  • Ensure accountability
  • Identify serious, potentially hidden issues to direct improvements and avoid scandals
  • Monitor and assure consistent quality of surgical outcomes (particularly whilst regions tackle the challenge to clear the waiting list backlog)
  • Identify and share best-practices more widely
  • Support assessment of outcomes drilled down across SDoH/EDI etc. (and hence identify inequities in outcomes)
  • Improve patient outcomes in the ICS.

Example ICS Observatory report categories

Get in touch about ICS Observatory

SOLUTION – Preventing avoidable conditions acquired in hospital

Up to 25% of ICU patients can have AKI/HAP.
The average additional length of stay in hospital for patients developing these conditions is 6-8 days.
Our app is used at the point of care to triage patients for risk of acquiring these conditions and suggests risk-adjusted approaches that reduce the conditions by 50% while reducing staff workload.
Learn more

Example individual hospital improvement using our approach

direct, in-year savings
bed-days freed monthly
days additional LOS avoided (HA-AKI)
reduction in overall AKI
reduction in HAP
days additional LOS avoided (HAP)

Recent awards and recognition 

Unique capabilities performing truly ground-breaking analysis…


more issues detected across hospitals – clearly actionable for in-year ROI

9 × 10⁴⁵³

permutations per patient delivering clincial risk assessment with exceptional accuracy – validated and published


AI-enhanced discrete metrics that matter – uncovering even hidden issues (failures to respond, omissions to treat)

Successfully delivering meaningful outcomes and insights…


Potential direct cost savings per hospital (recurring per annum)


complication metrics for medical patients


Reduction in emergency admissions


years of surgeon time served (NHS at 100% scale)


bed-days saved per 1,000 patients


reduction in Hospital Acquired Pneumonia/AKI

Based on decades of research and extensive hospital data


patient records processed from 46 countries


of research and 15 years of real world deployment across 11 countries


adoption in NHS ICS regions as well as government + regulators + ‘for profit’ hospitals in US 


combinations of operative type and physiology


person years of surgeon time could be saved 


Reduction in harm and mortality


weeks of triage time saved per surgeon

What experts say about our solutions

C2-Ai have the most robust software approach to comparing safety and quality across hospitals, systems and physicians that I have ever seen. The algorithms are backed up by years of published international research. I believe their approach could be most useful as a solution for providers across any network.

James C Bonnette, MD
Executive Vice President, the Advisory Board (USA).

“It took 2 years and a very costly investigation to deal with a competence issue in our organisation some time ago. We set CRAB® the blind challenge of seeing if they could have found the problem in our historical data. They did so in 20 minutes. Needless to say, we have invested in the system

Dr. Michael Roberts
Chief Medical Officer, Northland District Health Board, New Zealand

CRAB® can identify outcomes that are better than expected, as well as those that are worse, and thus can be used as an improvement tool as well as to assure clinicians and others of the standard of care being provided, and to measure productivity

Lord Ara Darzi

“CRAB® predictions have proved accurate in my primary external research validation of the system. I currently don’t know of any other electronic system in use that can deliver this kind of overall and detailed qualitative feedback to the department and the individual surgeon. It has been a great benefit for our clinic and helped develop our work on patient safety.”

Wilhelmina Ekström, MD, PhD
Senior Consultant, Karolinska University Hospital, Sweden

“To have reports of this quality dropping on to my iPad is a real joy”

Marcus Bankes
Consultant Orthopaedic Surgeon

“This exercise is not about making data/surgeons/departments look good, but about being accurate so that performance can truly be assessed”

Steve Corbett
Consultant Orthopaedic Surgeon and Clinical Lead

“CRAB has allowed real time review of data, which has raised awareness and led to change in both clinical practice and hospital culture. I think it will become an essential part of the appraisal and governance structures of secondary care.”

David Williams
Consultant Surgeon, Northern Devon Hospital Trust

“We use CRAB to provide us with a detailed monthly audit report of each surgeons complications, adjusted against CRABs risk methodology, in order to monitor outcomes performance. Our Clinical Leads meet monthly and review any complications that arise in order to inform and learn from the evidence. We find CRAB provides outcomes intelligence quickly, enabling us to be ‘on top’ of outcomes immediately.
One of the significant gains from using CRAB is a massive improvement in our coding from an engaged clinical workforce”

Brian Wells
Former Director of Orthopaedics, GSTT

“CRAB just makes sense. It presents data in a way that is easy to understand and interpret. It has been immensely useful for me both personally in my appraisal and in my role as a Clinical Director. It helps me to pick up early warning of problems with intelligence that can be believed and acted upon”

Jeremy Cundall
Consultant Colorectal and General Surgeon - Executive Director, CDDFT

“CRAB® is 100% better than any solution available to us at the moment. It has turned out to be a very useful tool in analysing and understanding our case-mix and where our complications are occurring.”

Per Svedmark MD, PhD
Senior Consultant, Stockholm Spine Centre, Sweden

“We are thrilled to receive this award, which reflects a great deal of hard work and support from within and […] the support of CRAB® Clinical Informatics (C2-Ai) who enabled us to benchmark our Trust’s AKI rates against national levels – and then measure the significant impact of our AKI Programme, which coincided with a significant and sustained fall in AKI rates our Trust, especially across surgical wards”

Dr Jonathan Murray
Renal Consultant at South Tees Hospitals NHS Foundation Trust, UK

The problem with [HSMR systems] is that they tell you there might be a problem, but not where or why. CRAB® tells you exactly what and where the problem is, and even which patients are involved. Then you can do something about it.”

Dr. Aresh Anwar
Medical Director Royal Perth Hospital, Australia

“CRAB has provided data for the consultants to really understand their outcomes for patients in a user friendly way.”

Alison Diamond

“CRAB is generating trusted data which we can use to flag up areas of concern. From there we are able to take action in a much more sophisticated way than we have in the past.”

Timothy Ho
Medical Director, Frimley Health NHS Foundation Trust

“I have worked with C2-Ai for the past seven years, and their insights have shone a light on the quality and safety of patient care that other less sophisticated analyses have not been able to provide”

Consultant in Emergency Medicine, John Radcliffe Hospital, Oxford
Accurate benchmarking of outcomes was a real challenge to us as an independent hospital with limited access to big data sets, however our work with CRAB analytics has provided invaluable quality assurance. The risk adjusted reporting has provided confidence that our outcomes are better than comparable organisations and the level of detail enables us to focus on improvements in specific areas.  It was particularly useful during our regulatory inspection and follow up meetings with the CQC to show how this strengthens our clinical governance and contributes to our ‘effective’ and ‘well led’ domains.  
Dr Jenny Davidson
Director of Governance, King Edward VII's Hospital.

Net Zero Commitment

C2-Ai is committed to achieving Net Zero emissions for UK operations by 2050.


Net zero refers to achieving a balance between the amount of greenhouse gas emissions produced and the amount removed from the atmosphere.


Carbon Reduction Plan

Our Carbon Reduction Plan is currently being calculated and will be available shortly..

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