0102:14 · A&E — THE PROBLEM
EPR · ED CLERKING — MAJORS02:14 · FY2
77M. Sudden severe abdo pain → back. "Tearing." Felt faint on standing. PMH: HTN. 40py smoker. FHx: father & brother — aneurysms. On bisoprolol. O/E grey, clammy. HR 78, BP 104/62. Vague pulsatile fullness above umbilicus. Imp: ?renal colic ?pancreatitis. Plan: CT KUB. Home if settles.
0204:47 · THE RETURN
HR 128
04:47
01THE PROBLEM
£2.6bn
lost by the NHS to clinical negligence claims in a single year —
and it keeps rising, year on year.
'20
'21
'22
'23
'24
'25
↗ still rising
NHS RESOLUTION · ANNUAL REPORT
02WHY IT HAPPENS

Most missed diagnoses trace back to three things.

😮‍💨

Exhausted doctors

13-hour shifts. Life-or-death decisions at 4am.

🧑‍⚕️

Understaffed shifts

One junior doctor, a corridor full of patients.

⏱️

High pressure

First impressions stick — and red flags get buried in the notes.

03THE SOLUTION · MEET LENNOX
What if there was a safety net?
Meet Lennox.
04READS THE NOTES · NO NEW WORKFLOW
05RED FLAG · CAUGHT BEFORE IT'S TOO LATE
EPR · ED CLERKING — MAJORS02:14 · FY2
77M. Sudden severe abdo pain → back. "Tearing."
Felt faint on standing. PMH: HTN. 40py smoker.
FHx: father & brother — aneurysms.
Meds: bisoprolol (β-blocker), amlodipine.
O/E grey, clammy. HR 78, BP 104/62.
Vague pulsatile fullness above umbilicus.
Imp: ?renal colic ?pancreatitis.
Plan: urine dip, bloods, CT KUB. Home if settles.
LENNOX · SAFETY-NET FLAGDECISION SUPPORT — CLINICIAN DECIDES
⚠ DIFFERENTIAL TO CONSIDER

Ruptured abdominal aortic aneurysm

Tearing abdo→back pain, pulsatile fullness, presyncope, 77M smoker, FHx aneurysm — and a β-blocker may be masking tachycardia.

NICE NG156 · RCEM rAAA Toolkit
🔬 ONE INVESTIGATION

Immediate bedside aortic ultrasound

Before CT KUB. Do not delay definitive care if unstable.

RCEM rAAA Toolkit
🔴 ONE ESCALATION

Senior + vascular review before discharge

Do not discharge. Document the discussion.

NICE NG156
⚡ PROACTIVE

Flagged before discharge — not after harm

Lennox acts at the point of decision, while there is still time to change the outcome.

06RIGHT CALL · PATIENT SAFE
HR 84
07YOUR SAFETY NET
Protecting patients · Supporting doctors · Every shift
lennoxai.co.uk
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Lennox

The safety net for NHS doctors — in about a minute
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