Content development process
Our clinical content — referred to as the ontology — is a clinician-managed, cross-specialty knowledge resource that has been developed and iterated over more than a decade. It underpins the application’s ability to support consistent, treatment-specific informed consent across a wide range of treatments.
At a high level, this can be understood as a library of approximately 3,000 consent templates. In practice, it is a structured collection of thousands of clinical concepts that are assembled in different combinations to form those templates.
These concepts represent the core components of informed consent, including treatment descriptions, indications and expected benefits, alternatives, anaesthetic options, and risks. Each concept has a clear, patient-friendly description and is structured so that it can be reused safely and flexibly across different clinical contexts.
This ontology-based architecture enables:
- Consistent presentation of treatment-specific information
- Safe scaling and reuse of content across organisations and treatments
- Systematic and efficient updating of related content when changes in evidence or guidance are identified
- Comprehensive traceability of change over time
Development and Governance Process
In line with our PIF TICK accreditation, all clinical content is created, reviewed, and maintained through a defined, clinician-led, and auditable process.
Content needs may arise from:
- Requests from clinicians or partner organisations highlighting gaps or areas for improvement
- Internal quality improvement or standardisation work
- Updates to national and professional guidance, or emerging evidence
Content requests are logged and managed through a structured ticketing system, enabling appropriate prioritisation, visibility of progress, and identification of cross-cutting themes. Some organisations operate local governance processes to review or approve requests prior to submission. Further details on this process are available on the ontology requests process page.
Research, Development and Revision
When a content need is taken forward for review and action, a GMC-registered clinician undertakes a structured review of the relevant evidence, which may include national and professional guidelines (including Royal College and specialist society guidance) and peer-reviewed literature. Evidence is critically appraised for relevance, strength, and applicability. Where relevant, consultation takes place with the requesting clinicians to sense-check our interpretation of the evidence base and its representation within the ontology.
Following evidence review, the Concentric clinician develops or revises the relevant clinical content. This may involve creating new concepts, refining or updating existing concepts, improving clarity of language, or updating risk information. References supporting content decisions are recorded in our internal audit trail.
All content is developed in line with the principles underpinning our PIF TICK accreditation and Information Standard compliance. Content is written in plain language at a reading age of around 9–11 years, reflecting the average reading age of adults in the UK. Further details on our approach are available on the Standards and guidelines conformance page.
Quality Assurance and Clinical Safety Review
Any addition or modification to the ontology undergoes a structured internal review. A second GMC-registered clinician conducts a formal peer review, assessing clinical accuracy, clarity and appropriateness of language, and consistency with the existing ontology.
Where content is incorporated into the centrally maintained version of the ontology — meaning it is not organisation-specific and will be used across the majority of organisations — an additional review is undertaken by the Clinical Safety Officer prior to release. This reflects the broader impact of the content and ensures appropriate governance oversight.
All content changes are version-controlled, and review decisions are documented to maintain comprehensive traceability.
Clinician Responsibility in Practice
The clinical content provides population-level, treatment-specific information designed to support informed consent discussions. In line with the user responsibilities outlined in the user guides, clinicians remain responsible for exercising their professional judgement to tailor discussions to the individual patient, including identifying and explaining risks that are particularly relevant to that patient’s circumstances.