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Perioperative Risk Governance

Every Risk Flagged.
Every Decision Documented.

Structured pre-operative screening, Montgomery-aligned informed consent, and post-operative follow-up — in a single auditable platform for aesthetic and plastic surgery clinics.

Montgomery-Aligned Consent
GDPR Art. 9(2)(h)
BAPRAS / ISAPS Guidelines
100% Clinician-Controlled
No Installation · Live in 48h
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0
Perioperative Modules
0+
Rule Set Criteria
0
Drug Classes Evaluated
<3 min
Triage Time
100%
Clinician-Controlled

Not a Mockup

The Actual Clinician Dashboard

Live case review, patient declaration, and the clinical risk engine — exactly as your clinicians see it.

SurgiCheck clinician dashboard showing patient case review and clinical risk engine flags

The Pre-Operative Documentation Gap

In aesthetic surgery, clinical risk decisions are often undocumented, inconsistent, and — when things go wrong — difficult to substantiate.

Medico-Legal Exposure

Post-operative complaints increasingly centre on inadequate pre-operative risk disclosure. Without structured documentation, "the patient was told" is not a defence.

Cross-Border Documentation Gap

Clinics treating international patients may face additional contractual, consumer-protection, professional, and evidentiary expectations depending on the jurisdictions and professionals involved. Inconsistent paperwork can itself become a complaint trigger.

Audit Unreadiness

Regulatory inspections (CQC, accreditation bodies) require demonstrable, reproducible decision processes — not ad-hoc checklists or free-text notes.

Inconsistent Triage

Without a standardised rule set, the same patient profile can yield a different decision depending on who conducts the assessment that day.

Montgomery-Aligned Documentation

Since the UK Supreme Court ruling in Montgomery v Lanarkshire Health Board (2015), clinicians are legally required to disclose all risks that a reasonable patient in that individual's circumstances would consider material — not just risks the clinician considers significant.

This creates a documentation obligation that generic consent forms cannot satisfy. Each patient's risk profile must be individually assessed and recorded.

Montgomery v Lanarkshire Health Board [2015] UKSC 11 · UK Supreme Court
Montgomery 2015 GMC Good Medical Practice UK GDPR Art. 9(2)(h) BAPRAS Guidelines ISAPS Safety Standards

Transparent Decision Support — At Every Step

Not a Black Box — Every Flag Has a Source

Not a communication tool. Not a bloated EHR.

Paper consent forms and WhatsApp-based patient follow-up are not a standard — they are a liability. Large clinic management systems, on the other hand, take months to implement and are built for scale your clinic doesn't need. SurgiCheck fills the gap between the two: a lightweight risk governance engine that requires no installation, goes live in 48 hours, and helps reduce documentation gaps while supporting consistent perioperative risk governance.

Every SurgiCheck pathway — INFO, VERIFY, REVIEW, or DEFER — is linked to a defined clinical rationale, source, and required workflow action, grounded in published clinical guidance: ASA, ISAPS, ESAIC, BAPRAS, RCOG, or BSH. The system does not generate a decision — it structures the clinician's decision process and supports it with documented rationale.

When a post-operative complaint arises and a patient's solicitor asks "Why was this patient cleared for surgery?", the answer is not "the system approved it" — it is "this specific risk profile was evaluated against these published criteria, the clinician reviewed the flags, and the decision was recorded with documented rationale."

SurgiCheck does not constitute medical advice. Clinicians must exercise independent professional judgement in all cases.

Built for Rule-Based, Auditable Clinical Workflows

Pre-operative to post-operative — documented risk management at every stage.

Pre-Operative Risk Assessment

Standardised rule engine surfaces structured risk flags at patient intake — with full rationale and guideline references — informing the clinician's Suitable / Conditional / Not Suitable decision.

Montgomery-Aligned Informed Consent

Procedure-specific consent documentation is generated from the assessed risk profile to support — not replace — the clinician-patient consent discussion. Digital signature, timestamp, and append-only, versioned Firestore archive.

Post-Operative Complication Monitoring

Structured follow-up questionnaires at defined intervals (Day 1, 3, 7, 14, 30). Abnormal responses trigger clinician alerts automatically.

Audit Trail & Rule Versioning

Rule set versions, decision timestamps, and the data behind every clinical outcome are recorded automatically. Append-only and versioned by design.

Multi-Role Access Control

Role-based access architecture designed for surgeon, nurse, clinic coordinator, and medical director workflows. Production deployment requires clinic-specific role and tenant configuration.

Privacy-First Infrastructure

All data in transit over TLS. Special category health data handled under GDPR Art. 9(2)(h) — lawful basis documented in privacy notice. Patient data is not sold or disclosed to third parties for advertising or unrelated commercial purposes.

From Patient Intake to Post-Operative Follow-Up

Eight structured steps — seamless perioperative workflow in a single platform.

▶ Pre-Operative
1

Patient Intake

Standardised online form with procedure context, medical history, and medications.

2

Preliminary Flags

System generates initial risk flags from patient-reported data. Case record created.

3

Clinician Verification

Clinician completes CV fields: ASA class, smoking status, anticoagulants, measured BMI.

4

Final Risk Assessment

Flags re-evaluated with CV data. Clinician records Suitable / Conditional / Not Suitable with mandatory rationale.

▶ Perioperative
5

Informed Consent

Procedure-specific consent form generated from patient's individual risk profile. Digital signature captured and archived.

6

Case Locked

System locks case record. Printable clearance report generated. Case content is locked against direct overwrite from this point; corrections are recorded as new, timestamped versions.

▶ Post-Operative
7

Follow-Up Questionnaires

Structured patient follow-up at Day 1, 3, 7, 14, 30. Accessible without login.

8

Complication Alerts

Responses exceeding alert thresholds trigger clinician notification immediately.

Designed for UK / EU Compliance Standards

SurgiCheck's rule set and documentation architecture are aligned with the regulatory frameworks relevant to clinics treating UK and European patients.

Montgomery v Lanarkshire (2015)

The platform's individual patient risk assessment and per-profile consent generation directly supports the clinician's duty to disclose material risks to the specific patient — not a generic checklist.

UK Supreme Court · [2015] UKSC 11

UK GDPR / EU GDPR Art. 9(2)(h)

Health data is processed under the lawful basis of medical purposes. Patient data is not sold or disclosed to third parties for advertising or unrelated commercial purposes. Append-only records support data integrity obligations. Privacy notice provided at patient intake.

UK GDPR · EU GDPR 2016/679

BAPRAS / ISAPS Clinical Standards

Clinical pathways are informed by current professional guidance and consensus sources — BAPRAS, ISAPS, ASA, ESAIC, RCOG, BSH, and ADA — with rule versions and source references recorded for clinician review.

BAPRAS · ISAPS · ASA · ESAIC · RCOG · BSH

GMC Good Medical Practice

The platform's mandatory rationale field and clinician verification steps support the GMC documentation standard: decisions must be recorded, explainable, and traceable to clinical criteria.

General Medical Council · Good Medical Practice 2024

Append-Only Audit Architecture

Case records, consent documents, and follow-up responses are preserved as an append-only audit trail — the original entry is never overwritten. Corrections are recorded as new, timestamped versions alongside the original. Rule set versions are logged at decision time — a complete, traceable, and review-ready audit trail.

Firestore Security Rules · Append-only, versioned

Sample Case Assessment

A typical cross-border patient assessment — UK patient, rhinoplasty, multiple risk flags.

EXAMPLE CASE · #UK-2041
Risk Assessment — Rhinoplasty
34 F · Referred from London · 02.04.2026
⚠ Conditional

Risk Signals Identified

GLP-1 Agonist (semaglutide) — Anaesthesia review required: assess GI symptoms, titration status, and gastric-emptying risk before proceeding. Multisociety guidance, Oct 2024
Active Smoking (<4 weeks) — Nicotine-mediated vasospasm; wound-healing and perfusion risk elevated. At least four weeks of preoperative abstinence is generally targeted; final scheduling depends on the procedure, patient risk, and clinical protocol. Sorensen, Plast Reconstr Surg 2012
OCP / Hormonal Therapy — Oestrogen increases VTE risk (approx. ×3–4 vs baseline). Individualised review of total VTE risk, procedure duration, and alternative contraception is required for major procedures. RCOG Green-top No. 37a
VERIFY: Anticoagulant — CV Required — Patient reports aspirin use. Drug, dose, indication, and last dose date must be confirmed before surgery date is set.

✓ All flag sources are named clinical guidelines — documented and traceable.

EXAMPLE CASE · #UK-2041
Post-Op Follow-Up — Day 7
✓ No Alert
Pain Score
2/10
✓ Within normal range
Wound Appearance
Normal
✓ No discharge

Next follow-up: Day 14 — scheduled per rhinoplasty protocol. All responses logged to an append-only audit trail.

Clinical Insights Across Your Practice

Aggregate risk signal data and decision outcomes — available to clinical directors and quality managers.

Decision Outcomes Distribution
Illustrative data.
Most Frequent Risk Signals
Illustrative data.
Post-Op Response Rate
By follow-up day · Illustrative data.

Governance by Design

SurgiCheck provides decision support — final surgical decisions remain entirely under clinician control.

Deterministic rule logic — no AI black box
Transparent flag layers with guideline citations
No autonomous surgical decision output
Clinician-signed and dated final decision
Versioned rule sets — logged at decision time
Append-only, versioned case, consent, and follow-up records
Mandatory rationale field for every decision
GDPR-aligned data architecture
TLS Encryption in Transit
Firestore — Role-Based Access (Configurable)
No Medical Record Deletion
Timestamp on Every Action
Feature Paper Forms / WhatsApp SurgiCheck
Standardised assessment criteria✗ Variable✓ Always
Append-only audit trail✗ Manual notes✓ Automatic
Decision explainability✗ Implicit✓ Guideline-referenced
Triage time15+ min✓ <3 min
Montgomery-aligned consent✗ Generic form✓ Per risk profile
Post-op complication monitoring✗ Patient calls in✓ Structured protocol
GDPR-aligned privacy architecture~ Variable✓ Privacy-first

From Pilot to Enterprise

Three tiers designed for every stage of clinical adoption. GBP pricing available on request.

Pilot
€290
/month
Structured validation environment before full deployment.
  • 1 clinic, 1 surgeon
  • Up to 100 patients
  • Core risk rule set
  • Digital informed consent (50/month)
  • Email and video support
  • Post-op follow-up module — higher tiers
  • Analytics dashboard
  • Multi-user access
  • EHR integration
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Enterprise
Custom
Bespoke pricing
Multi-site groups, hospital networks, and accredited medical tourism operators.
  • Multi-site deployment
  • Unlimited clinicians
  • Custom rule set development
  • EHR / PMS integration
  • White-label available
  • Dedicated implementation
  • SLA + technical support
  • Regulatory compliance review
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Common Questions

SurgiCheck is a Clinical Decision Support System (CDSS) — a software tool that supports clinical decision-making by surfacing risk signals and structuring documentation. It does not diagnose, prescribe, or make autonomous clinical decisions; all final decisions are made and signed by the treating clinician. SurgiCheck’s regulatory classification depends on its final intended purpose, claims, functionality, and deployment jurisdiction. A formal UK/EU qualification and classification assessment is in progress. We recommend that clinics seek independent regulatory advice specific to their jurisdiction.
Montgomery v Lanarkshire (2015) requires that material risks be disclosed based on the individual patient's circumstances — not a generic template. SurgiCheck generates the informed consent form directly from each patient's assessed risk profile. The specific flags triggered for that patient (and their evidence basis) are embedded into the consent documentation, creating an individualised, traceable risk disclosure record for each case.
Yes — this is one of SurgiCheck's primary use cases. Clinics treating international patients may face additional contractual, consumer-protection, professional, and evidentiary expectations depending on the jurisdictions and professionals involved — for example, where a UK-registered doctor is involved or where a complaint is raised with a UK body such as the GMC. SurgiCheck's documentation architecture (individualised consent, audit trail, guideline-cited flags) is designed to support scrutiny under multiple regulatory frameworks. We recommend clinics seek jurisdiction-specific legal advice for their particular patient mix.
Patient health data is classified as special category data under GDPR Art. 9. SurgiCheck processes it under Art. 9(2)(h) — for the purposes of preventive medicine and medical diagnosis, carried out by or under the responsibility of a health professional. Data is encrypted in transit (TLS), access is role-gated by Firebase Authentication. Patient data is not sold or disclosed to third parties for advertising or unrelated commercial purposes; authorised infrastructure providers process data only under contractual instructions. Append-only audit records ensure data integrity is maintained over time.
The Clinic and Enterprise tiers support rule set customisation — adding procedure-specific flags, adjusting thresholds, or incorporating local protocol requirements. All customisations are versioned and logged, so the rule set active at the time of any given decision is permanently recorded. Rule set customisation requests are handled during onboarding with our clinical team.
The Pilot tier can typically be live within 48–72 hours of account setup — no local software installation required. The platform runs as a web application accessible from any device. Full Clinic tier deployment, including staff onboarding and any rule set customisation, typically takes 1–2 weeks.

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