Agent operating model
Practical examples of how agentic AI could be operationalised safely in a Business & Performance team — with bounded agents, approved sources, citations and human sign-off at every stage.
AI can help draft, structure, analyse, check and explain performance intelligence, but accountable humans remain responsible for definitions, validation, judgement and sign-off.
Demonstration caveat: Agent rules are illustrative templates in agent-rules/. They are not deployed in production and do not connect to live Trust systems.
What "an agent" means here
An agent is an AI assistant given a narrow, written brief and a fixed set of approved sources — for example one return's published specification and the local data dictionary. It answers questions and drafts text strictly within that brief, always citing where its answer came from, and stops and escalates when something falls outside its sources. Think of it as a well-briefed, source-bound assistant for one task — not a general chatbot, and never the decision-maker.
Core principles
- AI supports human judgement — it does not replace subject matter experts
- Subject matter expert (SME) agents answer from approved sources only — with citations the user can verify
- AI does not make operational decisions or submit returns autonomously
- Definitions must link to authoritative sources — public specifications, the local data dictionary, standard operating procedures (SOPs)
- Information governance is a hard boundary — the Information Governance (IG)/Safety Agent can block the workflow
- Explicit human approval before external or system changes — code changes, pull request (PR) creation, project-tool updates, external communications
Pairing agents with approved sources
Reporting specification agents — for the Mental Health Services Data Set (MHSDS), Community Services Data Set (CSDS), Patient Level Contract Monitoring (PLCM) and Aggregate Data Collections (ADC) — should be paired with:
- Downloaded public specification documents (version-dated)
- Local data dictionary (
docs/local-dictionary-placeholder.md in demo; MHSDS worked example uses docs/synthetic-mhsds-local-dictionary.md)
- MHSDS public source pack index (
public-data/mhsds-source-pack-register.csv) for the SME worked example
- Local SOP or process notes (IG-approved; not published here)
- Source restrictions and citation requirements in the agent rule file
- Named human sign-off points before operational use
Example questions SME agents should support
Definition
“What is ADC E07 based on?”
Schedule
“When is the next PLCM dataset due?”
Fields
“Which fields are required for this return?”
Local mapping
“What source table or local definition is this metric using?”
Caveats
“What caveats should go with this report?”
Each answer must cite the source section so the user can check at source. If the answer is not in approved documents, the agent must say so and escalate.
Worked example: asking an MHSDS SME agent about an unusual figure
In plain English: when a number on a report suddenly jumps, the first job is to find out why — is it a genuine change in activity, or just a change in how things were recorded or counted? "Tracing a figure back to source" means following that number step by step, from the original record a clinician entered through to the final total on the report, checking each stage. The technical chain below is kept deliberately, because that traceability is the whole point — but the takeaway is simple: the agent helps you ask better questions, and a person still decides.
This example shows how a source-bound SME agent could support a Business & Performance user investigating an unusual movement in a synthetic MHSDS-derived metric. The agent traces the figure back to source forms, extract logic, fact tables and mapping rules, separates data-quality from operational explanations, and offers draft pack wording — sign-off is discussed only when the user asks whether the figure is ready for the pack.
Synthetic demonstration only. Fictional records from RiO (an electronic patient record system), warehouse tables and aggregate data. Not an official Dorset HealthCare report, not a live Trust agent, and not connected to operational systems.
What this demonstrates
Practical data lineage (RiO contact → staging extract → fact table → team mapping → count), movement calculation (+370 contacts, ~29.8%), data-quality vs operational hypotheses, numbered investigation checks, and draft directorate pack wording pending human review.
User:
I'm drafting the March directorate pack. Synthetic All Age MH access contacts have jumped from 1,240 to 1,610. Why has this gone up?
MHSDS Expert Agent:
First check: real activity increase or recording/extraction change?
Synthetic lineage: RiO contact (DemoMHContactForm) → StgMHSDSContactExtractDemo → FactMHSDSContactDemo → DimMHSDSServiceTeamDemo (All Age MH teams) → count where ContactStatusCode = attended and ContactMonth = March.
Movement: 1,240 → 1,610 (+370, ~29.8%). March includes 180 late-recorded contacts — do not assume pure demand increase.
Checks: RiO form/process change, form usage, team mapping, duplicates in FactMHSDSContactDemo, status coding, late recording, backlog clinic or capacity.
Draft pack wording (pending review): "All Age MH access contacts rose from 1,240 to 1,610 (+29.8%) in March. This may reflect increased activity and/or recording effects including late-recorded contacts. Definition and data quality checks are in progress."
User:
Can I use this figure in the March directorate report?
MHSDS Expert Agent:
Not yet as a final figure — draft wording with caveats only until checks are complete. Confirm team mapping, dedup logic and late-recorded contacts with Information Lead; confirm operational context with Performance Manager. Sign-off required before treating as final. See full transcript for lineage, calculation and performance interpretation.
Why this matters: The value of an SME agent is tracing a reported number back to RiO forms, extract tables, fact tables and mapping rules — and knowing what data-quality and operational checks to run. It helps the user ask better questions and draft proportionate caveats; it does not replace human validation or sign-off.
Supporting files:
Worked example: Report Analysis Agent reviewing a draft Talking Therapies brief
In plain English: before a draft report is shared, someone needs to check that it answers the basic performance questions — what the figure is, what it should be (where a standard exists), how it is trending, what judgement is fair, and what a human must still verify. The Report Analysis Agent does that review using approved public sources only. It cites evidence, suggests draft fixes, and never signs the report off.
This example uses a synthetic pre-fix draft (deliberate errors) based on issues found during the June 2026 public-data report improvement pass. The agent catches total errors, misleading period wording, missing standards and mixed-up trend columns — the same classes of problem that automated validation and human review now guard against in the corrected briefs.
Synthetic demonstration only. Flawed draft v0.3 in examples/ — not the corrected published brief, not a live Trust agent, and not connected to operational systems.
What this demonstrates
Eleven-step review framework: period/total/standard/trend-column/caveat/bottom-line checks; CSV traceability; revised wording marked for human review; refusal when asked to approve publication. Cross-references 04_validate_public_reports.R where mechanical checks apply.
User:
I've drafted a Talking Therapies access brief for our directorate huddle. Please review this draft against approved public sources and tell me what needs fixing before I share it.
Report Analysis Agent:
Critical finding: KFE row says M019–M022 total 5,870 but CSV sum is 6,780 (M019=4705, M020=705, M021=460, M022=910). Would fail check_tt_wait_totals.
Major: "Six-month trend" uses six non-consecutive data points (Aug–Apr gaps). M053 missing 75% standard cite. Trend column mixes "Falling" with "Finance sign-off". Judgement "Performance is strong" should be "above 75% standard but falling" (95→88).
Draft revised M053 wording and corrected band totals offered — DRAFT, REQUIRES HUMAN REVIEW.
User:
Can I publish this to the directorate huddle now?
Report Analysis Agent:
No. I cannot approve publication. Critical total error must be fixed. Pathway owner must confirm M053 definition. Report author and Performance Manager sign-off required. Status: Draft — pending named human sign-off.
Why this matters: This agent operationalises the AI assurance checklist in practice — the same issue classes that drove the June 2026 public-data improvement pass. See the corrected Talking Therapies brief for the post-fix outcome. For source-scope patterns (A&E without ED), see the urgent diagnostics brief.
Supporting files:
Workflow (conceptual)
Reporting workflow
Approved or synthetic data
→
Performance Manager
→
SME agent (on demand)
→
Demand & Capacity
→
Report QA
→
Executive Summary
→
IG / Safety
→
Human sign-off
For performance reporting and mandatory returns: interpret data, check definitions, quality-assure (QA) drafts and prepare narratives — each step produces drafts or findings for human review, not autonomous outputs.
Admin and delivery workflow
Delivery task or open branch
→
Project / Admin or Backlog Sync
→
Branch Review & Delivery
→
IG / Safety
→
Human sign-off
For delivery work: coordinate project actions, reconcile backlogs and close down branches before merge or handover — still subject to IG/Safety rules. Neither workflow implies autonomous changes to the code repository (Git), the project-tracking tools (such as Azure DevOps) or any external system. See agent-rules/README.md.
A. Reporting specification SME agents
MHSDS Expert Agent
Before MHSDS-derived figures enter a report or mandatory return, checks whether local metric logic matches published national definitions.
- Outputs
- Compatibility assessment, cited definitions, flagged risks and questions for the information lead.
- Must not
- Approve submissions, guess field mappings, or process patient-identifiable data (PID) — the personal information that identifies an individual.
- Sign-off
- Performance Manager or Information Lead with MHSDS accountability.
View rule file
Review metric against published MHSDS definitions. Cite sources. Do not approve submission.
CSDS Expert Agent
Before community service metrics are published, flags CSDS coding, cohort and data-quality risks with authoritative citations.
- Outputs
- Coding and cohort risk flags, data-quality warnings, suggested caveats and questions for clinical or information owners.
- Must not
- Make clinical judgements, sign off CSDS submissions, or assume local Patient Administration System (PAS) coding matches national spec without verification.
- Sign-off
- Information Lead or community services performance owner.
View rule file
PLCM Expert Agent
When preparing PLCM returns, answers schedule, field and validation questions from approved specifications only.
- Outputs
- Schedule and field guidance with citations, validation notes and escalation prompts where the answer is not in the approved pack.
- Must not
- Approve submissions, invent field rules, or process patient-identifiable data.
- Sign-off
- Performance Manager or Information Lead with PLCM accountability.
View rule file
When is the next PLCM dataset due? Cite calendar source. Flag if not in approved pack.
ADC Expert Agent
When interpreting ADC elements (e.g. E07), explains mappings, definitions and caveats from authoritative sources.
- Outputs
- Definition summaries with spec citations, local mapping notes and suggested report caveats.
- Must not
- Approve ADC submissions, guess element mappings, or recommend operational actions beyond definition guidance.
- Sign-off
- Performance Manager or Information Lead with ADC accountability.
View rule file
What is ADC E07 based on? Cite spec section and local dictionary if documented.
B. Performance and reporting workflow agents
Performance Manager Agent
During operational or directorate reviews, interprets performance trends and variation in plain English — separating facts from hypotheses.
- Outputs
- Trend narrative, labelled hypotheses, risk summary and suggested questions for service leads.
- Must not
- Make operational or clinical decisions, present correlation as causation, or bypass SME or QA flags.
- Sign-off
- Business & Performance Business Partner or delegated Performance Manager.
View rule file
Demand & Capacity Agent
When testing backlog clearance or capacity plans, shows transparent arithmetic and stated assumptions — not commitments.
- Outputs
- Backlog clearance estimates, sensitivity notes, plain-English gap explanation and questions about missing inputs.
- Must not
- Guarantee clearance dates, invent hidden assumptions, or approve workforce or financial decisions.
- Sign-off
- Operational lead and Business Partner validate assumptions before any capacity plan is used.
View rule file
Report Analysis and Improvement Agent
Before a performance report leaves draft, runs structured pre-publication review: totals, periods, standards, trend columns, caveats, readability and revised wording — workflow step labelled Report QA.
- Outputs
- Numbered findings (critical / major / minor) with evidence cites, draft revised wording, human validation register, publication refusal when asked.
- Must not
- Approve reports for Board or external use, invent standards, remove caveats, or process patient-identifiable data.
- Sign-off
- Report author and Performance Manager resolve findings; IG/Safety gate still required.
View rule file · Worked example
Review draft against approved sources. Cite evidence. Propose wording only. Do not approve publication.
Executive Summary Agent
After QA, drafts Board or service-facing narratives with visible caveats — for human selection and approval, not autonomous publication.
- Outputs
- Executive summary draft, “so what?” section, visible caveats and alternative phrasing for sensitive messages.
- Must not
- Bury bad news, remove QA or IG caveats, or make commitments on behalf of the Trust.
- Sign-off
- Business Partner and, where appropriate, Service or Medical Director before Board or external use.
View rule file
C. Admin and delivery agents
Project / Admin Agent
For day-to-day delivery coordination: tracks meeting actions, summarises project status, drafts RAID (risks, assumptions, issues and dependencies) entries and flags overdue items.
- Outputs
- Draft action lists, meeting summaries, project status notes, RAID entries and overdue reminders.
- Must not
- Send external messages, commit managers to deadlines, or change project records without approval.
- Sign-off
- Project lead or Business Partner approves actions and record changes before saving or sharing.
View rule file
Backlog Sync Agent
When Teamwork and Azure DevOps diverge, reconciles tasks with work items — proposing aligned entries with traceable ID mapping.
- Outputs
- Proposed work items, acceptance criteria drafts, duplicate matches, status-change proposals and Teamwork ↔ DevOps ID traceability.
- Must not
- Create, close, reassign or update items in either system without explicit human approval.
- Sign-off
- Developer or PM approves each proposed item or status change before any system update.
View rule file
Branch Review & Delivery Agent
Reviews the current branch before handover or merge; summarises code/report changes, drafts commit and PR text, checks documentation and file headers, records testing, and proposes related Azure DevOps updates for human approval.
- Outputs
- Changed-files summary, suggested commit message and PR description, changelog entry, doc/header update suggestions, testing summary, risk list and proposed DevOps actions.
- Must not
- Push to Git, update DevOps work items, claim tests passed without evidence, or present changes as safe to merge without human review.
- Sign-off
- Developer or analyst confirms the handover package before commit, push, PR creation or DevOps updates.
View rule file
D. Information governance
IG / Safety Agent
Hard gate before any agent output proceeds to human review or publication — blocks PID, unpublished internal data, over-automation and unsupported claims.
- Outputs
- PASS or BLOCK decision with explicit reasons, IG violation list, required redactions and escalation recommendations.
- Must not
- Waive IG rules for convenience, allow disclosive data through, or be bypassed in the documented workflow.
- Sign-off
- Always active; human sign-off still required after PASS. IG lead consulted for any BLOCK.
View rule file
PASS or BLOCK with reasons. No exceptions for convenience.