In an era where cyber attacks are targeting the NHS as it steadily progresses with its digitisation plans, C2-Ai supports the NHS with technological advancements that have helped trusts safely modernise.
The company, led by Dr Mark Ratnarajah, has harnessed the power of artificial intelligence to improve patient safety, optimise hospital performance, and enhance healthcare outcomes worldwide.
But what exactly is C2-Ai, and how does its AI-driven approach set it apart?
A name rooted in innovation
C2-Ai’s name is deeply tied to its origins. The ‘C’ references Copeland, after the company’s Chief Medical Officer, Graham Copeland, who played a pivotal role in creating the deep learning platform known as CRAB – Copeland’s Risk Adjusted Barometer.
“In the UK the formal name of our company is CRAB Clinical Informatics. C2-Ai draws on the two instances of the letter ‘C’,” Dr Ratnarajah explained.
A mission to reduce harm
Founded by Graham Copeland and Stephen MacKenney, C2-Ai was born from a desire to elevate patient safety and enhance healthcare quality.
Copeland, a recognised expert in patient safety, developed the POSSUM scoring system, widely adopted in more than 30 countries, and MacKenney, a former head of quality and safety at the Department of Health, brought his extensive experience in clinical governance to the table.
Together, they envisioned a system that would go beyond surface-level metrics to assess the true impact of healthcare services on patient outcomes.
Today, C2-Ai’s technology is being used globally to improve transparency in healthcare, uncovering problems before they escalate into systemic failures.
The aim is to reduce harmful events, prevent omissions of care that result in harm, and create an ability to compare like with like
“C2-Ai was created to promote reductions in avoidable harm for patients, and to help healthcare organisations better measure both mortality and morbidity.
“The aim is to reduce harmful events, prevent omissions of care that result in harm, and create an ability to compare like with like.
“This comparison means that healthcare organisations, services, and even wards, can be compared based on the observed versus expected outcomes of the actual patients being seen, through a process known as clinical risk adjustment,” Dr Ratnarajah explained.
AI transforming healthcare systems
At the heart of C2-Ai’s innovation lies its ability to provide actionable intelligence.
The technology allows healthcare providers to assess patient risk on an individual level, predict complications, and measure the effectiveness of treatments over time.
Some of the world’s leading hospitals use C2-Ai’s platform to pinpoint areas for improvement and ensure consistent, high-quality care.
For healthcare systems, this intelligence enables more strategic resource allocation. The NHS, for example, is leveraging C2-Ai’s insights to safely manage waiting lists.
The technology allows healthcare providers to assess patient risk on an individual level
“The intelligence offered by C2-Ai technology enables systems to streamline and stratify, with greater assurance that patients remain low acuity,” Dr Ratnarajah said.
“It also means an ability to deal with the most complex first, rather than dealing with all of a waiting list on a first come, first served basis.”
By stratifying patients according to risk, integrated care systems can optimise surgical hubs and independent sector capacity, easing pressure on the NHS while maintaining high standards of care, according to Dr Ratnarajah.
Uncovering hidden risks in patient care
Traditional hospital performance assessments often struggle with the challenge of comparing disparate services – the proverbial ‘apples and oranges’ problem.
C2-Ai’s technology overcomes this by employing clinical risk adjustment, which considers individual patient characteristics, comorbidities, and pathophysiology to provide a more accurate picture of expected versus observed outcomes.
This capability has already proven invaluable in several NHS trusts.
Traditional hospital performance assessments often struggle with the challenge of comparing disparate services
In Cheshire and Merseyside, the system identified high-risk patients, leading to an 8% reduction in A&E presentations, a two-thirds drop in ICU dependency, and significant capacity benefits.
In County Durham and Darlington, C2-Ai’s insights helped reduce hospital-acquired acute kidney injury by over 80%, preventing unnecessary deaths and long-term complications.
“In short, we measure dynamic risk as it changes over time to identify both pockets of excellence and quality improvement opportunities – whether that’s by hospital, department, consultant, or procedure,” Dr Ratnarajah said.
A commitment to ethical AI
Ensuring fairness and transparency in AI is a top priority for C2-Ai. Its platform has been trained on over 500 million patient records from 46 countries, ensuring a broad, unbiased dataset.
Additionally, patient data never leaves secure NHS environments, and the company meets rigorous regulatory standards, including GDPR and NHS DTAC compliance.
Importantly, C2-Ai’s AI serves as a decision support tool, not a replacement for human judgment, according to Dr Ratnarajah.
Clinical teams retain full control over patient care, using the insights provided to make more informed decisions
Clinical teams retain full control over patient care, using the insights provided to make more informed decisions that align with individual patient needs.
“It is also worth noting that this is clinical decision support – clinical teams remain in full control of decisions and establish parameters for escalation,” Dr Ratnarajah said.
“Application in practice – examining the needs of individual patients – by its nature is also helping healthcare to equitably focus resources on patients in greatest clinical need.”
The future of AI in healthcare
Looking ahead, as the NHS and global healthcare systems continue to evolve, Dr Ratnarajah predicts that AI-driven insights will play an increasingly indispensable role in shaping the future of medicine.
Beyond generative AI and robotic process automation, Dr Ratnarajah pointed out two AI solutions that are gaining momentum.
Firstly, AI solutions that enhance care delivery and operational efficiency.
Dr Ratnarajah predicts that AI-driven insights will play an increasingly indispensable role in shaping the future of medicine
Secondly, multi-modal AI models that integrate both clinical and operational insights are expected to drive further innovation, according to Dr Ratnarajah.
C2-Ai itself is actively developing new solutions, including a recently launched maternity safety initiative aimed at reducing risks for expectant mothers and newborns.
AI as an enabler, not a replacement for humans
Despite concerns about automation in healthcare, Dr Ratnarajah has emphasised that AI is not here to replace doctors but to empower them.
By providing more precise risk assessments and helping healthcare providers make the most of finite resources, AI is enabling a more sustainable approach to patient care.
Despite concerns about automation in healthcare, Dr Ratnarajah has emphasised that AI is not here to replace doctors but to empower them
“This is not about replacing people: it is about upgrading the type and quality of information available to clinicians and hospital managers enabling a more precise and sustainable approach to healthcare, improving outcomes for patients, making the most of finite capacity, and mitigating rising demand.
“AI remains a computational technique, deployed by people to improve outcomes and productivity,” Dr Ratnarajah concludes.