City Research Online

Abstract

Purpose
AI governance commonly emphasises procurement, validation, deployment and performance monitoring but lack guidance on how embedded AI tools should be withdrawn when funding, contracts or strategy change abruptly. We examined staff experience after withdrawal of a chest radiograph AI triage tool and developed a practical framework for responsible AI off-boarding.

Methods
An anonymous staff survey was circulated two months after decommissioning of a chest radiograph AI triage tool at a multi-site NHS trust. The survey repeated selected items from three earlier implementation-phase surveys, with added decommissioning-specific questions on workflow, perceived patient benefit, emotional burden and future AI engagement. Quantitative responses were summarised descriptively. Free text responses were analysed deductively and interpreted using the Job Demands-Resources (JD-R) model.

Results
The response rate was 21.4% (40/187), comparable to earlier survey rounds. Perceived patient benefit from AI remained stable, with 70% (28/40) agreement post-decommissioning versus 71.1% (32/45) pre-implementation, 65.5% (19/29) early implementation, and 67.9% (36/53) late implementation. Perceived logistical burden post-decommissioning (35%, 14/40) was higher than at late implementation (26.4%, 14/53) but lower than at early implementation (51.7%, 15/29). Response rate from reporting staff was low (5/40), with two voicing disappointment in AI tool withdrawal, and one stating they had grown reliant on the tool. Across 22 free-text entries, frequent themes included loss of clinical value or pathway efficiency, operational relief after withdrawal, and patient-facing emotional labour during AI-enabled escalation.

Conclusions
Decommissioning produces both operational relief and perceived clinical loss, with effects differing by staff role. We propose a three phase AI off-boarding protocol - pre-withdrawal assessment, graduated transition and post-withdrawal support. Decommissioning management should be treated as a central part of responsible governance across the AI lifecycle.

Publication Type:	Article
Additional Information:	© 2026. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords:	Survey, Artificial Intelligence, Chest Radiography, Decommissioning
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform Q Science > QA Mathematics > QA75 Electronic computers. Computer science R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Allied Health
SWORD Depositor:	Symplectic Administrator

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