The People Overview & Scrutiny Sub Committee met to discuss the use of artificial intelligence (AI) in social care, the NHS 10-year plan, and the awarding of a contract for the Ageing Well Community Wellness and Empowerment Service. The sub-committee scrutinised reports on each of these topics, but made no decisions at the meeting.

NHS 10 Year Plan

The sub-committee reviewed the NHS's Fit for the Future 10-year health plan, which aims to shift from hospital-centric care to community-based services, embrace digital technologies, and prioritise preventative care. The plan includes moving outpatient care to the community, expanding neighbourhood care, and utilising technology to improve efficiency and patient experience.

The plan also makes provision for Foundation Trusts¹ (FTs) as part of a broader shift towards a more integrated and community-focused healthcare system, and introduces the concept of Integrated Health Organisations (IHOs). The report also noted that Integrated Care Boards² (ICB) across England have to deliver 50% savings against their running costs by March 2026, and that NHS North East London are therefore about to embark on a staff consultation that could see numbers of posts reduced by half, which will impact the Havering Integrated Team. The report highlighted a number of key shifts and reforms:

• Shift from hospital to community: This involves providing more care closer to home through Neighbourhood Health Services and co-located centres open 12 hours a day, six days a week. The plan aims to shift two-thirds of outpatient appointments to digital alternatives and ensure 95% of complex patients have universal care plans by 2027.
• Shift from analogue to digital: The plan includes a Single Patient Record accessible through the NHS App by 2028, which will serve as the front door to the NHS. This will support AI-powered diagnostics, medicine management, and care planning.
• Shift from treatment to prevention: The plan aims to create a smoke-free generation, tackle obesity, reduce alcohol harm, and eliminate cervical cancer by 2040. It also seeks to increase access to screening services and scale genomic and predictive analytics to support prevention.

The plan also outlined five enabling reforms:

• A new operating model merging NHS England with the Department of Health and Social Care (DHSC), empowering ICBs as strategic commissioners, and reintroducing earned autonomy for high-performing NHS organisations.
• Enhanced transparency of quality of care through publishing league tables of providers and patient experience measures, revitalising the National Quality Board, and implementing AI-led warning systems to identify at-risk services.
• Workforce transformation focusing on AI-enabled productivity, advanced practice roles, ultra-flexible contracts, and technology to release staff time.
• Innovation and technology with five big bets (AI, data, genomics, robotics, wearables) drawn from the Future State Programme, new Global Institutes, and faster clinical trial and medicine approval pathways.
• Financial sustainability via a value-based approach focused on better outcomes for the money spent, clearing deficits through annual productivity gains, multi-year budgets, and innovative capital investment models, alongside Patient Power Payments linking funding to patient experience.

The plan emphasises prevention and the development of Integrated Neighbourhood Teams, adopting a population health approach to supporting local people at a neighbourhood level. The 'Neighbourhood' footprints within Havering will likely align with the Primary Care Network Footprints, covering three areas: 'North Havering', 'Central Havering', and 'South Havering'.

The report also identified a number of key considerations, risks and implications for the London Borough of Havering:

• The London Borough of Havering has the opportunity to come forward as a partner in the proposed 'Integrator' function within the Integrated Neighbourhood Teams.
• There are risks that programmes like the Live Well Havering programme could suffer with the potential reduction in resource at the Havering team. The Live Well Havering programme has revitalised the council's relationship with the community and voluntary sector, and will be the key delivery programme for prevention into the future.
• There is the potential that the impact / influence between the NHS and Council could be impacted due to a likely reduction in the number of staff, and therefore resource at place.
• The London Borough of Havering are responding to the NHS North East London restructure by planning a restructure for the staff employed by the Council, to be run concurrently with the NHS consultation, to ensure that the commissioning team structure is not destabilised by the reductions within the NHS Team.
• There is a risk that the capacity to continue to drive forward work around addressing health inequalities could significantly reduce, due to a potential reduction in the number of staff within the team relating to the restructure on the NHS side.
• There is a risk that local knowledge and connections will be lost as a result of the ICB staff consultation.
• There is a risk that the ability of partners to continue co-production with local people will be reduced, with reduced capacity at place, and loss of connections and knowledge from staff moving on.
• There are financial implications for the Local Authority as the ICB becomes a 'strategic commissioner' and the new NHS landscape places more impetus on NHS Providers to deliver transformation.
• The Better Care Fund[^3] will be restructured from 2026/27 to align with new commissioning and neighbourhood plans. [^3]: The Better Care Fund (BCF) is a programme spanning health and social care. It was created to encourage integrated services.
• There is a risk of potential decommissioning of Healthwatch England, and it is essential to ensure that the needs of local people are championed.
• The Havering Place based Partnership Board and Partnership governance will need to be reviewed and adapt, to ensure that forums remain in Havering where partners are able to come together to effect real change and champion Havering's cause within the content of North East London and wider.
• There is indication that Mayors (or their delegates) will replace local authority representatives on Integrated Care Boards (ICBs).

Artificial Intelligence in Social Care

The sub-committee received a presentation on the use of Artificial Intelligence (AI) within social care and broader council services, focusing on two AI applications: Magic Notes and Microsoft Copilot.

Magic Notes

Magic Notes is an AI-powered meeting summarisation tool designed to support social care professionals. It captures voice recordings, transcribes sessions, and generates structured summaries including suggested actions. Enhancements now include report functionality compiling reports such as Best Interest Assessments (BIA) and Education and Health Care Plans (EHCP) in one click.

A pilot phase involving 14 Adult Social Care (ASC) staff over six weeks showed significant reduction in time spent on admin and documentation, improved quality and consistency of reports, and enhanced engagement between workers and clients.

The tool offers various templates, including Care Act Assessments³, Occupational Therapy Assessments, Supervision, 121s, and Homelessness Triage. It also suggests actions, compiles follow-up communications and referrals, and translates outputs into other languages. The report consolidation capabilities of Magic Notes streamline EHCP drafting, generating drafts in minutes and offering a cost-effective solution compared to agency staff. The contract details indicate a cost of £10 per report, with 1000 reports included in a two-year contract, compared to £130-£240 per report for an EHCP Plan Writer.

Survey results from staff using Magic Notes indicated that 86% reported time savings on admin, with an average saving of 38.62 minutes across various categories such as team meetings, client meetings, supervision meetings, and assessments. Staff reported using the time saved to spend more quality time with service users/families, manage more and complex cases, and increase productivity while maintaining work-life balance.

Staff feedback on the tool was positive, with social workers noting that it allowed them to focus on clients without notetaking distractions and that it provided strong support for multiple languages. However, some concerns were raised about notes being repetitive and lacking context, as well as concerns about body language cues and being recorded.

Magic Notes complies with UK GDPR and the Data Protection Act 2018, requiring consent-based use, retaining data for 30 days, and storing data on secure UK-based cloud servers. A Data Protection Impact Assessment (DPIA) was completed prior to the pilot, and updated privacy notices are in place.

To address potential bias in AI, the supplier Beam is taking mitigation actions such as using GPT-4o for its fairness and accuracy, including accuracy tools like ElevenLabs Scribe, conducting ongoing reviews, using built-in safeguards with gender-neutral language in templates, and ensuring human oversight with practitioners verifying details with citations.

Microsoft Copilot

Microsoft Copilot is an AI-powered tool that drafts documents, emails, and presentations, analyses real-time data, and integrates across Microsoft 365 applications. A pilot phase with 150 licenses rolled out and a Community of Best Practice setup tracked time savings and efficiencies, with uses ranging from taking meeting minutes to producing draft documents and assisting with coding. Time savings of up to 48 hours per month were logged.

The next steps involve identifying use cases for trackable time and/or cost savings to inform a business case for wider rollout across the organisation.

Ageing Well Community Wellness and Empowerment Service

The sub-committee also discussed the upcoming Executive Decision (ED) by Cabinet to award the Ageing Well Community Wellness and Empowerment Service. The decision and appendices were exempt from the public and press as the outcome of the tender had not been signed off.