Clinically Intelligent is written by Juwon Akinyande in a personal capacity and is not affiliated with, endorsed by, or representative of Barts Health NHS Trust or any other NHS organisation. Content is for general educational purposes only. It does not constitute clinical, legal, or information governance advice. Before applying any guidance to your own practice, consult your Trust information governance lead, your Caldicott Guardian, your line manager, and your professional body.
As I mentioned in the last issue, I was previously avoiding Copilot. I decided that I would start to explore it since it was the tool commissioned by the NHS and the one tool that our colleagues at work will be using. I mentioned that two apps caught my eye during my first exploration of Copilot. The first tool that I decided to review is OneNote.
OneNote is described as a digital note taking tool. What drew me to it is the similarities it appeared to have with one of my favourite tools, Gemini Notebook (previously NotebookLM), which I covered in Issue 02.
What OneNote actually is.
From a user interface perspective it seems simple and straightforward to use. You open the toolbar and get two different options. Copilot Notebooks and Notebooks. From my understanding, Copilot Notebooks is the AI chat function embedded in the notebook. That is the version I tested for this issue. The regular Notebooks version is what OneNote has always been, without the AI features layered on. I have not explored the standard notebook version as much as the Copilot side, and I will report back on that in a future issue.
What I tested.
The Copilot Notebook function has a similar use case to Gemini Notebook. You can upload files and documents and it provides you with the option of a mind map and study guide. You are able to ask the chat questions regarding the file that you uploaded.
For the test I used the workflow I created in Issue 04. It is a twenty page document that has a lot of detail. For a resource that requires repetition so that it becomes second nature, having a tool like Copilot Notebook is useful. I asked it to provide a detailed explanation of the workflow. It gave me a clear breakdown before providing an interpretation of the document.
The mindmap feature.
There is an option to generate a mindmap, which will instruct the AI to construct one based on your file. I am a big fan of this feature. It breaks down your file, in this case the workflow, and you can click different parts of the mindmap and get the chat function to explain them further. It is a useful feature if you are a team manager or service manager trying to help your team understand new policies and guidelines.
Two things to keep in mind before you rely on it.
The mindmap regenerated when I came off the tool and came back. That may be a technical issue on my side rather than a design decision, but it is worth knowing if you build a mindmap for a specific purpose and expect to come back to the same version later.
The mindmap I generated on 11 August had an expiry date of 10 September. That is a thirty day window. The mindmap is not a permanent document. If you build one for a team session in a fortnight, plan to use it inside the window. If you need something you can refer back to for months, screenshot it or save the underlying material another way.
Despite the timeframes and regeneration, I would use this feature for a short term project or as a way to organise my thinking on a piece of work. The workflow explainer example is one use case. It has more potential than that, and I will keep exploring what it can do.
One other feature worth naming.
You can upload emails into OneNote. This is a genuinely useful feature. If you have a long email trail you have been meaning to catch up on, you can drop it in and pull out what is relevant to you.
Information governance.
OneNote Copilot Notebooks sits inside the same Microsoft 365 environment as Copilot Chat. That means it is a different governance category from consumer AI tools like Gemini Notebook. Same enterprise licensing. Same NHS account. Same broad principles.
But it is not the same tool as Copilot Chat and there are things I do not know yet about how it handles what you upload. Copilot Chat processes a prompt and returns a response. Copilot Notebooks processes whole documents that you upload, generates mindmaps, creates study guides, and produces outputs that are stored in the notebook.
What I have not been able to confirm is whether uploaded documents are treated the same way as prompts in Copilot Chat under enterprise licensing. Whether the mindmap generation happens locally in Microsoft’s protected environment or somewhere else. Whether the temporary artefacts like the thirty day mindmaps are held under the same rules as your Trust’s usual clinical documentation systems. These are questions worth asking your digital lead before you upload anything sensitive.
Same discipline applies as always. The Safety Check from Issue 07 is the framework. Composite documents. No patient identifiable information. If your Trust has published specific guidance on OneNote and Copilot Notebooks use, read it first. If they have not, ask when it will be available. Do not upload anything you would not want a colleague outside your team to read.
For the test I ran in this issue, I used the Issue 04 workflow. That is a document I produced for this newsletter. It contains no patient information and was already public. That is the level of safety worth applying until you have specific Trust guidance to work with.
How it compares to Gemini Notebook.
Gemini Notebook is a better tool. Saying anything else would be me being dishonest.
The studio function on Gemini Notebook is more exhaustive than OneNote’s equivalent. Gemini has the audio and video overview features and you can make infographics based on your files. The notebooks do not have an expiry date, which means what you build stays available. The output Gemini produces is better than the Microsoft counterpart. So if you are speaking purely based on the product, Gemini Notebook is better. Issue 09 does a full breakdown of it.
Where OneNote wins is that it sits under NHS enterprise licensing, which means there is more flexibility regarding what you can upload safely for Trust work. It also sits inside the ecosystem where the rest of your work lives, so it connects easily to SharePoint, OneDrive, and your email. That is not a small thing when you are trying to work with material that belongs inside your Trust.
The decision rule is straightforward. If the material you are working with is fine for consumer AI and you want the best available tool, Gemini Notebook. If the material belongs inside your Trust’s ecosystem and you need a tool that sits under enterprise governance, OneNote.
Will I be using this going forward.
For personal use, no. Gemini Notebook is the better tool for the work that does not touch Trust data.
For team and Trust work, yes. It is useful. It has real features. It fits into the ecosystem where I already work. As I continue using it, I will experiment with different ways it can fit into my workflow.
Both tools have their place. Neither replaces the other.
What you can do this week.
Upload one thing. A guideline you have been meaning to read. An email trail you have been meaning to catch up on. See how OneNote interacts with what you upload. That will teach you more than any guide or policy can.
In Case You Missed It.
HSSIB opens investigation into AI scribes.
The Health Services Safety Investigations Body has launched an investigation into the use of ambient voice technology in NHS hospitals. It will look at whether AI scribes could contribute to patient harm, wider safety risks, and how responsibility for safe use is understood locally and nationally. Source: HSSIB, August 2026.
The question everyone has been asking is how much time AI scribes save. The question now be asked, which is probably the most important question: What happens when something goes wrong. AI generated notes go into the record. Errors, omissions and accountability do not disappear because the writing was automated.
NHS leaders say skills are the biggest barrier to AI adoption.
A survey of 50 senior NHS digital and clinical leaders by Aire Logic found that skills, not technology or money, are the biggest threat to AI adoption over the next five years. Only 6 per cent rate their own organisation as well prepared to adopt AI responsibly and at scale. 96 per cent said the national AI strategy does not reflect their priorities. Source: Aire Logic survey, published on Health Tech World, August 2026.
The tools keep arriving. The support to use them is not being built at the same pace. This survey puts numbers on it.
Manchester expands its single patient record.
Manchester University NHS Foundation Trust is extending its Hive electronic patient record into more than 150 community services across Manchester and Trafford. The Trust is also building a new Digital and Data Academy and a secure data analytics platform. Source: Manchester University NHS Foundation Trust. mft.nhs.uk
AI gets most of the attention but this is the infrastructure that makes AI useful. A clinician who has to piece a patient’s story together from four disconnected systems is not going to get value out of AI on top of that. Data first. AI second.
That is all for Issue 14.
Clinically Intelligent drops every Wednesday. If you are not yet subscribed you can join free at clinicallyintelligent.com.
The AI tools discussed in Clinically Intelligent are consumer products. They have not been independently assessed by the author against DCB0129 or DCB0160 clinical risk management standards, and they may not be approved for clinical use by your employer. Before using any tool described in this newsletter in connection with your clinical practice, you must satisfy yourself that its use is permitted under your Trust information governance policy, your DSP Toolkit obligations, your professional registration requirements, and any applicable contractual terms with your employer. The author accepts no liability for use of any tool or workflow described in this publication. Patient identifiable information must not be entered into any consumer AI tool under any circumstances, irrespective of any guidance contained in this newsletter.