Seven out of ten acute trusts in Greater Manchester have stopped using paper to send discharge summaries to local GP practices. The other three will follow suit by the end of this month.

Daniel Alexander, project manager for Electronic Clinical Correspondence at NHS Greater Manchester CSU, said rapid progress is being made to remove paper completely from the processes used to send 5m clinical letters a year from acute and mental health trusts to primary care.

All ten acute trusts have their own Electronic Document Transfer Hub and 393 out of 508 GP practices are technically ready to receive correspondence using a standard, single, end-to-end system based on PCTI’s EDT Hub system.

A hub is also planned for the local NHS 111 service. Currently, the system allows acute trusts to send electronic clinical correspondence such as discharge summaries, end of life care reports, and notification of patient referral to district nurses to GP practices.

However, Alexander told the best practice showcase at EHI Live 2013 that the commissioning support unit is working on an information sharing arrangement to link the hubs.

This would mean that any trust treating a Greater Manchester registered patient would be able to send electronic correspondence direct to the patient’s GP. An information sharing agreement has been developed and the hubs have been interfaced to allow this to happen.

“We have tested the system with simulated and live correspondence and it works,” he said. “Now the GPs want to know when we are going to turn it on.”

Despite this, there are a number of hurdles to overcome before going live with the expanded system. These include developing and agreeing common business continuity arrangements.

“We need to understand how each of the trusts are going to interact if a hub goes down, for example, or how they are going to handle letters sent back by the GP because the patient is no longer registered,” Alexander said.

His other challenge is to make the EDT Hub “business as usual”, he said, as some trusts have removed paper but still treat the EDT as a project with a project manager.