Some Nottinghamshire GPs have used the October e-discharge target to stop receiving faxes altogether, forcing all providers to adopt electronic processes.

Andy Evans, programme director for Connected Nottinghamshire, said having an October 2015 deadline for trusts to stop sending discharge summaries by fax has had a ripple effect across the area.

Of the region’s three main providers, two out of three were compliant on 1 October and the third was compliant by the end of the month. “That’s been relatively straight forward,” Evans said.

“The interesting thing [the deadline has done] is to fish out just how complicated and diverse our processes are – not just around discharge, but around using faxes. That’s the unforeseen result really, which has been really helpful.”

He said examples of complicated business processes involving faxes include referrals to community services and urgent medication changes. But in some cases they have all have been replaced by e-messaging.

“You forget just how much the NHS has been using faxes all these years. Some forward thinking practices decided to finish with the world of faxes altogether and move towards more structured messaging or at least NHSmail as a stop-gap,” he explained.

NHS England head of enterprise architecture, Inderjit Singh, told Digital Health News in July that NHS providers must be able to send discharge summaries to GPs electronically by October this year.

It has since emerged that the target is not being monitored nationally, and that returns submitted to the commissioning board’s new ‘digital maturity index’ are likely to be the first indication of whether it has been delivered.

Despite this, supporters of the target argue that it has focused activity on changing business processes.

 Evans added that Nottinghamshire providers had either moved straight to structured messaging or, if they could not do this or wanted to move to ITK messaging, had adopted NHSmail as an interim step.

 “Our worry was that the centre would be too prescriptive when all providers are at different place, so to have some flexibility has been good,” he said.

Evans said the common ground has been NHSmail and part of making that work has been ensuring practices have generic mailboxes set-up to receive emails and that these are being monitored.

Connected Nottinghamshire was set up at Nottingham Clinical Commissioning Group to drive integration across health and social care.