OUR VISION

On April 1, 2010 the Department of Health introduced a new target requiring NHS hospitals to send patient discharge notes to GPs within 24 hours.

Once a patient is discharged from hospital a document, called a patient discharge summary needs to be sent directly to the patient’s GP. Historically, clinical correspondence, such as this was posted to GP practices and could take a number of days to arrive.

When a practice received this correspondence, practice staff needed to scan the information and upload it to their own GP system, which took additional time. This meant that a patient could visit their GP immediately after being discharged from hospital and the GP may not actually have been able to access the patient’s discharge notes.

In line with the new government requirements, hospitals and GP practices in Greater Manchester began to consider the use of an electronic system to send clinical correspondence to help overcome these issues.

NHS hospitals in Bolton, Stockport and Salford were already using various electronic systems to send clinical correspondence to GP practices, which worked well and highlighted many benefits.

In 2012, the Greater Manchester health economy invested in an electronic document transfer (EDT) system to connect hospitals with GP practices and began to plan and deliver the project through Primary Care Trusts.

The EDT system is an off-the-shelf software solution that integrates with patient administration systems (PAS) and electronic patient record systems (EPR). It allows data to be transferred electronically between organisations - in this case the hospital and the GP practice - securely within the national NHS computer network. The system also integrates with the document management system used by many GP practices, NHS hospitals and community centres.

Hospitals upload clinical correspondence to the EDT system, which becomes immediately available to the associated GP practice. Hospitals can upload clinical documents in batches or as and when they need to.

Practices connect to the system and use their own document collection systems to pull the correspondence down. The information is then instantly transferred onto the practice system for GPs to access. This process happens automatically every two hours and can also be done manually if practices are expecting urgent information. This ensures that clinical information is guaranteed to be with GPs within 24 hours.

On April 1, 2013, when the NHS landscape changed, GMCSU began to deliver the EDT project on behalf of the 12 CCGs and 14 hospital trusts in Greater Manchester. This involved leading on the roll-out of the project to connect hospitals and GP practices to one another and could effectively use the EDT system. 

GMCSU’s Total Provider Management service pulled together a specialist team from the IT project management office (PMOi) made up of highly skilled project management professionals with the knowledge and experience of delivering large scale IT programmes for the NHS. The team brought the added value of being able to build on existing relationships with CCGs and hospital providers.

The project team has been working closely with GP practice managers and the CCG clinical leads for IT to ensure that each practice has the right software and systems in place to connect to the EDT system. The PMO team also provides CCG boards with monthly update reports and arranges IT training for GP practice staff so they know how to use the new systems.

The PMOi team is currently working on linking the hospital EDT systems together. At present, hospitals can only send information to GP practices that are connected to their EDT system on a geographical basis. For example, Salford Royal Hospital can upload clinical documents to the EDT system for all Salford GP practices to see. However the aim is that in the future, clinical correspondence from any NHS hospital in Greater Manchester can be accessed by any GP practice in Greater Manchester.

Work is also taking place to build resilience levels for business continuity and consistency. This will involve embedding elements of EDT hub into operational teams at GMCSU so that the GMCSU IT service desk can provide technical support to practices, adding significant value.

GMCSU has been leading on the rollout to GP practices since April 2013, on behalf of the local health economy.

A total of 385 out of 507 GP practices are now connected to the EDT system.

The system is already adding value and bringing about a number benefits, including increasing costs savings, enhancing clinical decision making and improving patient experience.

It costs the NHS approximately 65p each time a letter is sent, with five million letters sent every year. The system will bring significant costs savings for hospitals by reducing paper consumption and associated printing and postage costs.

The EDT system is also benefitting GP practices, by improving work flow and cutting down the time that practice staff previously spent scanning and uploading information, so they can make better use of their time. It not only speeds up delivery and improves productivity but also reduces the risk of losing or duplicating documents.

GPs themselves are benefitting from immediate access to clinical information following a patient’s discharge from hospital. This is improving clinical decision-making - and ultimately patient care - as patients can be seen and treated quicker and more effectively.

Using an electronic system also addresses the wider NHS sustainability agenda by reducing the amount of paper that is used for administration purposes.

GMCSU’s PMOi team is on track to roll the system out to the remaining GP practices over the next two months. The aim is to get all of the practices that are technically ready to receive the necessary software required to connect to the relevant EDT systems by March 2015.