Central Surrey Health

This is saving over £35,000 a year in reduced paper and postage costs together with over 3000 hours of processing time within our service and at the GP Practices.

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Central Surrey Health provides award winning therapy and community nursing services to the population of Central Surrey.

It was the first not for profit, social enterprise to come out of the NHS and is owned and run by the 750 co-owners it employs. Care is delivered at 18 clinic and hospital sites on the fixed network and remotely at schools, patient homes and community locations.

We have implemented electronic transfer of patient documents in a community setting. These are generated from our RiO Community System directly into the systems used by our GPs without the need of any manual intervention. This covers discharge letters and messages updating the GP on the progress of care for their patients. As the project rolls out we plan to send all our GP communications using the CSH EDT Hub including confirmation of referrals being received and medical reports for vulnerable patients.

This is completed through the EDT Hub product provided by PCTI which allows for seamless integration between systems. Building on the integration method that is used by Acute Trusts to transmit discharge letters to GPs in our area, we commissioned the developments to RiO and tested the integration with the Docman installations at the Practices. This is the first time that electronic transmission of documents has been enabled from RiO in a community setting.

By implementing the integration, we have cut out all of the previous manual printing, mailing and scanning processes that were previously in place. This is saving over £35,000 a year in reduced paper and postage costs together with over 3000 hours of processing time within our service and at the GP Practices. The care for the patient is also enhanced with timely information available at the GP Practice.


A detailed cost and benefit analysis has been completed. This has demonstrated direct patient benefits where the GP can access information relating to the care of their patients immediately that it has been produced. This allows the GP to be informed and make timely clinical decisions rather than having to wait to receive communications. It has also reduced a frustration for patients where they previously beat the document back to the Practice for discharge. They would end up telling their GP what happened to them rather than the GP being informed before a follow up appointment.

There are financial savings of over £35,000 a year through not having to print and post the documents. The cost of sending the document electronically is 3p opposed to over 45p through the manual process.

Efficiency savings are realised both at Central Surrey Health and at the GP Practices. The previous manual process has been replaced by a seamless electronic one where we know that the document has reached its destination through an audit trail.

The non-financial benefits include a positive impact on the environment by not printing and reducing the road miles for transporting the post. The integration has also made it easier to do business with our GPs and this has encouraged thinking around other areas of integration particularly on referral management.

How has this improved Communication between Healthcare Staff?

The communication between clinicians at Central Surrey Health and GPs has been improved by the GPs knowing that the information about the care of their patients is readily available and timely. This has promoted the engagement of the GP Practice staff into how the process of information transfer between the organisations could be made better for the patient. GPs are now talking more to our community clinicians as they can review progress notes for patients straight away. This has opened up further dialogue to enhance the care for patients through the GP being involved directly in something that they only heard about days or weeks later previously.

This has resulted in more efficient treatment for the patient with less duplication and repeating of tasks which was a previous frustration from all healthcare staff involved in the care pathway.

Evidence of how integration can be developed or replicated

The development within RiO that enabled the integration to happen is available to all RiO customers and is available for deployment by them. This means that the technology can be replicated to any other integration solution as it uses a standard method of output.
Within our immediate vicinity, we can now use the integration solution with any GP in Surrey as they already have compatable systems.

We are expanding the use of the integration to also cover the transmission to GPs of urgent documents such as test results.

By implementing the integration one way to our GPs and proving it works, we are now working on information flows from our GPs back to us. We are progressing this using the same technology but in reverse to allow GPs to electronically transmit documents directly into our RiO System. This would cover items such as Referrals, requests for information and test requests.