NHS Connecting for Health has announced that more than 50,000 summary care records have now been uploaded to the 'spine' that underpins the NHS care records service.

It has also announced that staff at Bolton's out-of-hours service will be the first in the country to start using the records, while patients in Bury are likely to be the first to view their own summaries through an enhanced version of the website HealthSpace.

Bolton and Bury are among the first four 'early adopter' sites for the records. The other two sites - Dorset and South Birmingham - are still in the early stages of informing patients about the new service, which is being launched holding details of allergies and medications.

The care records service has been dogged by concerns about confidentiality. Patients in the early adopter sites are given three options: to 'opt out' of having a record created, to prevent clinicians seeing their record unless they give consent, and to give access to all authorised users.

Gillian Braunold, clinical director for the records and HealthSpace, said that of the 237,759 people in Bolton who have been sent letters about the new service, 2,209 or 0.93 per cent have asked to opt out entirely. But a number of Bolton GP practices are opposing the creation of the summary records.

In Bury, the opt-out rate is lower, at about 0.43 per cent.

Bolton's out-of-hours service is in the final stages of staff training in the new record and is expected to start using it within the next few weeks.

In Bury, patients are being invited to register for a secure log-in to HealthSpace so they can view their own summary, which will be expanded over time to include more health service and patient-generated information.