Confidential hospital patient notes are being sent more than 6,000 miles away to South Africa to be typed.

Brighton and Sussex University Hospitals NHS Trust has employed Cape Town firm Global Secretarial on a temporary three-month contract.

Under the system a consultant dictates the notes into a dictaphone, which are then transmitted digitally to South Africa, typed up and emailed back.

The decision, which could save the trust about £150,000 a year, has sparked concerns about patient confidentiality and potential job losses.

One hospital worker, who did not want to be named, told The Argus: "The idea of information about patients being sent all over the place is unnerving.

"Although the hospital will say the information is secure, there are plenty of determined hackers and I'm worried they could get in and work out a person's full name and address.

"The trust could find itself open to being sued for breach of confidentiality if that happens."

Other workers say that if the trust finds the new system efficient and money-saving it might expand the service and cut jobs.

A spokeswoman for the trust said the decision to use the company was made to help clear a backlog of patient notes at the Sussex Cardiac Centre based at the Royal Sussex County Hospital in Brighton.

She said under pressure secretaries working in the department had asked for help to manage their high workloads.

She said: "Difficulties recruiting locally and the high cost of using local bank and agency staff meant the department looked into the possibility of using the company.

"Patient care and safety will not be endangered in any way as the South African staff are fully qualified English-speaking medical secretaries.

"While cost was not the predominant behind outsourcing this work, if the trial is successful the overall financial annual saving could be around £150,000.

"To ensure patient confidentiality is not compromised the trust has followed European Commission guidance on sensitive data being processed outside the EU. Posters are also in outpatient wards to give patients the opportunity to object to their notes being sent to South Africa.

A pilot project started on August 8 and a recent audit found that trust secretaries were supportive of the scheme.

Some felt it led to less tension and stress and staff were able to enjoy holidays instead of having to come back to huge workloads and complaints from GP practices and patients regarding delays in receiving letters."

The audit found that notes are now typed up by within 48 hours, which means they are always up-to-date and readily available for further appointments or for A&E in an emergency.

The trust is having serious financial problems and needs to save £34 million this year if it is to balance its books. Chief executive Peter Coles has already warned jobs are at risk.

Long term plans include cutting outpatient appointments and reducing the amount of agency staff used.