Four hospitals from Bury, Oldham, Rochdale and Salford have joined together to form a later NHS Trust.
The two largest Trusts in Greater Manchester - Salford Royal NHS Foundation Trust (SRFT) and the Pennine Acute Hospitals NHS Trust (PAT) will formally merge into the Northern Care Alliance NHS Foundation Trust.
Professor Michael Luger, Chair of Northern Care Alliance NHS Foundation Trust said: "This marks the start of a new era for our organisation and for everyone who works and volunteers across our hospitals and services.
"Today is a monumental day for the NCA. We formally transition from two Trusts to a single, joined-up organisation - the Northern Care Alliance NHS Foundation Trust.
"We are delighted that this day has arrived. A great deal or work has been going on behind the scenes, involving many of our teams, working with our partners, to bring us to this point.
"And we have already seen the benefits of bringing our staff and services together under one group over the past five years.
"We can now focus our attention and efforts on what is important - investing in and further transforming and integrating our services for our staff, patients and service users.
"The NCA will continue to take an active role across our four localities in Oldham, Bury, Rochdale and Salford, working with our place-based partners to drive further integration and improvements in the health outcomes of the communities we serve.
"I also want to thank our staff for everything they do every day for each other and for those who need our care.
"It is right that we come together today to recognise the exceptional hard work undertaken and look forward to a positive future, together."
This will bring together the four hospitals along with their 2,000 beds, specialist and acute services, and 20,000 strong workforce of caregivers.
Dr Roger Prudham, Consultant Gastroenterologist and Lead Cancer Clinician for the NCA, based at Fairfield General Hospital in Bury, said: "This formal coming together of the two parts of our Group - Pennine Acute and Salford Royal - is a pivotal moment for us.
"As a new combined NHS Foundation Trust we will see further investment and development across our services, giving us a real and significant opportunity to improve and transform, working with our local and Greater Manchester partners.
"I am hugely proud of the work we've done to improve cancer services, including the development of our Rapid Diagnostic Centres across NCA, based in Rochdale and Salford and the imminent launch of Community Diagnostic Hubs.
"I'm hopeful and optimistic that as we recover from the pandemic the NCA is now in a stronger position than ever to help patients who need our care."
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