Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ashton Medical centre on 26 September 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was a clear leadership structure and staff felt supported by management. The practice had systems in place to obtain feedback from staff and patients.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and all further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day.
• Staff understood their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed and there was a system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand.
• The practice was part of the SSP Health group of practices and provided flexible staff working across different SSP locations.

We saw two areas of outstanding practice :

• The practice identified a high number of patients in residential and nursing homes requiring home visits. To reduce the impact on clinical time an acute visiting service was introduced. Following consultation with 12 neighbouring practices it was ascertained that they would also benefit from this service and a business case was submitted to the Clinical Commissioning Group (CCG) to introduce a community acute visiting services. This was approved and commenced in March 2017 and a re-audit in September 2017 confirmed that home visit demand had reduced because of this service.
• The practice implemented and developed a Childhood Initiative Scheme for parents, expectant parents, guardians and grandparents. The sessions included professional advice and support on how best to deal with common minor illnesses such as coughs and colds, fever and febrile convulsions. In addition Basic Life Support training was delivered. The practice was able to evidence that this service reduced attendance at accident and emergency, hospital admissions and inappropriate requests for GP appointments. Feedback from the first year’s appraisal identified where improvements could be made and the sessions now included meningitis awareness, help and advice about routine emergency conditions and one-to-ones at the end of each session. Collaboration has taken place with the CCG who plan to link the practice with Sure Start in order to share the learning more widely across the Wigan Borough.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice