This practice is rated as Good overall. (Previous rating March 2016 – Good)

The key questions at this inspection are rated as:

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced focused inspection at Aughton Surgery on 7 August 2018. This was in response to concerns raised. We inspected two key questions across all population groups.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• Patients found the appointment system generally easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Take action to respond to patient feedback on NHS Choices.
• Develop the Patient Participation Group to represent the needs of the locality.
• Continue to improve access to routine appointments.
• Continue to improve communications and teamwork using teambuilding events.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Aughton Surgery on 4 March 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had evaluated the needs of its patient population and tailored services offered as appropriate. For example it offered in house anticoagulant clinics where patients’ bloods were tested and their anti-coagulant medicine reviewed and dose changed as required. Also, in light of the high number of patients accessing private health care, the practice had facilitated private healthcare practitioners running clinics from the practice premises.
• Information about services and how to complain was available and easy to understand.
• Some patients expressed concern around appointment availability but we saw that the practice was responsive to this feedback and had implemented changes to address these concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt extremely supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• There was a focus on continuous improvement and the practice was involved in a number of pilot projects and studies in an effort to improve patient care.

We saw two areas of outstanding practice:

• A mental health support worker offered a weekly clinic at the practice to support patients with mental health needs in a familiar environment.

• Two dieticians offered weekly clinics at the practice, one of whom specialised in catering for the needs of diabetic patients.

The areas where the provider should make improvement are:

• Ensure an electrical safety certificate is obtained for the practice premises.

• Consider formalising documentation around communication of changes within the practice so that there is a clear audit trail of what information has been disseminated and to whom. For example, through use of meeting agendas and minutes.

• Ensure that modifications to practice made following the inspection regarding emergency equipment checks and DBS risk assessments being documented are fully embedded into practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice