Ashworth Street Surgery

Updated 20 December 2017

Ashworth Street Surgery, 85 Spotland Road, Rochdale, OL12 6RT is located in Rochdale, Greater Manchester and provides general medical services to patients within the Heywood, Middleton and Rochdale Clinical Commissioning Group area.

The practice have a branch surgery at Norden Old Library, Edenfield Road, Norden, OL11 5XE which was not visited on this inspection.

The practice website is www.ashworthstreetsurgeryrochdale.co.uk.

Since the last inspection the practice list of registered patients has increased from 11,121 to approximately 12,500.

Information taken from Public Health England placed the area in which the practice is located as second on the deprivation scale of one to ten. (The lower the number the higher the deprivation). In general, people living in more deprived areas tend to have greater need for health services.

Updated 20 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 12 February 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Ashworth Street Surgery on 1 November 2017 as part of our inspection programme.

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.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system 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 practice, with other practices in the Clinical Commissioning Group and the wider NHS, had receptionists who were trained as care navigators who signposted patients to the right person at the right time across a variety of health services.

We saw one area of outstanding practice:

• The patients’ group organised a Saturday morning Health Check event every other year where patients could attend and take advantage of a free NHS health check. Invitations were sent to 145 patients who had not attended the practice for over five years and those that had not responded previously for an NHS health check.Other service providers such as Mcmillan, Carers Resource, Alzheimers Society, MIND and CIRCLE ( a befriending support group for isolated patients) were invited and offered information, support and guidance. 79 patients had attended the last event. As a result many patients had been identified who required further primary or secondary care treatment,for example, significantly high blood pressure, high cholesterol, pre diabetes and asthma. There was evidence that the intervention which occurred as a result of the health check impacted on health outcomes.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 9 April 2015

Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health. When needed longer appointments and home visits were available. To improve access for less mobile patients the practice opened a branch surgery at nearby Norden in 2012. Patients with long-term conditions had structured annual reviews to check their health and medication needs were being met. For those people with the most complex needs the practice clinicians worked with relevant health and care professionals to deliver a multidisciplinary package of care. During reviews of long-term conditions patients were advised about self-managing their condition, were signposted to appropriate support groups and given health promotion advice. When patients did not attend this was followed up to determine the reason and provide an alternative appointment. One of the nurse practitioner’s roles was to contact difficult to engage patients to encourage them to make convenient/flexible appointments to improve uptake of care and treatment. Bi-annual health events were held (on Saturdays) to target patients who seldom attended the practice. They were provided with a series of health checks. Health trainers also provided a wide range of health promotion information during these events. These events were also attended and actively supported by the practice’s very pro-active patient participation group (PPG) to help maximise patient engagement.

Updated 9 April 2015

Systems were in place for identifying and following up children living in disadvantaged circumstances and who were at risk. For example children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises was suitable for children and babies. We were provided with good examples of joint working with midwives, health visitors and school nurses. Emergency processes were in place and referrals made for children and pregnant women who had a sudden deterioration in health. The weekly baby clinic had been structured to ensure that care was provided utilising a multi-disciplinary approach. Parents had access to health visitors, nursing staff and doctors. A primary prevention initiative was also in place aimed at providing specific health screening for the practice’s younger Asian population to detect early signs of disease that had a higher prevalence in this group than the rest of the population. The initiative included staff going into local schools to promote the importance of such screening.

Updated 9 April 2015

The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments. Patients over 75 years had a named accountable GP to aid continuity of care. The practice had undertaken care plans for the 2% of patients most at risk of admission in this population group and reviewed these every 3 months. The practice worked closely with the community matron to coordinate the care of elderly patients with complex health needs. To improve patient access the practice had extended hours on a Monday and Wednesday (630pm to 8pm) and provided Saturday morning appointments once per month (8am to 11am. To improve access for older patients the practice opened a branch surgery at nearby Norden in 2012.

Updated 9 April 2015

The needs of the working age population, those recently retired and students, had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. To improve patient access the practice had extended hours on a Monday and Wednesday (630pm to 8pm) and provided Saturday morning appointments once per month (8am to 11am). Face to face and telephone appointments were available and the Practice provided an on line facility to make appointments the day before so that workers have the facility to book an appointment after work. On line appointments were also offered up to six months in advance. Every surgery session included two pre-bookable telephone consultations. Doctors would phone patients after surgery if needed. Students who are leaving to go to university are reassured they can become temporary residents or re-join the practice. Advice was available regarding safe sex and sexually transmitted infections screening. Some of the GP partners had undertaken Sexual Health training. Bi-annual health events were held (on Saturdays) to target patients who seldom attended the practice. They were provided with a series of health checks. Health trainers also provided a wide range of health promotion information during these events. These events were also attended and actively supported by the practice’s very pro-active patient participation group (PPG) to help maximise patient engagement. One of the nurse practitioner’s roles was to contact hard to engage patients to encourage them to make convenient/flexible appointments to improve uptake of care and treatment.

Updated 9 April 2015

The practice had carried out annual health checks for people experiencing poor mental health. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations such as MIND. There was a system in place to follow up on patients who did not attend practice appointments or had attended accident and emergency where there may have been mental health needs. The practice was providing primary health care services to a local residential service for adults with complex mental health needs.

Updated 9 April 2015

The practice had carried out annual health checks for people with learning disabilities and offered longer appointments for people with learning disabilities. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and third sector organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours. There were no barriers to people in vulnerable circumstances being able to register with the practice.