Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ashley Surgery on 16 November 2016. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, a member of staff had completed the ‘Walk Leader’ training and set up a monthly ‘Walking for Health’ group to reduce social isolation. In collaboration with the health visiting service, there were plans to start a pram walk for rurally isolated new mothers.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, a practice nurse studying for a diploma in frailty worked with Age UK North Staffordshire to provide the Senior Plus service, providing extra support to older patients to help them to continue to live independently at home.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example, to overcome problems for older adults living in a rural community in accessing phlebotomy services, the practice provided a blood test monitoring service for patients on a long-term medicine used to prevent the formation of blood clots.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• There was a clear leadership structure and staff felt supported by the management.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw two areas of outstanding practice:

• The practice was proactive and effective in reducing the number of emergency hospital admissions and A&E attendances for all population groups. Comparison of data for 2014/15 and 2015/16 demonstrated an ongoing downward trend in the number of A&E admissions.

• A health care assistant (HCA) at the practice offered smoking cessation support for patients. A 74% smoking cessation rate had been achieved at four weeks with a 56% cessation rate at 12 weeks. Due to the effectiveness of this service, the HCA had been presented with an award from the ‘Time to Quit NHS Stop Smoking Service’ for the ‘Most Consistent Quit Smoking Advisor’ in North Staffordshire for 2014/15.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice