Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Premier Health Team, Bridgewater Medical Centre on 19 October 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. All opportunities for learning from internal and external incidents were maximised.

• Risks to patients were assessed and well managed.

• The practice used some innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the practice had engaged in annual school visits to encourage health promotion since 2011 and the office manager led the “Think Ahead” pilot to facilitate increased care and wellbeing for stroke patients.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. They were the link practice for the Live Well Complex Team, holding two clinics per week for homeless patients across the Leigh Locality.

• The Patient Participation Group (PPG) had been in existence since 2009 and in addition to the PPG role, the practice was also part of the Atherleigh and Patient Focus Group (ALPF).

• The practice is part of the Prime Minister’s challenge fund awarded to Wigan Borough ensuring patients can access a GP at the practice Monday to Friday 8am to 8pm and Saturdays 10am to 4pm.

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

• Feedback from patients about their care was consistently positive and the practice did a lot of charity work and fund raising annually for Children in Need, The Sturge-Weber Foundation and Macmillan support.

• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• There were strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice manager submitted a business plan to the Single Commissioning Engagement and Outcome Scheme (SCEOS) and as a result of that the practice received money to fund a project creating displays and presentations on health topics for children of local schools.As a result vulnerable children had been identified and helped.

• The practice maximised opportunities to support learning and development for all staff. For example funding was provided for a diploma in management studies and placements were offered for pre-registration nurses so that students could experience this branch of nursing.

• As a result of links that had been forged with Wigan Council social services, the nurse partner became aware of and obtained cold-emergency boxes for elderly or vulnerable patients during the winter months.The boxes contained a blanket, gloves, hat, thermos, mask, socks and a hot water bottle. The practice shared this knowledge with other practices through the CCG-wide nurse forum so that they could also obtain supplies.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice